/ 9 June 2004

Female genital mutilation — or medical practice?

A society free of female genital mutilation, also known as female circumcision, appeared distant this week after a group of women’s rights activists accused medical personnel of carrying out the practice.

The activists made the allegation in Nairobi, Kenya, on Monday, after a meeting of former circumcisers organised by Equality Now, a New York-based women’s rights group.

The two-day gathering brought together ex-practitioners from East and West Africa, which include regions where up to 90% of girls are circumcised.

”There is medicalisation of FGM [female genital mutilation] in the region, and this is jeopardising efforts to phase out FGM,” Efua Dorkenoo, a public health officer and FGM activist from Ghana, said at a press conference.

FGM involves the cutting away of part or all of a girl’s genitalia.

According to Amnesty International, the severest form of FGM is infibulation, where the clitoris and other parts of the anatomy are removed — and the remaining surfaces stitched together to leave a small hole for passing urine and menstrual blood.

Older women may carry out circumcisions, as well as traditional healers, midwives and even barbers. Tin lids and pieces of broken glass are among the implements used.

Circumcisions are normally carried out without anaesthetic, and can result in infection as well as severe pain during urination, menstruation, intercourse and childbirth. Excessive bleeding and infection can also result in death.

Dorkenoo had discovered medical officers in countries such as Egypt, Sudan and Kenya were becoming professional circumcisers. FGM is banned in Kenya.

Some news reports have said the ”medicalisation of FGM” can provide a lucrative trade for physicians.

Girls whose parents can afford doctors are circumcised in a hygienic environment. Activists fear the diminished risk of infection and the respectability accorded by a medical setting could undermine efforts to root out the custom.

However, Dorkenoo’s findings have been questioned by Kenyan authorities.

”It is true I have heard these allegations before, but we have not caught anybody doing it,” said Josephine Kibaru, a Ministry of Health official, in an interview.

”FGM is illegal and this applies even to health workers. If they are doing it, then they are doing it underground, and if we catch up with them, then they know what will happen to them.”

According to Equality Now, FGM is practised in at least 28 African countries. Of these, 14 have passed laws outlawing the practice. However, sometimes this is not enough.

”Having laws on paper is one thing, while implementation is another. Yes, half of the countries practising FGM in Africa have laws; but [they] fail to implement them. Yet if they took advantage of the laws, the problem would reduce drastically,” said Taina Bien-Aime, director of Equality Now.

Kenya was cited as a country where laws had been used to good effect: FGM was banned in the Children’s Act of 2001. According to the director of the Centre for Human Rights and Democracy, Ken Wafula, his organisation has been able to rescue 53 girls recently thanks to the law.

Where laws are not in place, informal fines have sometimes been imposed. Isnino Shuriye, a former circumciser from Somalia who has been in the trade for 25 years, told journalists on Monday how she was threatened with paying 40 camels for every girl she circumcised.

”Anti-FGM campaigners in Somalia told me over and over again about the harm I was doing to young girls and women. At first I did not listen; but when they told me about the camels — and indeed I recalled the girls I had cut, and some who had haemorrhaged to death — I heeded their advice,” she said.

Shuriye has since joined the campaign to eradicate FGM. Mariam Bagayako, a former circumciser from Mali, remembered with sadness how she had removed the genitalia of girls and women for 10 years.

”I have now laid my knife down and I am trying to come to terms with the ills that I committed on fellow women and young girls,” she said. Mali has yet to legislate against FGM.

According to Equality Now, more than 130-million girls and women around the world have undergone genital mutilation, most of them from Africa. — Sapa-IPS