Monrovia, Liberia – Despite affecting an estimated 56 million women and girls across sub-Saharan Africa, Female Genital Schistosomiasis (FGS) remains one of the continent’s least recognized and most underreported gynecological conditions. Now, a Liberian scholar is leading the charge to change that.
By Gerald C. Koinyeneh, [email protected]
Ayesha E.R. Bell-Gam Woto, a PhD candidate at the Liverpool School of Tropical Medicine, is conducting groundbreaking research into the prevalence and impact of FGS in Liberia — a country where the disease remains largely hidden due to lack of awareness, stigma, and poor diagnostic tools.
In an interview with FrontPage Africa, Bell-Gam Woto explained that FGS is caused by a waterborne parasite that lives part of its life in freshwater snails before entering the human body — particularly that of women and girls — through unbroken skin during everyday activities such as bathing, washing, or collecting water.
“Once inside the body, the parasites grow into adult worms and release toxic eggs,” she said. “Many of these eggs fail to exit the body and become trapped in the reproductive organs, causing pain, vaginal discharge, irregular bleeding, and sometimes infertility.”
While the disease is treatable with a drug called praziquantel, many women suffer in silence due to misdiagnosis or the shame surrounding reproductive health issues.
Widespread, Yet Hidden
FGS is most prevalent in rural areas, particularly in riverine communities where access to clean water and sanitation is limited. In Liberia, girls as young as 10 can become infected, especially those who swim or play in contaminated water.
“Symptoms like vaginal itching, discharge, bleeding after sex, or pelvic pain are often mistaken for STIs or cervical cancer,” said Bell-Gam Woto. “This leads to misdiagnosis and mistreatment, leaving the root cause unaddressed.”
She noted that diagnosing FGS remains a challenge, particularly at rural clinics that lack the necessary equipment or trained personnel. Tools like colposcopes or even basic pelvic exams are rare, and standard lab tests often fail to detect the genital form of the disease.
A Personal Mission
Bell-Gam Woto said her decision to investigate FGS in Liberia was driven by a desire to fill critical gaps in research and public health infrastructure left in the aftermath of the country’s civil war.
“I am passionate about evidence-based healthcare,” she said. “When I discovered how little was known about FGS in Liberia, I knew I had to contribute — especially as a woman, I felt a duty to help fellow women who may be suffering without knowing why.”
Her research is already making an impact. The Liberian Ministry of Health has announced plans to develop a national health policy for FGS, informed in part by her findings.
“We’re fortunate to have Dr. Louise Kpoto, a brilliant gynecologist, as Health Minister,” Bell-Gam Woto said. “She has made FGS a priority, and I’m very proud of the momentum we’re building.”
Tackling the Crisis
Addressing FGS requires a multifaceted approach, Bell-Gam Woto emphasized. Among the key steps she recommends for governments and NGOs:
• Expand access to treatment, especially for adult women often missed by school-based drug distribution programs.
• Train health workers to recognize and diagnose FGS correctly.
• Improve water and sanitation infrastructure to break the cycle of infection.
• Raise public awareness to combat stigma and promote early care-seeking.
• Integrate FGS into national health strategies, particularly in reproductive health and HIV prevention programs.
The consequences of inaction are dire. Left untreated, FGS can lead to infertility, chronic pain, and increased vulnerability to HIV and possibly cervical cancer.
“This isn’t just a medical issue,” Bell-Gam Woto concluded. “It’s a development and gender equity issue. Millions of women and girls are affected, and it’s time we make them visible in our policies, programs, and research.”
As Liberia moves forward with its national response to FGS, the work of researchers like Bell-Gam Woto may finally bring attention to a long-overlooked threat to women’s health.
