Lessons learned
As in many rural areas of Africa, meeting basic needs remains the priority of the population of the Kankan region. About 55 per cent of Guinea’s population lives in poverty, and a large proportion of rural people face these challenges (World Food Programme 2024). Healthcare in Guinea is fragile, and HIV/AIDS, tuberculosis, and malaria are major public health issues here (Africa Health Organisation 2024). As a result, the needs and challenges remain enormous, and the fight against FGM/C is often not a priority and takes a back seat, especially in rural areas. Nevertheless, some of the lessons learned from the campaigns against FGM/C since 2012 might help in developing more locally-embedded strategies to tackle FGM/C.
Breaking the taboo in rural and remote areas
At the beginning of the campaign in 2012, topics such as FGM/C and early and child marriage were usually only discussed within homogeneous groups; for example, young girls talking among themselves, older men among themselves, and so on. Even parents generally avoided discussing these topics with their children, with a few exceptions. This taboo has been broken thanks to campaigns in which the vigilance committees played a crucial role. They have succeeded in bringing men and women together around entrepreneurial activities and sensitive issues such as FGM/C. They have facilitated dialogue between generations and genders. Raising awareness of FGM/C is presented as a cross-cutting theme, not as an isolated issue. For example, awareness is also being raised about malaria and COVID-19.
The impact of lifting this taboo was assessed during an assessment mission carried out by the two NGOs in 2023. In the two villages visited (Tenkelen and Djirlain), women and men, young and old, came together with the NGOs to discuss the challenges and successes of previous campaigns and current livelihood difficulties. FGM/C was discussed openly. For example, both women and men mentioned that since girls are no longer cut, they have found that ‘more love exists between a husband and a wife’ as the fear of intimacy has decreased for women. Another positive aspect mentioned is that there is a financial benefit to no longer cutting girls, now that the costs associated with FGM/C are zero, including medical expenses if a girl needs healthcare as a result of being cut.
Strengthening entrepreneurship at the local level
As the campaigns progressed and the links with the ten villages strengthened, the awareness campaign against FGM/C was supported by strengthening local entrepreneurship, especially for women as food producers. According to the World Food Programme, women play an important role in agriculture, particularly in food production, but they often struggle to access land and inputs, education, formal employment, and income-generating activities (World Food Programme 2024). By providing gardening equipment, seeds, a shea butter machine, a van to transport the women and their produce to local markets, and a fence to protect the vegetable garden from livestock, the two NGOs in collaboration with the vigilance committees sought to support women in developing their income-generating activities. Addressing FGM/C as a stand-alone issue has proved problematic, as local populations face many challenges in earning a living and obtaining appropriate healthcare. In addition, the activities of income-generating programmes for women have helped to improve their personal agency and collective agency as an economic interest group. The support for local entrepreneurship has also unified the villagers, as they identify challenges together and, supported by the vigilance committees, the two NGOs explore opportunities to address needs and solve problems.
Supporting and creating health posts
A major achievement of past campaigns was the creation of the Poste de Santé (health post) in Dabadou, facilitated by the vigilance committee. Traditionally, pregnant women give birth at home, and vaccination campaigns face challenges such as transportation and cold chain maintenance for vaccines, as vaccinators must make home visits in the absence of a health post. The main goal of the health post in Dabadou is therefore to improve the health of villagers while advancing the fight against FGM/C. The latter came to the forefront during the establishment of the health post, because the vigilance committee’s FGM/C activities were central to it. Obviously, the health post is very important for the village but also for the vigilance committee: it strengthens its activities and valorises the committee.
Although there is room for improvement (such as more support from the town mayor and the health authorities to maintain the health post, provision of local means of transport for health personnel to visit the surrounding villages, and provision of training in the use of equipment provided by international donors, etc.), the health post in Dabadou is often flagged up by local health authorities as a model of good practice. At the inauguration ceremonies for the health post, important kits were distributed to health structures by Aniké (Kankan Regional Hospital, Karifamoriah and Balandou Health Centres). One of the major advantages of a health post is that it is a community-centred structure, which ensures proximity to the local population. The success of the health post is demonstrated by the fact that other villagers in the vicinity come to Dabadou to obtain health services, and express their desire for health posts to be established in their own villages. A specific dynamic was created through the interconnection between the health post and the anti-FGM/C campaign, which contributed to the effectiveness of the campaign.
Since the health post became operational, very few, if any, women deliver their babies at home in the village, and staff at the health post are frequently consulted on issues related to child health, maternity, and general health. The activities of the health post focus on the prevention of FGM/C; for example, at the birth of a girl, the intention to cut her is assessed and the mother or parents are informed of the negative health consequences of FGM/C. In addition, causeries (talks) are held with patients to discuss the harmful aspects of FGM/C. Since medicalised FGM/C is on the rise in Guinea, staff are required to sign an agreement committing to refrain from performing FGM/C. All these activities employ a pacifist style of communication, promoting dialogue and understanding.