Female Genital Mutilation

Amnesty International estimates that over 130 million women worldwide have been affected by some form of Female Genital Mutilation (FGM) with over 2 million procedures being performed every year. But what exactly is FGM, why is it practiced and why is there so much controversy about it?

According to Wikipedia:

Female genital cutting (FGC), also known as female genital mutilation (FGM) or female circumcision, refers to “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural, religious or other non-therapeutic reasons.”

In other words it is the disfigurement of a woman’s private parts for non-medical reasons. It is practiced in many parts of the world but primarily in Africa, the Middle East and Indonesia. The traditional cultural practice of FGM predates both Islam and Christianity. A Greek papyrus from 163 B.C. mentions girls in Egypt undergoing circumcision and it is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs.

The procedure is now practiced among Muslims, Christians, and Animists. Some African societies consider FGM part of maintaining cleanliness as it removes secreting parts of the genitalia. However, just the opposite is true. Vaginal secretions play a critical part in maintaining female health.

There are 4 categories of FGM: Type I, II, III and IV each of which will be described more fully later. Organizations like the WHO have been campaigning for decades to have this procedure stopped. Nevertheless, because of cultural and religious practices it is still popular in many societies.

There have been disagreements about the actual name of the procedure.

• Female Circumcision “implies a fallacious analogy to non-mutilating male circumcision”.

• Female Genital Mutilation (FGM) “may imply excessive judgment by outsiders as well as insensitivity toward individuals who have undergone some form of genital excision.” Parents may resent the suggestion that they are “mutilating” their daughters.

• Female Genital Cutting (FGC) is deemed to be more politically correct because “local languages generally use the less judgmental “cutting” to describe the practice.” Also, so as to avoid alienating communities and demonizing certain cultural and religious practices, “cutting” has been gaining in popularity.

The following video describes FGM as practiced in the African country of Sierra Leone.

As mentioned before there are four categories of FGM: Type I, II, III and IV. The diagrams below will help in identifying the parts affected by each of the categories.

TYPE I:

Sunna circumcision in which the prepuce (the clitoral covering) is removed, along with part or all of the clitoris. This is called Clitoridectomy, Sunna, meaning removal of the clitoris in the tradition of the Prophet Mohammed. It is called “Sunna Kashfa” (Open Sunna) in Sudan. This is found most commonly in West African countries like Burkina Faso, Mali, Nigeria, and Senegal.

TYPE II:

Excision: The entire clitoris and prepuce are removed, along with all or part of the labia minora. This is called “Sunna Magatia” (Closed Sunna) in Sudan. It is most commonly found in Burkina Faso and Sudan.

TYPE III:

Infibulation(a.k.a. Pharaonic circumcision): This involves removal of the clitoris and prepuce, followed by sewing up of the vulva. A small opening is left to allow urine and menstrual blood to pass. A second operation is done later in life to reverse some of the damage.

In some cultures, the woman is cut open by her husband on their wedding night with a double edged dagger. She may be sewn up again if her husband leaves on a long trip. During childbirth, the enlargement is too small to allow vaginal delivery, and so the infibulation must be opened completely and restored after delivery.

A five-year study of 300 women and 100 men in Sudan found that “sexual desire, pleasure, and orgasm are experienced by the majority of women who have been subjected to this extreme sexual mutilation, in spite of their being culturally bound to hide these experiences.” Many infibulated women will contend that the pleasure their partners receive due to this procedure is a definitive part of a successful marriage and enjoyable sex life.This is often referred to as Pharaonic or Sudanese circumcision. It is the most extreme form of FGC, and accounts for about 15% of all FGC procedures. It is most commonly practiced in Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Mali, Somalia and Sudan.

TYPE IV:

There are also various other practices, which may or may not involve any tissue removal at all, including stretching of the clitoris and/or labia, burning of the clitoris and adjacent tissues by cauterization, scraping of the vaginal orifice, cutting the vagina, placing corrosive substances or herbs in the vaginal in order to tighten it. Type IV is found primarily among isolated ethnic groups as well as in combination with other types.

Health Risks:

A recent study by the WHO found that women who have undergone FGM were more likely to have difficulties during childbirth and that the babies themselves were more likely to die. The study involved 28,393 women at 28 obstetric centers in six countries, where FGM is common – Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. The centers varied from relatively isolated rural hospitals to teaching hospitals in capital cities. They were chosen to provide appropriate diversity of types of FGM.

Serious complications during childbirth include the need to have a cesarean section, dangerously heavy bleeding after the birth of the baby and prolonged hospitalization following the birth. The study showed that the degree of complications increased according to the extent and severity of the FGM.

