McNab

Female Genital Mutilation/Cutting

Female Genital
Mutilation/Cutting

Neyah McNab
Independent Study-Based Unit
Mr. Toole
13 May 2016

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Female Genital Mutilation/Cutting

Table of Contents
Table of Contents........................................................................................................... 2
Preface......................................................................................................................... 3
Summary of Research Methods......................................................................................... 7
Background................................................................................................................... 8
Expert........................................................................................................................ 13
Role of Control............................................................................................................ 15
Logic of Evil................................................................................................................ 17
Case Study: Colombia................................................................................................... 20
Case Study: Malaysia.................................................................................................... 23
Case Study: Somalia..................................................................................................... 26
International Organizations........................................................................................... 32
Canadian Connection.................................................................................................... 38
Solutions..................................................................................................................... 41
Bibliography............................................................................................................... 45

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Preface
Number one: She did not see Gods axe.
Number two: No, she was blind like us then. She did not see it.
Number three: God struck the blow that made her Queen!
Number four: Beautiful enough for him to fuck.
Number one: God liked it fighting!
(Laughter)
Number two: God liked it tight!
Number three: God like to remember what He had done, and how it felt before it got
loose. Number four: God is wise. That is why He created the tsunga [traditional birth
assistant].
All: With her sharpened stone and bag of thorns!
Number one: With her needle and thread.
Number two: Because He liked it tight!
Number three: God likes to feel big
Number four: What man does not?
(Laughter)
Number one: Let us eat this food, and drink to the Queen who is beautiful, and whose
body has been given to us to be our sustenance forever (Walker, 1992).
Society has a long history of dominance and control over the female body and feminine
sexuality. This dominance and control can be attributed to patriarchy. Patriarchy is the social
structure of society based on the father having responsibility for the security of and jurisdiction
over their families. However, the true scope of patriarchy outstretches the familial domain.

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Patriarchy conveys that men hold the most powerful roles because of their ability to exert control
through violence or threat of violence, and that personal attributes and social activities related to
men are highly esteemed in society (Johnson, 2005).
Female genital mutilation/cutting, in the same like as foot binding, breast ironing and
corsetry, are part of the perpetuation of the control over the female body and sexuality. Refusing
womens self-governance spawns and sustains womens economic, political, social and sexual
inferiority (Monagan, 2010). Yet, females are forced to undergo severe, traditional or cultural
practices that reject their rights and cause them great anguish. These practices occur globally
and are not specific to any one nation or culture, but instead, the unseen power of patriarchy.
The World Health Organization (WHO) estimates that more than 3 million girls are
estimated to be at risk for female genital mutilation/cutting annually and more than 200 million
girls and women alive today have been mutilated in 30 countries in Africa, the Middle East and
Asia, where female genital mutilation/cutting is concentrated (WHO, 2016). Female genital
mutilation/cutting comprises 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,
UNICEF, UNFPA, 1997). The name of this procedure has changed numerous times throughout
the years. When the practice first came to global attention, it was generally referred to as female
circumcision. However, the term female circumcision has been criticized for comparing and
confusing the two distinct practices. It is also been stated that the term takes away from the
serious physical and psychological effects of genital cutting on women. The term female
genital mutilation is used by a wide range of womens health and human rights organizations.
Use of the word mutilation also stresses the seriousness of the practice and supports the
argument that the practice is a violation of women and girls basic human rights. This theory
garnered support in the late 1970s and since 1994, it has often been used in United Nations
conference documents and has served as a policy and advocacy tool. In the late 1990s, the
procedure started being referred to as female genital cutting, partially due to discontent with the
term female genital mutilation.

The belief was that communities could find the word

mutilation degrading, or that it could presuppose that parents or practitioners perform this
procedure maliciously (UNFPA, 2015). To accommodate the variance of terminology, this report
will refer to the practice as female genital mutilation/cutting or FGM/C.

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The WHO/UNICEF/UNFPA Joint Statement classified FGM/C into four types. Most
often performed are, type I, clitoridectomy, which removes all or part of the clitoris and type II,
excision, which includes the removal of the labia, as well as all or part of the clitoris. These
procedures are believed to maintain virginity until marriage, but essentially to take away all
carnal desires and pleasures including masturbation. Infibulation with excision is type III; the
vagina is surgically closed with the exception of a small opening for urination and menstruation.
Type III is arguably the most barbarous of the three primary forms of FGM/C and the goal is to
guarantee virginity until marriage. Typically, type III is performed by midwives, tribal leaders or
elder female relatives. Upon completion of the procedure, the vagina is stitched closed and the
girls legs are tied together for nearly two weeks until the wound has healed. Often, there are
marital ceremonies where the husband cuts the wound open or the wound is forcefully
penetrated. The final type of FGM/C is type IV, which includes other hurtful acts such as blood
piercing, scarping or cauterization (WHO, 2016). Girls between the ages of 0 to 15 years are
subjected to FGM/C, notwithstanding, adult and married women may have to endure to
procedure as well. Local tradition and circumstances often determines the age when FGM/C is
performed but it is decreasing in some countries (UNICEF, 2005).
FGM/C can be conducted by a designated elder from the community, who is usually a
woman, or by a midwife. In certain communities, the practice can be conducted by traditional
health practitioners, barbers, members of secret societies, herbalists, or a female relative. When
medical professionals perform the procedure, it is referred to as the medicalization of FGM/C
(UNFPA, 2015). UNFPAs estimates around one in five girls subjected to FGM/C were cut by a
medical professional. According to estimates from demographic and health surveys and multiple
indicator cluster surveys, countries where the majority of FGM/C cases are performed by health
workers are Egypt (77%), Sudan (55%), Kenya (41%), Nigeria ( 29%) and Guinea (27%)
(UNFPA, 2015).
FGM/C has no health benefits. It is a harmful and risky procedure that involves the
removal and damage of healthy, normal female genital tissue and the interference with the
natural functions of females bodies. Generally speaking, risks increase with increasing severity
of the procedure. FGM/C can cause immediate and long-term medical problems. Immediate
complications can include severe pain, hemorrhaging, genital tissue swelling, fever, infections

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e.g. tetanus, urinary problems, wound healing problems, injury to surrounding genital tissue,
shock, and death. Long-term consequences can include urinary problems (painful urination,
urinary tract infections); vaginal problems (discharge, itching, bacterial vaginosis and other
infections); menstrual problems (painful menstruations, difficulty in passing menstrual blood,
etc.); scar tissue and keloid; sexual problems (pain during intercourse, decreased satisfaction,
etc.); increased risk of childbirth complications (difficult delivery, excessive bleeding, caesarean
section, need to resuscitate the baby, etc.) and newborn deaths; need for later surgeries and
psychological problems (depression, anxiety, post-traumatic stress disorder, low self-esteem,
etc.) (WHO, 2016).
FGM/C is typically supported by an entire community, notwithstanding the known
harmful consequences to girls. Men and women support the practice because the social benefits
outweigh the disadvantages. Families are unable to disregard the practice without the support of
the community due to shunning, persecution and judgement (WHO, 2008).

