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ZONA

Zona is a Italian multimedia association founded in 2012 that works with NGOs and other institutions to boost social awareness through photography and video production.

A blade, a needle and a thread: the infibulation tools used by the Waredube people, a community living in southern Ethiopia's Oromyia region

UNCUT: The War Against Female Genital Mutilation

Emanuela ZuccalÃ

Cut From Africa To Europe: Female Circumcision Among Migrants In Italy

FLORENCE — "My first child died inside me while I was trying to give birth ..."

Hamdi Abdurahman Ahmed is 30 years old and has a marked Florentine accent as she begins to speak. In 2007, she left Somaliland and arrived in this Tuscan city where she currently works as a cultural mediator.

In Italy it is rare to meet women like Ahmed who accept to speak serenely about the scar they have had to live with since they were young: female genital mutilation (FGM), a ritual practice inflicted on 125 million women in 29 countries (27 in Africa, as well as in Yemen and Iraq).

"He was a breech birth and I was too sewn up," Ahmed recalls of the baby she lost. "My people say that a breech birth brings bad luck, so his death was seen as destiny. It didn't dawn on anyone, not even me, that the baby had been strangled by my infibulation."

An insignia of chastity and respectability that in certain societies, from Gambia to the Horn of Africa, takes the most extreme form of infibulation: the removal of all external genitalia, followed by the sewing of the vagina almost completely closed.

Until three years ago, even Hamdi was not able to talk about it: that which in her country is seen as virtue, in Italy and other Western destinations of migrants, it becomes a stigma of barbarity that creates an insurmountable rift between cultures.

"For me, infibulation was a natural condition, like breathing," explains the young woman. "Until one day, all my world turned upside down. I was taking care of a friend who was recovering from a de-infibulation surgery: she needed my help to dress the wound. One day I was late for work so I asked my Italian roommate to look after her. I came back home and found her crying, vomiting, asking me what kind of crime could a woman possibly be guilty of to deserve such torture. In that moment, my mind exploded with every single memory I had suppressed: the cut performed in my tiny room, the unbearably painful menstrual cramps, the death of my child. They teach us that it's normal, that suffering is part of your womanhood. But it's not true. Today, I try to rouse the memories of other women, speaking out against infibulation."

An elusive phenomenon

In Italy, and elsewhere in Europe, how many Somali, Egyptian, Senegalese, Ethiopian, Nigerian women are bearing the same pain as Hamdi? But above all, how many, unlike Hamdi, are still devoted to a tradition handed down from grandmothers and mothers who in turn impose it on their daughters, "cutting" them illegally here in Italy or in their country of origin while on vacation?

The figures are unclear. The latest survey promoted by the former Ministry for Equal Opportunities dates back to 2009: Of the 110,000 women who emigrated from FGM-practicing countries, it was estimated that 35,000 had been subjected to the practices and 1,100 of their daughters were at risk. Italy is currently the European country with the fourth highest prevalence level after Britain (170,000 women), France (53,000) and Sweden (42,000).

The Department for Equal Opportunities has guaranteed that on Feb. 6, the International Day of Zero Tolerance for Female Genital Mutilation, it will publish on its website all the initiatives financed to date. In fact, Italian law not only punishes whoever practices the "cut" with imprisonment from 3 to 16 years, it also allocates five million euros annually for the investigation of the phenomenon throughout Italy, public awareness campaigns to inform and sensitize communities, and training courses for educators and mediators. Still, much of the European and national funding has since dried up.

What Italy is doing against FGM?

Local initiatives are in fact numerous: It would suffice that the government coordinate them. In Perugia, in 2014, a Reference Center for the Study and Prevention of FGM was opened. In the northern region of Piedmont, the coordinating body for Regional Family Healthcare Clinics organized eight training courses within healthcare facilities, while in the Burlo Garofalo Hospital in Trieste, an 80,000-euro project involving the African migrant associations in Friuli-Venezia Giulia has just been concluded.

