Hi!
Just thought this might be of interest in the debate on FGM. Enjoy.
Buharry.
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Sudanese women's struggle
to eliminate harmful traditional practices
By Amna Hassan, Executive Secretary of the Sudan National Committee on Harmful Traditional Practices (SNCTP.)
Introduction
Harmful Traditional Practices (HTP) include a wide range of cultural specific practices ranging from minor ones to major societal beliefs and practices that are truly damaging to the health of women and girls.
Four practices can be identified as most harmful and urgent to be eradicated. There are Female Genital Mutilation (FGM), Nutritional Taboos, Early Marriage and non-spaced pregnancy. FGM is the most harmful one and therefore worthy of more efforts for its eradication.
FGM is a term used to describe partial or complete removal of the clitoris. It is evident that this practice did exist before Christianity, Islam and Judaism began; it is as old as the Pyramids of Ancient Egypt.
International and national action against FGM in Africa The Inter-African Committee (IAC) campaign against harmful traditional practices was established in 1984. After years of massive efforts 24 African committees were established and affiliated to Inter-African Committee working for the same objectives, strategies and plans of action, in order to eradicate Female Genital Mutilation (FGM) by the year 2000.
The Sudan National Committee on Harmful Tradition Practices (SNCTP) affecting the health of women and children was established in 1985 as a women 5 non-governmental organization, immediately after the Nairobi Women Conference, to fight against harmful traditional practices (HTP). SNCTP focuses on the issue of female genital mutilation from various points of view trying to contribute to its eradication starting from land practical experiences, assisting other National Committees (NCs) or other organizations which are working towards the same goal.
The persistence of FGM
According to research efforts and interviews with those involved in FGM in Sudan, as well as in other African countries, the following factors were found to contribute to the persistence of FGM:
Psycho-social beliefs:
These often run deep and may appear to many people outside that particular belief system to be irrational. But women in African countries often believe that the clitoris would be dangerous during childbirth, when the baby's head touches it, and this will lead to its death.
In some areas in Ethiopia and Sudan, women believe that if female genital mutilation were not carried out, the clitoris will grow to dangle between the legs like a man's penis: because of this myth, the clitoris is viewed as a rival to the male sexual organ, and is as such intolerable to men. In other instances, society is quite direct about the curtailing women 's sexuality. The reasons given by both women and men for FGM is "the attenuation of sexual crime", since the cause of this desire is clearly the clitoris. Excision is believed to protect a woman from her sexuality by preserving her from temptation, suspicion and disgrace, while preserving her chastity. These beliefs must be understood in the context of a society that sees female virginity as an absolute and clear prerequisite for marriage. In societies where men have several wives, it is said that since it is physically impossible for him to satisfy them all, it helps if they are not too sexually demanding. It also supposedly reduces the chance of women straying.
In research carried out with 200 prostitutes in Sudan, Dr A A Shandall concluded:
"Infibulation does not confer any protection or deterrent action on females". Moreover, the vulval skin diaphragm, being an artificially constructed device, can always be reconstructed without any suspicion that this is not the original infibulation. In his opinion, infibulation would encourage immorality rather than protect against it. He concludes that prostitutes do not generally work for pleasure but for economic survival. Of course excision is not a barrier to penetrative intercourse. However, the frustration resulting from not being able to achieve full sexual pleasure might encourage promiscuity. In such situations a woman is never satisfied during sexual intercourse and, consequently she may seek several partners in an attempt to find satisfaction.
Religious views on FGM
One of the major constraints is the ambiguity which is associated with religious beliefs towards FOM. There is no coherence and there are no final statements (fatwas) about FOM from an Islamic point of view. However, most of the statements made have repeatedly stressed it is only a rnakrama, in other words, a "third or fourth order duty". The issue is therefore ambivalent, especially in the rural areas. Physicians are another constraint. They often defend FGM, partially on "scientific" and sometimes on "religious grounds". They voice their opinions in the media as well as in medical circles.
The beliefs of modern contemporary scholars may be summed up in the words of Sheikh Mahmoud Shaltout, former Sheikh of M-Azhar in Cairo, the most famous university of the Islamic World, who stated: "Islamic legislation provides a general principle, namely that certain issues should be carefully examined and if these are proved to be definitely harmful or immoral, then it should be legitimately stopped, to put an end to this damage or immorality. Therefore, since the harm of excision has been established, excision of the clitoris is not mandatory nor a so-called "Sunna" (duty).