Cultural,

psychosexual, sociological, as well as socioeconomic, aesthetics and hygiene have been reason
to justify the practice of FGM/C (UNFPA, 2015); these will be further discussed in the Logic of
Evil.
FGM/C and early marriage are greatly connected. They share the same social factors and
sometimes are requirements of one another.

Both practices are present in patriarchal

environments resulting in value systems that classify girls and women beneath boys and men.
FGM/C and early marriage are entrenched in powerful and extensively supported beliefs and
norms, which place expectations on families to comply with certain attitudes. If a large segment
of the community is marrying their daughters early to practice FGM/C, other families may feel
pressured to do the same.

They acquiesce out of fear of being rejected due to lack of

conforming. The practice of FGM/C and early marriage allows communities to exact dominance
over girls and women, specifically their ability to reproduce and sexual behaviour (World Vision
UK, 2016).
FGM/C is a global concern because it violates, a series of well-established human rights
principles, norms and standards, including 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, inhuman or degrading treatment or punishment, (WHO, 2016).

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Summary of Research Methods

This report includes an in-depth study of the history and issues regarding female genital
mutilation/cutting. The majority of the content written is based on information procured from
sources, including scholarly reports, news articles, and reliable internet websites. In addition, the
validity of the content was confirmed by examining various sources. Some of the reputable
organizations that were used as sources for information include UNICEF, UNFPA, and WHO.
Furthermore, cultural and religious beliefs are investigated to provide further understanding.
All perspectives were portrayed and it is therefore the readers duty to formulate their opinion on
the issue presented in this report.

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Background
A concrete historical origin of FGM/C is uncertain, however it is known that it originally
had no relation to any religion and commenced long before the rise of Christianity and Islam.
The term infibulation derives from Ancient Rome from the piercing of female slaves labia with
fibulae (brooches) to oppress their sexual activity and prevent pregnancies. However, it is
generally believed that FGM/C originated in Egyptian culture (Discover News, 2012). While the
practice of male circumcision is evident in the Old Kingdom Egypt, there is none for female.
Salima Ikram, a professor of Egyptology at the American University in Cairo, told Discovery
News, This was not common practice in ancient Egypt. There is no physical evidence in
mummies, neither there is anything in the art or literature. It probably originated in sub-Saharan
Africa, and was adopted here later on. A common name for the infibulation is Pharaonic
circumcision and the Somali name for this practice is Gudniin Fircooni, which means remove
according to the Egypt Pharaoh, (Discovery News, 2012). In addition, many of the ancient
Egypt medical doctors were Nubians. This leads to the idea that the Nubians brought the
practice of circumcision with them (Global Alliance Against Female Genital Mutilation). The
Greek geographer Strabo, who visited Egypt around 25 B.C., first wrote about the male and
female circumcision. In his 17-volume work Geographica, he wrote, One of the customs most
zealously observed among the Egyptians is this, that they rear every child that is born, and
circumcise the males, and excise the females, (Discovery News, 2012).
There are multiple theories surrounding the reason for the circumcision. According to the
6th century A.D. Greek physician Aetios, the cutting was necessary in the presence of a large
clitorism, which was seen as a deformity and a source of shame, The clitoris was also said to
produce irritation while rubbing against clothing thus, stimulating the appetite for sexual
intercourse. In The Gynaecology and Obstetrics of the Sixth Century A.D, Aetios wrote, On
this account, it seemed proper to the Egyptians to remove it before it became greatly enlarged,
especially at that time when the girls were about to be married, (Discover News, 2012). Another
theory is the pharaohs believed that the gods were androgynous and therefore, every human must
have a male and female part. The female part of the man was located in his prepuce and the male
part of the woman in her clitoris. The pharaohs believed everyone needed to be circumcised to
become a full part of the male or female society. Some even believe circumcision was used to

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preserve their wives chastity during periods of war (Global Alliance Against Female Genital
Mutilation).
FGM/C had been practiced in indigenous communities around the world: Africa, Asia,
the Middle East and South America. However, many centuries later, 19th century gynecologists
in England and the United States performed clitoridectomies to cure hysteria and prevent
masturbation, female homosexuality and nymphomania. Gollaher, medical historian, said, The
surgeries we see in Victorian England and America were generally based on a now discarded
theory called reflex neurosis, held that many disorders like depression and neurasthenia
originated in genital inflammation, (Brown, 1866).

The same theory was behind the

medicalization of male circumcision. The last record of clitoridectomy performed for one of
these reasons was conducted in Kentucky in 1953 (Wright, 2006).
Commencing in the 1990s, FGM/C has been acknowledged worldwide as a human rights
violation of girls and women. Discovery New states:
Sweden was the first Western country to outlaw FGM/C, followed in 1985 by the UK. In
the United States it became illegal in 1997. FGM/C has been condemned by numerous
international and regional bodies, including the United Nations Commission on Human
Rights, the United Nations International Children Emergency Fund (UNICEF), the
Organization of African Unity and the World Medical Association (Discovery News,
2012).
Even though today the practice is recognized as a criminal offence in almost 30 countries, it is
still practiced illegally (Center for Reproductive Rights, 2012).
In February 2008, a joint statement was made by the United Nations Agencies and it
indicates (...) that female genital mutilation is a manifestation of unequal relations between
women and men with roots in deeply entrenched social, economic and political conventions,
(UNAIDS, 2008). Not only are there human rights and health concerns associated with FGM/C,
it is also gender-specific inequity akin to the historical suppression of females that is specific to
children and women (UNAIDS, 2008).

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FGM/C is a global matter because of its abuse of well-established human rights
principles, norms and standards:
As it interferes with healthy genital tissue in the absence of medical necessity and can
lead to severe consequences for a womans physical and mental health, FGM/C is a
violation of a persons right to the highest attainable standard of health. For FGM/C,
even in cases where there is an apparent agreement or desire by girls to undergo the
procedure, in reality it is the result of social pressure and community expectations and
stems from the girls aspiration to be accepted as full members of the community. That is
why a girls decision to undergo FGM/C cannot be called free, informed or free of
coercion (WHO, 2008).
FGM/C was conceived as a human rights concern at the 1993 World Conference on
Human Rights. During the conference, there were two major developments First, female
genital mutilation became classified as a form of violence against women (VAW); second, the
issue of VAW was for the first time acknowledged to fall under the purview of international
human rights law, (UNICEF, 2013). Categorizing FGM/C as a human rights violation under the
category of international law was debated throughout the mid-1990s. And even though
international human rights polices dont categorically identify the practice, Article 25 of the
Universal Declaration of Human Rights stipulates, everyone has the right to a standard of living
adequate for health and well-being, (The United Nations, 2016). The article has been used to
defend opposition to FGM/C and its violation of the right to health and bodily integrity.
Categorizing FGM/C as brutality, torture and violence against women, brings the practice under
the rubric of both the UN Convention on the Elimination of All Forms of Discrimination against
Women and the Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment
or Punishment. Additionally, FGM/C has long been performed mainly on children and has
consistently been prejudicial to their health and therefore a violation of the Convention on the
Rights of the Child (WHO, 2008).
FGM/C has also been identified as discrimination based on sex due to its entrenchment in
gender based inequalities and the uneven power structure between women and men; this impedes
womens complete and equal enjoyment of their human rights. It perpetuates violence against
girls and women, resulting in mental and physical consequences. FGM/C thwarts girls and

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women's self-governance around a practice that has long-term effects on their bodies and steals
their right to self-determination over their lives. Freedom of religion and the right to engage in
cultural activities are rights protected by international law.

