Despite a 1995 law banning the practice, about 98% of women and girls in Djibouti have undergone the extreme form of female circumcision, according to official figures. First lady Kadra Mahmud Haid called for it to stop.
"These practices are not gone," she told the opening session of a regional conference on the issue in Djibouti on Wednesday.
Worldwide "an estimated two million young girls a year, 6000 per day, still undergo these mutilations in all their forms," she said, noting that most operations are done outside of hospitals in unsanitary conditions, without anesthesia and result in serious pain and often deadly complications.
"The consequences are dramatic, it can cause death by haemorrhage, urinary infections, cysts and childbirth difficulties, not to mention psychological damage," she said.
As in most nations in the Horn of Africa, excision in Djibouti involves slicing whole or part of external female genitalia, then stitching the wound, leaving a tiny opening for passage of urine or menstrual flow.
On Thursday, Djibouti is expected to sign the African Union's 2003 Maputo Protocol on the rights of African women, which among other things commits signatories to speed efforts to stamp out female genital mutilation.
"We need a synergy of action and firm engagement by politicians, lawmakers, civil society, doctors, media and imams to bring about the elimination of female genital mutilation"
Kadra Mahmud Haid,
First Lady, Djibouti
European Parliament member Emma Bonino, who is attending the conference, lamented the fact that only six of 33 African and Arab nations that expressed support for the protocol had actually ratified the accord.
"We need a synergy of action and firm engagement by politicians, lawmakers, civil society, doctors, media and imams to bring about the elimination of female genital mutilation," she said, calling for there to be zero tolerance for the practice.
About 300 participants from Eritrea, Ethiopia, Somalia, Sudan, Yemen and Islamic scholars from Egypt's Al-Azhar University are attending the two-day meeting in Djibouti sponsored by the UN children's agency.