Sociological factors
The practice is performed as a rite of passage in many areas, such as Northern Sudan, Somalia, Kenya and Mali. An elaborate ceremony surrounds the event there, with special songs and dance intended to teach the young girl her duties as a good wife and mother. In some areas the very young girl will be given gifts, such as gold, clothes and food. However, it seems that today in many of these societies the ceremonial aspects are disappearing due to education and eradication campaigns.
'Hygienic' justification
In many African countries where FGM is practised, such as Sudan, Egypt, Somalia, Ethiopia, and others, the external female genital organs are considered dirty. The unexcised female is called nagisha (unclean), yet in practice FGM clearly does not promote hygiene, because urine and menstrual blood cannot escape naturally, resulting in discomfort and infection. Similarly it is sometimes considered that the female genital organs are ugly in their natural state.
Repression of female sexuality
Women are victims of out-dated customs, attitudes and male prejudice. This results in negative attitudes of women towards themselves. In fact, there are many forms of sexual oppression, but FGM is based on the manipulation of women's sexuality, in order to assure male domination and exploitation. Other cultures look on FGM as a barbaric procedure. But it should be recognized that FGM is part of a continuation of patriarchal repression of female sexuality which has been represented in a variety of ways in all parts of the world throughout history. Methods vary in scope and degree but not in kind. Psychological consequences Professor T A Ba'shor, a Sudanese psychiatrist, and former WHO Regional Adviser for the Eastern Mediterranean on mental health, has stated:
"It is quite obvious that the mere notion of surgical interference in the highly sensitive genital organs constitute a serious threat to the child and that the painful operation is a source of major physical as well as psychological trauma. It violates the human rights of children when performed on infants and young children. The reactions of the children are panic and shock from extreme pain, biting through the tongue, convulsions etc..., and even death. FGM, however, is a form of torture that violates article (5) of the Universal Declaration of Human Rights."
Sexual health problems
Dr Shandall studied 300 men in Sudan, questioning them about their sexual experiences with women who have had been genitally mutilated. Every man interviewed with more than one wife, of whom only one was infibulated, stated that they preferred non-excised or so-called "Sunna" circumcised women sexually. They enjoyed intercourse with them more because they seemed to share with them the desire, the act and the pleasure. Some authors point to a link between FGM and drug-taking in men, specially the smoking of hashish. Apparently these men experience difficulty in bringing their wives to orgasm. To be able to arouse them and for them to experience pleasure, men have to take drugs to help them hold their erections as long as possible.
Attitudes towards FGM in Sudan
A Sudanese demographic and health survey conducted in 1989/90 showed that support for FGM was widespread among women and had remained almost unchanged over the past decade. Women with no education or only primary education generally supported FGM whereas less than half of those with senior education did so, thus there is no evidence of erosion of support for it. The same survey shows that 88 per cent of men aged 15 and over were in favour of FGM. A majority of them (73 per cent) prefer the so-called "Sunna" type and a minority of about 18 per cent prefer infibulation, while 4 per cent prefer an intermediate type. A major obstacle to eradication is that Traditional Birth Attendants (TBAs), nurses, midwives and health visitors use FOM fees to subsidize their salaries. Eradication, therefore, will bring financial misery to some of them.
The campaign against FGM
SNCTP has conducted several activities, ranging from training of trainers (TOT) involving community leaders, higher education students associations and religious leaders, training and information for health workers at all levels. Alternative Employment Programme for TBAs and nurse midwives and public group discussions. Production and distribution of educational materials, a mass-media campaign including drama plays, songs, reports from various experts and specialists tackling the issue of (HTP) and exchange of research results on HIVIAWS in relation with (I~UFP) generally and (FGM) in particular were also discussed on the regional and international meetings. SNCTP successfully injected its strategies and plan of action in the government comprehensive strategies for the year 2002. SNCTP collaborates closely with the Sudan Family Planning Association, women and youth unions, National Aids Programme and National Population Council. An impact assessment of SNCTP activities was carried out by an expert professor from the University of Khartoum in December 1994. It showed some positive results:
1. The very fact that the issue of (FGM) is now publicly discussed in the media among both men, women and youngsters is in itself a major indicated of attitudes of a change. The mere discussion of the issue used to be a taboo and at best "a women's private issue
2. Due to the national process of the household demographic cycle, and to the other social and economic processes, the role of the elders particularly grandmothers who are the traditional proponents of the practice gradual residing.
