Communities that continue to circumcise girls, do so secretly.
Beatrice Cheptoyet underwent female genital mutilation (FGM) at the age of 16. That was three decades ago.
At the time, it was common practice for girls from her Sabiny tribe as well as a section of the Karimojong tribes of eastern and northeastern Uganda to undergo the procedure as a rite of passage into womanhood.
A girl who was not circumcised was considered impure. She was called promiscuous and faced daily ridicule. She had little chance of getting married and was not be allowed to pick food from the granary or cow dung from the kraal.
“Even if you got married and bore children, you would still be called a child,” said Cheptoyet, who is now an anti-FGM crusader. “Every girl was therefore eager to undergo the rite, not knowing what dangers they were exposing themselves to.”
The mother of 10 has four scars on her right arm, known in the local Sabiny language as “mamitek,” which identify a girl who is circumcised. None of her five daughters is circumcised.
“I never wanted my daughters to go through the same pain I underwent,” said Cheptoyet.
She says her mission is to see an end to female circumcision, even though she admits it is a tall order.
A law passed in 2010 banning FGM in Uganda has helped to bring the number of incidents down. Communities that continue to perform the rite do so secretly. Anti-FGM crusaders refer to such communities as hotspots.
Female circumcision often involves partial or total removal of the clitoris and labia minora.
The United Nations Population Fund (UNFPA) says there are about 200 million girls and women around the world who have gone through the cut. The consequences are both physical and psychological and can last a lifetime.
The procedure can cause severe bleeding, infections as well as complications urinating and during childbirth, UNFPA notes.
“FGM is a big threat to the reproductive health of women and girls,” said UNFPA country representative for Uganda Alain Sibenaler.
According to the Uganda Demographic and Health Survey (2011), the FGM prevalence in the country stands at 1.4 per cent, but the figure rises in communities where the practice continues. This is despite the tough penalties imposed on those convicted.
Such a person faces up to 10 years in prison. If the cut results in death, disability or infection with HIV/Aids, the punishment is life imprisonment. Anyone who provides aid or takes part in the practice in any way is liable, upon conviction, to a prison term of up to five years.
Kenya passed the law against FGM in 2011, while Tanzania did so much earlier in 1998.
Officials from the Sebei region of eastern Uganda say that despite the decline in the number of incidents the hotspots remain a challenge.
In Kapchorwa district of eastern Uganda, officials said the number of women who have undergone the cut declined from 970 per circumcision season in 1990 to as low as 120 cases by 2012.
In Kween district, a senior community development officer Saul Chebet said that while there have been no recent studies on the FGM prevalence rate, there is evidence to show the numbers have reduced drastically.
While this is encouraging, Kween resident district commissioner Kennedy Adolla Otiti said a lot more work still needs to be done to eradicate the practice.
“This is a deep-rooted culture and you cannot wipe out a culture in one go. But one day we hope we shall end it as more girls attend school and become aware of its dangers,” said Mr Otiti.
Yet even as pressure mounts to end the practice, former circumcisers like 61-year-old Prisca Yapkwobei feel that they have been left with no alternative source of income.
“We used to get a lot of money and many gifts including chicken and goats. We were also respected. Now we have been left with nothing,” said Ms Yapkwobei.
In the hotspots, female circumcision is no longer a ceremonial event held once every year. It happens sporadically such as when a woman is giving birth.
Uncircumcised married women facing stigma opt for this route in later years, officials said.
“Those who want to be circumcised seek the services of traditional birth attendants to perform the procedure during childbirth,” said Lillington Mukhwana, an official from Bukwo district.
Others take a trip deep into the forests and mountains at night and perform the rite.
The UNFPA notes that the global target of eliminating FGM by 2030 will only be achieved if efforts are intensified to address the problem.
“We need to ensure adequate allocation for efforts to keep girls in school and provide access to health, legal and psychological services for survivors,” said Mr Sibenaler.
Over the past three years, UNFPA alongside the Church of Uganda and the Ministry of Gender, has been staging the annual anti-FGM marathon to raise awareness about the dangers of circumcising girls.
This year’s event was held on September 16.
The Archbishop of the Church of Uganda Stanley Ntagali said since the inaugural event in 2015, at least 15 communities from the three districts of Kapchorwa, Kween and Bukwo have abandoned the practice.
“There are still a few hotspots, but with improved education and road networks it is possible to phase out FGM in the region.”