In gloomy, mud clinics from Nigeria to Egypt, ritual native healers whet rusty blades to slice off the clitoris' of baby girls despite years of efforts by the UN and modern doctors to halt the ancient practice.
A new U.N. report in July finds that nearly 100 million African girls and women have already undergone Female Genital Mutilation or Circumcision (FGM/C) and another 30 million are expected to endure the practice.
While the percentage of girls being mutilated has fallen somewhat in recent years, the practice remains entrenched in ancient social patterns fueled by superstition.
Despite years of pleading by Western and African health workers millions of families from Nigeria to Egypt are still about to put their children under the knife to cut off their clitoris and sometimes labia.
The percentage of girls being cut is somewhat reduced in recent years in the 29 countries in Africa and the Middle East where female mutilation is practiced, said the report by UNICEF -- the UN children's agency. On average 36% of girls ages 15-19 have been cut compared to an estimated 53% of women ages 45-49.
But in places such as Egypt, cutting remains nearly universal.
I was able to witness this up close during a visit to Nigeria where I taught journalism some years ago. I had completed the day's seminars with working reporters and broadcasters and set about walking through the streets of Ibadan, a sprawling huge city in the Yourba-speaking heartland of Southern Nigeria.
I soon spotted a sign advertising the services of a traditional circumciser. Wisely, the sign painter showed only the smiling face and robes of the clitoris cutter himself rather than the final product of his work.
I chatted with him for a few minutes as a few customers came by and sat on benches to wait. It could have been a health clinic in any other country in the world except that this was devoted to slicing off the female organs of baby girls.
The circumciser agreed to allow me into his surgical chamber to witness how clean, swift and relatively painless the procedure was.
The baby girl was about one month old. She was held down by her mother as the man sharpened his razor blade on a stone. Then he threw some red liquid disinfectant into a bowl of water and rinsed his hands as well as the razor blade.
It was done in about a minute. He sliced off the top half inch of the clitoris. Then, for free, he threw in a few tribal marks by slicing her cheeks. A moment later the baby was nursing at her mother's breast and a few naira in crumpled bills worth less than $2 U.S. was handed over to the cutter.
I know that as a journalist witnessing other people's cultural practices, I should first of all not voice my opinions. And second, I should respect their right to have cultural values that differ from ours.
But my mother was a pediatrician and I could almost hear her voice coming through me as I asked "Why? Why is this done?"
It was the mother-in-law who was most adamant that the surgery take place and she explained to me her reasoning.
"Girls who don't get cut are too sexed up and can't control their sexual appetite. They would be unfaithful to their husbands," she said.
Evidently many people in Nigeria and other affected nations believe that cutting the clitoris --and in countries such as Somalia and Mali the labia of the vagina as well - reduces the pleasure women get from sex and make them less inclined to it.
However the Guttmacher Institute reports that women who have been cut experience the same number of orgasms during sex as those who were not cut.
"In addition," said the mother-in-law, as the traditional circumciser translated her Yoruba into English, "if the woman is not cut and her baby's head touches the clitoris during birth, the baby will die."
She told me this with absolute certainty even though it is completely untrue, she had never seen it herself with her own eyes, and the government has made efforts for many years to dispel this superstitious belief.
I later went to Nigeria's top medical school to interview the senior obstetrics and gynecology professors. They shook their heads sadly and admitted that no one -- not even the wife of the head of state -- has been able to shake the common people from this ancestral belief.
One senior professor of obstetrics told me she speaks around the country against the mutilation and brings her grown sons -- both of them doctors. She tells Nigerian women that both were born healthy even though she has not been cut.
To little avail.
While UNICEF's report showed some decline in the percentage of women getting cut, in Egypt and Sudan and Somalia the practice remains nearly universal.
In fact, when the Muslim Brotherhood held power in Egypt this past year, it tried to repeal a law banning such cutting. Not that the law is effective -- it is rarely enforced.
In Somalia and a few other countries, the cutting of the clitoris is far deeper than in Nigeria. First the clitoris is completely cut out -- down to the bone -- and then the sides of the vagina or labia are completely sliced off. Then the vagina is sewn shut except for a small opening to excrete urine.
When the girl is married the husband rips open the vagina. The whole process is very painful, unsanitary and leads to many medical problems including infections and death.
"In Somalia, Guinea, Djibouti and Egypt, [female mutilation] remains almost universal, with more than 9 out of 10 women and girls aged 15-49 being cut," said UNICEF in a statement. "And there has been no discernible decline in countries such as Chad, Gambia, Mali, Senegal, Sudan or Yemen."
I found it telling that it was the husband's mother - and sometimes his brothers - who insist that the baby girls in the family are circumcised. They fear that an uncut woman will dishonor them and have sex outside marriage.
UNICEF, the World Health Organization and NGOs have tried many ways to end this awful practice. Sometimes the cutter can be persuaded to offer a substitute ceremonial prayer and offer the tribal mark cuttings instead of the clitoris.
Efforts to prosecute the practitioners and families have proved futile.
Educating the people to the downside of the mutilation is hard when so many people cannot read and have never been to school.
And even though wives of political and religious leaders, movie stars, female doctors and others have spoken out against it, the practice endures.
Some African families in Europe and America are so attached to it they perform the cutting in secret in violation of Western laws; or they take their children back home to their native villages where they force the girls to endure the cutting.
Some women have even applied for political asylum in the West to escape mutilation.