Saturday, December 11, 2021.
I may come out as ‘very vulgar’ in the Ghanaian culture after this piece. This piece may also win an award (likely a posthumous one) because it may lead to the change we need. Whatever be the case, it is necessary for us to look at this if we want to improve women’s health in Ghana, especially if we want to win the fight against cervical cancer.
Growing up in Kumasi four decades ago, ‘wo maame twɛ’ (your mother’s vagina/vulva) was about the worst form of insult to anybody. It was used by the most ‘notorious’ or uncouth people. People still use it. The effect could be psychologically devastating for the person who is so ‘insulted.’ How a normal female anatomy could become the worst form of insult still baffles me. I never heard ‘wo papa kɔte’ (your father’s penis) as an insult. If it had been used, it might have signified how ‘powerful’ the man was, especially in bed. Is this one of the ‘subtle’ biases against women in the Ghanaian culture which we perpetuate subconsciously?
Culturally Ghanaians do not generally talk about the genitalia publicly. It is a taboo subject. When the genitalia have to be mentioned, one must precede them with ‘sebi’ or tafratse’ (with all due respects/apologies). These same people do not feel uncomfortable when they have to mention the vagina, vulva or penis in another language. When the late musician, Ebony Reigns, sang the song ‘Maame hwɛ’ (Mother, look), it tickled people’s imagination ‘in the wrong sense culturally’ because it sounded like ‘Maame twɛ’ (Mother’s vagina/vulva).
Our culture has created a situation where many of our women believe there is something wrong with their genitalia. They have low self esteem when the genitalia are mentioned. The vagina and vulva have become so much of a taboo subject that when a woman has a medical problem at these sites, she would rather complain of ‘mayaase’ when she presents to a health facility. This may be interpreted by the health worker as ‘my lower abdomen’ or ‘my deep pelvis’ at best and can delay diagnosis and proper management. Women do not also feel comfortable discussing their gynaecological problems with others. I have seen many advanced vulval and cervical cancers due to this. There have been countless preventable deaths as a result.
Why should a woman have low self esteem for a great anatomy she has because of biased cultural beliefs? Almost Everybody in the world today (except those delivered by caesarean section) have come out of the vagina. Our women should be proud of this and be proud of their anatomy.
We need to demystify and destigmatize the vagina. We should be able to talk freely about it and make people see what a great thing it is and how availing it for medical review/screening can prevent deaths. Will this increase promiscuity? In many of the developed countries where the vagina is not so much of a taboo, they have been able to reduce deaths from cervical cancer significantly through screening to detect precancerous lesions of the cervix and treating these lesions so that they don’t progress to cancer. Let’s get our women to also get screened to prevent cervical cancer.
So the next time you hear Ebony Reigns’ song ‘Maame hwe,’ your imagination should not be tickled in the wrong way. It should be a wake-up call to our collective responsibility to our women, our mothers. And the next time you hear ‘wo maame twɛ’ (your mother’s vagina/vulva), you should be proud and tell the person who says it that “my mother’s ɛtwɛ (vagina/vulva) has been medically examined and declared sound. What about your mother’s vagina?”
Dr. Kofi Effah is a gynaecologist and head of the Cervical Cancer Prevention and Training Centre in Catholic Hospital, Battor in the North Tongu District of the Volta Region of Ghana.