Despite these rights, they are

conditional in that they do not override the fundamental rights and freedom of others. Hence,
social and cultural claims cannot be used to defend FGM/C (International Covenant on Civil and
Political Rights, Article 18.3; UNESCO, 2001, Article 4; WHO, 2008).
Human rights laws specifically protect children due to their dependence on others for
care and support. The best interest of the child is the leading principle and consideration that
came out of the Convention on the Rights of the Child (WHO, 2008). Parents who subject their
daughters to FGM/C believe the gains obtained from this practice exceed the risks. This view
cannot be used to condone an everlasting and life altering procedure that promotes violence
against girls and the encroachment of fundamental human rights. Legal action geared at the
defence of childrens rights pointedly calls for the elimination of traditional customs that are
discriminatory to their health and lives. The United Nations Human Rights Treaty Monitoring
Bodies and the Committee on the Rights of the Child have regularly raised FGM/C as an
infringement on human rights, asking State Parties to take all necessary actions to eliminate the
practice (WHO, 2008).
The call for a worldwide ban on FGM/C was advanced on December 18, 2014, when the
United Nations General Assembly adopted the Resolution [A/69/150], which was also
cosponsored by the Group of African States and an additional 71 Member States, and was
adopted by consensus by all UN members. Preceding Resolution [A/69/150], the United Nations
General Assembly had already taken a strong position on wiping out FGM/C by adopting
Resolution [A/RES/76/146], which was approved by the coalition of African and European
NGOs Ban FGM campaign (No Peace Without Justice, 2014). These resolutions called on
countries to denounce all harmful customs that impact women and girls, mainly FGM/C by
taking any action necessary, such as enforcing laws or aid, aimed at protecting women and girls
as well as boosting awareness and holding violators accountable for their actions. Advancing
womens rights and universal efforts for eradicating FGM/C were important milestones taken by
the 194 UN Member States when they approved five General Assembly Resolutions (No Peace
Without Justice, 2014). Many more countries are advocating the Resolution, which signifies the

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unity among states deliberate in their actions to eliminate FGM/C as a grievous and major human
rights violation. Moreover, the global efforts by UN Member States provides categorical and
staunch backing for activists at all levels (grass roots to policy) and campaigning for precise and
convincing national legislation to decisively prohibit FGM/C in their individual countries. In
order to legitimize local education and advancement of the rights of women and girls, local
communities must implement and enforce legislation. Legislation is essential to strengthen the
resolve of anyone who wishes to go against tradition and the practice of FGM/C, as well as
shield its victims and abrogate impunity. Notwithstanding, globally, a great number of countries
lack the laws to protect women and girls. In countries where laws exist, the political volition to
fully execute and enforce them has not followed. Collaborating action among all key players in
the abolition of FGM/C, including civil society institutions, is imperative to progress the
effectiveness of political and legislative actions geared at combatting the human rights violations
common to the practice (No Peace Without Justice, 2014).

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Expert
Kakenya Ntaiya is a Kenyan activist and an educator. She is the founder and director of
the Kakenya Center for Excellence. She is also a member of the Vital Voices Global Leadership
Network (CNN, 2013).
Recounting her experience, Ntaiya said, I really liked going to school. I knew that once
I went through the cutting, I was going to be married off. And my dream of becoming a teacher
was going to end, (CNN, 2013). Ntaiya was engaged by the age of five, and her dream of going
to school was not the norm for little girls from Enoosaen, a little village in western Kenya. Like
all little girls in her village, Ntaiya spent her childhood acquiring the skills she would need to
become a worthy Maasai wife. She said, Everything I had to do from that moment was to
prepare me to be the perfect woman by age 12, (CNN, 2013). In her village, girls were raised to
be mothers and boys were raised to become warriors. With the support of her mother, Ntaiya
was encouraged to aim for a better life and she did. She delayed her eventual destiny of FGM/C
for as long as she could. She made a deal with her father, a trade-off for going through her rite of
passage to womanhood, which included clitoral circumcision in her community. She asked that
after FGM/C, could she go back to school to continue her studies. Ntaiya wanted to become a
teacher, and her courageous question was advantageous, because her father agreed to her request.
As a teen, she won a scholarship to attend college in the United States. Ntaiya, also won the
support of her Maasai community, they came together to raise the funds she needed for airfare.
Ntaiya became the first girl to leave Enoosaen and she vowed to not only come back, but also
give back. Eventually, she kept her promise and created a safe place for girls to realize their
dreams, the first primary school for girls in her community. Throughout the next decade, she
received her doctorate in education and worked for the UN. (CNN, 2013; TED, 2013)
Ntaiya opened the Kakenya Center for Excellence in 2009. It commenced as a traditional
day school, but it has become the home for girls between the fourth and eighth grade. This
eliminates their daily walk for miles to and from school and it reduces the risk of being sexually
assaulted in the process, a prevalent issue in rural African communities. Living at the school also
cuts down on the girls time spent doing household chores. The Kakenya Center for Excellence
provides opportunities and education to the girls that Ntaiya sacrificed to access:

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I believe that there is great power in education. I have seen how it changes lives it
changed mine. My school is special for many reasons, and it is unique in one important
way. At my school, 100 percent of the girls have not been cut. It has been their decision.
And all the parents have agreed (CNN, 2013).
The Kakenya Center for Excellence seeks to empower and motivate young girls through
education to become agents of change and to break the cycle of destructive, such as cultural
practices such as FGM/C and early forced marriage in Kenya, (Kakenyas Dream, 2013). In an
interview with ABC News Australia in 2015, Ntaiya vocalized her denunciation for the practice
of FGM/C and shared her experience. Unbeknownst to her, by the time Ntaiya underwent
FGM/C at the age of 14, the practice was already illegal in Kenya. Presently, the law has
advanced and criminalizes all types of FGM/C, no matter the age.

Passed in 2011, the

Prohibition of Female Genital Mutilation Act ensures that anyone caught assisting in cutting or
removing girls from the country to have the procedure done is held accountable (ABC News
Australia, 2015). Aimed at protecting girls and preventing lifelong pain, the law also makes it a
crime to disgrace women and girls whom have not been cut:
We need to encourage parents and communities to respect it, and we need police and
government officials to enforce it. Cutting limits girls potential and denies them the
possibility to achieve their dreams. When daughters and mothers learn the truth about
cutting, they put a stop to it. Today, all around the world, men and women, girls and boys
are coming together to say no to cutting (ABC News Australia, 2015).