"We estimate that there are about 500 girls at risk in the region," explains Head of Gynecology, Salvatore Alberico. "Every year, we perform 2 or 3 de-infibulation procedures: They are carried out in day-hospital and the patient can choose between local and general anesthetic. But it's not simply a matter of restoring an anatomical normalcy in women affected by pelvic infection, chronic cysts, and in more serious cases, recto-vaginal fistulae. The emotional scar tissue must also be repaired."

Cristina Vecchiet, a psychotherapist at the hospital in Trieste, stresses the importance of the physician's attitude and behavior towards the patient: "We avoid calling it â€˜mutilation,' to start with because the women don't see it that way," Vecchiet explains. "Before they migrate, it is simply their culture. If they ask for de-infibulation, they need to be made aware of the entire process, releasing them from the silent submission they were subjected to at the moment of the cut."

The motivations that prompt them to get operated are always the same: liquid stasis, painful sexual intercourse, wanting to give birth naturally without a caesarian section. The emotional preparation leading to the procedure is long and marked by inner conflicts. "They fear judgment from their families who maintain a strong influence over them," says Vecchiet. "Of the nine cases treated here in four years, seven husbands were African and they supported their wives' decisions completely."

A young woman from Burkina Faso had to resort even to a plastic surgeon: The cutter who had "fixed" her as a child had let the blade slip, lacerating her up to her bellybutton. A woman from Sudan had postponed the procedure twice in the grip of ambivalence between desire and the terror that had reawakened the shock of the infibulation she had undergone when she was nine years old.

"I have seen women with extremely tightened stitchings, almost incompatible with life," recalls Aldo Morrone, President of the Mediterranean Institute of Heamatology, who was the Director of a division for migrant healthcare at the San Gallicano Hospital in Rome. "For some women, de-infibulation in preparation for childbirth is equivalent to betraying their roots."

Morrone recalls a young university graduate who grew up in Rome, the daughter of an African diplomat, who didn't want to suffer during sexual intercourse any longer. "She made an appointment for de-infibulation seven times and she did not show up seven times," he said. "And a girl with a tumor on her vaginal labia asked us to operate without unsewing her. It's a complex cultural model that must be handled without any prejudice."

Convictions are nearly inexistent

To date, convictions for this crime in Italian courts can be counted on one hand. The first case exploded two months after the 2006 law was entered into force: A Nigerian woman, arrested in Verona as she was preparing to "operate" on a 20-day old girl, after having cut another girl, was then sentenced to one year and eight months. But the parents of the two victims were acquitted in the Court of Cassation. The most recent episode dates back to last October when the Court of Cassation confirmed the relinquishment of parental responsibility for a husband and wife from Nigeria living near the town of Teramo: They had allowed their daughters of 9 and 10 years old to undergo genital mutilation by their grandmother while on a trip to Nigeria.

In Nigeria, 27% of the women have undergone one of the types of FGM. There are 35,700 Nigerian women living in Italy, the largest community of female immigrants from an African FGM practicing country. There are also many women immigrants from Senegal (25,700), Ghana (20,200), the Ivory Coast (10,900), Burkina Faso (5,300), Ethiopia (5,000), and Eritrea (4,500). From Somalia and Somaliland, where the infibulation prevalence stands at 98%, there are about 2,300 women living in Italy.

Every African community is a world in itself: "A Nigerian woman told me in confidence that they turn up the volume of the music really loud and proceed with the cutting," reports Laila Abi Ahmed, a 49-year-old Somali, President of the Nosotras association in Florence. "In Italy, immigrants perform only Type I and II, the partial or total removal of the clitoris and the labia minora, at a cost of 300 to 500 euros. Not infibulation with the sewing: It's too complicated and dangerous."

According to Laila, this hidden suffering persists because Italy isn't doing enough: "Many doctors can't distinguish between the various types of circumcision," she explains. "Ministerial circulars are not provided at the local state-run healthcare units, and in our training courses we meet health care workers who know nothing about the law against FGM.

