Introduction
Guinea-Conakry is one of the countries with the highest overall prevalence of female genital mutilation/cutting (FGM/C) in the world. In 2011, following rumours of a disease that would kill girls who had not undergone FGM/C, there was an upsurge in the cutting of girls. In consequence, girls under the age of one were subjected to FGM/C. Following this event, the Association des Amis de la Solidarité Sociale et du Développement (ASD, or the Association of Friends of Social Solidarity and Development), in collaboration with the Belgian NGO Aniké, decided to counter this with campaigns against FGM/C in the Kankan region. The campaigns are locally embedded through community assemblies, local ‘vigilance committees’ against FGM/C, and by supporting local entrepreneurship. Given that the basic needs of the rural population (such as food, drinking water, and healthcare) are high and often not met, tackling FGM/C as an isolated issue without addressing these needs is difficult, as the problem of FGM/C is not a priority for local communities to address if there is insufficient food or healthcare. People in general, and women in particular, believe that the practice is normal because it is both a religious act and a social norm, and therefore an obligation for all adult women.
Hence the campaigns have combined raising awareness against FGM/C with supporting local entrepreneurship and healthcare in villages. We believe this is one of the main drivers for motivating communities to re-assess the necessity of continuing FGM/C. The campaign first started in three villages in 2012 and is now active in ten villages in Kankan prefecture.
1 A prefecture is a sub-division of one of Guinea’s eight administrative regions. By 2024, the local NGO (ASD) was active in four of the fifteen sub-prefectures of the Kankan prefecture: Karifamoriah, Balandou, Gberedou Baranama, Koumban, and the urban commune of Kankan. This chapter explains how the campaigns were developed and discusses the successes and challenges. Before giving an overview of the different elements of the campaigns, we will provide some insights into the context of FGM/C in Guinea.
FGM/C in the context of Guinea, Kankan region
The overall prevalence in Guinea of FGM/C in women aged fifteen to forty-nine is 94.5 per cent (Institut National de la Statistique [INS] and Inner City Fund [ICF] 2019). Figures published by UNICEF in March 2024 (UNICEF 2024) indicate that some progress has been made in Guinea, shown by a significant decline in prevalence in adolescent girls aged fifteen to nineteen over the past thirty years, i.e. from 98 per cent thirty years ago to 92 per cent (ibid.:13). However, this report also states that if no additional efforts are made, the projected prevalence of FGM/C in Guinea among adolescent girls aged fifteen to nineteen in 2030 will be 88 per cent (ibid.:14), which is far from achieving the Sustainable Development Goal (SDG) 5.3 of eliminating FGM/C by 2030. Acceleration is therefore needed, according to UNICEF, and progress in Guinea should be at least a hundred times faster to achieve the FGM/C-related SDG target (ibid.:16).
The UNICEF report also highlights the fact that ‘while some countries are making progress towards abandoning the practice, FGM/C will become increasingly concentrated around pockets of resistance, where no progress is yet evident’ (ibid.:14). In Guinea, support for the practice is highest in rural areas and among those with lower levels of education. Overall, 65.4 per cent of women and 59.6 per cent of men aged fifteen to forty-nine in Guinea who have heard of FGM/C believe that the practice should continue (28 Too Many 2021a).
The most common form of FGM/C in Guinea involves cutting and removing flesh (this applies to 58 per cent of women aged between fifteen and forty-nine, and may correspond with WHO Type 1 or 2). Eleven per cent of women have undergone a simple cut, with no flesh removed (WHO Type 4), and in 10 per cent of cases women have been infibulated (WHO Type 3).
2 In the Demographic and Health Surveys (DHS), women are asked if they are cut and if they had a ‘simple cut or if flesh was removed from the genital area’ (INS and ICF 2019). Women and girls are not asked what type of FGM/C they have had, according to the WHO classifications. Hence it is not possible to state whether it is Type 1 or 2 in this instance. Some 21 per cent of women report that they do not know what type has been performed on them (INS and ICF 2019:346).
In Guinea, one region where the prevalence of FGM/C exceeds the national average is the prefecture of Kankan, where 96.3 per cent of women aged between fifteen and forty-nine have undergone FGM/C (28 Too Many 2021b). Kankan prefecture has fifteen communities (collectivités communautés), of which fourteen are rural communes and one urban. The total population of Kankan prefecture is 595,403, of which 300,646 are women (INS 2023).
Finally, to better understand the context of FGM/C in Guinea, it is important to note the growing trend towards medicalisation. The percentage of women and girls cut by a health professional in Guinea rose from 9 per cent in 1999 to 17 per cent in 2018. Among girls aged nought to fourteen, the percentage rose from 31 per cent in 2012 to 35 per cent in 2018 (figures derived from DHS reports cited in 28 Too Many 2021a:5). Although FGM/C is prohibited under Guinean criminal law, including the criminalisation of health professionals’ involvement in FGM/C, the law is very poorly enforced (28 Too Many 2018), especially in rural areas.