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Role of Control
The perpetuation or discontinuation of an issue is attributed to whomever is in control.
Most often than not, the party in control does not have good intentions and this is why the issue
remains.

FGM/C procedures are normally carried out by older female tribal leaders and

midwives. Women, because of their nurturing role in society, are expected to protect their
children from all harm and are ultimately responsible for their well-being. Despite this reality,
the men in these societies determine the meaning of virtuosity and allowable female image. Due
the female dependence on their fathers and husbands for protection and financial well-being,
women reconcile this rite of passage as imperative. Women also comply silently with this
tradition to improve their standing in society and be seen as acceptable for marriage (Monaghan,
2010).
A father from Ivory Coast told the New York Times, If your daughter has not been
excised. No man in the village will marry her. It is an obligation. We have done it, we do it, and
we will continue to do it. () She has no choice. I decide. Her viewpoint is not important
(Poggioli, French Activists Fight Female Genital Mutilation, 2009).

Ultimately, the final

decision of FGM/C for a girl rests with the fathers family. It does not matter if her parents
disagree with the practice. (Monaghan, 2010).
No gender is immune from humiliation and dishonour. It is experienced by both women
and men. However for women, shame means feeling lesser and recognizing that they are
different, but not in an acceptable way (Bartly). Women alone bear the responsibility of shame
in this patriarchal society because of their husband and fathers failure to control her sexuality.
Shame and dishonour brought by a male in the family cannot compare to that brought on by
female sexuality. Should a father choose to defy tradition and not allow his daughter to undergo
FGM/C, he becomes an outcast in society and his daughter brings dishonour to the whole family
(Bartly; Monagan, 2010).
Ayaan Jirsi Ali narrates her experience as woman in a patriarchal society:
I was a Somali woman, and therefore my sexuality belonged to the owner of my family:
my father or my uncles. It was obvious that I absolutely had to be a virgin at marriage;

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because to do otherwise would damage the honour of my father and his whole clanuncles, brothers, male cousins-forever and irretrievably. The place between my legs was
sewn up to prevent it. It would be broken only by my husband (Ali, 2007).
Patriarchy is the foundation on which the issue of FGM/C is predicated; it restricts and extremely
hinders the participation of a fundamental part of that society, the woman. Consequently, if a
society is to excel and attain its full capability, it must encourage self-determination, unrestrained
freedom from violence and detriment for everyone including the marginalized (Monagan, 2010).

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Logic of Evil
It is difficult to discuss FGM/C without considering the sides of both the challengers and
supporters of the practice. For the mutilation of innocent girls to occur for centuries, the
supporters must have logic supporting their actions. Procedures are normally performed by older
female tribal leaders and midwives. Women inflict these pains upon their daughters or other
young girls, even though women are expected to protect their children from all harm and are
ultimately responsible for their well-being because of their nurturing role in society. Fathers may
force their daughter into having the procedure completed (Monagan, 2010). Many girls willingly
partake in the practice. It is important to understand why they are all active participants in this
practice, when there are such grave physical disadvantages. According to the UNFPA, FGM/C is
practiced generally because of psychosexual reasons, sociological and cultural reasons, hygiene
and aesthetic reasons and socioeconomic factors (UNFPA, 2015).
The legacy of tradition and absence of choice leave girls no other option but to accept
FGM/C and its rationales as being natural and necessary.

To advance or preserve social

acceptance and financial and physical security, it is paramount for women to accept the custom.
The emphasis placed on marriageability also plays a significant role in women's acceptance of
FGM/C, considering in some cultures, a womans very existence depends on being suitable for
marriage. Without it, they would have little to no access to education and finance. In many
communities, circumcision is mandatory before marriage. In fact, in Somalia, a prospective
husbands family has the authority to verify the brides body pre marriage. In addition, her
mother will often ensure the stitching is still there and remains closed. For parents, early
marriage and infibulation are the keys to ensuring their daughters virtue and worthiness of the
bride price. Other reasons for circumcisions have also been linked to maintaining a girls
virginity (UNFPA, 2015; WHO, 2000).
The traditional excisor perpetuates the practice for a couple of reasons: personal interest
and tradition. Due to her job, she is well known and a respected member of her community.
FGM/C may also be her only source of income. She also believes the procedure is a rite of
passage and helps girls into womanhood (WHO, 2000).

Overwhelmingly, tradition is the

primary reasons embraced by many girls for the continuation of FGM\C. However, other

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reasons favoured for continuing include religious requirements, preservation of virginity premarriage, faithfulness after marriage, increased sexual pleasure for husbands, increased chances
for fertility, reduction of infant and childhood mortality and cleanliness (WHO, 2008).
Some practicing communities use hygiene and aesthetic factors as reason for cutting.
The womans external genitalia are seen as dirty and ugly and presumed to continue growing
bigger if not cut away and stitched closed. The parts of the woman's genitalia that secrete fluids
are infibulated, which makes the girl clean and beautiful. Removal of the clitoris is seen as
getting rid of masculine parts and infibulation is done for smoothness, both seen as the desired
beauty result. Some even argue that circumcision reduces the chances of contracting HIV and
AIDS in regions that are plagued with these diseases. They argue that being cut reduces sexual
yearning, which leads to less sexual partners for women and thus reduces the chances of
contracting the diseases. Grace Kemunto, a traditional circumciser said, When you are cut as a
woman, you do not become promiscuous and it means you cannot get infected by HIV,
(UNFPA, 2015; WHO, 2000).
Despite not being sanctioned by either Islam or Christianity, another favoured
justification for the practice of FGM/C is religion. People behave there are religious principles,
which mandate the external genitalia be removed because it is vital in making a girl spiritually
hygienic (UNFPA, 2015; WHO, 2000).
Psychosexual reasons are another argument for the validation of FGM/C, which is rooted
in eliminating girls sexual desires. An uncut girl is perceived to have hyper and an indomitable
sex drive. The view is that if the girl is left uncut, the clitoris will grow big and pressure on the
organ will stimulate exaggerated sexual desire. She will inevitably loose her virginity before
marriage, become ineligible for marriage, be promiscuous and a menace to her community, and
finally, dishonour her family. It is deemed that with the tight vaginal cavity of a stitched woman
will augment male sexual gratification, resulting in his faithfulness to her and the prevention of
divorce. If a woman who has not been cut is unable to conceive, it is also believed that once she
has been circumcised, her problems of infertility will disappear (UNFPA, 2016).
Socioeconomic factors also reinforce the practice of FGM/C because often it is a
requirement for marriage. Due to being reliant on men, financial necessity can be the primary

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reason for having the procedure done. FGM/C is sometimes mandatory for the right to inherit
(UNFPA, 2015; WHO, 2000).
The medicalization of FGM/C is justified by medical professionals by specifying how a
hygienic performance of the operation reduces pain and the risks to the health of the victim.
According to medical professionals who perform FGM/C, medicalization will aid in ending the
practice. They also claim that if they do not perform the operations in hygienic conditions, the
patient will have the procedure anyways in potentially unhygienic conditions and with pain
caused (UNFPA, 2015; WHO, 2000).

