What is female genital mutilation (FGM), why does it occur, what is it prevalence and how does it affect the women and girls in the society? How do we curb it and protect the women from it?
Female Genital Mutilation is the female circumcision or female genital cutting. It comprises all surgical procedures involving partial or total removal of the external genitalia or other injuries to the female genital organs for cultural or other non-therapeutic reasons. The health consequences of the practice vary according to the procedure used. Never the less it is universally unacceptable because it is an infringement on the physical and psychosexual integrity of women and girls and is a form of violence against them. They are different traditional practices that involve the partial or total removal of the external female genitalia and/or injury to the female genital organs.
FGC is seen as an understatement by many due to male circumcision. Without making judgments on the consequences of male circumcision, female circumcision represents a serious violation of a girl’s health and human rights; the most minimal form can affect her wellbeing in a negative way. The use of the word “mutilation” reinforces the idea that this practice is a violation of girls’ and women’s human rights, and thereby helps promote national and international advocacy towards its abandonment. At the community level, however, the term can be problematic. Local languages generally use the less judgmental “cutting” to describe the practice (Amnesty, 1998).
There many classifications of Female Genital Mutilation. Excision of the prepuce, with or without excision of part or the entire clitoris, this is known as Type I or Type A. Excision of the clitoris with partial or total excision of the labia minora is classified as Type II or B. Excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening or in other words infibulations, this is the Type III or C. The unclassified form includes piercing or incising of the clitoris and/or labia, cauterization, scraping, or cutting of vaginal tissue etc. These operations are all irreversible. Acute complications include death, hemorrhage, shock, infection and severe pain. In addition, women can suffer severe long-term damage to their reproductive and sexual health, risk HIV infection, and are often left with psychological scars (Amnesty, 1998).
Female genital mutilation is an age old practice that its roots are not found. The origins of this practice are unknown. It existed before the beginning of Christianity and Islam. It is not required by the Quran or the Bible. It crosses religious lines. It also crosses ethnic and cultural lines and is performed in many countries around the world, but is most prevalent in Africa. FGM is prevalent in 28 African countries, in a few Arab and Asian countries, and among certain African immigrants in the West (Yoder et al, 2004).
An estimated 130 million girls and women worldwide have undergone the practice, with another three million girls being affected each year. Types I and II account for 80 to 85% of all cases, although the proportion may vary greatly from country to country. For instance in Djibouti, Somalia and Sudan most women undergo Type III. Infibulations is practiced on a smaller scale in parts of Egypt, Eritrea, Ethiopia, Gambia, Kenya, Mali, Malaysia, Oman, Saudi Arabia, Israel and Pakistan. Some immigrants practice various forms of FGM in other parts of the world, including countries in Europe, the United States, Canada, New Zealand and Australia. Many of these countries have enacted laws banning the practice. In countries where it is practiced, FGM affects a segment of the population that is critical for development, economic growth and prosperity. These development and health implications and concern over the violation of basic human rights make FGM a matter of pressing concern. FGM is also an important reproductive health issue, but it must be approached with clear understanding of the cultural context in which it is practiced (Yoder et al, 2004).
FGM tends to be justified among others because of many reasons. The apparent need to control women’s sexuality was seen as men empowerment over women. It was also viewed as an alleged medical advantage of genital cutting. Religious obligation and the belief that female circumcision was the only cleansing customary tradition made it rampant in prevalence. Implicitly underlying these is the social construction of female sexuality and identity. In the psychosexual beliefs it attenuated sexual desire in the female hence maintaining chastity and virginity before marriage and fidelity during marriage and it was also believed to increase male sexual pleasure. It was believed in the sociological class as identification with the cultural heritage, initiation of girls into womanhood, social integration and maintenance of social cohesion. Among some societies, the external female genitalia are considered unclean and unsightly, and so are removed to promote hygiene and provide aesthetic. It is practiced in a number of communities, under the mistaken belief that it is demanded by certain religions. Others have the belief that it enhances fertility and promote child survival (Gruenbaum, 2001).
FGM can have devastating and harmful consequences for a woman throughout her life. The health problems a girl can experience depend a great deal on the severity of the procedure, the sanitary conditions in which it was performed, the competence of the person who performed it and the strength of the girl’s resistance. Old women and barbers who perform FGM are medically unqualified and can do extreme damage to a woman or a girl, sometimes resulting in death. In cases where the procedure is carried out in unsanitary conditions and unsterile equipment is used, the dangers of infection are great. When it is performed in the sanitary conditions of a hospital by qualified personnel risk of infection may be reduced, but the long-term consequences remain (Amnesty, 1998).
