The Scars of Tradition

AT LEAST 100 young girls in south-western Kenya fled their homes during February 2003, and sought sanctuary in local churches. Sympathetic pastors allowed them to sleep in church property with church-supplied bedding. Why? They were hiding from their parents as they sought to escape forced Female Genital Mutilation (FGM). Traditionally known as female circumcision, the practice remains widespread in much of rural Kenya, even though it was outlawed among young girls in 2001, with girls above the age of 16 able to make their own decision.
Challenged by having to provide sanctuary, Kenya’s bishops, one month later, joined an inter-religious committee of Christians and Muslims working to end FGM in the country, and urged all clergy to take a public stand against it. A committee statement noted that, by keeping largely silent in the past, faith-based organisations have been perceived as giving assent to the practice. Religious leaders could be effective in combating it because of their close interaction with communities through congregations. Catholic clergy, for example, might in future speak out against female circumcision when they baptise female babies. Kenya’s bishops were taking a public stand against genital mutilation for the first time. Their action reflected increasing Church attention to a human rights issue cloaked in silence and mired in social and cultural complexities.

An ancient practice

The tradition of female circumcision goes back 14 centuries. An estimated 135 million of the world’s girls and women have undergone genital mutilation, and two million girls a year are currently at risk of mutilation – approximately 6,000 per day. It is practised extensively in Africa, and is common in some countries in the Middle East. It also occurs, mainly among immigrant communities, in parts of Asia and the Pacific, North and Latin America and Europe. Girls or girl infants living in industrialised countries are sometimes operated on by doctors from their own community who are resident there. More frequently, traditional practitioners are brought into the country or girls are sent abroad to be mutilated.
Genital mutilation is widespread in at least 28 African countries, where it is an important religious and cultural tradition which some communities believe they have the right to continue. In Somalia, for example, virtually all girls are circumcised. But it is a painful procedure that is often poorly carried out.
Female genital mutilation is the term used to refer to the removal of part, or all, of the female genitalia. The vast majority (85%) of genital mutilations performed in Africa consist of clitoridectomy or excision. The least radical procedure consists of the removal of the clitoral hood. The most severe form is infibulation. An estimated 15 percent of all mutilations in Africa are infibulations. This procedure consists of clitoridectomy (where all, or part of, the clitoris is removed), excision (removal of all, or part of, the labia minora), and cutting of the labia majora to create raw surfaces, which are then stitched or held together in order to form a cover over the vagina when they heal. A small hole is left to allow urine and menstrual blood to escape. The procedure involved varies widely from culture to culture, but a particularly brutal operation can leave the woman with haemorrhaging, infections, abscesses, a lifelong loss of sensation during sex, and problems during childbirth.
In a traditional African culture genital cutting is the climax of initiation, something that both boys and girls have to take part in before they are accepted as adults in the community. Some girls undergo genital mutilation alone, but mutilation is more often undergone as a group of, for example, sisters, other close female relatives or neighbours. Where genital mutilation is carried out as part of an initiation ceremony, as is the case in societies in eastern, central and western Africa, it is more likely to be carried out on all the girls in the community who belong to a particular age group. The procedure may be carried out in the girl’s home, or the home of a relative or neighbour, in a health centre, or, especially if associated with initiation, at a specially designated site, such as a particular tree or river. Sometimes the event is associated with festivities and gifts.

Human rights issue

Opponents argue that it is a barbaric and needless practice inflicted on young women. It is sometimes carried out by a midwife and with anaesthetics, but more often by an older woman, a traditional midwife or healer, and there is nothing to ease the pain. Human rights activists criticise the allegedly unhygienic conditions in which the operation is often conducted. Razor blades, scissors, kitchen knives and even pieces of glass are used, often on more than one girl, which increases the risk of infection, such as HIV.
The Pan-African Committee on Traditional Practices highlights the inability of the girl to make a choice. Cutting takes place when a woman is young (as young as three and rarely older than 10) and vulnerable, and therefore unable to make her own decision. In a small village community pressure is great. Girls who have not been circumcised are considered “unclean” in Egyptian villages and many towns, and can find it extremely difficult to find a husband.
Girls undergoing the procedure have varying degrees of knowledge about what will happen to them. Usually only women are allowed to be present. In some cultures, girls will be told to sit beforehand in cold water, to numb the area and reduce the likelihood of bleeding. The girl is immobilized, held, usually by older women, with her legs open. When infibulation takes place, thorns or stitches may be used to hold the two sides of the labia majora together, and the legs may be bound together for up to 40 days. Antiseptic powder may be applied, or, more usually, pastes – containing herbs, milk, eggs, ashes or dung – which are believed to facilitate healing. The girl may be taken to a specially designated place to recover where, if the mutilation has been carried out as part of an initiation ceremony, traditional teaching is imparted. For the very rich, the mutilation procedure may be performed by a qualified doctor in hospital under local or general anaesthetic.