According Ahmed of Nosotras, the most important healthcare professionals to train are pediatricians: "When a woman who has undergone FGM gives birth, she should be given a personal medical chart that she can present to her daughter's pediatrician," she says. "This way, the pediatrician will know immediately that the girl is at risk of cut and can monitor her. Serious, responsible prevention can only truly take place this way."

*Photography: Simona Ghizzoni, Maps and graphic: Alessandro D'Alfonso, Data research: Emanuela Zuccalà, Valeria De Berardinis, Video: Emanuela Zuccalà, Simona Ghizzoni, Video editing: Paolo Turla

**This report is part of the UNCUT project on female genital mutilations (FGM). Produced with the support of the "Innovation in Development Reporting Grant Program" of the European Journalism Centre (EJC), funded by the Bill & Melinda Gates Foundation, and carried out in partnership with ActionAid NGO and the cultural association Zona.

Copyright: Emanuela Zuccalà Simona Ghizzoni - Zona.

UNCUT, A Multimedia Report On Female Genital Mutilation

UNCUT: The War Against Female Genital Mutilation

Emanuela ZuccalÃ

UNCUT, A Multimedia Report On Female Genital Mutilation

An ordinary room, or a dark hut in a rural village. A razor blade bought at a market will suffice, or a sharp knife, or simply a shard of broken glass. Sometimes needle and thread, or the thorns from a wild-growing bush. The women of the family restrain the little girl while a circumciser is paid to inflict in her a pain so intense that it will never be forgotten.

For at least 200 million women around the world, the passage from infancy to adulthood is marked by the blood of female genital mutilation (FGM).

Follow this link for an exclusive webdoc on women's war against female genital mutilations.

Still life of the instruments used in the practice of FGM in Kenya.

UNCUT: The War Against Female Genital Mutilation

Emanuela ZuccalÃ

When Migrants Carry Scars, Female Genital Mutilation In Europe

LONDON — According to a new British law, any teacher, doctor, nurse or social care professional who comes across a case of a girl who has undergone genital mutilation has the duty to report it to the police.

This law, which took effect on Oct. 31 and applies to any victim under the age of 18, can result in sanctions and job termination if a case is not reported. It is just the latest legislation passed in Europe to deal with the issue of female genital mutilation (FGM), a phenomenon that until recently was thought to be limited to faraway countries.

But as can be seen by the below interactive map, FGM is surprisingly widespread in Europe as well, amid migrant communities from Somalia, Eritrea, Nigeria, Senegal, Gambia, Egypt.

Actually, Europe has its own, fortunately brief, history of "the cut." The first case of clitoridectomy was reported in 1825 by the medical journal The Lancet: In Berlin, the surgeon Karl Ferdinand von Gräfe believed it could be the perfect cure for the excessive masturbating of a 15-year-old girl. For decades, cutting female genitals was thought to heal hysteria and certain sexual deviations, even in France and England. Then scientific societies imposed a ban on the procedure, which soon fell into oblivion and seemed to have been eliminated once and for all in Europe.

Today, following decades of migratory waves, the problem has resurfaced with a different aspect, forcing European countries to confront a societal wound as complex to fight as it is to understand.

The first challenge is measuring the scope of the problem. The only official statistic about FGM in Europe is a registered increase in women asking for asylum who come from countries where FGM is practiced: from 18,110 in 2008 to more than 25,000 in 2013. According to the UN Refugee Agency, this is due to a rise in the number of women asylum seekers from Eritrea, Guinea, Egypt and Mali, where FGM prevalence is over 89%. On the map you can see how many women were granted asylum from 2008 to 2011: from 2,225 in Britain to 75 in Italy. The reasons for fleeing from their countries varied, but in 2011 more than 2,000 girls and women were escaping precisely the threat of being forced to undergo circumcision.

