Today in the African countries, we increasingly talk about women's promotion policies, of liberation and emancipation of women, but we can't talk about women's liberation if we don't respect their physical integrity.

Abatani Assoumanou, is satisfied.  She'll be well paid by Koura's family for this morning's work. Now it's time to celebrate and dance.

It's a ritual Koura wouldn't do without, even if she did get the opportunity to avoid the circumcisor's knife. Uncircumcised, she'd risk being outcast by her people and her family.

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Balkissa's mother believes in circumcision but she's come to see the film anyway. It's the first time she's seen anything she can relate to which succeeds in showing her a different perspective.

Abatani is one of the people selected by the ancestors to cut away the clitorises of young women - at least that's what the inhabitants of this village in Togo believe. They believe circumcision, often called excision, makes girls ‘pure' before their marriage, thereby bestowing honour on their families.

She can be excised at the age of  five.  That's the  best age, five or seven years old.  Five, seven or nine.  That's a good age for excision.  At this age there will be no problem.  It's good for the person.

As Koura's ordeal comes to an end, she is in fact one of the more fortunate. Koura had only her clitoris removed. At worst, she might have had all of her external genitalia cut away, then her vagina might have been sewn up. This practice leaves just two openings - one for urine, the other for menstrual blood. Before sex could occur the vagina would have to be cut open again.

This is where the practice finds its most vocal support, amongst older women and men.  Those who make a living out of circumcision are not ashamed of it.

The Nakoulma family is large and close.  But the harmony of this scene belies the tensions all the women in this household have gone through because of circumcision. For Marie, sex has always been painful.

But Agirata is a conscientious mother who believes excision is a cleansing ritual.  One that will make her daughter pure, fertile and a good wifely prospect. No circumcision means no husband, no land and no respect. And that's an outlook  many mothers would do anything to avoid.

In neighbouring Burkina Faso, female genital mutilation is now illegal. But it's still deeply rooted in tradition and widely practiced.

80% of Burkina Faso's population can't read or write, but they do go to the cinema. Ougadougou, the small capital has 12 of them. It's a medium that has the power to educate an illiterate population.

It's half past five in the morning in a village in the small West African country of Togo. Fifteen year old Koura Tene takes off her skirt for a ritual she's been waiting for all her life.

The circumcisors have brought along a baby girl to be circumcised in front of the mid-wife. The women are keen, as if they want to show the best they can do.

Akim Banabesse is a qualified midwife. Since she took over as head of the Family Planning department at the clinic 30 years ago, she's been trying to discourage women from all forms of female genital mutilation.

I disagree, but I'm also not against circumcision. But I have seen a lot of things during childbirth. The head of the baby is squashed because there's not enough room.

But Marie's family is a respectable one. She was so convinced that circumcision was needed to protect the honour of her daughters that despite all her own physical complications, she subjected her two eldest daughters to the same fate.

I  didn't really want it to happen.  I said, "You'll kill me, I will die, don't kill me." They said, "You'll not die. The girl near you, does she look like she's dead? And if you are not excised it isn't good.  No man will marry you, so it's good for you to be excised."  I continued to cry until the excision was finished. Then they put ash on the wound. After the third day, the pain was gone but the skin was healing too tight so they took me back to the excisor for a second operation.  So I suffered.

Balkissa Sawadogo is five years old.  She lives in Burkina Faso, and like most girls her age, she is soon to be circumcised. Here it's commonly practiced on girls between the ages of five and eight, who are too young to know what is happening to them.

Clearly I have problems because of the excision, my husband and I have had difficulties.  He wants me but I don't want him.  I have no pleasure with him.

In the town of Sokode one of the few women to escape circumcision is Rissola Esso. She has been working for six years as a secretary in the Togo office of the World Health Organization. Her father saw a cousin bleed to death after a clitoral circumcision. He wasn't going to expose his daughter to the same danger.

The hen is prepared. The claws and beak are washed - it's all done strictly according to tradition. It will be cooked later and prepared with healing medicines that will give Koura strength for the healing and in her future.

The women Akim sees become mothers at a very young age. And on average they have seven children. Most cannot read and few consider circumcision  as wrong. But many discover that it causes problems during childbirth. Often, there's not enough room for the baby in the mutilated birth canal. Or, sometimes the scarring in the vagina ruptures, putting both lives in danger.

Further North in Egypt the government recently took a harder line on the circumcision debate. Last year it prosecuted local journalists who worked on a CNN news report about it. Following an outcry Egypt outlawed the practice but that hasn't deterred many women from visiting Cairo's back street barbershops to be circumcised.