Health risks

Genital mutilation can occasionally lead to death. At the time the mutilation is carried out, pain, shock, haemorrhage and damage to the organs surrounding the clitoris and labia can occur. Afterwards, urine may be retained and infection develop. More commonly, the chronic infections, intermittent bleeding, abscesses and small benign tumours of the nerve which can result from clitoridectomy and excision cause discomfort and extreme pain.
Infibulation can have even more serious long-term effects: chronic urinary tract infections, reproductive tract infections resulting from obstructed menstrual flow, and excessive scar tissue.
During childbirth, existing scar tissue on excised women may tear. Infibulated women have to be cut to allow the baby to emerge. If no attendant is present to do this, perineal tears or obstructed labour can occur. After giving birth, women are often re-infibulated to make them “tight” for their husbands. The constant cutting and re-stitching of a women’s genitals with each birth can result in more tough scar tissue in the genital area.
The psychological effects of female genital mutilation are more difficult to investigate scientifically. Personal accounts of mutilation reveal feelings of anxiety, terror, humiliation and betrayal, all of which would be likely to have long-term negative effects. Some experts suggest that the shock and trauma of the operation may contribute to behaviour described as “calmer” and “docile”, considered positive in societies that practise female circumcision. However, festivities, presents and special attention at the time of mutilation may mitigate some of the trauma experienced. In addition, the girl may feel she has become acceptable to her society, having upheld the traditions of her culture and made herself eligible for marriage, often the only role available to her. It is possible that a woman who did not undergo genital mutilation could suffer psychological problems as a result of rejection by the society. Many women are caught between the social norms of their own community, and those of the majority culture.

Religion

Female circumcision predates Islam, and is not practised by the majority of Muslims, but has acquired a religious dimension. Where it is practised by Muslims, religion is frequently cited as a reason. Many of those who oppose mutilation deny that there is any link between the practise and religion, but Islamic leaders are not unanimous on the subject. The Qur’an does not contain any call for genital mutilation, but a few hadith (sayings attributed to the Prophet Muhammad) refer to it. In one case, in answer to a question put to him by ‘Um ‘Attiyah (a practitioner of FGM), the Prophet is quoted as saying “reduce, but do not destroy”.
Mutilation has persisted among converts to Christianity. Christian missionaries in Africa in the last century sometimes tried to discourage the practice, but found it to be too deep rooted. Female circumcision was practised by the minority Ethiopian Jewish community, most of whom now live in Israel, but it is not known if it persisted following their emigration to Israel. The remainder of the FGM-practising community follow traditional Animist religions.

Tackling FGM

Female circumcision is outlawed in Britain, France, Sweden and Switzerland, as well as some African countries, including Kenya, Senegal and Egypt. But banning genital mutilation does not provide a simple solution. Countries imposing a ban may force the practice underground, resulting in higher mortality rates. They will also have to consider the effect on women who have already had the operation. These women will have taken part in this rite for religious and cultural reasons, and these reasons will now be undermined.
Many people in FGM-practising societies, especially traditional rural communities, regard female circumcision as so normal that they cannot imagine a woman who has not undergone mutilation. A girl cannot be considered an adult in a FGM-practising society unless she has undergone mutilation. In many of these societies, it is extremely difficult, if not impossible, for a woman to marry if she has not undergone mutilation. Societies that practise infibulation are strongly patriarchal. Preventing women from indulging in ‘illegitimate’ sex, and protecting them from unwilling sexual relations, are considered vital because the honour of the whole family is seen to be dependent on it. Also, cleanliness and hygiene feature consistently as justifications for female circumcision. In some FGM-practising societies, un-mutilated women are regarded as unclean and are not allowed to handle food and water.
In addition some African women have demanded the right to continue this traditional practice. One woman argued at a recent women’s conference in London that, “you have the right to ask a doctor to put silicon bags in your breasts, why should I not have the right to ask for him to alter my body in the way that I find acceptable?” Action by the UN and other international bodies, or indeed Western feminists, can smack of paternalistic Western intervention, lacking respect for the cultural traditions of Africa. The questions is: who has the right to determine what cultural practices are acceptable or not in African societies?

Change through education

The Kenyan organisation Maendeleo ya Wanawake, which means the Development of Women, has worked to stop genital mutilation in Kenya. But so sensitive is the issue that campaigners cannot approach it head on. Instead they use education and economic factors as a lever. Among the Masai community parents are increasingly eager for their daughters to finish school because this increases their chances of earning money for the whole family. But the problem is that once a girl is circumcised, she drops out of school to get married and her earning power drops to nil. “I had to go around the area for one year without even mentioning female circumcision” says one worker. “I just asked parents why their girls were dropping out of school when they could be the teachers and doctors of tomorrow”. Gradually, the parents themselves are choosing not to have their daughters circumcised. Many are sending them instead to Maendeleo ya Wanawake, where, over the course of a week, the girls are taught what their community expects of them as adults. Then at the end there is a ceremony of singing and dancing. It is a rite of passage for the girls and marks their passage from childhood to adulthood. But they have become women without being cut.

Hannah’s Story – Sierra Leone
I was genitally mutilated at the age of ten. I was told by my late grandmother that they were taking me down to the river to perform a certain ceremony, and afterwards I would be given a lot of food to eat. As an innocent child, I was led like a sheep to be slaughtered.
Once I entered the secret bush, I was taken to a very dark room and undressed. I was blindfolded and stripped naked. I was then carried by two strong women to the site for the operation. I was forced to lie flat on my back by four strong women, two holding tight to each leg. Another woman sat on my chest to prevent my upper body from moving. A piece of cloth was forced in my mouth to stop me screaming. I was then shaved.
When the operation began, I put up a big fight. The pain was terrible and unbearable. During this fight, I was badly cut and lost blood. All those who took part in the operation were half-drunk with alcohol. Others were dancing and singing and, worst of all, had stripped naked. I was genitally mutilated with a blunt penknife.
After the operation, no one was allowed to aid me to walk. The stuff they put on my wound stank and was painful. These were terrible times for me. Each time I wanted to urinate, I was forced to stand upright. The urine would spread over the wound and would cause fresh pain all over again. Sometimes I had to force myself not to urinate for fear of the terrible pain. I was not given any anaesthetic in the operation to reduce my pain, nor any antibiotics to fight against infection. Afterwards, I haemorrhaged and became anaemic. I suffered for a long time from acute vaginal infections.