In Senegal, my struggle against genital mutilation and HIV

By Fatimata SY, activist and General Secretary of Association Sénégalaise pour l’Avenir de la Femme et de l’Enfant (ASAFE). Fatimata is recipient of the Voix Essentielles fund in Senegal. 

Sali was only 9 years old when I met her during one of my outreach tours in northern Senegal. Yet her young body had already been scarred for life by female genital mutilation. The anger and sorrow I saw in the girl’s eyes reminded me of the essence of my commitment, 25 years ago, against female genital mutilation in Senegal. 

Being from a family of female excision practitioners, my fight to preserve women’s bodies and dignity has always seemed obvious to me, regardless of the stigma and hostility resulting from it. The rapid development of our continent in recent years may lead one to believe that these practices no longer exist. 

Still, an estimated 50 million girls are at risk of being subjected to genital mutilation in Africa by 2030, according to UNICEF. In Senegal, nearly 2 million girls and young women underwent genital mutilation in 2019. The prevalence of female genital mutilation among girls under 15 years of age is 16%. 

Barriers to HIV response

This violence still persists mainly because of gender inequalities in our communities and patriarchal values and superstitions that crystalize fantasies around women’s bodies. In addition to being an extreme violation of their dignity and freedom, genital mutilation undermines women’s mental and sexual health. According to UNAIDS, such violence increases women’s vulnerability to sexually transmitted infections, including HIV, which affects women two to six times more than men in sub-Saharan Africa.

Using the same surgical instrument without sterilization, as well as the increased risk of bleeding during sexual intercourse, highly increases HIV risk among victims. Not even the medicalized practice of genital mutilation is without risk.

In many cases, the trauma and other psychological consequences of such violence undermine girls’ confidence and ability to insist on condom use from their partners. Memories of this painful experience and the shame of their scarred bodies prevent them from seeking screening or care for even the most minor genital infections.

Bodily autonomy

Giving women and girls back control of their bodies, their lives and their futures is urgent for an effective response to HIV. How can we accept that even today, 93% of women in Senegal do not have the freedom to make their own decisions about health, contraception or simply to choose when and how to have sex with their partner? As long as these inequalities exist, as long as genital mutilation persists, and as long as women are silenced about their bodies and their sexuality, the elimination of HIV will unfortunately remain a wishful thinking… 

Organizations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria are helping women and girls to claim their sexual and reproductive health rights through empowerment programmes and access to education, as well as actions to remove gender-based barriers to accessing health services. In Senegal, hundreds of girls aged 13 to 18 have received sexual health support through the « Voix Essentielles » initiative launched in July 2021 by Speak Up Africa and supported by the Global Fund. 

These young girls, exposed to sexual activity at an early age, usually with adults, are now empowered and able to avoid risky sexual practices and take control of their health.  Such programmes for women and girls must be supported, expanded and strengthened by governments, international agencies, private sector and civil society.  This is the only way we can effectively tackle gender-based violence and finally put an end to AIDS…

This article was originally published on Jeune Afrique