FGM in Kenya

 In Kisii town, south-west Kenya like many others in the area, a pharmacy doubles as a clinic that offers female genital mutilation (FGM) services on request. In Kisii county, medicalisation is standard. Two out of three cases of cutting are performed by health practitioners, in contrast to much of the country, where 70% of FGM cases are performed by traditional practitioners. Figures from 2014 place Kisii’s FGM prevalence at 84%, the third highest rate in the country. However, older reports also recorded an 87% opposition to the practice among the Kisii community – the highest among different ethnic groups – and gender officials from the region say tensions between women who support the practice and those who don’t have become increasingly apparent.

The number of unlicensed health clinics in Kisii has grown significantly over the last few years due to poor and inadequate services at public hospitals, according to health workers and rights groups. They are often run by nurses, lab technicians, paramedics, hospital support staff or community health workers who have worked in cities and return to their communities where they are trusted to perform FGM, even though they are not qualified to carry out surgical incisions. In rural areas, they are called daktari (doctor), as long as they are working in the hospital.

 “Every chemist has a ‘behind’,” says Carol Makori*, a retired medical practitioner from the area, referring to the common pharmacy backroom for FGM and other illegal medical services, which serve many purposes. “It’s a consultation room, an examination room, a bed,” she says. “It’s good business. People want the service and they want it as secretly as possible.”

FGM rates in Kenya have gone down significantly over the past decade. The country passed strong laws in 2011, imposed hefty fines on practitioners, and stepped up surveillance and enforcement. Kenyan president William Ruto backed the country’s chief justice who said that FGM “should not be a conversation we are having in Kenya in the 21st century”, and reiterated his administration’s commitment to eradicating the practice.

Roughly 475,022 girls are at risk of FGM in Kenya between 2022 and 2030, and 75% of girls undergo the cut between the ages of eight and 14.

Traditionally, FGM among the Kisii was carried out as a means of controlling girls’ libido, but health workers say there’s been a shift. “Some parents feel like it is a way of fulfilling the culture in a modernised way,” says Ruth Mogaka, a retired nurse and counsellor, who has worked at one of the area’s largest hospitals for years.

‘Every chemist has a backroom’: the rise of secret FGM in Kenya | Female genital mutilation (FGM) | The Guardian