By MA Jun, Carey
Table of Contents
1. Introduction
2. Understanding FGM/C and its Consequences
2.1. Rationale
2.2. Complications
3. Support from Organizations
4. Challenges
5. Suggestions
6. References
7. About the Author
1. Introduction
TheWorld Health Organization(WHO), the United Nations Children’s Fund(UNICEF), and the United Nations Population Fund (UNFPA) have been committed to the eradication of Female Genital Mutilation/Cutting (FGM/C), a global concern given its violation of human rights of women and girls. FMG/C refers to ‘all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons’ (WHO et al., 2008, p. 4), and it can be classified into four types:
Type I: Partial or total removal of the clitoris and/or the prepuce (clitoridectomy).
Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).
Type III: Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).
Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.
Apart from the immediate complications such as hemorrhage and vaginal infection, that are a result of unhygienic conditions and unprofessional operators, there are further complications such as a 25% death rate during childbirth as well as impaired urinary health and infertility (Momoh, 2005). While ongoing efforts over the last three decades have led to an overall decline in the prevalence of FGM/C worldwide, variations in path of decline among countries and the fact that more than 200 million girls and women in 30 countries have undergone FGM/C till now are alarming (UNICEF, 2016b).
Female genital mutilation/cutting (FGM/C) is most prevalent in the Horn of Africa (Abulkadir, 2011; UNICEF, 2016b), in which Somalia is one of the four countries with a high percentage of girls and women aged 15-49who went through FGM/C (Somalia (98%), Djibouti (93%), Eritrea (83%), Ethiopia (74%)) (UNICEF, 2016b). Somali government has prohibited Female Genital Mutilation/Cutting (FGM/C) with clear statement in part of Somali provisional constitution (WHO, 2012). However, only 33% of Somali girls and women aged 15-49 think that the practice should end (UNICEF, 2016b).
This entry explores the rationale behind the undertaking of FGM/C and complications that arise from it. It also examines the challenges that may arise in the prevention of FGM/C and the current support provided by organizations such as WHO and UNICEF, before finally making recommendations on how to end FGM/C in Somalia. The eradication of female genital mutilation is mentioned as atarget of Goal 5 of the UN’s Sustainable Development Goals (SDGs) (2015), and these recommendations may help facilitate the global community’s resolution to end FGM/C by 2030 (UNICEF, 2016).
2. Understanding FGM/C and its Consequences
2.1. Rationale
Several reasons can be identified that perpetuate FGM/C in Somalia, which might also be found in other countries. They include religion, gender relationships, and social pressure (Momoh, 2005; Abulkadir, 2011; Johnson-Agbakwu, Helm, Killawi & Padela, 2013). Additionally, lasting political chaos in Somalia hinders efforts in legal system and humanitarian aid at the same time (Powell, Ford & Nowrasteh, 2008).
Religion has always been claimed as one of the reasons perpetuating the practice. No appearance of FGM/C is in the Koran and Muslim religious authorities agree on the sinfulness of all kinds of mutilations (Rouzi, 2013). Yet FGM/C is reported, according to UNICEF (2016a), to be concentrated in parts of Africa, the Middle East, and Asia where Islam plays a dominated role in shaping social traditions and rituals. Asymmetry between biomedical categories and terminologies used in places where these practices are implemented, especially in Islamic countries, when it comes to classification of female genital surgeries, complicated this situation. Also, the double meaning of sunnaas Type I or less extensive operations in local terminology and as normative words, deeds, and traditions of prophet Muhammad in Islamic beliefs (Obermeyer, 1999)fuels its perpetuation. Low levels of education in Somalia further contribute to misunderstanding and abuse, particularly in relation to men’s religious beliefs regarding the practice (Gele, Bø, and Sundby, 2013). As two Somali Imams expressed (Abulkadir, 2011), the continuing practice of FGM/C is more about culture than religion since people do what their ancestors did, and they are not well-educated to stop the harm.
Gender inequality in societies where FGM/C is practiced is another reason that perpetuates the practice. In areas where FGM/C is common, resection of the clitoris is undertaken to keep women away from their sexual desires before marriage. This is done apparently to preserve virginity, which is regarded as a necessity for women to get married. At the same time, it can amplify men's sexual enjoyment after marriage (Momoh, 2005). According to Abulkadir (2011), a Somali woman who underwent the practice, the government should allow FGM/C to preventgirls from sleeping around, as sexual intercourseafter the practice becomes painful. Ending FGM/C becomes harder when even women support the practice. The inferior status of women in this case can be seen to representthe suppression of women’s rights: the right to protect their own physical health, the right to change inhumane rules, and the right to speak in favor of education and employment for women.