There is a common idea in the Sudanese people's minds that female circumcision is something from the Sunna, from the practice of Prophet Mohammed. So we are always trying to tell them it has nothing to do with the practice of Prophet Mohammed. At his  time there was no female that was circumcised.

100km North, Balkissa's parents have come to watch the film "I will not excise my daughter." It tells the tale of a typical African tragedy.

An uncircumcised woman doesn't belong here. Our ancestors said so. I don't want my husband to sleep with somebody like that.

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In some cases a clitoral circumcision ends up with a hospital stay, through infection or wounds that don't heal, or sometimes with bleeding that the woman can't stop. I was shocked by these things as a child but otherwise I was not interested in circumcision.

Issaou Aboulay is a farmer. He's already got two wives. And, he's looking for a third. As soon as his harvest is sold and he has a bit more money, he wants to get married again. His two wives have borne him six children so far. Both women have been circumcised, but Issaou says he would take an uncircumcised wife.

It was many years ago that Marie Nakoulma was circumcised. But for her as with most girls who undergo the operation the physical and emotional pain did not go away.

In Togo uncircumcised female genitalia are considered impure and ugly. According to local tradition, girls and women left in their natural condition would become nymphomaniacs.

But there are women in Togo who would not see the event as a happy one. Not far from Koura's village in the town of Sokode, women come to this clinic to find medical help and advice they can afford. One woman here is fighting this traditional practice, with unorthodox methods.

I would marry a woman who still has her clitoris, as long as I found her attractive. I've already got two wives. In case one can't do it, the other is there for me.

I have something to say. It's about circumcision. I have seen it isn't good, we wouldn't like the same thing to happen to us.  We'll not do circumcision.

Why? I know that a woman is sensitive in that place. When the clitoris is mutilated then there's no more sexual sensitivity. When that sensitivity is gone, it means a couple doesn't have a sexual balance anymore.

The first born of the twins isn't breathing. It's up to the traditional midwife to try and save the child's life. She gives the baby mouth to mouth resuscitation and spits water in his face.

The countryside is where most of Burkina Faso's population lives. Here it's the same story as in Togo: illiteracy has fortified the prejudices of generations, and female circumcision is still firmly rooted in tradition.

Far from the hospital, Akim had felt powerless to help. Now she gives the struggling baby a vitamin injection and  even she's convinced that spells and not science have saved the child.

I circumcise the foreskins of boys. We simply can't stop doing it, it says in the Koran. Girls must also be circumcised - just like our ancestors did.

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It's often not the menfolk or politicians but the women themselves who encourage circumcision. In this Togo village, the fact that it removes almost all sexual feeling, is not something that women know, or want to know. Women fight against women, circumcised against uncircumcised.

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In our society nobody ever talks about sexuality. Later you learn from books that clitoral circumcision suppresses the sexual sensitivity of women, but that's never talked about. You are told that circumcision is just part of life for a girl from a good home - no questions are asked.

Rosalie and Monique are health workers for the aid agency PLAN International. They have called a public meeting to try and uproot some of the myths surrounding circumcision. Here it is widely believed that it makes women ‘clean and attractive'. Some say that a woman's clitoris can make a man impotent. Such rumours thrive in the bush where modern science is still distrusted.

A public meeting is a big event here.  Some of these villagers have walked for two hours. Among them are farmers, midwives, spiritual leaders and village chiefs. It's the first time they've discussed circumcision openly.

There's also got to be enough money for the hen. It's going to be slaughtered in Koura's honour. Everybody is excited about the ceremony, but Koura would prefer to go to school today.

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We are born into it.  Our mothers excised us, that's why we do it to our children, because we think that it will be good for them like it is for us.  That's why we do it.

Thanks to the power of the ancestors, the traditional midwife brought the baby back to life. I saw how she spat water at him. Just water - how did she manage to bring the baby back to life with just water? I know that her magic was in it.

Koura has seen it done many times before. In her culture it's like having a birthday, except her celebration includes a voodoo magician with a sharp razor blade. Koura is about to be circumcised.

The woman who circumcised Koura translates the word of the ancestors into language the rest of the village can understand.

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The ritual has been performed correctly. For everyone it's a relief. Koura as an uncircumcised pubescent teenage woman was something for the whole village to worry about.