In the case of cesarean section, women who have been subjected to the most serious form of FGM (“Type III“) will have on average 30 per cent more caesarean sections compared with those who have not had any FGM. Similarly there is a 70 per cent increase in numbers of women who suffer from postpartum haemorrhage in those with Type III compared to those women without FGM.

The study also found that FGM put the women’s babies in substantial danger during childbirth. Researchers found there was an increased need to resuscitate babies whose mother had had FGM (66% higher in women with FGM Type III). The death rate among babies during and immediately after birth is also much higher for those born to mothers with FGM: 15% higher in those with FGM Type I, 32% higher in those with FGM Type II, and 55% higher in those with FGM Type III. It is estimated that an additional 10 to 20 babies die per 1000 deliveries as a result of the practice.

“This research was carried out in hospitals where the obstetric staff are used to dealing with women who have undergone FGM. The consequences for the countless women and babies who deliver at home without the help of experienced staff are likely to be even worse,” added WHO’s Dr Paul Van Look, Director of the Special Programme for Human Reproduction Research (HRP) which organized the study.

Cultural and Societal Factors:

Given the brutality of the procedure and the permanency of the disfigurement to a woman’s body; the obvious question is WHY?? WHY is this procedure even permitted and WHY is it still prevalent in many countries?

The World Health Organization(WHO) and other similar international organizations have been for decades waging a battle to have the practice of FGM stopped. There are however significant cultural and societal obstacles that promote and perpetuate FGM. These include:

• Psycho-sexual reasons:

Reduction or elimination of the sensitive tissue of the outer genitalia, particularly the clitoris, in order to attenuate sexual desire in the female, maintain chastity and virginity before marriage and fidelity during marriage, and increase male sexual pleasure;

• Sociological reasons:

Identification with the cultural heritage, initiation of girls into womanhood, social integration and the maintenance of social cohesion;

• Hygiene and Aesthetic reasons:

The external female genitalia are considered dirty and unsightly and are to be removed to promote hygiene and provide aesthetic appeal;

• Religious reasons:

Some Muslim communities, however, practice FGM in the belief that it is demanded by the Islamic faith. The practice, however, predates Islam.

The justification for the operation appears to be largely grounded in a desire to terminate or reduce feelings of sexual arousal in women so that they will be much less likely to engage in pre-marital intercourse or adultery. The clitoris holds a massive number of nerve endings, and generates feelings of sexual arousal when stimulated.

Parents in those cultures where FGM is common often feel that it is the only way to guarantee that their girl children will remain “pure” until marriage. This belief is so strong that it can overcome the dangers to the girls: some do not survive the blood loss during the operation; others die from infection; most suffer life-long complications.

Uncircumcised women in countries where FGM is normally performed have difficulty finding a marriage partner. Men typically prefer a circumcised wife because they are considered more likely to be faithful.

FGM in AFRICA:

There are many countries in Africa that practice FGM, some of which continue the practice even though there are laws on the books against it. Although precise figures are hard to come by, the following indicates some of the countries where FGM is prevalent:

Somalia (98%) Djibouti (98%) Eritrea (95%) Mali (94%) Sierra Leone (90%) Sudan (90%) Egypt (85-95%) Ethiopia (70-90%) Guinea (65-90%) Nigeria (60-90%) Gambia (60-90%) Chad (60%) Kenya (50%) Liberia (50%)

In 14 African countries at least half the female population practice FGM. In most of these countries where some form of legislation exists against FGM, it is poorly prosecuted, if at all. See Basic Country FGM Facts for a country by country breakdown.

STORIES:

The following stories come from 4 Kenyan girls affected, one way or another, by FGM.

Grace’s Story

Grace starts by saying that FGM is very painful. She was only 12 years old when she was taken from her grandmother’s house at 5 am. They took her to the river she recalls how cold the water was, in order to numb her body. She was taken with other girls of her age. She went first; she was naked and had to sit on a special stone. A very strong woman covered her eyes and mouth. “If you scream, you bring omen in your family.”

The knife came down and it was painful, it wasn’t too sharp and cut everything off. The pain was so bad it went into her head. She was in the house for over a month and desperately ill when they took her to the hospital, looking for medication. Grace felt how inhumane it is, so she will never do it against her daughters’ wishes. God blessed her with 3 girls and she has kept her promise. Her daughters are adults now, almost married and performing well at school.

