The number of women with genital mutilations visiting South African government hospitals is steadily increasing, reports Khadija Magardie
Any memory Rooksana has of her “circumcision” at the age of seven is blurred. All she remembers is two pairs of strong arms forcibly holding her legs apart.
But what she does remember is her wedding night when she was 14 years old. This was when, as is customary, her husband forced his penis into a hole the size of the head of a matchstick …
Every year, millions of girls and women are subjected to genital mutilation, most of them in Africa although it happens in Asia as well.
And as the ever-increasing number of immigrants, refugees and asylum-seekers spill into South Africa, the shadow of this custom follows.
Rooksana is a refugee from Somalia who has lived in Fordsburg, Johannesburg, for about four years.
As more and more women join the diaspora, South African doctors are struggling to deal with such “anatomically different” women.
According to Dr Trudy Smith of the obstetrics and gynaecology unit at Johannesburg hospital, the numbers of mutilated women coming to government hospitals for ante-natal care is, though not of alarming proportions, steadily increasing.
And though it is not obligatory reading in the formal curriculum just yet, trainee doctors are being taught how to deal with obstetric and gynaecological complications as a result of mutilation.
The usual definition of the practice as “circumcision” is misleading, Smith says. “Whilst male circumcision – a mere removal of the foreskin of the penis – makes physiological sense, to cut a woman and call it circumcision makes no sense whatsoever.”
For a “circumcised” woman childbirth is extremely complicated. For one, Smith says, it is virtually impossible for doctors to perform internal examinations on labouring women. This can have grave consequences for the life of the foetus as well as the mother.
Doctors also have to deal with the negative attitude many “circumcised” women have towards caesarean births. “They see it as a sign of weakness,” Smith says; and would rather endure a long and painful labour than be judged “less of a woman”.
However, the option of a caesarean is a luxury not available in the societies from which some of the women come. For some, the fear of a painful childbirth in the future puts them off sex completely.
According to Smith, the complications that arise from an obstructed labour could have near fatal consequences. She recalls a “circumcised” patient who had to undergo serious surgery to repair an acute case of necrosis – a rotting of the area between the vagina and the rectum.
Infection in the “circumcised” area, she says, left a gaping hole.
A number of horror stories abound regarding mutilation – about virgins being “opened up” with kitchen knives on their wedding night; of widows being sewn closed again until another man is found for them.
The procedure has extremely serious consequences for the physical, psychological and emotional well-being of women. In most cases the procedure is condoned by mothers, who despite knowing the suffering they endured, continue to perform it on their daughters.
Though there is a variety of interpretations regarding the exact origins of female genital mutilation, the common thread running through societies which advocate and practise it is that women who are “uncircumcised” are “unclean”. Many women who have been led to believe the practice is in their favour justify it on the grounds that it keeps their sexuality in check, and stops them from “running after the men”.
There are different types of mutilation, but most serve to severely inhibit, if not totally eradicate, the sexual response of women.
This act of suppressing female sexuality has been commonly attributed to religion – the Islamic faith in particular. This has served to give it a measure of credibility in the eyes of an often, but not necessarily, uneducated population.
In reality, the Qur’an, makes no mention of it whatsoever. Those who justify it on religious grounds make use of a weak and unsubstantiated hadith or tradition of the Prophet Muhammad. In the narration, Muhammad is said to have commented favourably on the practice.
There are two forms of female genital mutilation commonly practiced. The first, known as a clitoridectomy, involves the partial or whole removal of the clitoral hood. Given that the sole function of this organ is to enhance female sexual pleasure, the motive is clear.
Unfortunately, the majority of women, like Rooksana, endure the second type – known as Fir’auni. This involves the hacking away of all visible sexual organs of the female, such as the clitoris and the labia (tissue surrounding the vagina).
This is carried out with razors and other unsterilised instruments, and the wound is sewn together with cotton, catgut and even acacia thorns. A small hole is then left as an outlet for a combination of urine, menstrual flow and childbirth.
Rooksana not only had to endure being “opened up” on her wedding night; she had to endure a traumatic childbirth three times. Each time, she recalls, “they cut me . and sewed me up again”. Luckily for her, the trauma of “re-sewing” ended when she had her third child, in a South African hospital.
Rooksana’s four-year-old daughter Muna stares intently at the pain etched in her mother’s face as she describes her ordeal. She, unlike millions of other girl children in her native Somalia, will not have her childhood brutally cut away at a tender age. Rooksana and her husband are adamant that their daughter will never undergo the procedure. Because, as Rooksana’s husband Sa’eed says: “I have seen my wife suffer.”
According to Sa’eed, many men in countries practising female mutilation will refuse to marry an uncircumcised girl.
The issue of mutilation has been taken up by human rights activists but is mired in cultural sensitivity. It is in the name of culture that some humanitarian agencies have adopted a laissez faire attitude to the problem.
One cannot, they assert, interfere with a people’s culture. However, recognizing the brutality of the conditions under which female mutilation is carried out, they have chosen the “practical” approach.
This asserts that, while the practice cannot be eradicated totally, the least that can be done is to ensure that it takes place in hygienic and as painless circumstances as possible.
This, according to Smith, is akin to telling a drug addict: “If you must use drugs, make sure you use a clean needle.”
The custom is no longer something that happens to a people “far away”.
The maPulana tribe in Mpumalanga, hardly foreign, is just one of several indigenous communites practising female mutilation.