Social determinants can have an impact on health. There are many different types of determinants. A person’s health can be impacted by stress, education, social exclusion, unemployment, addiction, nutrition, transportation, and many more.

A social determinant of health that affects the women in Sierra Leone suffering for female genital cutting is Social Exclusion. “Life is short where its quality is poor. By causing hardship and resentment, poverty, social exclusion, and discrimination cost lives.” (World Health Organization, 2003) There are two sides of this that affect the women in Sierra Leone. One, is that the women would often be excluded if they do not participate in female genital cutting. Two, and perhaps more feasible, is that the women are usually living in poverty. Poverty causes there to be a lack of education and access to medical care. According to UNICEF, female secondary school participants is a small 33.2%. (UNICEF, 2019)

“Life is short where its quality is poor.” (World Health Organization, 2003) As of 2012, the life expectancy in Sierra Leone is 45.3 years old. (UNICEF, 2019) Providing a small bit of evidence for the World Health Organization’s statement. In this case, and probably most cases, they are correct. People, especially women, in Sierra Leone typically have poor quality of life. They have limited access to education and work. And barely any access to proper health care. The female adult literacy rate is a mere 52.1%. (UNICEF, 2019) They rank number one in maternal mortality rate as well.

What does all of this have to do with female genital cutting? I believe all of the above has a huge impact on female genital cutting. To begin, most women that participate in the ritual, know very little about it. Some girls, as young as 10 years old, have been impacted by this health issue. At 10 years old, you can not expect her to understand the impact of what is happening to her body.

Additionally, if women choose to not participate in female genital cutting, they are cut off from most, if not all, people they know. They will be truly excluded from their community, making an already difficult life even more difficult. They would be looked at as a dirty, not pure person.

On top of an already traumatizing procedure, the removal of genitalia is not done by a medical professional. And there usually isn’t access to a medical professional fast enough. Infections and bleeding can cause death and future issues.

It seems unfathomable that women are taking such a risk. But it is because of their circumstances that they don’t know better. Without proper education, a way to provide for themselves, access to proper health care, how can they risk being cut off from their community? They really cannot. Social exclusion due to their poverty and lifestyle causes them to make life threatening decisions in order to have a life with their families and friends.

Bibliography

Davies, V. A. (2002). War, Poverty and Groeth in Africa: Lessons from Sierra Leone. Centre for the Study of African Economies.

UNICEF. (2019, August 8). At a glance: Sierra Leone. Retrieved from UNICEF: https://www.unicef.org/infobycountry/sierraleone_statistics.html

World Health Organization. (2003). Social Determinants of Health. The Solid Facts, 16-17.