It's female genital mutilation - sometimes called female circumcision - and it is prevalent across a broad swath of Africa and chunks of Asia as well. Mothers take their daughters at about age 10 to cutters like Maryan Hirsi Ibrahim, a middle-aged Somali woman who says she wields her razor blade on up to a dozen girls a day.
"This tradition is for keeping our girls chaste, for lowering the sex drive of our daughters," Ms. Ibrahim told me. "This is our culture."
Ms. Ibrahim prefers the most extreme form of genital mutilation, called infibulation or Pharaonic circumcision. And let's not be dainty or euphemistic. This is a grotesque human rights abuse that doesn't get much attention because it involves private parts and is awkward to talk about. So pardon the bluntness about what infibulation entails.
The girls' genitals are carved out, including the clitoris and labia, often with no anesthetic. What's left of the flesh is sewn together with three to six stitches — wild thorns in rural areas, or needle and thread in the cities. The cutter leaves a tiny opening to permit urination and menstruation. Then the girls' legs are tied together, and she is kept immobile for 10 days until the flesh fuses together.
When the girl is married and ready for sex, she must be cut open by her husband or by a respected woman in the community.
All this is, of course, excruciating. It also leads to infections and urinary difficulties, and scar tissue can make childbirth more dangerous, increasing maternal mortality and injuries such as fistulas.
This is one of the most pervasive human rights abuses worldwide, with three million girls mutilated each year in Africa alone, according to United Nations estimates. A hospital here in Somaliland found that 96 percent of women it surveyed had undergone infibulation. The challenge is that this is a form of oppression that women themselves embrace and perpetuate.
"A young girl herself will want to be cut," Ms. Ibrahim told me, vigorously defending the practice. "If a girl is not cut, it would be hard for her to live in the community. She would be stigmatized."
Kalthoun Hassan, a young mother in an Ethiopian village near Somaliland, told me that she would insist on her daughters being cut and her sons marrying only girls who had been. She added: "It is God's will for girls to be circumcised."
For four decades, Westerners have campaigned against genital cutting, without much effect. Indeed, the Western term "female genital mutilation" has antagonized some African women because it assumes that they have been "mutilated." Aid groups are now moving to add the more neutral term "female genital cutting" to their lexicon.
Is it cultural imperialism for Westerners to oppose genital mutilation? Yes, perhaps, but it's also justified. Some cultural practices such as genital mutilation - or foot-binding or bride-burning — are too brutish to defer to.
But it is clear that the most effective efforts against genital mutilation are grass-roots initiatives by local women working for change from within a culture. In Senegal, Ghana, Egypt and other countries, such efforts have made headway.
Here among Somalis, reformers are trying a new tack: Instead of telling women to stop cutting their daughters altogether, they encourage them to turn to a milder form of genital mutilation (often involving just excision of part or all of the clitoris). They say that that would be a step forward and is much easier to achieve.
Although some Christians cut their daughters, it is more common among Muslims, who often assume that the tradition is Islamic. So a crucial step has been to get a growing number of Muslim leaders to denounce the practice as contrary to Islam, for their voices carry particular weight.
At one mosque in the remote town of Baligubadle, I met an imam named Abdelahi Adan, who bluntly denounces infibulation: "From a religious point of view, it is forbidden. It is against Islam."
Maybe the tide is beginning to turn, ever so slowly, against infibulation, and at least we're seeing some embarrassment about the practice. In Baligubadle, a traditional cutter named Mariam Ahmed told me that she had stopped cutting girls - apparently because she knows that foreigners disapprove. Then a nurse in the local health clinic told me that she had treated Ms. Ahmed's own daughter recently for a horrific pelvic infection and urinary blockage after the girl was infibulated by her mother.
I confronted Ms. Ahmed. She grudgingly acknowledged cutting her daughter but quickly added that she had intended only a milder form of circumcision. She added quickly: "It was an accident."
