Tradition of Genital Cutting Threatens Health of Liberian Women

Ma Sabah was only 13 years old when she was taken from Gbatallah in Bong County and forced into the Sande bush for a crime her mother committed in her village in 1976.

Dr. Torsou Jallabah of the James Davis Hospital in Paynesville treats many girls with complications from genital cutting

The Sande bush is where women and girls are sent to be circumcised and groomed into women ready for marriage, as culture and tradition demand.

See original story in FrontPage Africa newspaper here.

“It can hurt much more than delivery pain when they be cutting your clitorises with a knife because they cannot numb the place but only put leaves to cover the sore,” says Ma Sabah, now 47, as she recalls how five women held her down while another woman cut out her clitoris.

Despite the health risk of bleeding and death, the removal of the clitoris is a central element to the Sande initiation ritual. Ten out of Liberia’s 16 tribes practice female genital cutting (commonly known as FGC).

No one has reliable numbers on how many women have been cut.  The 2007 Department of Health Services study showed 40 percent of women in the city and 72 percent in the country were cut.  The Association of Female Lawyers of Liberia (AFELL) says as many as 85 percent of our population practices it.

“I have seen many uncountable cases of FGC,” says Dr. Torsou Y. Jallabah, medical director of the James N. Davis Jr. Memorial Hospital.  “I can recall last year some children who underwent genital cutting were bleeding and rushed to our hospital by the police and were taken to the operating room and some stitching was done to stop the bleeding.”

Many girls and women who experience complications from the procedure do not seek treatment until they are in dire condition, because they have taken an oath to keep secret what happens in the Sande bush.  The promised punishment for speaking out, according to women FrontPage Africa asked to interview on the subject, is death.

Ma Sabah, who requested that her real name not be used, has chosen to go against this taboo but has only agreed to speak hidden in a small, dark room.  Even in this isolated place, she is still scared that she will be spotted by someone who has been to the Sande bush and then hunted down, she says.

“I can’t use my real name because they will throw some kind of sickness on me to kill me when I visit our home because I burst out the secret,” says Ma Sabah.

Ma Sabah whispers as she recalls what happened to her in the secret women’s society.  The cutting procedure is especially vivid in her mind because it was done without anesthesia – something that adds to the risk.

“One medical complication is heavy pains because you have an accession of the genitalia,” says Jallabah.  “You have nerves endings and tissues that cause strong pains when cut.”

According to Dr. Jallabah, bleeding is another complication of FGC.

“If a fresh tissue is cut and not sewed, the person bleeds, and if so aggressive, the patient could go into shock and die,” says Jallabah.

Cutting is often carried out in an unsanitary environment by using unsterilized, unboiled instruments such as razor blades or knives and just natural herbs for healing.

“We was plenty girls who join the Grebo bush,” says Ma Sabah, using another common name for the Sande society.  “And the time they was ready to cut us, they use only three knives on all of us and just mashed the leaf and put it on our sore.”

Contamination could lead to urinary tract infections, tetanus or worse, says Jallabah.

“If one knife is used on more than four persons without being sterilized, it is a possibility that a person could be infected with the HIV virus and it can be transmitted to the next person,” says Jallabah.

Cutting not only carries immediate risks but long-term effects, especially when giving birth.

“For those who went through FGC, during delivery, there is a tear to where the clitoris was extracted,” says Mary Toe, a hospital midwife who also did not want her real name used.  “The mothers sometimes bleed heavily, and if you as a midwife are not swift to stitch the place, they could bleed to death.”

Many women are dying in the countryside today because of excessive tearing and bleeding during delivery and lack of medical instruments for stitching the damage, says Toe.

During her 27 years working as a midwife, the 52-year-old Toe has seen a lot of delivery trauma due to cutting, threatening the life of not only the mother but the child as well.

“The baby would be depressed if it stays long to come down because the clitoris is not there to extend for the baby’s head to come out, and brain damage could come about,” says Toe.

Despite the many risks, the removal of the clitoris is a sacred cultural practice that people in the Sande and Poro secret societies say will prevent promiscuity.  Ma Sabah says the aim is to stop women running around once they marry.

But both medical experts, Toe and Jallabah, say the opposite can occur.

“It is not true that women whose clitorises are cut off don’t run around,” says Toe. “During my 52 years of existence, women who are cut are sexually inclined, and they do more running around than women who have their clitoris.”

“Once the genital that serves as a stimulant to a woman is removed, their sexual gratification won’t be satisfied, and they would go out and have it satisfied,” says Jallabah.

Yet many circumcised women have discovered that men from the six tribes that do not practice FGC reject them.

“Since I came from the bush, I found out that the main problem we are facing today is that men who didn’t go to the Poro society don’t stay with we the women who have been there because the clitoris is no longer there,” says Ma Sabah.

In Ma Sabah’s case, cutting has completely killed her sex drive over time, much to the disappointment of her boyfriend, she says.

“By the time we reach our forties, you can’t get the feeling for sex again, because the clitoris is the feeling for the woman,” says Ma Sabah.

Some view cutting as a harmful tradition that needs to be abolished outright.

“I always advise my patients not to send their daughters to where they went and got cut, because their children would face the same difficulties in delivery as they are,” says Toe.

But others caution that coming down hard on cutting would not stop the practice because it is so deeply rooted in culture.  Legally banning FGC would only cause it to be done in even more secrecy and unsafe conditions, warns Dr. Jallabah.  Instead, he says, any change should start with education first in order to win people over.

“The most important thing is to go around and find out how the procedure is being done and teach ways to minimize or control the complications,” says Jallabah. “Then let people know that while there are some positives [to the Sande culture overall], the negative effects of this particular practice are greater than the positive effects.  Make them see reason to do away with it.  But if you just come down hard and frown on it, people will hide and still do it, and more women will suffer.”

Twenty-one African countries including Senegal and Somalia have banned or partially banned cutting.   Only Liberia and five other countries are still holding onto this cultural heritage that has been passed down from generation to generation.

For Ma Sabah, there is no question about the future for her two daughters.

“I won’t send my children to the Grebo bush because it will cripple them in the future if they get a man to marry,” she says.  “It was good in those days, but not these days when all our eyes are open now.”

Mae Azango is a fellow of New Narratives, a project supporting independent media in Africa. Please see more at