3. Among the most educated, the practice is now viewed as "a symptom of backwardness, anti-modernity and shameful," to the extent that some people have started to practise it in secret and without ceremonies. There is a trend toward the so-called "Sunna" method which is less harmful, and also a new version of "false" circumcision has been produced which involves only the placement of a plaster round the labia minor as a substitute for the operation (basically to convince the girl and the relatives that the operation has taken place).
In conclusion, with the increased female education, age of marriage has considerably increased and there is a general awareness about HTP and FGM being associated with health hazards. We expect eradication of 60 per cent by the year 2002 if efforts are continued and if pressure groups for monitoring are established.
Case histories
"I am 55 years old and my husband is 80 years old. He has now been blind for three years. I have diabetes and hypertension. I was married when I was less than 15 years old. I don't have sons but three daughters aged 21, 15 and 13 years respectively. My mid daughter was circumcised at the age of six. Since she reached puberty, she has continuously had problems with menstruation. The doctor in Sinnar said that it was due to infibulation. At the age of 14 she was married to a blacksmith in Omdurman. Her problems and complications continued. Her husband and I took her to the hospital. She was given some treatment. After that she became pregnant and her husband brought her back to Sinnar to have her first baby with us. In October last year she gave birth to a girl and four days later she died of tetanus infection. Recently two girls and a doctor had discussions with all the people in the neighborhood about the bad effects of FGM. When we realized that we lost a daughter just recently due to FGM and early marriage and delivery, her youngest sister refused to get married since she is only 13 years old. My brothers are angry and stopped every support to us. My husband was insisting that she must marry her cousin, but she refused. Hiyam, the little daughter of my daughter who died, will never ever be circumcised". (A woman from Magharba tribe)
"The first time I did female circumcision was in 1981, after I became a health visitor. I remember, I was working with the Blue Nile health project at that time. I never got any formal or informal training about FGM; I just saw some of my colleagues practising it. One of the strong reasons to do it is of course, the economic gains. In 1981, I circumcised a girl from a rich family, they paid me about ten Sudanese pounds in cash and about the same amount in kind. That represented about a quarter of my monthly income. Poor families pay half of that paid by the rich and they usually go for midwives or TBAs rather than "an expensive health visitor". At that time, I used to circumcise 2-3 girls per month, that means, I used to get fifty to seventy per cent of my income from circumcision. Of course, the whole business is seasonal, especially in urban areas because people prefer to circumcise their girls during school holidays (specially during dry season).
During the period 1983-1989, prices of circumcision had dramatically increased to S£50.00, then to £100.00 and to £1,000.00 in 1989. In 1989 my monthly salary was about £1,300.00. That means, if I circumcised 2-3 girls per month I earned the equivalent of double my monthly salary. About 80 per cent of my circumcisions used to be infibulation type as only few educated people especially men, request the so-called 'tSunna" type. I remember a teacher who asked me to circumcise his two daughters the so called 11Sunnan type, but when he left, his wife asked me to do "pharaonic" circumcisions. I retused because I was afraid that the father might check on his daughters and that might cause me some trouble. A year later, the women had her daughters recircumcised by the pharaonic method without the knowledge of her husband.
"Since I got trained by (SNCTP), I completely stopped FGM, and in fact, I regretted that past experiences very much. So far, I have trained (during the last two years) more than 150 paramedicals on HTP."
A health visitor
"The first experiences were very painful for her. For a long time we could not enjoy sex together because it was a unilateral thing. It was I who had the orgasm. She only had fear and pain. I had had some experience and knew either I would ruin the whole relationship or with gentleness and patience, I would eventually solve the problem. I loved her very much, and for a long time, for several months, we both tried very hard to make it work. It was a nightmare. Of course I wanted sex. Every time I approached her sexually, she bled. The wound I had caused was never able to heal. I felt horribly guilty. The whole thing was abnormal. The thought that I was hurting someone I loved so dearly troubled me greatly. I felt like an animal. It is an experience that I would rather not remember. It was bad for both of us. It was not until after our first child was born that she could have relations without pain, and then she was able to enjoy sex for the first time. The child was born in England and she was not resutured. I would never permit that to be done to her again. Things are very good the way they are now, and we both enjoy sex together very much, now that nobody is suffering any pain."
(A testimony of a Sudanese man's first sexual experience with his circumcised bride)
©Copyright IPPF 1995.
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