An estimated 140 million girls and women world-wide have undergone some form of FGM and 2 million girls face the risk of the practice each year.

Mostly practised in sub-Saharan Africa, the practice is also known in parts of the Middle East and Asia. Nowadays more and more women are found in Europe, Northern America and Australia due to the migration from countries where FGM is a cultural tradition.

Female genital mutilation constitutes all procedures which involve the partial or total removal of the external female genitalia or other injury to the female genital organs, whether for cultural or any other non-therapeutic reasons (WHO, 1995).

FGM is carried out using special knives, scissors, razors, or pieces of glass. On rare occasions sharp stones are used and in some regions cauterization (burning) is practised. The instruments might be re-used without cleaning.

Usually an elderly woman of the village who is specially designated this task performs the operation. Anaesthesia is rarely used, instead the girls is held down by a number of women, often including her own relatives. Depending on the skills of the operator, the extent of the excision and the resistance put up by the girl the operation may take 15-20 minutes. The wound is dabbed with anything from alcohol or lemon juice to ash, herb mixture, porridge, coconut oil or cow dung, and the girl's legs may be tied bound together until it has healed.

There are different types of FGM as classified by the WHO:

• Type I: Excision of the prepuce with or without excision of part or all of the clitoris.
• Type II: Excision of the clitoris with partial or total excision of the labia minora
• Type III: Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening/infundibulum)
• Type IV: Unclassified: includes pricking, piercing or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization by burning of the clitoris and surrounding tissues; scraping of the vaginal orifice or cutting of the vagina; introduction of corrosive substances or herbs into the vagina to cause bleeding, into the vagina for the purpose of tightening or narrowing it; and any other procedure that falls under the definition of FGM given above.

There is a variety on age at which FGM is performed, depending on the ethnic group or geographical location. In some regions FGM is performed on babies around the 7th day of birth, more common is the age group 4-10 years, but FGM is also performed during adolescence, at the time of marriage, during the first pregnancy or under labour if not performed before.

Increasingly FGM is also performed in hospitals, then with the use of anaesthetics and antiseptics, thus reducing pain and the risk of infection. But it is important to not that FGM, whether performed in a hospital or any other modern setting, is wilful damage to healthy organs for non-therapeutic reasons. It violates the injunction to "do no harm", and is unethical by any standards.

We, as medical students need to be aware of the situation and we in SCORA see it as our responsibility to inform others through awareness campaigns, lectures and exhibitions.