Apart from refugees, it is difficult to calculate exactly how many FGM victims are living in Europe: The available data of member States, as well as Norway and Switzerland, only supplies us with a rough estimate.

The European Parliament has long cited the estimate of 500,000 victims and some 180,000 girls at risk, "but we really don't know what's the source of these numbers," notes Jurgita PeÄiÅ«rienÄ— from the European Institute for Gender Equality (EIGE) in Lithuania, author of the only two existing comprehensive European studies on the issue. "But our main problem was that statistics gathering methods vary in each member State," points out the expert. "Some use immigration data and others use health registrations so it is impossible to compare the results, and therefore the figures remain approximate."

At the request of the European Commission, the EIGE is now working to provide a method, already tested in Sweden, Ireland and Portugal, which starting in 2016 will allow all the member States to assess FGM prevalence with more precision.

In the meantime, even though the actual extent of the phenomenon is unknown, the EU continues to invest in projects to raise awareness of and limit the practice of FGM in Europe. In addition to allocating almost 10 million euros in 2009 for 26 programs against FGM in 15 countries throughout Africa and the Middle East, the European Commission has invested generous sums to study and stop the "foreign ritual" from being practiced inside our own borders.

Some 800,000 euros has recently been earmarked for a web platform that will train health care, social workers and legal professionals in nine countries. "But at a time of economic crisis, we should be able to understand where our resources are required most urgently," says Els Leye, a senior expert on FGM at Ghent University in Belgium. "I get the impression that the issue of FGM is being exploited by politicians because they believe that by pointing fingers at ethnic minorities, they will strike a chord with the audience."

A special program has been launched in the UK, which has the largest Somali community in Europe (approximately 103,000 people). Taking into consideration that in Somalia the FGM prevalence is 98%, and exploring other communities from countries at risk, the House of Commons estimates that there are 170,000 victims and 65,000 girls at risk of FGM in UK.

The spokesperson for the massive anti-FGM campaign sponsored by The Guardian, Fahma Mohamed, a student of Somali origin, demanded that the government alerts all schools in order to prevent the female migrant students from undergoing the torture of the cut during travels to their countries of origin. "It has taken us this long just to get people talking about it," she says. "We don't care how long it takes to make people listen."

Female genital mutilation is a taboo, clandestine by definition, and elusive to those carrying out surveys: Little girls are "fixed" by traditional circumcisers or during holidays abroad, "and migrant communities don't report cases due to their internal loyalty," adds Els Leye.

There was an uproar in Sweden in June 2014 when it was discovered that 60 girls originating from Africa and attending an elementary school in the city of Norrköping had been cut: One of them was taken to the emergency room due to lacerating menstrual cramps. Yet Sweden was the first country in Europe to be on the look-out for similar cases, having passed a law abolishing FGM as far back as 1982: Today it counts 42,000 victims and thousands of girls at risk of FGM.

France, the Netherlands, Italy, Spain and Portugal have invested resources to fight against the practice, as has Cyprus, where an estimated 1,500 victims reside, and Hungary which counts a maximum of 350 victims. A few member States have established a national database; Belgium is the only EU country to have developed a method for constant monitoring; France depends on police registers and data from the Public Prosecutor's offices, NGOs and a Department for FGM data collection begun in 2008; Portugal (even with only 43 victims) and Ireland gather data from hospitals.

"We have to study the migrant attitudes more deeply," points out Leye, who is now involved in an international project on FGM in Belgium, France and Italy. "There are huge differences between ethnic groups in each African country. Furthermore, migration has a great influence on the practice of FGM, in two very opposite senses: Some groups abandon it because, living now in Europe, they don't feel the social pressure from their societies anymore; for others, genital mutilation becomes a mark of cultural identity, believed to preserve their daughters from customs considered "too Westener" or leading to promiscuousness."

