By the time she was 14, Oureye Sall had been sent to live with her husband in Nguerigne, Senegal. She also had a profession of sorts: She was trained to be a female genital cutter. And it wasn't long before she was performing the customary rite of passage into womanhood for girls in her village and the surrounding region.
But through Tostan, a nonprofit organization created to empower women in Africa, Sall later learned that those longstanding rituals cause severe physical and emotional harm to the women and girls. So she decided to abandon her profession and instead campaign against female genital cutting and child marriage throughout Senegal and other African countries. Now in her 60s, Sall remains a face and advocate for change.
During his global health initiative trip to Senegal in March 2011, Dr. Richard Besser, chief health and medical editor at ABC News, met Sall, along with Molly Melching, the founder of Tostan, who is originally from Illinois but has lived in Senegal for nearly 40 years.
Through Melching's efforts with Tostan, women throughout the poorest regions of Africa are empowering themselves with a better understanding of the myriad of violent effects that FGM has on the body and mind.
On Thursday, Melching joined Secretary of State Hillary Clinton in Washington D.C. to celebrate International Day of Zero Tolerance to Female Genital Mutilation. The press conference was intended to highlight the continuing need for policy changes and new strategies to end FGM and promote support for women who have undergone the procedures.
"Molly is a real hero of mine, a friend of mine," said Clinton at the conference Thursday.
Melching's program in Senegal was successful where so many others failed because the program approached women and culture through empowerment not condemnation. When discussing her approach to the program, Melching explained at the conference Thursday that the Senegali women told her, "Don't talk about fighting a tradition, talk about promoting health and human rights."
"[The program] talks about health as a fundamental human right and gives women the skills to exert control over their health decisions," Besser wrote in an e-mail Thursday. "Decades of efforts by international bodies to condemn and outlaw this practice have been unsuccessful. We need to see replication of programs that work if we are to see an end to this brutal practice."
Melching created the Community Empowerment Program, a non-formal education model that builds on local language, culture and tradition to enable communities to take ownership of their own development and lead massive movements for positive social change. Since 1998, more than 6,000 villages in five African countries have publicly declared their abandonment of FGM under Melching's guidance. Tostan estimates that over 800,000 girls have been spared FGM because of these declarations.
For centuries, FGM has been culturally entrenched in customs and practices throughout the world. Between 100 and 140 million girls and women throughout the world are estimated to have undergone the procedure, according to the World Health Organization.
There are no health benefits to FGM. But the risks are profound. The pain and trauma of the initial procedure can begin a lifetime of severe physical and mental health complications.
A 1985 Sierra Leone study found that 97 percent of 269 women interviewed experienced intense pain during and after FGM, and more than 13 percent went into shock. Hemorrhages, wound infections (including tetanus) and damage to adjoining organs are common after the initial procedures in girls. Long-term complications include painful and abnormal periods, scarring, infertility, psychological trauma and an increased risk of maternal and child mortality due to labor complications.
Despite the severe consequences, in parts of the world where the ritual is practiced, many believe the procedure ensures cleanliness and better marriage prospects, prevents promiscuity and excessive clitoral growth, enhances male sexuality and encourages childbirth by widening the birth canal.
"Let's be clear, this is a deeply entrenched practice in many places," Clinton said at the conference Thursday. "So we have to be both unrelenting in our efforts to end it and understanding about what works and what doesn't work... We enter into this with a lot of humility."
Nevertheless, Clinton went on to say that excusing the practice as a cultural tradition is unacceptable.
"We cannot excuse it as a private matter because it has very broad public implications," she said. "This is such an important issue that deserves attention from the United States Congress and from leaders across the globe."
In moving forward, Clinton said the United Nations and other partners in foreign relations and global public health initiatives will be looking at laws and resolutions, new efforts and strategies to raise awareness of the damaging practice. The Secretary of State also announced a partnership with the University of Nairobi to fund a pan-African Center of Excellence in Kenya to advance African research to address female genital cutting.
"This is not a women's problem, this is not a women's issue," said Clinton. "This affects the human family, and therefore, we all have a stake in it... We want to create conditions for every child, girl and boy, to have a chance to live up to his or her God-given potential."
ABC News' Gitika Ahuja contributed to this report