Female genital Mutilation takes three basic forms:
Most operations take place on young girls and adolescents, sometimes on babies and toddlers. Most are carried out by older women with traditional instruments and without anaesthetics. It is a painful operation, sometimes a fatal one.
Both the operation and its aftermath have grave implications for the health of women and girls. It is impossible to estimate the number of deaths. Immediate medical complications include haemorrhage (bleeding), post-operative shock, tetanus, septicaemia (blood infection).
Among long-term complications are infections of the uterus and vagina, keloid scar formation, dermoid cysts, vulval abscesses, dysmenorrhoea and dyspareunia (extremely painful menstruation an ,d intercourse). Infibulated women need their vulval scars reopened in childbirth and are then reinfibulated - each stage increasingly dangerous.
Female genital mutilation has been practised at different times in many cultures and countries. Today circumcision is practised in parts of Africa, Asia and the Middle East. Excision and infibulation are concentrated in over 20 African states from the Atlantic to the Red Sea, the Indian Ocean to the Eastern Mediterranean. In Somalia, Djibouti, northern Sudan, central Mali and eastern Senegal most women are infibulated.
The origins of the various forms of female genital mutilation are unknown but it has been practised in parts of Africa for centuries. In some areas and some ethnic groups it is so widespread that it is an accepted and unquestioned aspect of everyday life, even though it brings pain and fear. An uncircumcised woman is seen as shameful and unnatural, by both women and men.
Excision and infibulation are practised by Moslems, Catholics, Protestants, Copts, Animists and nonbelievers in various countries. Yet it has no basis in any religious creed or commentary, even though some people genuinely believe it is justified by religious teaching.
Movements for change
Although it is widely accepted in many societies, the practice of female genital mutilations has been largely surrounded by secrecy. It has been difficult and sometimes dangerous for those women or men who want to stop the operations, to speak out against the practice. They are frequently accused of being anti-tradition, antifamily, anti-religion, anti-national, or of rejecting their own people and culture.
The reformers reply that female genital mutilation is medically unnecessary, painful and extremely dangerous, a deliberate disfigurement and disablement affecting millions of women and children, carried out solely in the name of tradition without ideological, political or religious sanction.
It permanently impairs womens sexual potential. It does not protect women but makes them more vulnerable. It violates the right of every girl child to develop physically in a healthy and normal way. Although parents sincerely believe that they are helping their child, it is a form of abuse and torture.
There have been determined women reformers in a number of African countries - Egypt, Sudan, Somalia, Senegal, Nigeria - who have had long experience in speaking and acting against female genital mutilation. They are health professionals, social scientists, journalists, rural and urban organizers. Although there are differences in their methodology and organization a number of common themes emerge from their work.
The first is that much more needs to be known about the type and extent of the practice in each country. Without this vital background knowledge it will not be possible to initiate and organize campaigns against it.
The second theme is that appropriate and wide-ranging education against the practice is essential. Changing deep-seated and widely held attitudes is a long and complex process. It is not possible to bring about change merely by legislation - in Sudan, for example, legislation has. had a negative effect as children are infibulated at.an ever earlier age.
Thirdly is the importance of agents for change, those whose words carry weight and who can act in the forefront of any campaign. These might be individuals (health professionals, teachers, journalists, policy-makers, political figures, religious leaders etc.) or organizations (hospitals, schools, womens societies etc.) whose leadership will provide a positive incentive for change. Men can play an important role in these campaigns.
Finally, while change must come from within Africa, international support, co-ordination and funding is necessary to make programmes effective. Some important initiatives have been launched by UN agencies such as the World Health Organization (WHO), UNICEF and the UN Commission on Human Rights they must be strengthened and extended. Other international agencies have yet to commit themselves.
In Western countries
Cases have been reported where African migrant and refugee communities in the West continue with female genital mutilations, either by means of clandestine operations or by sending their daughters to circumcises in their home country. Appropriate legislation and community education and awareness are needed to combat the practice while the existing child protection system should be extended to ensure that African girl
Three generations of Sudanese women. Amner (left) is a traditional midwife and circumcises. Her daughter, El Ham, has undergone the operation but does not want her young daughter to be operated on.
Issues for action
Female genital mutilation is an extreme example of the general: subjugation of women. Because it is a practice backed by centuries of tradition, its elimination will require far-reaching changes in the status and role of women. Today African women and men are arguing against the custom; they need practical, positive and non-sensationalist support.
Most of the victims of female genital mutilation are babies and girls. Although parents circumcise their daughters in the belief that it is right and necessary, the operation and its aftermath is comparable to torture. The 1990 UN Convention on the Rights of the Child states (Art 24(3)): States Parties shall take effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.
Female genital mutilation is not a harmless cultural practice but a major cause of permanent physical damage and death to women and girl children in the societies in which it is practised. Education against the practice should be part of grassroots health campaigns.
Female genital mutilation is practised in some of the worlds poorest countries. Yet the deteriorating economic conditions in which poor women live make survival even more precarious. Development programmes should give priority to health, education and income- generating schemes to raise the quality of life for woman