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Case Study: Colombia

Colombia, officially the Republica de Colombia, is a country situated in the Northern
South America, bordered by Panama, Venezuela, Brazil, Ecuador and Peru. With a population of
46 million, the national language is Spanish. The capital and largest city of Colombia is Santaf
de Bogot and home to almost nine million. Colombia has a presidential republic and been
governed by Juan Manuel Santos since 2010 (CIA, 2016).

Columbia adds to the discussion of FGM/C because the indigenous group practising it
was outed in 2007. They are also the only known group practicing the procedure in Latin
America. The practice has been taboo in this community and has only recently become known.
After a newborn Ember girl died due to complications in Pueblo Rico, unlike in many cases, the
doctor who treated her decided to report it. The story was covered by national news and
Colombia was added to the list of countries practicing FGM/C.

The news of the practice

shocked the majority of Colombia, including the Ember people. Due to the hushed nature of
FGM/C, the men in Ember society are said to be oblivious of the practice and completely
unaware of its occurrence. Not to mention, the women despite experiencing FGM/C, say they
have no memory of it until the birth of their first daughter. There are no official statistics on
FGM/C in Colombia due to silence surrounding the practice. Dana Barn of the UNFPA in
Bogot, Colombia said, We dont know the magnitude of the problem in the country, () Girls
can die and are buried quietly, and no one finds out, (UNFPA, 2016).

Although the practice is longstanding and widespread, according to Siagama of CRIRES,

research from the Ember community revealed that the practice was not indigenous (Orchid
Project, 2016). The origin of circumcision among the Ember people is unclear. The most
reasonable theory is that the practice was adopted from Africans brought as slaves to South
America (UNFPA, 2016).

The Ember-Chami is an indigenous ethnic group, who lives

dispersed in the rural areas of the province of Risaralda. Approximately, 250,000 Ember live in

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Colombia. They are the second largest indigenous group in Colombia after the Wayuu. The
group is autonomous and they have their own culture and spiritual leaders (Orchid Project,
2016).

The exposure of the practice prompted the formation of the Ember Wera (Ember
Women) movement.

This movement worked to transform the practice from within the

community and eradicate the practice. The slogan of the campaign: I am a woman, I am
an Ember and I do not practice female genital mutilation! The Ember Wera initiative is
supported by the Colombian government and the UNFPA, and works with indigenous authorities
and community members. It is part of the joint United Nations programme Integral strategy for
the prevention and awareness of all forms of gender-based violence in Colombia, financed by
the MDG-Fund worldwide to achieve the Millennium Development Goals of poverty reduction
(MDG Fund, 2013). With a five-year campaign, the Ember-Chami realized FGM/C has no
health or cultural benefits.

Miriam Negarabe, an Ember, recognizes that the indigenous women of Ember were
known to be undervalued in their community. Moreover, due to historical views and the sense of
being lesser than in the community, talk about FGM/C and other forbidden topics in the public
was difficult.

However, through organization and education, the women have begun to

acknowledge their rights:

We found women were really marginalized. They werent represented and didnt have a
voice. It was fundamental to get Ember women talking. Some didnt speak Spanish or
make eye contact with you at first. It was a long process, said Ruiz of UNFPA.
Some Ember women who took part in workshops on the health risks of FGM/C paid a
high price. We did hear of some women who were beaten by their husbands after they
had attended a workshop. They left their kids at home and men didnt know how to deal
with their wives' new role as activists. Men felt a loss of control (MDG Fund, 2013).

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Opponents of FGM/C have found that while educating the population and emphasizing
the dangers and health risks of FGM/C has proven to be a better educational resource than
detailing how cut women have less sexual gratification.

The UN educational program,

commenced with trained Ember nurses teaching women about their general anatomy. However,
when the nurses began teaching about the genital areas, the women in one community became
extremely angry and forced them to leave. They went as far as warning other communities not to
permit the nurses to talk to the women (UNFPA, 2016).

The funding for the educational workshops dwindled in 2011. Despite the lack of
continued funding, Columbian public health officials maintained their stance to eliminate
FGM/C. Nevertheless, these programs were void of meaningful support and did not completely
get off the ground and the programs can be deemed as unsuccessful. They ended and not all the
communities the projects intended to reach materialized. By 2012, the leaders of Ember
officially prohibited FGM/C by signing an agreement (UNFPA, 2016). Undeterred, FGM/C
persists in the more remote communities. Those performing the cutting have learned to sterilize
their devices and themselves with herbs, which appears to have reduced the mortality rates of the
girls being cut. The year of 2015 brought about the anti-FGM/C intervention, which was
instituted in eight other communities. Additionally, it has been reported by the indigenous
leaders that women whom have learned about their rights through intervention began to feel
legitimized to speak out against other issues between women, including gender-based violence
(Brodzinsky, 2015).

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Case Study: Malaysia

Malaysia has a total landmass of 330,803 square kilometres that is separated by the South
China Sea into two similarly sized regions, Peninsular Malaysia and East Malaysia. Peninsular
Malaysia is bordered by Thailand and East Malaysia is bordered by Brunei and Indonesia. The
capital city of Malaysia is Kuala Lumpur, while Putrajaya is the seat of the federal government.
With a population of over 30 million, Malaysia is the 44th most populous country (CIA, 2016).

The presence of Islam in Malaysia, as well as the compliance of the girls makes Malaysia
an ideal case to study when discussing FGM/C. Islam spread to Southeast Asia in the 13th century
and many scholars believe the practice was introduced at the same time. Even though there is a
lack of literature on the outset of FGM/C in the area, the past faiths (Hinduism and Buddhism)
that predate Islam reject both male and female circumcision (Taha, 2013).

FGM/C is prevalent among the Malay people, which is an ethnic group of the Malay
Peninsula and adjacent island in Southeast Asia. The peninsula comprises southeastern
Myanmar (Burma), southwestern Thailand, Peninsular (or West) Malaysia and Singapore. This
region shares many cultural and linguistic similarities, however this study will focus on
Malaysia. The Malay religion is Sunni Islam, which follow the Shafii school of law that declare
female circumcision (sunat perempuan) as a wajib meaning any religious duty commanded by
Allah (Britannica, 2016; Taha, 2013). In contrast, the other three Islam schools of law consider
female circumcision a sunnah or a recommended act (Taha, 2013). To enforce the practice as
a wajib, in 2009, the Fatwa Committee of Malaysias National Council of Islamic Religious
Affairs ruled that real circumcision was, obligatory for Muslims but if harmful must be
avoided, (Taha, 2013). On the contrary, there is no authentic text, in which the Prophet
Mohammed required or recommended female circumcision.

Its popularity stems from an

increasingly conservative interpretation of Islam. Previously it was a cultural practice, but now,
because of Islamization, people just relate everything to Islam. And when you link something to

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religion, people here follow it blindly, (Kasztelan, 2015). Regardless of this truth, the majority
of Muslim women in Malaysia are circumcised. Dr. Maznah Dahlui, an associate professor at
the University Of Malayas Department of Social and Preventive Medicine, conducted a study
in 2012 and found that 93 percent of the Muslim women surveyed had been circumcised
(Kasztelan, 2015).