Despite the increase in anti-FGM legislation, cases that have actually made it to court are quite rare, with only about 60 convictions, 50 of which are in France alone.

Elsewhere, beyond the silence that envelops the cutting tradition, there are few social care professionals or doctors with enough knowledge or expertise to assist victims. In UK, for instance, a law criminalizing FGM was passed in 1985 and in the past five years the police have investigated 200 cases. Still, the only trial that has ever been held took place last February and ended with an acquittal: He was a doctor, accused of re-sewing up after childbirth a Somali woman who had been a victim of infibulation.

On February 6, on the International Day of Zero Tolerance for Female Genital Mutilation, the European Commission will release the results of a new study into whether current national anti-FGM laws are effective enough in curbing ritual cutting. The findings may push authorities to look for whole new strategies to combat an inevitably complex problem, which includes such factors as gender inequality and migrant integration.

Copyright: Emanuela Zuccalà Simona Ghizzoni - Zona.

Nuura Mahamud Muse holds one of her girls

UNCUT: The War Against Female Genital Mutilation

Emanuela ZuccalÃ

In Somaliland, Mothers Save Daughters From Genital Mutilation Rites

When fear gets hold of me

When anger seizes my body

When hate becomes my companion

Then I get feminine advice, because it is only feminine pain

And I am told feminine pain perishes

like all feminine things.

— Dahabo Ali Muse, "Feminine Pains" poem, 1998

HARGEISA — "On my wedding night, it felt like having a flame on an open wound," the woman with honey-colored eyes says, enraged. "He enjoyed it, but I experienced the same pain I felt when I was a little girl and they cut open my genitalia with a razor and then sewed it closed with thorns," she continues. "I couldn't move for 10 days because my legs were tied together, and I couldn't even go to the bathroom. My memory of it is still bitter and intact."

On the outskirts of Daami, the undergrowth overflows with garbage and the round huts are covered in rags. Nuura Mahamud Muse, 35 and the mother of six girls, sits on a filthy mat and remembers the torture ritual that her country practices to sanction female virginity. "I won't let my daughters to be touched, though," she says over the noontime call to worship. "I don't want them to suffer like I do every menstrual cycle, during sexual intercourse, when giving birth. I don't care if the neighbors badmouth me."

Daami is situated beyond the Waaheen River shoal in Hargeisa, the windy capital of Somaliland, a republic not easily found on a map. North of the Horn of Africa, the former British Somalia declared independence from the former Italian Somalia in 1991 to disengage from the conflict that continues today in Mogadishu. But it paid for its freedom by being virtually non-existent. The international community doesn't recognize this state of four million residents, who are divided into three family clans that, aside from the war, have everything else in common with Somalia: language, poverty and a patriarchal culture that blends Islam with ancient traditions.

Barbaric rites

These traditions include gudniinka fircooniga, the "pharaonic" female genital mutilation or infibulation, a seal of chastity inflicted on girls from the age of five and beyond in which all external genitalia is removed. Then the vagina is sewn together using needle and thread or thorns from the wild-growing qodax plant, until the tissues from the wound bond leaving a small hole for urine and menstrual blood, to be cut open on the wedding night.

All over the world, more than 125 million women are branded by blood and condemned to infections, chronic cysts, excruciating menstrual pain, agonizing sexual intercourse, complications during childbirth, all in the name of presumed ideals of morality and respectability. Of the 27 African countries where various types of vaginal amputation are in use, Somalia and Somaliland practice the most extreme type and hold first place with the highest prevalence rate.

"Ninety-eight percent of our women are infibulated and sewn up again after the birth of each child, resulting in 6 to 13 stitchings throughout their lives," says Sadia Abdi, the young country director of the ActionAid NGO in Somaliland who studied in England and later returned to the dirt roads and hectic marketplaces of her native Hargeisa to resume the battle she started when she was just 14 years old. "I saved my younger sister from infibulation," she says. "My mother kept telling me, "You can't fight against it, it's part of your identity and womanhood, an Islamic precept." When an Imam assured me that there is no mention of this practice in the Koran, I told my mother and she gave in but placed the honor of the family upon my shoulders. I felt so relieved when my sister found a husband who wanted to marry her for love even though she was different from the others."

