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Post 20. FGM
It kills me to have to write this blog.
On a personal level, the whole reason why I am here is to chip away at my own ignorance and try to understand all the perceptions and misconceptions, realities and reasonings that make up this place that so kindly hosts me. Both in my own mind and in the minds of whoever has the patience and interest to follow my bumbling journey, I want to break stereotypes and foster understanding.
In this particular case, however, I remain eons away from any sort of understanding.
Female genital mutilation. Those three words should never be found in the same paragraph, let alone neatly abbreviated to the common acronym of FGM. Sorry – I can’t abbreviate it. FGM rolls off the tongue too easily; but the words “female genital mutilation” slap me in the face every time I read/write them.
According to the Female Genital Mutilation Network, the practice is most common in counties such as Somalia, Guinea, Egypt, Sudan and Mali, all of which have a prevalence of over 90%. The WHO reports that worldwide, between 100 and 140 million girls and women are living with the consequences of female genital mutilation, with 3 million new cases per year. Most often girls from 4 to 14 years of age.
WHO describes 4 different categories of female genital mutilation:
- Type I: Clitoridectomy – partial or total removal of the clitoris
- Type II: Excision – partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora
- Type III: Infibulation – narrowing of the vaginal opening through the creation of a covering seal, formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
- Type IV: Other – all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.
You can only imagine the list of health risks that accompany this mutilation. Immediately following the procedure there is risk of infection, severe bleeding, tetanus, and urine retention. Not to mention pain. In the longer term, there is the risk of recurrent urinary tract infections, cysts, infertility, childbirth complications and newborn deaths.
Female genital mutilation obviously has no health benefit for the girl whatsoever; rather its justification is purely cultural. UNICEF lists the following factors perpetuating the practice:
- Sexual – to control or reduce female sexuality by reducing libido and sexual enjoyment; to ensure virginity and fidelity.
- Sociological – as an initiation for girls into womanhood, social integration and the maintenance of social tradition and cohesion.
- Hygiene – where it is believed that the female genitalia are dirty and unsightly.
- Health – in the belief that it enhances fertility and child survival.
- Religious – in the mistaken belief that FGM is a religious requirement.
Increased sexual pleasure for men, family honour and an income source for those performing the procedure are also frequently listed as contributing factors.
A survey in Chad in 2004 found a prevalence of 45%. Type II was found to be commonly practiced across the country, while Type III was limited to the border area with Sudan. However, in the MSF supported maternity ward in Am Timan, seeing a woman without mutilation is the exception, suggesting that the prevalence might be higher in Am Timan than reported by the 2004 survey. Most often just the clitoris is removed, but the remaining scar tissue is so thick it requires significant incisions to deliver the baby.
As MSF, we treat the medical consequences, but we are aware that actions going beyond the medical sphere, involving all the local leaders, are required. This limited role is hard for the team here in Am Timan to swallow, particularly those of us with our own clitorises, perfectly intact. As an innovative initiative to rectify this impasse, MSF is planning to partner with a well established Chadian NGO who will train, sensitize, and inform in an attempt to reduce the phenomenon.
Many of my male Chadian colleagues openly balk and laugh at me when I suggest the possibility of equality between men and women and are appalled when I tell them Grant makes pancakes for me on Sunday mornings. While I am amused by this light-hearted banter, the profoundness of their sentiments strike me silent whenever I think of that simple little abbreviation, F.G.M.
References
UNICEF
World Health Organization
Measure DHS
Female Genital Mutilation Network
Tags: female genital mutilation, FGM
June 29th, 2011 at 9:02 am
Thank you for this blog. I am a nursing student in Chicago, IL and have read a few memoirs regarding Female Genital Mutilation and I too still cannot abbreviate. I am going to share your blog with my classmates. And if your clinic ever needs nursing volunteers please do not hesitate to contact me.
-Brittony
June 29th, 2011 at 9:46 am
Thank you very much Chantelle for this insightful look at a human rights issue that many do not want to acknowledge.
FGM is gender violence- pure and simple. And we must look at ways to stop this practice for the sake of our women and girls. Unfortunately, it is a ritual that is hard to think about, depressing to research, and even more difficult to stop. But I believe it all comes down to education through culturally-sensitive health communication and social marketing techniques. While it is easy to back away, horrified, we must attempt to understand so that we can change the system from within. I believe that is exactly what you are doing and I applaud you. In fact, consider this a virtual hug.
Please remember the health atrocities that you are seeing as a result of simply being born a woman in a far away country. You must help be the voice for the little girls that are still happy and healthy, who have yet to be forcibly held down so that a “butcher” can remove, cut, or sew on her most private and sacred body parts. Continue to speak out for the little girls who have not yet had to deal with the aftermath of these untrained back-alley surgeons and the resulting fistulas, obstructions, infections, and ultimately shunning and divorce from husbands and families due to unnecessary leakage and odors from once perfect little bodies that have been broken through “rite of passage”.
FGM has no place in our world or in our bedrooms. It does not make a woman more faithful or hygienic or less likely to masturbate or become a lesbian. It does not keep a clitoris from growing into a penis or create a woman from a girl. And it certainly does not come from any religious text- neither Koran nor Bible. What is does is remove a woman’s right to her own body, to her own reproductive health, and to her own sexuality. I once read in my research that FGM, particularly infibulations, demotes a woman into nothing more than a “masturbatory object” for her husband. In turn, the research article found that the men in this study often reported a lack of sexual pleasure with their wife because she could not enjoy it and often he felt as though he was causing her pain. So who does FGM benefit? Obviously not the woman and it appears not the man, either.
Thank you again for bringing up this incredibly difficult issue. I wish you the best during your Honeymoon in Chad.
Amber Barnes, MPH
STOP Team 37, Sierra Leone 2011
June 29th, 2011 at 11:19 am
Wow. I am always overwhelmed by the realities you see every day.
Nonetheless, here’s what I think: at one time it was common practice for boys in Canada to be circumcised shortly after birth. Now, if i’m not mistaken, that number has been cut by half or maybe more. In my circles/my generation of child-bearing women, circumcision is thought of an an old Jewish tradition, not common practice. And I believe it is because the health field has educated and supported us, helping us to see that religious rituals such as these are not a path to heaven – just out-dated practice. I support you 100%. Your being there, fully intact, not persecuted or damned to hell, with a husband who loves you, an education and a position of authority, speaks volumes. There is no greater teacher than to practice what you preach.
For us it took only one generation – one health push – and we were on a better track. Press on. You’re doing the right thing.
Thank you for sharing and for doing what you do over there.
June 29th, 2011 at 6:32 pm
Thank you for taking the time to share this first hand experience with the rest of the world.
We need to know the realities and you have shared this with us impartially and compassionately.
The work that both you and your colleagues do is very humbling …….
FEMALE GENITAL MUTILATION does not in anyway honour anyone – least of all women and what people think it actually achieves is way beyond my comprehension.
Thank you for your love & light in all that you continue to do.
Sally x