Female Genital Schistosomiasis (FGS) is one of the most overlooked health challenges affecting women and girls across sub-Saharan Africa, including Liberia. Caused by parasitic infection from contaminated freshwater, FGS can lead to chronic pain, infertility, and increased vulnerability to other infections including HIV. The effects on family life, mental health, livelihoods and social participation can also be profound. Yet despite its serious consequences, FGS remains widely underdiagnosed, misunderstood, and untreated.
FGS remains so often unseen for a simple but critical reason: most people have never been taught to recognize it. Women and girls may live with symptoms for years without knowing what is wrong or that care is within reach. At the same time, many healthcare providers have not received the training needed to identify FGS, especially since its symptoms closely resemble other reproductive health conditions. This gap in awareness leads to misdiagnosis, delayed care, and ongoing stigma, leaving too many women without the support and dignity they deserve.
For Justina, a woman affected by FGS in Nimba County, Liberia, a lack of awareness about the symptoms of FGS and treatment options had devastating consequences. She was frequently misdiagnosed and endured years of pain. When properly diagnosed, FGS can be treated with a short course of praziquantel, an antiparasitic medication that can stop the infection and help prevent long-term damage.
While praziquantel stops ongoing infection by killing the worms, it cannot always reverse existing tissue damage that has already occurred. This is one reason why community awareness must be part of any plan to address FGS, as early diagnosis and treatment is critical to preventing long-term health consequences.
Access to praziquantel is only part of the solution. In many communities, lack of understanding and misinformation can prevent people from taking treatment even when it is available. Justina described how she had refused praziquantel during earlier community distribution because she and others believed “this medicine not good, it can treat people bad.” She was not unwilling to seek care, but she had not been given clear information about what the medicine was for.
Her experience underscores why community awareness is essential. When people understand the condition, trust treatment, and receive accurate information, medicines like praziquantel can do what they are meant to do.
Unlocking the path to FGS care women and girls can count on doesn’t begin in a clinic, it begins with awareness. This work needs to reach both the community and the health care system, bridging the gaps that keep women from accessing timely and appropriate care.
At the community level, awareness helps break the silence and stigma that so often surround FGS. Many women experience symptoms such as pain or bleeding, but do not recognize them as signs of a treatable infection. Instead, these symptoms can carry shame or be misunderstood, making it harder for women to seek help.
Through awareness and education activities, communities begin to see FGS for what it is, a treatable condition caused by a parasite, not the women themselves. Women are empowered with knowledge about their bodies and encouraged to seek care earlier.
At the same time, awareness within the healthcare system is essential to ensure that care is not only available, but accurate and compassionate. Many frontline health workers in Liberia have had limited or no training on FGS, which makes it difficult to identify and treat the condition correctly. Because FGS symptoms often resemble other reproductive health conditions, this gap in awareness can lead to misdiagnosis and inappropriate treatment. Investing in training, clinical guidance, and integration into other health services helps ensure that when women come forward, they are met with informed, respectful, and effective care.
When both communities and providers share a deeper understanding of FGS, the barriers keeping women from accessing care begin to break down.
Liberia’s new national strategy on this issue recognizes that awareness, prevention, screening, diagnosis, and treatment must be integrated into a coordinated response. This includes training healthcare workers, equipping facilities, and embedding FGS education into sexual and reproductive health services.
Awareness is what connects women to care. It builds understanding, reduces stigma, and equips health workers to respond with confidence and compassion. Without it, solutions remain out of reach for the women who need them most.
Learn more about the work we are doing to address FGS in Liberia, in partnership with the Liberian Ministry of Health and Unlimit Health.