Motherly protection

Abdi doesn't talk about herself. She emphasizes the fact that infibulation is "an extreme act of violence against women, a concept of male domination that saturates our society and perpetuates gender inequality."

But listening to her, you notice that her subversive tenacity flows from deep within. "My daughter is five years old and she will remain intact," she says. "She won't miss a day of school because her menstrual blood burns with pain. She'll be able to play and run free from the fear that the stitches could rip open. She will never damn the fact that she was born female."

To understand just how overwhelming the social pressure is, Abdi recalls the tragic story of her cousin, who committed suicide because she didn't undergo infibulation, which meant she was called kintirleeyi at school, an insult for a trampy woman with a clitoris.

Thanks to Abdi's placid stubbornness and ActionAid's commitment, there are currently 53 women's coalitions in Somaliland challenging the cruel custom. Hawa Muhumed Madar, 65, leader of the women in Agamsaha village, admits to the guilt she feels for having had her daughter infibulated. "Back then, tradition was not put under discussion, but now we are strong, united, and we won't take it anymore."

Maryan and Nymco, who were professional circumcisers earning $10 to $15 per girl until recently, have taken the same stance. "We've been taught that it's against Islamic law, so now we teach this to our communities."

A 40-year-long fight

The iconic spokesperson for the abolition of female genital mutilation is a glowing, energetic 78-year-old lady, Edna Adan Ismail, a midwife, former foreign minister and a UN delegate. In the 1970s, she was the first woman in the Horn of Africa who dared to publicly challenge the ferocity of the pharaonic ritual. "It means death for mother and child," she says today in the hospital she had built in Hargeisa with her own funds, recalling that the maternal-infant mortality rate in Somaliland is over four times higher than the average of developing countries. "Only seven hospitals in Somaliland carry out caesarean sections. In the other health facilities, if the artificial barrier hasn't already suffocated the child, the stitching is ripped open with scissors which can lead to the fistula, the worst death sentence possible. Why do you think I've been fighting against infibulation for over 40 years? Because it kills."

Aamina Milgo, chair of the Network Against FGM in Somaliland (NAFIS), says there is now a national movement that involves even husbands and religious leaders. "But we haven't reached a critical mass yet," she says. In a country where 85% of the women are illiterate (and 64% of the men), her primary target is ignorance. "There are people who believe the clitoris will grow disproportionately if it's not cut, and those who accuse you Westerners of inciting us against our own culture," she explains. "In the past, they instilled us with the belief that suffering through the torture was something to be proud of. To this day, for many women, not being sewn is a stigma."

Though the codes of the clans here come before the laws of the state and even before Islamic Sharia, the women's coalitions continue to fight to make female mutilation illegal, just like in 21 African countries where it has been banned. "A draft of a proposed law has been in the Parliament since 2011," Abdi says, "but the Ministry of Religious Affairs that examines and evaluates all decisions has yet to take a stand."

Eminent Imam Yousuf Abdi Hoore explains that while infibulation "is cruel and extraneous to Islam," a milder type of female circumcision appears in a prophetic tradition (hadith) and so, according to the Islamic school followed in Somaliland, it's recognized as an obligation. "It's called Sunnah, a very small incision to the clitoris thereby bestowing beauty and purity."

But women reject any sort of compromise. "We demand zero tolerance for all types of genital mutilation," says Abdi who, law or no law, wants to first and foremost change the way people think. "By creating awareness and knowledge in the villages, and getting mothers, fathers and religious leaders involved, my hope is that the next generation will be free from the horrors of infibulation."