In this study, Dahlui also discovered that female circumcision is increasingly performed
by trained medical professionals in private clinics, instead of by a mak bidan or midwife (Taha,
2013). The institutionalizations and medicalization on is a growing trend in Malaysia. Female
circumcision became more acceptable among the population when the Ministry of Health
announced it was, developing guidelines to reclassify the procedure as medical, (Kasztelan,
2015). This reclassification and medicalization of the procedure misleads people into thinking
the procedure is medically sound, despite it having no medical benefits. The medicalization of
FGM/C was recently described as a new disturbing trend by the UNFPA, UNICEF, the
International Confederation of Midwives and the International Federation of Gynaecology and
Obstetrics. Abdul Khan Rashid, a professor at Penang Medical College said, The problem with
the West is that it's just so judgmental. Who the hell are you to tell us what to practice and what
not to practice? A lot of women now do it in private clinics in safe conditions, but if youre
going to make it illegal, the practice will just go underground, (Kasztelan, 2015). He is not
alone in believing that international organizations such as the aforementioned should not be
determining how they live. Malaysian medical practitioners also defend the practice by passing
judgment onto other countries. Dr. Ariza Mohamed, an obstetrician and gynaecologist at KPJ
Ampang Puteri Specialist Hospital said, We are very much against what is going on in other
countries like Sudan, () That is very different from what we practice in Malaysia, () And
there is a big difference between circumcision and female genital mutilation, (Kasztelan, 2015).

Medical professionals insist Malaysia's method of female circumcision is less invasive

than the types practiced around the world. Dahlui explained that the procedure involves pricking

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the clitoral hood with a needle and it is performed on girls between the ages of one and six.
However, more invasive procedures exist. Obstetrician and gynaecologist Dr. Mighilia of the
Global Ikhwan private clinic located in Rawang explained, I just take a needle and slit off the
top of the clitoris, but it is very little [one millimetre], (Kasztelan, 2015).

Female circumcision is not illegal in Malaysia, even though the practice is only permitted
in private Muslim clinics. Due to the acceptance of the procedure, there are not any active
campaigns against the practice. However, studies are being done and research centres such
as the Womens Development Research Centre of University of Science, Malaysia (USM) and
womens rights organizations, such as Sisters In Islam are hosting public talks about FGM/C.
The Sisters In Islam, particular, is a local womens rights group against FGM/C and other
violence against women. They fight these injustices by advocating the Islamic principles of
gender equality, justice, freedom and dignity and womens empowerment (Sister In Islam, 2016).

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Case Study: Somalia

Somalia, officially the Federal Republic of Somalia has been in turmoil for many years
and is being led by Hassan Sheikh Mohamed. It is a former Italian colony and British territory
created in 1960. In 1991, the military regime of President Said Barre was over thrown and the
country went into a state of anarchy. During this time, Somaliland and Puntland, two northern
regions of Somalia broke away from Somalia to get away from rivalling fractions within
southern Somalia. Somaliland home of 3.5 million is internationally recognized as a selfdeclared autonomous state but its political system and working government is not. Puntland has
a population of 2.4 million; its leaders also have declared their territory autonomous but do not
wish to be identified as a sovereign entity but rather a part of a federal Somalia.
I was just 7 years old when I was cut, Leyla Hussein, a British woman who is
originally from Somalia, told WHO. The first thing I heard was my sister screaming. Then it
was my turn. Four women held me down while they cut my clitoris. I felt every single cut. The
pain was so intense I blacked out. (Goldberg, 2015). Somalia has some of the highest rates of
women who have undergone FGM/C in the world. 95 percent of the girls in Somali undergo
female genital mutilation and this is due to the long history of it in the country and continent of
Africa, as well as following the supposed beliefs of Islam (WHO, 2016). FGM/C is deeply
rooted in tradition. Despite knowing the health risks, even some girls that have experienced the
procedure feel that not all aspects of the practice should be eradicated. It's our tradition and if
the girls are not subjected to sunna (cutting) she will not be accepted for marriage, said Asthma
Ibrahim Jabril, a seventeen year old girl whom has already been circumcised (Daily News,
2014).

As previously mentioned, FGM/C can cause many health complications such

as problems with childbirth, infertility, problems with urination, infections, cysts, and the
potential for death of a new born. The cultural expectation to undergo FGM/C is about marriage
and sex. Girls that have not undergone the procedure are deemed unclean because men have an
expectation to marry virgins. Many Somalis still practice FGM/C because they are God fearing.
They have the saying, Caado la anyone, Carra Allay Leedaha, which means, stopping a
tradition brings the anger of God, (World Bank, 2004).

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The most common type of FGM/C practiced in Somalia was type III, commonly known
as the Pharaonic circumcision. 80 percent of procedures consisted of this type, which is the most
damaging. The less severe is type I, commonly known as the sunna, is practiced mainly in the
towns of Mogadishu, Brava, Merca and Kismayu (U.S. Department of State, 2001). Asha
Moalim Ahmed, a practising TBA, says, Pharaonic is going down, and people now ask for
sunna. I myself do not like Pharaonic. My father told me long ago that it is against religion and
I should only perform sunna. Even though the use of Pharaonic circumcision has decreased,
many parents still choose it for their daughters. I discourage parents. But some insist, because
they think Pharaonic is more beautiful, she says (UNICEF, 2016). Today, female circumcision
occurs between the ages of five and eight and in the privacy of peoples homes. However, it used
to be something the community was proud of and spectators were encouraged. Below is a
recount of someone who bore witness to the procedure:
With the Somalis, the circumcision of girls takes place in the home among women
relatives and neighbours. The grandmother or an older woman officiates. At each
occasion, usually only one little girl or at times two sisters are operated; but all girls,
without exception, must undergo this mutilation as it is a requirement for marriage. The
operation itself is not accompanied by any ceremony or ritual. The child, completely
naked, is made to sit on a low stool. Several women take hold of her and open her legs
wide.

After separating her outer and inner lips, the operator, usually a woman

experienced in this procedure, sits down facing the child. With her kitchen knife, the
operator first pierces and slices open the hood of the clitoris. Then she begins to cut it
out. While another woman wipes off the blood with a rag, the operator digs with her
sharp fingernail a hole the length of the clitoris to detach and pull out the organ. The
little girl, held down by the women helpers, screams in extreme pain; but no one pays the
slightest attention. The operator finishes this job by entirely pulling out the clitoris,
cutting it to the bone with her knife. Her helpers again wipe off the spurting blood with a
rag. The operator then removes the remaining flesh, digging with her finger to remove
any remnant of the clitoris among the flowing blood. The neighbour women are then
invited to plunge their fingers into the bloody hole to verify that every piece of the clitoris

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is removed. But this is not the end. The most important part of the operation begins only
now. After a short moment, the woman takes the knife again and cuts off the inner lips
(labia minor) of the victim. The helpers again wipe the blood with their rags. Then the
operator, with a motion of her knife, begins to scrape the skin from the inside of the large
lips. With the abrasion of the skin completed, according to the rules, the operator closes
the bleeding large lips and fixes them one against the other with long acacia thorns. At
this stage of the operation, the child is so exhausted that she stops crying, but often has
convulsions. The women then force down her throat a concoction of plants () When
the operation is finished, the woman pours water over the genital area of the girl and
wipes her with a rag. Then the child, who was held down all this time, is made to stand
up. The women then immobilize her thighs by tying them together with ropes of goat
skin. This bandage is applied from knees to the waist of the girl, and is left in place for
about two weeks. The girl must remain lying on a mat for the entire time, while all the
excrement evidently remains with her in the bandage. After that time, the girl is released
and the bandage is cleaned. Her vagina is now closed, and remains so until her marriage
(Hosken, 1989).