Social rules that apply to both women and men also contribute to FGM/C. Some older women’s collective acceptance of their inferior position characterizes FGM/C as a sexual symbol of a mature woman, and social norms identify a woman as a tool of procreation (Momoh, 2005). Women’s obedience towards FGM/C affects men’s attitudes as well. For example, Somali men in Oslo stated that they do not agree with the practice because of the complications or trauma it leads to; however, social pressures in Somalia keep perpetuatingit (Geleet al., 2012). Many men choose to follow the practice not to let their mothers down (Johnson-Agbakwu et al., 2013).
2.2. Complications
FGM/C is referred to as the ‘three feminine sorrows,’ as it causes sorrow when the woman undergoes the practice, when she is cut open on her wedding night, and when she gives birth and is cut again (Fourcroy, 1998, p. 15). In addition to short-term physical health complications such as hemorrhage and pain, survivors endure severe psychological problems such as depression and phobia (Elnashar andAbdelhady, 2007), long-term gynecological problems such as dyspareunia, and psychosexual difficulties such as less sexual pleasure (El-Defrawi et al., 2001).
The psychical harm caused by FGM/C negatively affects possibilities for women to use their rights to play positive supportive roles for themselves, their families and their communities. The use of either mutilationor cutting violates human rights such as ‘the principles of equality and non-discrimination on the basis of sex, the right to life when the procedure results in death, and the right to freedom from torture or cruel’(WHO et al., 2008, p. 9). These rights involve far-ranging domains including cultural, economic, and political and are addressed in many international treaties such as the Covenant on Economic, Social and Cultural Rightsand the Convention on the Rights of the Child(WHO et al., 2008, p. 8). FGM/C, along with other controversial trends such as early marriage and human trafficking, hinders women’s access to education, employment, and other possibilities. Somalia’s low female literacy rate (25.8%) and high infant mortality rate (89.8 per 1000 live births) (Susumanet al., 2016)demonstrate how the practice harms two generations when it comes to pushing girls to early marriage and to facing more threats when giving birth.
3. Support from Organizations
Elimination of the practice has been a global concern, especially after 1997, with the joint statement of WHO, UNICEF and UNFPA calling for abandonment of FGM/C (Shetty, 2014). Sustained actions include, but are not limited to, on the ground programs and media campaigns against FGM/C. Tostan (meaning ‘breakthrough’ in the Wolof language) is one inspiring organization leading sustainable programs in Africa. Its model for community-led change, which has had great impact on ending FGM/C and child marriage, by helping girls’ access education and developing community’s economic potentials, is implemented across 6 African countries (Tostan, 2017). Local fighters against FGM/C promote the eradication through engagement in health education with the help from various programs and organizations.
4. Challenges
Somalia’s statelessness has hampered the effectiveness and efficiency of its law-enforcement agencies, while decentralized and clan-based social structures in especially rural areas enable independent interpretations and enforcement of the Somali customary law (Powell, Ford, andNowrasteh, 2008). Thus, understanding contexts is a necessity for any well-meaning actions given the potential variations among clans.
Social rituals, religious beliefs, and gender relationships, which are deeply entrenched in people’s minds, shape people’s behaviors. Common language and clan origins contribute to a cultural homogeneity in Somalia (Morison et al., 2004). Dialogues in the documentary The Day I will Never Forget(Longinotto, 2010) demonstrate attitudes of people who live in the Somali community of Kenya regarding the practice and their cultural traditions. For example:
Men
‘According to our religion, it’s the husband who makes the decisions, not the wife.’
‘In our society, we do not have mutilation. What we have and we still advocate it is female clitoridectomy.’
Women
‘I cursed my mom. I said “why did you do this to me?”.’
‘You can keep it [clitoris], but it’s going to be a problem later. Your husbands will leave you the day they fail to penetrate you.’
‘In our tradition, we do it to stop our girls from sleeping around. It’s our culture. It started a long time ago. I’ve done it to my daughters as it was done to me.’
While men claimed that what the society supports is clitoridectomy, which belongs to Type I, the majority of Somali women who underwent the practice experienced Type III (Gele et al., 2013). What is also evident is that some women who went through FGM/C justify their own experiences.
