A 10-year-old girl died after undergoing female genital cutting during a mass initiation ceremony into a women’s secret society in Sierra Leone, Reuters reported on Wednesday, quoting police officers.

“She died of blood loss,” said Amadu Turay, unit commander of the police division in the country’s northern Tonkolili district, around 250 kilometres from the capital Freetown. Turay added that the woman in charge of the ceremony has been arrested and a police investigation is on.

According to an unidentified local activist, 67 other girls were also reportedly initiated and will undergo a medical examination.

Former minister Rugiatu Turay said that a number of women, including the dead girl’s mother, are on the run, The Guardian reported. She said that the girl had completed her examinations for year five when she was taken to the initiation.

“As soon as she dropped the pen, she was taken away,” said Rugiatu Turay. “This is the second time that a girl has died in that family: one of the sisters died of excessive bleeding after being initiated two years ago, and the father was against it this time, but the mother is the breadwinner in the family and she wanted it.”

Rugiatu Turay said that three other girls involved in the ceremony, aged between 10 and 11, were taken to a police station for questioning.

Sierra Leone has one of the highest rates of female genital cutting in Africa, according to the United Nations, and is widely practised. It is most prevalent in the countries of Somalia, Guinea and Djibouti.

The ritual removal of female genitalia is a dangerous process and is usually carried out without anaesthesia. The practice differs according to ethnic groups and countries, but most involve removal of parts of the clitoris and labia and closure of the vulva. It results in severe health problems, including chronic pain, cysts, fatal bleeding, and an increased risk during childbirth.

Earlier this month, Sierra Leone’s President Julius Maada Bio launched a campaign called “Hands Off Our Girls”, which focuses on eliminating rape and child marriage. But the campaign, led by First Lady Fatima Maada Bio, does not mention female genital cutting.