Mali has one of the highest rates of female genital excision in Africa, but organisations working to stop the practice say they are slowly making headway to change attitudes.

About 92 percent of all Malian girls between the ages of 15 and 49 have already undergone the procedure, according to the government. Excision is practiced in about 28 African countries as a traditional way of keeping women chaste and eligible for marriage.

It involves removing part or all of the external labia and clitoris and can lead to haemorrhage, infection, complications during pregnancy and long-term psychological scarring, according to the World Health Organisation (WHO). The most severe form of the practice involves sewing the opening of the vagina to a hole about the size of a matchstick for the passage of menstrual blood and urine.

Records of female circumcisions taking place have been found from thousands of years ago, but the practice is now recognised by a growing number of African governments as posing serious hygiene and health problems.

Aissata Diakite, head of an association of women’s nongovernmental organisations (NGOs) in Mali, said since 1991 at least 200 of the practitioners of the ancient ritual have put down their scalpels and vowed never to cut girls again.

“Another 15 large Malian villages are today on the way to abandoning the procedure too,” she said.

Excision is still practiced in all the regions of Mali, both in urban and rural areas, and by all the country’s religious groups, although the extent of the practice varies between regions and ethnicities.

Diakite said the greatest resistance to change is found in the south of Mali, while in the sparsely populated north excision is now rarely practiced.

Mali’s government set up a national committee to examine women’s and children’s health in 1996, which now has branches in all the regions of the country. The government in 1999 banned mainstream medical practitioners from practicing excision.

Mali’s Minister for Women, Children and Family, M’Bodji Sene, said education is the key to change.

“Communication is the beginning and the end of the process of change,” Sene said at a meeting on excision last month. “All the progress registered in the change of behaviour is owed to the positive impact of traditional and modern communications.”