5. Suggestions
While legislative powers are expected to be the leading drivers to end the practice, the unsettled political condition in Somalia forces other approaches to play stronger roles. First, international organizations’ support in capital, human resources, and techniques aids the establishment of local education institutions as intellectual bases which might be more sustainable in terms of uniting local strength to solve conflicts whichare interwoven with the perpetuation of FGM/C to sustain the efforts with contextualized education. Second, enforcement of customary law based on clan networks calls for community-oriented programs. Such programs work towards understanding conflicts, needs, and potentials in contexts by cooperating with local people. Men’s roles should also be considered to aid towards sustainable development, since social pressure and lack of education perpetuate their notions about the practice and hinders women’s actionsto make a change. Therefore, ongoing human-rights based education programs connecting men and women, children and adults might make a positive impact on gender and psychosexual relations. Open discussions about the practice heldby local Imams, if possible, may relieve misunderstanding and abuse of religion.
Health education is another necessity to evoke public understanding of how the ending of FGM/C can benefit health and bring harmonious family and community environments, which underpin more possibilities. Lastly, equipping local people with knowledge and skills which they can apply to develop their own community economy might help sustain a harmonious environment. Promising economic sectors such as plantation economy, fishing, manufacturing and foreign trade (Laitin, 1993) calls for opportunities both inside and outside Somalia, and international organizations can help connect European customers while community-driven organizations can help circulate resources among communities. Challenges to the eradication of FGM/C in Somalia are deeply embedded in local people’s minds. Changing education, improving economic circumstances, and establishing political stability with functioning legislative powers play crucial roles. While all efforts are certain to face challenges, progress can be made with continuous cooperation between devoted organizations and persistent Somalis.
6. References
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Elnashar, A. & Abdelhady, R. (2007). The Impact of Female Genital Cutting on Health of Newly Married Women. International Journal of Gynecology and Obstetrics, 97(3), 238-244. doi:10.1016/j.ijgo.2007.03.008
El-Defrawi, M.H., Lotfy, G., Dandash, K.F., Refaat, A.H. & Eyada, M. (2001). Female Genital Mutilation and its Psychosexual Impact. Journal of Sex and Marital Therapy, 27(5), 465-473. doi: 10.1080/713846810
Fourcroy, J.L. (1998). The Three Feminine Sorrows. Hospital Practice, 33(7), 15-21, doi: 10.1080/21548331.1998.11443711
Gele, A.A., Bø, B.P. & Sundby, J. (2013). Have We Made Progress in Somalia after 30 Years of Interventions? Attitudes Toward Female Circumcision Among People in the Hargeisa District. BMC research notes, 6, 122. doi: 10.1186/1756-0500-6-122
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Johnson-Agbakwu, C.E., Helm, T., Killawi, A. & Padela, A.I. (2013). Perceptions of Obstetrical Interventions and Female Genital Cutting: Insights of Men in a Somali Refugee Community.Ethnicity and Health, 1-18. doi: 10.1080/13557858.2013.828829
Laitin D.D. (1993). The Economy. In Helen Chapin, M. (1993). Somalia: A Country Study(4th ed.) (pp. 146-149). Washington D.C.: Federal Research Division.
Longinotto K. (2010). The Day I Will Never Forget Can ku de ge li. Taibei Shi : Nü xing ying xiang xue hui chu pin.
Momoh, C. (2005). Female Genital Mutilation. In Momoh, C. (Ed.). (2005). Female Genital Mutilation(pp. 5-12). Abingdon, Oxon: Radcliffe.
Morison, L.A., Dirir, A., Elmi, S., Warsame, J. & Dirir, S. (2004). How Experiences and Attitudes Relating to Female Circumcision Vary According to Age on Arrival in Britain: A Study among Young Somalis in London. Ethnicity and Health, 9(1), 75-100. doi: 10.1080/1355785042000202763
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Susuman, A.S., Chialepeh, W.N., Bado, A. & Lailulo, Y. (2016). High Infant Mortality Rate, High Total Fertility Rate and Very Low Female Literacy in Selected African Countries.Scandinavian Journal of Public Health, 44(1), 2-5. doi: 10.1177/1403494815604765
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About the Author
MA Jun, Carey
MEd, The University of Hong Kong
Email: scmj717@163.com