Health, fitness and Food

Understanding Female genital mutilation

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Female genital mutilation (FGM) has its roots in African tradition. There are different types of FGM ranging from partial to complete removal of the clitoris as well as other procedures including “pricking, piercing, incising, scraping and cauterizing the genital area”. The removal of healthy tissue not only interferes with the natural functions of girls’ and women’s bodies but often results in immediate acute pain, shock, severe bleeding, and bacterial infection as well long term recurrent urinary tract and bladder infections, complications in childbirth and often leads to painful sexual intercourse. UNICEF estimates that “at least 120 million girls and women have undergone FGM in Africa and the Middle East”.

Thankfully the popularity of FGM is declining however, up to 30 million girls may still be at risk, with “more than 90 per cent of women aged 15–49 years having been ‘cut’ in Djibouti, Egypt, Guinea and Somalia.” Although FGM is illegal in the UK, it is difficult to ensure that families don’t encourage the tradition especially as it is common among migrants from the aforementioned areas to send young girls back to their ancestral homelands to undergo the procedure, usually over the duration of the summer holidays. According to Human rights organization Equality Now it is estimated that “66,000 women and girls have undergone FGM in England and Wales” and up to “24,000 girls under the age of 11 are at risk of undergoing it”. The Evening Standard carried out a Freedom of Information request which found that “over 2,100 women and girls in London have sought medical treatment for female genital mutilation since 2006, with 708 of those needing to be admitted or have surgery.”

Zarah Hassan a devout Muslim living in the UK believes that the barbaric tradition continues to be perpetuated because of the mistaken belief that the practice is rooted in the Koran. She says “sometimes you cannot differentiate what is culture and what is religion: you might think this is the way you have to live.” Zarah actively works with Christian-based charity Initiatives of Change in re-educating her community by encouraging families in the Diaspora not to cave in to immense pressure they face from family members back home who demand they conform and continue the practice.

Pointing out the power exerted by grandparents she says “we have this culture that even if you are a parent, your mother and father are your decision-makers. But if that is the case, don’t take the children out there (to stay with the family over the holidays)”… “I know some grannies who are very powerful, and they will do it (have the girls circumcised) with or without the parents’ consent.” Speaking of some of women she works she says “often, they tell me: ‘My mother is phoning me from back home, telling me it is good to have my daughter circumcised while she is young, under five. She is forcing me.’” As a 51 year old woman who has also been ‘cut’, she believes it is an age old method of controlling women “…it was a form of power-gaining. Men wanted to show the power they have, because when (the vagina) is stitched together, a very narrow gap is left and the man shows his power when he presses there.” She speaks of the ongoing pain suffered during intercourse. Horrifyingly this agony is often re­lived by some women, who are subjected to “re-infibulation”. Re-infibulation is the process of sewing up the vagina again following childbirth, thus exposing the woman to further pain, health risks and undue complications which may result from repeated interfering with the vagina. This is often carried out by the older women, challenging the notion that it is only men who are the perpetrators of this cruel tradition.

It is commonly believed that removing the clitoris controls women’s sexual desire and behavior. It supposedly protects her honour and virginity however; it has no credible health benefit or religious basis. In countries such as Egypt where it is banned and indeed condemned by the Christian Coptic Church together with the leading Muslim authority Al-Azhar, prevalence remains high with a rate of 91% of 15 – 49 year old women having undergone the procedure according to UNICEF, indicating that attitudes are still to change. Indeed until the 1950s, FGM was even performed in England and the United States as a common “treatment” for lesbianism, masturbation, hysteria, epilepsy, and other so-called “female deviances” according to Koso­Thomas. Clearly this method of chastity is effective because a study carried out in Sudan in 1981 found that 50% of 1,545 women who had undergone the operation said “they did not enjoy sex at all and only accepted it as a duty…” a clear indicator that FGM may have a detrimental effect on women’s sexuality.

Hardly surprisingly when FGM oftentimes involves complete removal of the clitoral hood, clitoris, labia minora, and labia majora and/or stitching/narrowing of the vaginal opening. Ill-founded claims that it ensures cleanliness, preserves virginity, prevents promiscuity and excessive clitoral growth need to be challenged. It can hardly enhance male sexuality as it commonly thought when the vaginal opening is often so narrow as to prevent penetration altogether! “5.5 percent of women experienced painful intercourse while 9.3 percent of them reported having difficult or impossible penetration.” And far from facilitating childbirth by widening the birth canal “the highest maternal and infant mortality rates are in FGM­practicing regions” thus detreminentally affecting the lives of even the unborn.

More education is needed to alert men as to the severity and consequences of the practice. Some think it is comparable to male circumcision, not so. FGM is far more drastic as it “destroys much or all of the vulva nerve endings.” Male circumcision involves removal only of foreskin, albeit the part with the highest concentration of nerve endings. Some argue that if female circumcision were done in a sterile hospital room, it would be very much the same as that of a male child however, that argument is a non starter as even male circumcision has already been proven to have long-term physical and psychological effects. So circumcision as a whole leaves a sour taste in everybody’s mouth. However a lot more needs to be done to stop the lives of young girls and women being put at risk.

In 2007 two girls died post operation, followed by 13-year old Nermine El-Haddad who bled to death in a hospital room following the procedure, in 2010. The issue has again risen to the fore following the recent death of Sohair al Bata a 13 year old Egyptian girl who suffered “a sharp drop in blood pressure resulting from shock trauma” and subsequently never woke up. As data is not readily available it is difficult to determine actual death rates and according to Koso-Thomas “where medical facilities are ill-equipped, emergencies arising from the practice cannot be treated… a child who develops uncontrolled bleeding or infection after FGM may die within hours.” According to Path studies carried out “in areas in the Sudan where antibiotics are not available, it is estimated that one-third of the girls undergoing FGM will die.” Furthermore, “conservative estimates suggest that more than one million women in Centrafrican Republic (CAR), Egypt, and Eritrea, the only countries where such data is available, experienced adverse health effects from FGM”. Path also found that “there is a direct correlation between a woman’s attitude towards FGM and her place of residence, educational background, and work status” Research indicated that urban and employed women with secondary or higher education are less likely than their rural counterparts to support FGM. Meaning that the way to bring about change is to educate and empower these women.

Wrong ideology needs to addressed and challenged. FGM needs to be taken out of the religious and cultural context and treated as a human rights and child protection issue in order to make perpetrators fully accountable. It is worrying that even though it is illegal in several countries not a single perpetrator has ever been brought to justice. A number of countries ratified or at least adopted The Maputo Protocol (TMP) following the “Assembly of the African Union”.

TMP promoted women’s rights and called for an end to FGM as well as right to abortions. Fast forward to today and the UN has introduced a Global Ban on FGM. Furthermore in the UK Prevention of Cruelty to Children (NSPCC) now considers it to be a child protection issue.

Keir Starmer, the Director of Public Prosecutions (DDP), QC, recently published an Action Plan aimed tackling the problem in the UK.

But it is still very much an exploratory plan rather a provision of concrete solutions because data is very limited. It will throw further light on the issue to enable us to come up with more direct, conclusive solutions, such as demanding greater accountability from parents who send their children abroad for the procedure. Initiatives such as the ‘health passport’ offer a glimmer of hope however they are yet to be tested fully and rely too heavily on cooperation from distant relatives who have been shown to be uncooperative. Thankfully, awareness is increasing.

If you are worried about a child affected or in danger of being affected by FGM please contact NSPCC 0800 028 3550 for information and support.

Alternatively, contact Women’s Aid on 0117 944 4411



By Katasi Kironde

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