A history of violence: Ifrah Ahmed's campaign to end female genital mutilation

As the credits rolled, my hands were shaking as I clapped. Tears welled up and ran. Choked with surges of raw emotion, I was at a loss for words.

Over a running time of 105 minutes, the privileged world I live in had disappeared into the darkness of the cinema auditorium. I had entered a different world – not one of make-believe, but the very real world I had seen reflected in A Girl from Mogadishu – the world in which 200 million women suffer, day in, day out, the horrific consequences of female genital mutilation (FGM) and where millions of young girls are cut, year in, year out, with dirty razor blades, broken glass and knives - their legs bound so tightly together, to stop them bleeding to death, that they sometimes can’t empty their bladders and die slow, painful deaths as a result.

With an imaginative sensitivity that skilfully side-steps any charges of voyeurism, explicit exposure or sensationalism, A Girl from Mogadishu, leaves no doubt in the viewer’s mind as to the exact nature of this gender-based torture.

Judging by the reactions of those around me, the audience felt as I did. This is the kind of emotional nuclear explosion that happens when the power of testimony and cinema come together.

I was at a private screening in Dublin of A Girl from Mogadishu, the feature film based on the testimony of Somali-born Irish citizen and global anti-FGM activist Ifrah Ahmed. Made by Mary McGuckian, it stars Aja Naomi King (of How to Get Away with Murder fame) and Oscar-nominee Barkhad Abdi.

Sitting a few rows in front of me – in real life – and witnessing the portrayal of her own mutilation and gang-rape on screen, was the special Gender Advisor to the Government of Somalia and Ireland’s International Person of the Year 2018: Ifrah Ahmed.

At the Q&A afterwards, this elegant, Irish-Somali Muslim woman inspired the packed auditorium with her eloquent determination “to be the voice and not the victim”, and to put an end to FGM in Somalia by 2030. And what’s more, we believed her when she said it could be done.

So how cruel is the world for women who suffer from FGM?

At the time when their genitals are cut and mutilated, usually with crude implements and without pain relief (“the first sorrow”), young girls can die from haemorrhage. They can also die early on from blood poisoning due to soft tissue and urine infections or tetanus. Later, they can suffer and die from hepatitis B or C or HIV.

Women with FGM can suffer from excruciating pain due to the formation of thickened scar tissue in the vulva and vagina and the development of cysts due to the blockage of natural secretions from glands. The creation of a narrow, scarred vaginal opening also causes extreme problems with intercourse (“the second sorrow”). FGM can also cause severe period and bladder problems – with the build-up of blood and urine resulting in leakage, infection and pain.

When it comes to childbirth, women with severe forms of untreated FGM can tear badly (“the third sorrow”) and haemorrhage profusely. Because of the narrow, scarred opening, there may also be delays and difficulties in delivering babies. This may result in babies being stillborn or dying shortly after birth due to lack of oxygen. Obstruction of the baby’s head by the narrow opening, for hours on end, can sometimes result in a breakdown of vaginal tissues and the creation of a fistula or hole between the vagina and bladder - making the woman totally incontinent of urine.

And on top of all this physical torture, there is the almost unimaginable burden of mental pain and the total erosion of self-esteem and human dignity.

Although there are medical and surgical interventions that may greatly alleviate some of the consequences of FGM, because tissues have been cut away it is not possible to cure women of this condition. To add insult to injury, in areas where the practice is rife, there are invariably no specialist services for women who suffer from FGM - and when tissues are ripped or cut apart at the time of childbirth, they are just sewn back together to make a narrow opening again.

A Girl from Mogadishu is a powerful clarion call to end FGM in all the Mogadishus around the world – wherever they may be. There is no medical condition that causes so much suffering to so many people – women in this case – that can be totally eliminated by simply not doing something, something truly awful, something that does not need to be done, something for which there is no medical or religious justification, or benefit.

There is a magical scene in A Girl from Mogadishu, in which Ifrah Ahmed unfurls her End FGM banner in the eyeline of US president Barack Obama as he addresses the crowds in Dublin city centre during his presidential visit to Ireland in May 2011. Inspired by Obama’s vision of justice, this young, Irish-Somali global activist repeats after him in Irish and in English: “Is féidir linn. Yes, we can. Yes, we can. Is féidir linn.”

Like an earlier visitor to these shores, Frederick Douglass (the great African-American abolitionist and hero of Barack Obama), Ifrah Ahmed’s political conscience had also been transformed during her time in Ireland. She had become an abolitionist too: in her case against the slavery of FGM.

#Metoo began in Hollywood. Ifrah Ahmed, a girl from Mogadishu, brings the revolution from the silver screen to where it must also go, if half the world’s population are to say that they can be truly free. Yes, Ifrah Ahmed, and courageous women like her, can end FGM. But we must help them to do it.

FGM is a crime against women. It is a crime against our common humanity. It must be stopped, and the suffering of women who are affected by it, relieved.

Professor Chris Fitzpatrick is a consultant obstetrician and gynaecologist at the Coombe Women & Infants University Hospital and a clinical professor in the School of Medicine, University College Dublin. He is a board member of the Ifrah Foundation and played a cameo role, as a doctor, in A Girl from Mogadishu. A Girl from Mogadishu will be screened during the Galway Film Fleadh on Sunday, July 14. See galwayfilmfleadh.com

FGM worldwide

Female genital mutilation is a global problem. Although practised mainly in 30 countries across Africa, the Middle East and Asia, recent patterns of migration have resulted in the spread of FGM. Girls and women are also sometimes temporarily brought back to their countries of origin for the purpose of FGM. Two hundred million women and girls are currently living with the effects of FGM; approximately 44 million are under the age of 15 years. A further three million are still expected to be cut every year. The highest prevalence of FGM is in Somalia (98 per cent).

FGM in Ireland

Based on the 2016 Census, it is estimated that over 6,000 women and girls living in Ireland have been subjected to FGM. In Ireland, the Criminal Justice (Female Genital Mutilation) Act 2012 states that it is illegal to perform FGM or to take or to attempt to take a girl or woman to another country to undergo FGM. FGM is also included as a form of child abuse in the Children First National Guidance for the Protection and Welfare of Children, 2017. The Irish Family Planning Association in association with the HSE provides a free FGM Treatment Service, based in Dublin. New multidisciplinary national clinical guidelines and care pathways are currently being finalised for women in Ireland with FGM.