The most severe form known as infibulation, and performed about 15 per cent of the time is what happened to Derie. All of the external sexual organs are scraped away, and the wound is sewn closed with acacia thorns, catgut, silk or a homemade glue, with a matchstick-sized hole created to pass urine. Women are cut or forced open on their wedding night, cut open more to give birth, then sewed up again. In a way, Derie was lucky she survived. One of her sisters and a cousin didn't.
Many girls die from haemorrhaging, shock, infection of tetanus.
In the aftermath, Derie was severely depressed. Her legs were tied together from hip to ankle for weeks to keep her ripping open the wound. Urination was excruciating, and she became infected. She couldn't eat for a month. As she grew older, Derie refused to accept her fate as a Somali woman.