There is an influx of health professionals practicing female circumcision.

During

interviews with members of the Professional Nursing Association in Mogadishu, the members
disclosed, almost all the association's members carry out a milder form of circumcision for a
fee, (World Bank, 2004).

The associates also disapprove of the way traditional excisors

perform the procedure and the Pharaonic circumcision.

More families are using health

professionals, trained traditional birth attendants and nurses who perform the desired type of
FGM/C because of the complication, which emerge from the traditional procedure.
The medicalization of FGM/C commenced in Somalia at the beginning of the countrys
independence. A Lebanese medical professional started circumcising girls in Martini Hospital in
Mogadishu under anesthesia and sterile conditions. He professed to reduce the damage and
dangers related to FGM/C. Other health providers imitated him and distributed their services to
Mogadishu's affluent (VOA, 2015).

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In Somali communities, the practice of FGM/C has been an important custom and anyone
whom opposes it does so at their own peril. The practice is anchored in beliefs that lack
understanding and awareness, primarily with the obdurate elders. Many are knowledgeable of
the concerns surrounding FGM/C but also have inconsequential modification in attitude and
behaviour. Fatuma Hassan from the National Committee on Traditional Practices in Ethiopia
points out that if circumcisers do not have other duties, something else to occupy their time, they
will continue cutting. She points out, education is the best way to halt mutilation, but posters
and workshops are not enough (...) the circumcisers may be aware of the harmful effects of
FGM, but if they do not have something else to do, then they will continue to practice it,
(UNICEF, 2016). By Somali standards, the cutters earn a lot of money performing this service
and it is often their only source of income. If other possible ways to generate income can be
found, conceivably circumcisers will eventually be willing to end the practice. In fact, this
change has been noted when an aid worker detailed a visit to a village to see two sick girls:
We were called to the village to visit two girls who had become sick after an FGM
operation. After inquiring as to who had performed the operation, we discovered that it
was an elderly lady, who provided her service to villages within a 50km radius. She
showed us the place where she performed the operation, which was near to where she
kept her animals, and patently unhygienic. Discussions with the old lady revealed that
she was aware of the debates surrounding FGM, having attended community level
discussions on the topic. However, she believed it to be part of the Koran and Somali
tradition, and she pointed out that she had no alternative source of income.

We

encouraged her to attend more meetings on the topic, particularly with religious leaders,
and also offered to provide her with training on how to be a Traditional Birth Attendant.
Six months later, she started work as a Traditional Birth Attendant (UNICEF, 2016).
Across Somalia, leaders of Islam and Muslim scholars possess a great influence on their
congregations, maybe even more than any other authority. Their support has the potential to
increase efforts considerably to eliminate FGM/C. In Puntland, advancements were made in the
struggle in a conference between religious leaders.

With a collective congregation of an

estimated 100,000 followers, religious leaders including Sheikh Abdirizak Isse, a well-known
Muslim leader in Bosaso and teacher who led the discussion, gathered to declare they were
against all forms of the practice. FGM/C has continued because there is a perception that this is

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a religious requirement, and that is wrong, said Sheikh Abdirizak. It will take time to change
attitudes, but we are talking about this on the radio, we are talking about it in the communities
and we are talking about it in the mosques, he added (UNICEF Somalia, 2011). Further, they
promised to publicly repeat that female circumcision was not required by Islam. The conference
and the weeks of public meetings and dialogue were supported by UNICEF as part of its child
protection programmes in Somalia. Conditions have ameliorated, particularly in urban regions
and the disgrace of being uncut is dwindling. We see an acceptance in communities who used
to do FGM/C now to defend their position against it, said Sheikh Abdirizak (UNICEF Somalia,
2011). Governor Abdihafid Yusuf said there was an ongoing initiative at the Ministry of Justice
and Religion pushing for laws banning FGM/C in Puntland, it will soon be finalized. Events like
the Puntland Declaration are evidence of sincere support from the higher levels of regional
administration, (UNICEF Somalia, 2011). Similar actions and acceptance of the practice have
reached Somaliland too; Sheikh Aden Musa told a public meeting in Boroma that, People are
talking publicly about it, in the tea shops, in their homes, and that is something new, that they are
talking about whether this thing is demanded by the religion or not, (UNICEF Somalia, 2011).
However, there are still oppositions. Mohamed Hashim al-Kahim, a Sudanese Muslim scholar
who lead debates about FGM/C in Puntland said, Many Somalis think foreigners have a hidden
agenda to destroy society, to make debauchery, to send out diseases to kill our future with our
women going freely outside with no hijab, looking for men just to have sex with them,
(Goldberg, 2016).
There have been several key initiatives to eliminate FGM/C in Somalia. In 1977, during
the Somali Womens Democratic Organization (SWDO), the issue of FGM/C was publicly
highlighted for the first time (U.S. Department of State, 2001). Edna Adan Ismail, a Somali, was
also the first Somali person to criticize and campaign against the practice publicly and she
continued to do so for many years at important international gatherings, including the WHO
seminar in 1979 on the Mental and Physical Complications of FGM/C. Edna has since lectured
nursing and medical university students in Africa and Asia and had the issue and risks of FGM/C
added to the curriculum at the schools where she lectured (Ismail, 2002). In 1987, the SWDO
collaborated with the Italian Association for Women and Development to campaign against
FGM/C based on health risks, instead of human rights due to concerns that it would be
unsuccessful if based on human rights. By 1988, the Somali government advocated for the

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elimination of FGM/C based on health and religious reasons. Neither campaigns survived past
1991 with the defeat of Siyad Barre and the dissolution of the Somali Government (U.S.
Department of State, 2001). However, their actions have greatly influenced today. In 2012,
FGM/C was officially banned by the UN and Somalia stated they would ban the practice too.
And although many leaders have attempted to prohibit the practice, supporters have received the
most support when Prime Minister Omar Abdirashid Ali Shamarke said, Im committed to
outlaw FGM in Somalia through legislation, advocacy, education and community engagement to
confront the social norms that encourage the FGM practices within the society, in 2015, he
stated this is not response to a campaign launched by Avaaz (a platform that strives to make
people want to take action on issues worldwide). Prime Minister Omar Abdirashid Ali's
Shamarke also met with representatives from Avaaz regarding a petition to ban FGM/C, which
collected more than one million signatures (Goldberg, 2016).

