In countries like Guinea, Nigeria and Somalia, the vacation period could be called "cutting season," when the break from school means girls have time to undergo, and recover from, female genital mutilation (FGM).

In her community in Somalia, she is a circumciser, a role she inherited from her mother. She supports her family with income from the practice, and is considered the keeper of a cultural tradition. “Circumcision is important as a transition to adulthood," she said.

They are usually 7 to 10 years old. But she sometimes cuts girls visiting Somalia from abroad, who tend to be a little older. “It is a bit cumbersome to carry out the procedure on tissue that is more mature,” she said.

This practice can cause significant and long-lasting medical problems, including haemorrhage, infection, complications in childbirth and even death

When her own daughter was cut seven years ago, the girl developed an infection and has never fully recovered.

She uses a new razor for every girl she cuts, and she treats their wounds with a powder she creates out of traditional herbs and antibiotic capsules.

Her other tools include lidocaine, disposable syringes and cotton wool. She says she pours raw egg onto the wound to promotes healing, then uses a thick thread to sew the girls closed. Afterward, she cleans up with methylated spirits.

Her granddaughter is due to be cut this season, but the procedure has been delayed because the girl has been ill.

Her daughter died in childbirth at age 17; the baby died as well. Ms. Ismail blames FGM. “I have since banned all my 10 female grandchildren from being cut,” she said.

The school – as well as local organizations, religious leaders and youth – have partnered with UNFPA to encourage community members and policymakers to abandon the practice.

The institute’s midwifery curriculum was recently revised, with help from UNFPA, to cover the wide range of problems that can occur due to FGM.

Sheikh Almis Yahye Ibrahim preaches about the harms of FGM to roughly 5,000 people at his mosque. He is one of six sheikhs in the Arab region who have formed a network calling for FGM’s abandonment.

In Hargeisa, youth activists with the group Y-Peer talk to health workers, community members and other young people about ending FGM. “I wouldn’t marry any girl who has undergone FGM because I don’t want to live with the health complications,” said Mustafa, one of the youth activists.