When the wound is healed, Grace continues, there is a scar that isn’t flexible. Therefore it is dangerous to give birth at home. Even the delivery in hospital is extremely painful. “For those of you that think about circumcision for yourself or daughters; DON’T DO IT!” she said.

Ester’s Story

Esther begins, “We are conquerors. We were given information and insight into FGM but it was difficult to resist the rite. We were seen as sources of friction in the community, we had a big problem with our grandmother who talked about it for years. I could resist because I was educated.”

Esther couldn’t stay with circumcised girls but persevered even after the other girls shut her out. Circumcised girls were brought gifts and good clothing but she wasn’t given anything. One day, she went to her cousin to talk about FGM.

“My grandmother came for my cousin forcefully but she resisted with the help of my parents. The community came as the girl screamed and said we brought shame to the community. It created conflict between family members as the cousin stayed with me. People said we will become prostitutes and smell, but that didn’t shake us. Now we say we are conquerors. Join your hands together and say no to FGM!!”

Zipporah’s Story

“I was brought up in a Christian family and I knew that one day I would be circumcised. When my time came my mum said. ‘Read from the Bible. Genesis 17 where Abraham was circumcised.’ In the old days only boys were circumcised. The Bible doesn’t say that girls should be circumcised. Mum said it was painful when she give birth to me. At that time I was so young I didn’t even know where babies came from. So we were left out while all the other girls were circumcised. This meant that I didn’t have any gifts and was teased at school and on the field. I couldn’t even speak to the teacher about it, but mum did. As a result the girls who teased me were caned. Since then they started using my proper name and never teased again.

Zipporah goes on seminars into communities to inform parents in the fight against FGM.

Nurse Mary’s Story

“Very young girls came to the hospital in the early hours. I put them in a small bed, washed my hands and put gloves on. I would disinfect and anaesthetize the vagina before cutting off the clitoris with a knife and scissors. Then I put disinfectant on the wound to prevent infections. Today we have come to say no to FGM because there are so many complications afterwards, for example, urine tube infections, HIV/Aids, hepatitis, and tetanus.

“Circumcised women do not enjoy sex with their husband, leading to broken families. The men go to the cities to look for women who aren’t circumcised, let’s put our hands together to fight against FGM.”

The following video is an interview with super model Waris Dirie who, herself, is a victim of FGM. She has written a book about her experience and is an outspoken advocate against the procedure.

Changing Attitudes:

Attitudes towards FGM are slowly changing. Campaigners have tried for decades to bring an end to FGM. But their tactics of providing alternative employment to the circumcisers, introducing alternative rites of passage for girls, or demanding legislation to outlaw the practice have all failed to make a dent: an estimated 2 million girls in about 26 African countries are circumcised every year. There is however a movement started in Senegal that is gradually spreading and making a difference:

Back in 1997, 13 Senegalese villages publicly declared that they would no longer permit female circumcision, or female genital mutilation. In the eight years since, the number has grown to 1,527, representing 30 percent of Senegalese communities where FGM has been practiced. Dozens more villages are preparing to make similar declarations.

The change in Senegal is being credited to a slow but steady program of human rights education that allows villagers to make up their own minds about whether to abandon female circumcision. Spearheaded by a local rights agency called Tostan, the program’s success is proving so eye-catching that the United Nations Children’s Fund (UNICEF) is endorsing it as a model.

“The Tostan approach is working because it’s a holistic approach, and it works with communities,” says Lalla Toure, UNICEF’s regional adviser for women’s health. “The starting point is not female genital mutilation; it’s about rights, it’s about health, it’s about development. We think that’s the best approach.”

The program is being replicated with some success in Guinea, Burkina Faso, and Mali, and is currently being considered for one of the strongholds of FGM, Somalia, where nearly 100 percent of girls are circumcised. It’s this same power of social conformity that is helping the campaign to end FGM in Senegal. As more villages publicly announce that they are abandoning the practice, Tostan says others begin realizing it may no longer be a marriage requirement, momentum builds, and the number of villages following suit snowballs.

“People are realizing that the social convention is changing,” says Molly Melching, the Texas-born director of Tostan who has lived in Senegal for more than two decades.

The birthplace of the Tostan approach, Ker Simbara, Senegal, eventually declared in 1999 that its citizens would no longer practice female circumcision. Ramata Sow, who staffs the local clinic and nursery illustrates the transformation. She circumcised her eldest daughter, but her two youngest, Sadio, 13, and Nabou, 7, and her granddaughter Duma, 2, are not circumcised.

“I will never do it again,” she declares. “Things have changed.”