Archives Blog eBook

The circumcision of women: a strategy for eradication

London, England; Zed Books: 1987.

The circumcision of women: a strategy for eradication

Koso-Thomas 0


Female circumcision is a traditional practice in many parts of Africa that has significant medical consequences. The main arguments in its favor, including cleanliness, aesthetics, improved health and social benefits, are refuted in this monograph. This practice was studied in Sierra Leone, where it affects 90% of females, and is carried out by secret societies. Female initiates are usually in their early teens and must undergo training and participate in elaborate rituals. The health effects vary with the typ of circumcision and the conditions under which it is performed. Immediate consequences include pain, hemorrhage, urinary tract problems, and serious infections. Scar formation leads to late sequelae of dysmenorrhea, dyspareunia, pelvic infections and abscesses, hematocolpos, infertility, difficulty urinating, urinary tract infections and anal incontinence and fissures. Female circumcision is also a cause of later reproductive difficulty due to obstructed labor, resulting in several obstetrical complications. Psychological effects differ among women who have undergone it voluntarily, and those who have been forced to undergo this ritual, with the latter suffering much more psychologically. A pilot study of 135 people in Sierra Leone found that a significant number favor female circumcision and believe that it is essential to their culture. This attitude is related to illiteracy. In a survey of 300 women in Sierra Leone, tradition was the most common reason given for circumcision (85%), followed by social identity and religion. Circumcision was related to Muslim religion and inversely related to educational level. Statistical breakdown by tribe, method, complications, age, and attitude regarding circumcision is provided. A detailed strategy for the eradication of female circumcision is outlined.

This book can be accessed in this LINK

Archives Blog Original research

Female genital mutilation in Sierra Leone: who are the decision makers?

Afr J Reprod Health. 2012 Dec;16(4):119-31.FREE

Female genital mutilation in Sierra Leone: who are the decision makers?

Bjälkander O, Leigh B, Harman G, Bergström S, Almroth L.

Division of Global Health, Department of Public Health, Karolinska Institute, Stockholm, Sweden.


The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). Generally, decisions to perform FGM were made by women, but father was mentioned as the one who decided by 28% of the respondents. The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals’ associations need to consider how to prevent further medicalization of the practice.

This article can be accessed in this LINK.

Archives Original research

Empowering girls in Sierra Leone: initiation into the Bondo society.

J Dev Behav Pediatr. 2010 Feb-Mar;31(2):172-3. doi: 10.1097/DBP.0b013e3181d55a5d.

Empowering girls in Sierra Leone: initiation into the Bondo society.

Ahmadu FS.

There is no abstract available

This article can be purchased in this LINK

Archives Blog Review

The cultural context of the Sierra Leonean Mende woman as patient.

 J Transcult Nurs. 2010 Jul;21(3):228-36. doi: 10.1177/1043659609358781.

The cultural context of the Sierra Leonean Mende woman as patient.

Kallon I, Dundes L.

Department of Sociology, McDaniel College, 2 College Hill, Westminster, MD 21157, USA.


This article provides a clinically pertinent overview of Sierra Leonean immigrants, a growing patient population that most health care workers know little about. The focus is on Sierra Leonean Mende women and the relevance of their cultural perspective to clinical care. A literature review and interview responses from seven Sierra Leoneans are the sources of data. Immigrants from Sierra Leone are coming from a country that since the late 1990s has been ranked at the bottom of the United Nations’ Human Development Index. Practitioner knowledge of cultural norms such as female genital mutilation and discomfort with opposite sex health practitioners can improve cross-cultural interactions in the health arena. Given that most clinicians are unfamiliar with this unique patient population, this article provides background information including special
attention to medically relevant aspects of the Sierra Leonean cultural milieu that will enhance the rapport between health care workers and these patients.

This article can be purchased in this LINK

Archives Blog Original research

Health complications of female genital mutilation in Sierra Leone.

Int J Womens Health. 2012;4:321-331.

Health complications of female genital mutilation in Sierra Leone.

Bjälkander O, Bangura L, Leigh B, Berggren V, Bergström S, Almroth L.

Division of Global Health, Department of Public Health, Karolinska Institutet, Stockholm, Sweden.

Sierra Leone has one of the highest rates of female genital mutilation (FGM) in the world, and yet little is known about the health consequences of the practice. PURPOSE: To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors. PATIENTS AND METHODS: A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258) attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected.  Participants answered interview-administrated pretested structured questionnaires with open- ended-questions, administrated by trained female personnel. RESULTS: All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%), the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8%) sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser), and 16 a health professional. CONCLUSION: The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who undergo FGM before 10 years of age seem to be  more vulnerable to serious complications than those who are older at the time of FGM. It is important that health care personnel are aware of, and look for possible complications from FGM, and encourage girls and women to seek medical care for their problems.

This article can be accessed in this LINK

Actors Blog Ngo


  NGO HURRARC, Human Rights Respect Awareness Raising Campaigner.

According to their website, HURRARC is a Sierra Leone NGO based in Freetown. It was founded in 1992, by Sahr GMP Fania together with other refugees from Sierra Leone at the time of the outbreak of the civil war, to document the Human Rights Violations being committed by all parties. HURRARC has been registered as a Community Based Organisation (CBO) with Freetown City Council.”

Among its wide umbrella of activities, HURRARC denounces the practice of FGM in Sierra Leone.

Watch belowthe video interview to two women activist of Hurrarc related to female genital mutilation.
Hawa fights to protect children from genital mutilation, even after having been threatened.
Josephine is involved into the question: she’s a victim.


This is the HURRARC Website