Lawmakers in the West African nation of Gambia on Monday rejected a Bill that would have overturned a ban on female genital mutilation.

The attempt to become the first country in the world to reverse such a ban had been closely followed by activists abroad.

The vote followed months of heated debate in the largely Muslim nation of fewer than three million people.

Lawmakers effectively killed the Bill by rejecting all its clauses and preventing a final vote.

The procedure includes the partial or full removal of girls’ external genitalia, often by traditional community practitioners with tools such as razor blades or at times by health workers.

It can cause serious bleeding, death and childbirth complications but remains a widespread practice in parts of Africa.

Activists and human rights groups were worried that a reversal of the ban in Gambia would overturn years of work against the centuries-old practice that is often performed on girls younger than five, and is rooted in the concepts of sexual purity and control.

Religious conservatives who led the campaign to reverse the ban said the practice was “one of the virtues of Islam”.

“It’s such a huge sense of relief,” one activist and survivor, Absa Samba, told The Associated Press after the vote, as she celebrated with others in front of parliament.

“But I believe this is just the beginning of the work.”

Fatou Baldeh, another activist and survivor, said she woke up that morning crying.

“Why have we been put through this for 11 months?” she asked, her voice shaking. “Why have we been forced to relive our traumas? Just because men didn’t believe that female genital cutting harmed us.”

She added: “And right now, girls are still being cut. I hope this time it is not just a law for decoration.”

In Gambia, more than half of women and girls aged 15 to 49 have undergone the procedure, according to United Nations estimates.

Former leader Yahya Jammeh unexpectedly banned the practice in 2015 without further explanation.

But activists say enforcement has been weak and women have continued to be cut, with only two cases prosecuted.

Even now “it was widespread and there was public promotion of it”, Ms Samba said. She called for more public education about the health consequences of the practice.

Unicef earlier this year said some 30 million women globally have undergone female genital mutilation in the past eight years, most of them in Africa but others in Asia and the Middle East.

More than 80 countries have laws prohibiting the procedure or allowing it to be prosecuted, according to a World Bank study cited earlier this year by the United Nations Population Fund. They include South Africa, Iran, India and Ethiopia.

“No religious text promotes or condones female genital mutilation,” the UNFPA report said, adding there is no benefit to it.

Long term, the practice can lead to urinary tract infections, menstrual problems, pain, decreased sexual satisfaction and childbirth complications, as well as depression, low self-esteem and post-traumatic stress disorder.