While the usual afternoon wind blows, she takes us to view her Hargeisa from high ground: a flat geometry disturbed by the two twin hills Naasa Hablood, which means "girl's breasts" in the Somali language. As if femininity, in this non-place, were already blooming on the horizon.

Copyright: Emanuela Zuccalà Simona Ghizzoni - Zona.

A woman on the streets of Hargeisa, the capital of Somaliland.

UNCUT: The War Against Female Genital Mutilation

Emanuela ZuccalÃ

Facing The Scourge Of Female Genital Mutilation In Africa

Marking the International Day for the Elimination of Violence Against Women, the first in an in-depth multimedia series of reports from Africa, and beyond, about the continuing practice of female genital mutilation.

An ordinary razor blade, a sharp knife, or a shard of broken glass. The mother and the aunts restrain the little girl while a woman is paid to inflict a pain so intense that it will never be forgotten. Afterwards the girl won't be able to move for a week, waiting for the wound to heal and the whole family praying it won't get infected.

For more than 125 million women around the world, the passage from infancy to adulthood is marked by the blood that comes from a female genital mutilation (FGM). The procedure comprises cutting the clitoris, sometimes scraping away the labia minora, up to the most extreme form: removal of all the external genitalia and sewing the incision closed leaving a small hole for menstrual flow and urine, which will later be cut open on the girl's wedding night. An obligatory ritual in certain societies, it is believed to "purify" women from their femininity, sentencing them to undergo excruciating pain to make them virgins for life, resistant to sexual pleasure, and therefore — the main aim — make them devoted and faithful wives.

According to UNICEF and the World Health Organization (WHO), the victims are concentrated in 29 countries: with the exception of Yemen and Iraq, all the others are in Africa.

In 1993, the World Conference on Human Rights in Vienna declared that FGM constitutes a form of gender abuse, freeing it from the former definition — which was too exotic, too culturally distant from us — of "harmful traditional practice."

That's why today, Nov. 25, on the International Day for the Elimination of Violence Against Women, we are focusing on the humiliating tradition of "the cut" still practiced in Africa. By means of an interactive map — the result of a data journalism survey that cross-referenced data from the UN agencies UNICEF and UNFPA, the WHO, the U.S. Department of State, the former UK Border Agency (UKBA) and other non-profit organizations — you will be able to explore both the global and local impact of an ancient practice that is still too often clouded by clichés and myths: such as the misconception that associates it with Islam, when actually no Surah in the Koran prescribes female circumcision. In fact, in some countries — Egypt being the first in 2006 — eminent Islamic scholars have outlawed it denouncing it as anti-religious.

FGM is rather a social norm with blurry historical roots that is undeniably linked to female inequality. In Somali tradition, for example, it is considered an act of purification (halalayn): an uncircumcised girl is physically and morally unclean, while infibulation creates a beautiful and ethically superior woman who, in preparation for marriage, can represent her family in the most respectable way. For the Maasai People in Kenya and Tanzania, excision is considered a necessary passage from infancy to adulthood. While in Sierra Leone, Côte d'Ivoire and Liberia it is part of the initiation ceremony into secret societies.

But no matter where or why, the incision leaves scars on the women's psyche and triggers a vicious cycle that hinders social development. Girls who have been cut have in fact a higher rate of illiteracy: They must leave school and get married because they are considered grown women, even though they may be only 10 or 11 years old. Furthermore, FGM causes severe health complications in childbirth: in countries where it is practiced, with the exception of Egypt, the maternal-infant mortality rate is much higher than the average of developing countries.

Our map is not limited to the 27 African countries indicated by UNICEF and WHO as at-risk of FGM, since elsewhere — such as in Rwanda and Zimbabwe — other publications report that the practice exists, even though to a lesser extent. And in countries such as Morocco and Tunisia, although FGM is completely foreign to the culture, it has nevertheless been the source of recent debate.

