JOHANNESBURG (AP) – A 10-year-old girl has bled to death after undergoing female genital mutilation in Somalia, an activist said, a rare confirmed death in the country with the world’s highest rate of the practice.

The girl died in a hospital on Monday, two days after her mother took her to a traditional circumciser in a remote village outside Dhusamareb town in central Galmudug state, Hawa Aden Mohamed with the Galkayo Education Center for Peace and Development said in a statement.

“The circumciser is suspected to cut an important vein in the course of the operation,” Mohamed said.

About 98 percent of women and girls in the Horn of Africa nation undergo female genital mutilation, according to the United Nations. While Somalia’s constitution prohibits the practice, Mohamed said no laws have been enacted to ensure that those who perform the circumcisions are punished.

Lawmakers are “afraid of losing their political clout among the all-powerful conservative traditional and religious groups bent at retaining the practice,” she said.

Health workers have warned against the risks of the practice which in most cases the external genitalia is removed and the vagina is sewn almost closed.

Despite campaigns in Somalia against the practice it is “clouded in secrecy, so reducing it has been a massive challenge,” said Brendan Wynne with the New York-based Donor Direct Action, which connects women’s activists worldwide.

Over 200 million women and girls in 30 countries across three continents have experienced genital mutilation, U.N. Secretary-General Antonio Guterres said earlier this year, calling it a “gross violation of the human rights of women and girls.”

The U.N. Population Fund projects that the estimated 3.9 million girls subjected to genital cutting every year will rise to 4.6 million by 2030 due to expected population growth unless urgent action is taken.