Point - Counterpoint

Female Genital Mutilation: Maintaining Culture or Sustaining Women's Right to Health

Widely practiced in many countries in Africa and the Middle East, female genital mutilation (FGM) or female circumcision, involves partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons. The often crude and painful operations not only deprives victims of sexual feelings, but may also injure them in ultimately life threatening ways.

UNICEF, the United Nations Children's Fund, estimates that 130 million women, most of them in Africa, have undergone genital mutilation. Each year more than 2 million girls undergo the procedure some of them in infancy, the agency says. FGM in a variety of its forms is practiced in Middle Eastern countries: Yemen, Saudi Arabia, Iraq, Jordan, Syria, and Southern Algeria. In Africa it is practiced in the majority of the continent including Kenya, Nigeria, Mali, Ivory Coast, Egypt, Mozambique, and Sudan. Egypt, Ethiopia. Kenya, Nigeria, Somalia and Sudan account for 75% of cases according to UNICEF. In some countries, as many as 95% of girls are affected. In the United States it is estimated that about ten thousand girls are at risk for this practice.

Because of the large number of cases of FGM and some of the deaths it has caused, FGM is now outlawed in some European countries, specifically Britain, France, Sweden, and Switzerland. More than half a dozen African Nations south of the Sahara have now instituted bans which can be enforced with fines and jail sentences. The procedure is barred in Burkina Faso, the Central African Republic, Djibouti, Ghana, Guinea, Senegal and Togo. Some other countries like Uganda frown on it. In North Africa the Egyptian Supreme Court upheld a ban on the practice last year and also ruled that the practice has no place in Islam.

A CROSS-CULTURAL AND CROSS-RELIGIOUS TRADITION

Even though FGM is practiced in mostly Islamic countries, it is not an exclusively Islamic practice. FGM is a cross-cultural and cross-religious ritual. In Africa and the Middle East it is performed by Muslims, Coptic Christians, members of various indigenous groups, Protestants, and Catholics, to name a few.

In various cultures there are many "justifications" for these practices. A girl who is not circumcised is considered "unclean" by local villagers and, therefore' unmarriageable.

One of the most common explanations of FGM is local custom. Women are often heard saying that they are unwilling to change these customs, since they have always, done it this way. Oftentimes the practitioners are kept ignorant of the real implications of FGM, and the extreme health risks that it represents.

Family honor, cleanliness, protection against spells, insurance of virginity and faithfulness to the husband, or simply terrorizing women out of sex are the primary explanations for the practice of FGM.

THE PERILS TO WOMEN'S HEALTH

FGM has often been compared to male circumcision. However, such comparison is misleading. Both practices include the removal of well- functioning parts of the genitalia and are quite unnecessary. Both rituals also serve to perpetuate customs which seek to regulate and keep control over the body and sexuality of the individual. However, FGM is far more drastic and damaging than male circumcision. A more appropriate analogy would be between clitoridectomy and penisdectomy where the entire penis is removed,

The term FGM covers three main varieties of genital mutilation: 1) Named after the Arabic word for the tradition, "Sunna" circumcision consists of the removal of the prepuce and/or the tip of the clitoris. 2) Clitoridectomy ,also referred to as excision, refers to the removal of the entire clitoris (both prepuce and glans), and the removal of the adjacent labia. 3) infibulation also referred to as pharaonic circumcision. This most extreme form, consists of the removal of the clitoris, the adjacent labia (majora and minora), and the joining of the scraped sides of the vulva across the vagina, where they are sewn with catgut or thread. A small opening is kept to allow passage of urine and menstrual blood. An infibulated woman must be cut open to allow intercourse on the wedding night and is closed again afterwards to secure fidelity to the husband.

One of the major constraints of FGM is that it is often performed in unsanitary conditions. Often it is a midwife using unclean sharp instruments such as razor blades, scissors, kitchen knives, and pieces of glass. These instruments are frequently used on several girls in succession and are rarely cleaned. Antiseptic techniques and anesthesia are generally not used, or for that matter, not known.

Beyond the obvious initial pains of the operations, FGM has long-term physiological sexual, and psychological effects. The unsanitary environment under which FGM takes place results in infections of the genital and surrounding areas and often results in the transmission of the HIV virus which can cause AIDS. Some of the other health consequences of FGM include primary fatalities as a result of shock, hemorrhage or septicemia. In order to minimize the risk of the transmission of the viruses, some countries like Egypt have made it illegal for FGM to be practiced by anyone other than trained doctors and nurses in hospitals. While this seems to be a more humane way to deal with FGM and try to reduce its health risks, more tissue is apt to be taken away due to the lack of struggle by the child if anesthesia is used.

Long-term complications include sexual frigidity, genital malformation, delayed menarche, chronic pelvic complications, recurrent urinary retention and infection, and an entire range of obstetric complications whereas the fetus is exposed to a range of infectious diseases as well as facing the risk of having his or her head crushed in the damaged birth canal. In such cases the infibulated mother must undergo another operation whereby she is "opened" further to insure the safe birthing other child.

Girls undergo FGM when they are around three years old, though some of them are much older than that when they undergo the operation. The age varies depending on the type of the ritual and the customs of the local village or region.

It is also important to note that even though FGM is currently illegal in many countries in Africa and the Middle East, this has not reduced the number of the girls that are mutilated every year. The governments of these countries have no way of monitoring the spread and practice of FGM. However, trying to fight FGM on legal terms is ineffective since those who practice it oftentimes do not report it. FGM is also widely practiced in villages and remote places where the government does not have an easy access.

When women are respected and manage resources in a community, their own and their children's nutrition status improves.

SOURCE: UNICEF, The State of he World's Children, 1998

HUMAN RIGHTS

The United Nations, UNICEF, and the World Health Organization have considered FGM to be a violation of Human Rights and have made recommendations to eradicate this practice. The UNFPA named Somalian super-model, Waris Dirie, Special Ambassador to speak about the horrors of the practice. A native of Somalia, born into a nomadic family, Ms Dirie survived the traditional form of FGM which had already claimed a younger sister and two cousins who died from the procedure.

In the United States there are many efforts that are being made in order to abolish the practice locally and internationally. The National Organization of Circumcision information Resource Centers (NOCIRC), a networking organization have brought together social scientists and medical practitioners from all over the world who are fighting FGM as well as male circumcision. The Washington Metro Alliance Against Female Genital Mutilation in Washington DC has also been targeting FGM risk groups, and provides peer education for African Women by African women in WA Metro Community and interfaces with western health care providers and policy makers. In addition, Si-Kata has brought together the efforts of researchers and organizers around the United States in the hopes of exposing this practice on a national level as well as changing policies.

Education about the practice from the point of view of human rights and women's health counters the perspective of maintaining a tradition regardless of its human cost. As awareness of this practice, its origins and implications, has grown, FGM has started to come to a halt.

SOURCES: National Organization of Circumcision Information Resource Centers (NOCIRC) P.O. Box 2512 San Anselmo, CA 94979-2512, tel: (415) 488-9883; Si-Kata P.O. Box 204 Venice, CA 90294, tel: (310) 314-4833; Special Projects Fund, Population Action International 19th St, NW Suite 550 Washington, DC 20003; The Washington Metro Alliance Against Female Genital Mutilation 17700 New Hampshire Ave. Ashton, MD 20861, tel: (301) 774-4456; Atlanta Circumcision Information Center, 2 Putnam Drive, N.W., Atlanta, GA 30342; Women's International Network News, 187 Grant Street, Lexington, MA 02173, (617) 862-9431.