NIGERIA: Traditional Birth Attendants Advocate Ending Harmful Practices
Chief Aderibigbe is a traditional birth attendant. His job, until recently, involved carrying out the traditional cutting ritual on the genitalia of baby girls.
Now however, he and other colleagues in Osun State are helping to encourage others to observe the recently passed law banning female genital mutilation (FGM).
This change in role is a result of a widespread, sensitisation effort, involving the United Nations Population Fund (UNFPA), the Nigerian Ministry of Health and several local NGOs. to end to the practice of FGM in Osun State.
"UNFPA began its campaign in Osun State because it has the highest prevalence rate in all of the southwest - as high as 87%" says Stella Akinso, UNFPA Adviser in Osun State.
FGM is often carried out in unhygienic settings and the ritual can cause dangerous bleeding, infection, the development of scar tissue that leads to complications during childbirth or sexual intercourse later in life, and even death.
There is no national law banning the practice, so UNFPA and its partners decided to work at state level to see it outlawed. Efforts were made to involve people from all parts of society, especially the birth attendants themselves. The first round of the campaign failed because legislators were reluctant to abandon an important part of their heritage.
"Tradition dies hard," says Aduke Obelawo, Chief Social Welfare Officer for Gender and Women Development in the State Ministry of Health. "It took us a long time to sensitize the legislators."
In 2004, success was achieved. The Governor signed the Osun State Female Circumcision and Genital Mutilation Prohibition Law, which outlawed the practice throughout Osun State.
However, such a law is difficult to enforce because the ritual is carried out in private. Also, the banning affects the livelihood of practitioners and the Health Ministry has therefore taken steps to address this.
"If we don't provide them with alternative options for employment," says Mrs. Obelawo, "we are just saying it for saying's sake."
Chief Aderibigbe's group of attendants is part of an innovative program which is turning former FGM practitioners into forces for its eradication. They will become Community-Based Development workers, or CBDs who are trained in basic reproductive healthcare.
CBDs monitor pregnancies, make sure pregnant women go to health clinics for prenatal care, give advice on diet and conduct during pregnancy, and sell contraceptives and basic medicines. In general, their role is to serve as a bridge between the people in their communities and health care professionals.
"Even before the law, I noticed that during delivery, a woman who has been circumcised was likely to have problems, while one who has not been circumcised will have an easier time," says Chief Muratu Adebayo Yaloode, a female attendant. "Then, when the UNFPA lectures started, this was confirmed by the information presented."
Her colleagues agree, and though they are former practitioners of FGM, now believe that it ought not to be performed and are willing to work to see that it stops.
Other re-training methods are on offer to TBAs and some learn trades, such as tie-dying or soap-making. UNFPA and its partners run similar projects in other parts of Nigeria.
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