In terms of percentages, Somalia and Somaliland are the most entrenched, with 98% of women undergoing FGM. Extremely high prevalence is also found in Guinea (96%), Djibouti (93%), Egypt (91%), Eritrea (89%), Mali (89%), Sierra Leone (88%) and Sudan (88%), while Niger (2%), Cameroon (1%) and Uganda (1%) appear at the bottom of the list. However, within one single country, there are often vast differences between Africa's some 3,000 different ethnic groups.

In Kenya, where the national prevalence level stands at 27%, among the Maasai communities FGM is practiced on 73% of the women. And in Uganda, which registers only 1%, the Pokot people in the north-west register a 95% prevalence.

If we then examine the data in absolute terms, Egypt is the universal capital of FGM, with its 27.2 million female victims. In second place we find Ethiopia with 23.8 million, and third goes to Nigeria with 19.9 million. Of the 27 African countries considered by UNICEF and WHO, 14 of them account for over one million victims each.

But African women don't just stand by and watch. Since the 1970s, there have been activists and ordinary women alike fighting to try to eradicate FGM. Thanks to their campaigns, 21 countries where FGM is currently practiced have national laws that punish it as a crime, even though the tradition is still performed illegally, especially in remote rural areas. The first country to enact a law criminalizing FGM was Guinea in 1965; the most recent was Nigeria in May of this year.

An important push for reform was given by the Maputo Protocol on the African women's rights, adopted by the African Union on July 11, 2003. For the first time in history, Article 5 of the charter prohibits and condemns all traditional harmful physical and psychological practices on women. So today, only six African countries are still without laws abolishing FGM (Cameroon, Gambia, Liberia, Mali, Sierra Leone and Somalia/Somaliland) but even in countries where FGM is punishable as a crime, convictions are rare: one in Egypt last year, another one in Guinea-Bissau in December 2014, 10 in Côte d'Ivoire from 2012 to the present. Still, Burkina Faso boasts 97 convictions between 1997 and 2005.

Many local non-profit organizations, some of which are supported by a UNICEF/UNFPA joint program launched in 2008, are committed to raising awareness in communities in order to abolish FGM. And there are many African women who have been fighting for years in the frontlines of this war. One such activist is Edna Adan Ismail who has been advocating for 40 years, first in Somalia and now in Somaliland. A midwife, former First Lady and Minister, in the 1970s she was the first person in the Horn of Africa to publicly denounce the great taboo. Today, at 78, she runs a hospital she built with her own funds in the capital city of Hargeisa.

On the other side of the continent, in Benin, the most recognizable spokesperson for women's liberation is Isabelle Ekue Tevoedjre, 85, the founder of the local Inter-African Committee (IAC) on traditional harmful practices. In Egypt, the struggle against FGM is nourished by the pride of the lawyer Reda el-Danbouki, who secured the first ever conviction for FGM crime in the history of her country, in January 2015. In Mali Fatoumata Coulibaly, a journalist, director and actress, in 2004 shocked audiences at the Cannes Film Festival with her film Moolaadé on the horrors of FGM. And in 2003 it was an African First Lady, Stella Obasanjo, wife of former President of Nigeria Olusegun Obasanjo, who launched the International Day of Zero Tolerance to Female Genital Mutilation, which has been held each Feb. 6 ever since.

So, how much longer will it take to free Africa from FGM? Some countries already register considerable progress: In Benin, the annual rate of reduction among girls aged 15-19 is 23%, in Nigeria 7%, in Egypt 6%, in Niger 5%, in Kenya 4% and in Senegal 3%. But this race must be accelerated.

What could then be the winning strategy for the future? "That you Westerners support us in our battle," declares Edna Adan Ismail in Somaliland. "Because it isn't just an African problem anymore. Through immigration, girls that have been cut are in your schools, in your hospitals: Today the world shares our pain, and it must also share the responsibility. You were able to reach the moon, but you can't help African women to annihilate a tradition that kills them. We are asking for your partnership, which must go beyond slogans, driven by our shared humanity."