Rissola and her husband Safiou have a modern marriage. He's the financial manager at the biggest cotton factory in Togo. Nobody knows he married an uncircumcised woman - even his own family. Many uncircumcised women are shunned by society as impure.

They are worried. They think we are going to come with the police to stop them. But we've told them that this isn't the case. And there are also religious heads at the mosque who preside over marriages.  We've also explained things to them and they are trying to make women aware too. So we've seen fewer cases of clitoral mutilation, but it's not dying out. People continue to do it in secret.

Koura is at least spared this. After her wound has healed, she'll wait a few days for a purification ceremony, which will make her ready for marriage. For now she can relax a little.

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In East Africa religion often appears to prop up the tradition of female circumcision. Many Muslim women wrongly believe that it is advocated by the Koran.

Akim Banabesse visits this mainly Muslim village to help a voodoo priestess in the delivery of a child. Expectant mothers go to see Akim for check-ups, but when the contractions start, they prefer to turn to their traditional midwife.

Women are starting to change their minds about circumcision but Akim Banabesse has a long way to go before all rural women are convinced that circumcision must stop.

Midwife Akim Banabesse also wants to underline the physiological problems that can be caused by circumcision. Today she's invited traditional healers and magicians to a meeting at her clinic. She wants to impress on them that circumcision can lead to hemorrhaging, infection and disease, sometimes with fatal consequences.

This morning it's drizzling. The teenager lies down on the ground on a thin mat. It's right in the middle of the village. Four women hold her down. First the pubic hair around the genitals is roughly shaved off. The clitoris is touched. If it reacts and gets bigger it's believed the girl's already had sexual intercourse.

In my role as a midwife I have become a teacher for women and young girls. I've wondered why so many women here die during childbirth. We have confirmed that the problem of excision has got worse. So now  we are trying to make women aware. We want to understand why they accept being circumcised and what the consequences are.

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She is one with the dead and can pass messages to and fro - for a little money. Money naturally plays a big part. She earns $1-2 for the service. And in Togo that's a lot but it's a  cost most Togans would be sure to have saved for, as if it were a wedding. If the girl has already had sexual intercourse, Abatani charges a higher price.

The job is done and everybody is happy. Another of the village children becomes a woman. Koura, at the age of 15, is now ready for marriage.

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In the Sudan - Africa's largest country - circumcision has been officially banned since 1941 but more than 80% of Sudanese women today are still circumcised. This despite the government's insistence that it remains opposed to the practice.

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On reflection no, it's in the past now.  If you see something that isn't good you don't have to do it just because it is tradition.  There are a lot of traditions we have let go, and we are still healthy.  This also is tradition but it is not impossible to let it go so we'll abandon it.

And the women agree. The fact that their ancestors did it is their strongest argument. Why change what's been going on for hundreds of years?

Circumcision thrives on ignorance and superstition. And it's mostly health workers and midwives who are relied upon to educate rural women. But they too can be prone to the pull of traditional beliefs.

There are about 100 million girls living across Africa and the Middle East today who have been circumcised. Their clitorises have been cut out in order to deny them any chance of sexual pleasure. It is practiced by Muslims, Christians and Animists alike and it takes place in more than 30 countries.

In it, a doctor returns home just in time to stop his daughter being circumcised by her grandmother - but her friend has already bled to death.

Koura, like most of the women here, has no idea what function the clitoris performs. She only knows that her ancestors did it, and she must obey the ancestors.

Sitting in the meeting today are villagers of all religions. Circumcision is a custom borne out of centuries of male domination, regardless of the prevailing religion. The men of this village  are being asked to give up not only an entrenched tradition, but also their power over the womenfolk .

When the film ends, the audience is subdued. In one hour, a scratchy film viewed from the dust, has challenged the traditions and myths of ages.

It's like we have already said here, it's to make women dependent, to make them weaker. So we can dominate them and make them stay at home.

Most of the women in the village have come out, from all generations. Abatani the circumcisor has made sure the whole village knows about Koura's coming of age and that they all celebrate her circumcision. It would be an affront to Koura if they did not. It's by such means the practice has become enshrined in village life. And all the more difficult to stamp out.

There is no anesthetic and the razorblade isn't sterile. Koura is lucky. Some circumcisions are done with can tops, stones , saw toothed knives or pieces of glass. Koura is just one of an estimated two million girls who go through this experience every year. 15% of them will die as a direct result.

We prefer women not excised because there is a difference between excised and not excised women. Why is there a difference? When you are having sex with an excised woman it's like having sex with a mat.  There is no pleasure.