Short-term consequences include bleeding (often hemorrhaging from rupture of the blood vessels of the clitoris) severe bleeding sometimes leads to death. Post-operative shock may occur. There will also be damage to other organs resulting from lack of surgical expertise of the person performing the procedure and the violence of the resistance of the patient when anesthesia is not used. Infections, including tetanus and septicemia, can occur because of the use of unsterilized or poorly disinfected equipment. Urine retention caused by swelling and inflammation causes’ great pain to the females (Amnesty, 1998).
Long-term consequences vary from procedure to the next. Chronic infections of the bladder and vagina can easily occur in all types. In Type III, the urine and menstrual blood can only leave the body drop by drop; the build up inside the abdomen and fluid retention often cause infections and inflammation that can lead to infertility, dysmenorrheal, or extremely painful menstruation. There is excessive scaring of tissues at the site of the operation. Cysts form on the stitch lines. There is a possibility of child birth obstruction, which can result in the development of fistulas. The vaginal and/or bladder wall might tear up due to pressure build up and chronic incontinence. There is a growing speculation of a potential risk of HIV/AIDS associated with the procedure, especially when the same unsterile instruments are used on multiple girls.
Reinfibulation must be performed each time a child is born. When infibulation (Type III) is performed, the small opening left in the genital area is too small for the head of a baby to pass through. Failure to reopen this area can lead to death or brain damage of the baby and death of the mother. The excisors must reopen the mother and re-stitch her again after the birth. In most ethnic groups the woman is re-stitched as before with the same tiny opening. In other ethnic groups the opening is left only slightly larger to reduce painful intercourse. (In most cases, not only must the woman be reopened for each childbirth, but also on her wedding night when the excisors may have to be called in to open her so she can consummate the marriage.)Scientific studies are needed on the precise psychological effects of FGM on a girl or woman. However, changes have been observed in some girls who have been subjected to the procedure. Nightmares, depression, shock, passivity, feelings of betrayal are not uncommon among these girls (Amnesty, 1998).
In order to contain the vice various things must be placed in consideration. Building a protective environment for children is a major point to ponder as there the most vulnerable in the group. The attitudes, traditions, customs and beliefs need to change. Governments need to show commitment to ending female genital mutilation by supporting those fighting the vice. Children and adolescents need to be informed and enabled to reject female genital mutilation. Understanding the prevalence and nature of female genital mutilation is an essential first step to addressing it. Medical services have to be able to respond to the consequences of female genital mutilation promptly to avoid deaths or long term effects, and the education system should be able to contribute to preventing of the vice. There should be a non-coercive and non-judgmental approach whose primary focus is the fulfillment of human rights and the empowerment of girls and women. Awareness should be brought in on the part of a community of the harm caused by the practice. They should decide to abandon the practice as a collective choice of a group that intermarries or is closely connected in other ways.FGM. A process should be organized to diffuse and ensure that the decision to abandon FGM spreads rapidly from one community to another and is sustained (Yoder et al, 2004).
Other methods according to Amnesty (1998) are the empowerment of women by supporting micro credit schemes for women, job training of former excisors in other occupations, provision of information on the human rights of women, efforts to increase women’s participation in and access to decision-making in institutions of power and governance at local, national and international levels. Enforcement of FGM laws by supporting host countries’ efforts to draft, implement and enforce legislation pertaining to FGM. Support dissemination of information about the law throughout the country in all local languages. These can also be done by supporting provision of graphic information about the law in those areas of the country with a high degree of illiteracy and training for law enforcement officials, judges and lawyers about the law. Include in any information campaign about the law, information on the harmful effects of FGM on a woman’s health.
Bibliography
Amnesty International (1998), “Section 1: What is Female Genital Mutilation”, Female Genital Mutilation – A Human Rights Information Pack. Web.
Gruenbaum, Ellen (2001), the Female Circumcision Controversy, University of Pennsylvania Press, Philadelphia.
Yoder, P. Stanley, Noureddine Abderrahim and Arlinda Zhuzhuni, female genital Cutting in the Demographic and Health Surveys: A Critical and Comparative Analysis, DHS Comparative Reports No. 7, 2004, ORC Macro.