"I lay in a pool of blood. After a few days, the bleeding stopped, and the daya [midwife] peered between my thighs and said, 'All is well. The wound has healed, thanks be to God.' But the pain was there, like an abscess in my flesh."
The 80-year-old feminist activist has been shortlisted for tomorrow's Women of the Year awards after spending the past 60 years campaigning for an end to the barbaric practice of female genital mutilation (FGM), which has been suffered by 140 million women worldwide. An estimated two million girls are at risk each year. She was able to protect her own daughter from the practice, and her fight to "create awareness and unveil the mind" has saved many others.
"I have been fighting against this since medical college, but the political system, especially under [Anwar] Sadat and [Hosni] Mubarak, encouraged religious fundamentalists," she says. "When you have increasing power of religious groups, oppression of women increases. Women are oppressed in all religions."
She has written 47 books tackling problems faced by women in Egypt, including Women and Sex in 1972, for which she lost her job as director of public health for the Egyptian Ministry of Health. In the early Eighties, Dr El Saadawi – whose medical training was followed by work as a psychiatrist and university lecturer – spent three months in jail for "crimes against the state". She wrote her memoir of life in a female prison with eyeliner on toilet paper while behind bars.
She lectures on FGM and feminism, encouraging people to connect "cutting" with politics, economics, religion, class and history. She equally opposes male circumcision. "As a medical doctor, I don't separate cutting children from a physical, social point of view – cutting a female is more dangerous. People are now very aware of the dangers. They are not aware of male genital mutilation," she says. "It is a piece of an organ, it prevents infections."
But she constantly struggles to get her voice heard in her home country: "I teach in universities all over the world, except Egypt."
In 2008, the Egyptian government passed a law banning FGM, following the death of 12-year-old Badour Shaker in June 2007, during an operation. "When I heard that she died, I wrote an open letter to her parents, saying they should not be silent – they should scream so all the world would hear their voice. They should use the death to educate everybody," Dr El Saadawi says.
She wrote: "Badour, did you have to die for some light to shine into dark minds? Did you have to pay with your dear life a price ... for doctors and clerics to learn that the right religion doesn't cut children's organs?"
Despite the law, Dr El Saadawi believes that about 90 per cent of women are still circumcised in Egypt. "You cannot eradicate such historical, rooted habits by law only," she says. "We need education of mothers and fathers. There is lots of misinformation that cutting children is good, but this is lies."
The practice, started in the 2nd century BC, continues worldwide. Progress in preventing it is slow, and laws banning it often ignored. Senegal is one country where some success has been achieved: since 1997, more than 4,000 communities have given up FGM, and it could be close to eradication by 2015.
In the UK, up to 2,000 British girls undergo genital mutilation during the summer holidays each year. Many are sent abroad, often utterly unsuspectingly, to be mutilated. Others will be cut in the UK, sometimes at group "parties" where several girls will be mutilated at a time.
The Female Genital Mutilation Act 2003 makes it illegal for FGM to be performed anywhere in the world on permanent UK residents of any age. It carries a sentence of 14 years' imprisonment but, to date, there have been no prosecutions.
Naana Otoo-oyortey, executive director of the African diaspora women's charity Forward, believes that the true number of girls at risk in the UK is much higher than official figures suggest, with communities affected including those from Egypt, Sudan, Ethiopia, Eritrea, Somalia, Sierra Leone and Gambia. Political commitment is needed, she says, to engage these communities.
Last week, the Home Office put in a call for funding for work to stop FGM in the UK. A total of £25,000 was allocated for community programmes. In the Netherlands, the government is spending £3m on similar projects, Ms Otoo-oyortey says. "It's insulting. To allocate only £25,000: the Government is sending a message that this issue is not important enough."
A Home Office spokesman said: "Our focus is on prevention, and we have recently launched an FGM fund that can be used by frontline organisations to carry out work on this abhorrent form of abuse, and raising awareness."
Dr El Saadawi agrees that the fight against FGM must begin in the community. "Children should be taught in schools, parents should be educated," she says. "People need to understand this is dangerous for physical and mental health."
She has no intention of scaling down her radicalism now she is in her eighties, and was in Tahrir Square this February as Mubarak was overthrown. On Friday, she will announce an annual international prize in her name, supported with a university scholarship, to be awarded to a dissident revolutionary artist. In an impassioned statement, voiced with the militancy of someone a quarter of her age, she says: "I'm fighting against the patriarchal, military, capitalist, racist post-modern slave system. I am going to fight for this for ever."
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