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International Organizations
The fight to end FGM/C is now global, with international agencies, such as the United
Nations Childrens Fund and the World Health Organization in command. Governments such as
that of the United Kingdom and nongovernmental organizations are also strongly supporting the
eradication of the practice (WHO, 2014). Campaigns against FGM/C at grassroots, national and
international levels exist and all play a role in the fight to end the practice.

An example of an organization at an international level is the Inter-African Committee

(IAC). The Inter-African Committee on traditional practices affecting the health of women and
children is an African regional umbrella body. For the last 30 years, the IAC has been working
on policy programmes and actions to eliminate FGM/C, child marriage and other harmful
traditional practices and to promote the positive practices in the Africa. With the support of
UNFPA, UNICEF, WHO and the Government of Senegal, it was formed on February 6, 1984 by
African delegates to a seminar organized by a United Nations NGO Working Group on
Traditional Practices based in Geneva. It was established when FGM/C was a controversial and
sensitive issue to discuss and the necessity of an African regional voice in an international
campaign against FGM/C was crucial. The vision of the IAC is, an African region free
of FGM/C and gender related harmful practices, (IAC, 2016). Its two main objectives are:
to prevent and eliminate traditional practices that are harmful to or impede the health,
human development and rights of women and girls and advocate for care and support for
those who suffer the health consequences of harmful practices and to promote and
support those traditional practices that improve and contribute to the health, human
development and rights of women and children (IAC, 2016).
They have 29 national committees dispersed across the continent and many affiliates throughout
the world (Belgium, France, United Kingdom, Spain, Germany, Sweden, Norway, Italy, Canada,
USA, New Zealand, and Japan) to connect to African population groups in the diaspora. The
Inter-African Committee has consultative status with the United Nations (UN/ECOSOC) and

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holds an observer status with the African Union. It works in partnership with UNFPA, WHO and
UNICEF and is a member of the NGO network affiliated to the Organisation internationale de la
francophonie. The IAC works with several international organizations devoted to protecting the
human rights of women and children.

The IAC has a collaboration strategy on harmful

traditional practices with the African Union, the Economic Commission for Africa, UNFPA,
UNICEF, and the African Committee of Experts on the Rights and Welfare of the Child. The
IAC has formed regional and national networks of religious leaders, parliamentarians, media
professionals, health professionals and youth.

They also have the help of thousands of

volunteers in all the countries in Africa and around the world who participate in their work. The
IAC major achievements are:
demystification of FGM/C , inclusion of FGM/C in the programmes of Governments and
regional and international organizations, mobilization of African communities,
involvement of various socio-professional groups, i.e. creation of networks of religious
leaders, youth, media professionals, health professionals and parliamentarians; creation of
alternative income-generating activities for former excisors, assistance to victims
of FGM/C, participation in the conception and adoption of the Protocol to the African
Charter on Human and Peoples Rights, on the Rights of Women, proposition and
advocacy resulting in the adoption of February 6th as the International Day of Zero
Tolerance to FGM/C and proposition and advocacy resulting of the United Nations
General Assembly Resolution on the elimination of FGM/C (IAC, 2016).
The Former First Lady of Burkina Faso and Goodwill Ambassador of the Inter-African
Committee, Madame Chantal Compaor, have made monumental efforts in Africa and around
the world endorsing, especially to the Heads of State, governments, international institutions,
other development partners and communities against FGM/C. Since 2000, the IAC initiated the
creation of an African Regional Network of Youth for the elimination of FGM/C. This network
was created by young people from its 29 member countries in 2000. The second meeting of this
network was held in November 2006, in Addis Ababa, and it resulted in the creation of a youth
programme for both national and regional levels. For all of the Inter-African Committees
amazing work, it was awarded by UNFPA with the prestigious United Nations Population Award
in 1995 (IAC, 2016).

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An example of an organization at a national level is the Network Against Female Genital

Mutilation (NAFGEM).

NAFGEM Tanzania is a network of individual members working

towards total elimination of FGM/C, child marriages and other manifestations of violence
against women and girls. In 1998, the non-governmental organization was founded by women
human rights activists in Kilimanjaro. NAFGEM is legally registered in Tanzania under the
Society Ordinance Act of 1954 on February 4, 1999. They envision "a society without harmful
traditional practices notably FGM/C, child marriage and other types of GBV [gender based
violence] against women and girls, and their mission is "community sensitization and awareness
creation on effects of harmful traditional practices for the protection and restoration of women
and girls dignity," (IAC, 2016). The experience NAFGEM has acquired form working in
Kilimanjaro allows the organization to expand to other parts of Tanzania where FGM/C, child
marriage and other harmful traditional practices occur.

NAFGEM works to advance the

knowledge of the prevalence of FGM/C and its effects on health, development and the dignity of
women and girls through its programs. The organization also works to have an impact on
patriarchal mindsets, which are detrimental to enacting change, as well as women and girls.
NAFGEM has been engaging communities and other stakeholders in Kilimanjaro
and Manyara regions to contribute in the elimination of the FGM/C practice since its
establishment. They have created awareness for many on the practice through meetings,
community campaigns and posters with anti-FGM/C messages and its effects and have
challenged them to quit and support the initiatives of NAFGEM. NAFGEM has organized
meetings, workshops and trainings for various social groups including traditional leaders,
religious leaders, government leaders, women, men, youths, teachers, schoolchildren, police,
traditional birth attendants, health professionals and the circumcisers. They have created youth
programs where in and out of school youths are trained and challenged to say no to FGM/C
and other forms of GBV. They also have an anti-FGM/C radio program where anti-FGM/GBV
messages are spread through local radios and other media groups to have the community
constantly reached. NAFGEM collaborates with the local government, institutions and the
communities they operate in and is a member of the National Coalition Against Female Genital
Mutilation made up of eight organizations with similar missions. The other members include

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Legal and Human Rights Centre, Christian Council of Tanzania, World Vision, Women Wake-up,
Tanzania Media Women Association, Anti-Female Genital Mutilation Network and Dodoma
Inter-African Committee. In addition, NAFGEM works with Comprehensive Community Based
Rehabilitation in Tanzania in identifying and assisting women with fistula in the FGM/C
practicing areas. Recently, NAFGEM began working with local organizations dealing with
women, children protection and HIV/AIDS prevention in forming a regional coalition on women
and children protection issues. NAFGEMs work with and for the community has allowed it to
receive many achievements. The organization has won community trust and acceptance in the
areas of operation:
About 200 women, who identified themselves as female circumcisers, surrendered the
tools and confirmed in public that they will no longer perform the procedure. With girls
in primary schools, children camps were conducted in Rombeo, Same, Hai and Simanjiro
districts involving 800 pupils. In the camps, the girls had the opportunity to learn and
exchange information and ideas on FGM/C and strategies to prevent themselves from
being subjected to the practice. NAFGEM has participated in a rare Maasai traditional
gathering and was opportune to convince the decision makers to give order against
the FGM/C practice to their clan members (NAFGEM, 2016).
NAFGEM has made a great deal of improvement since it started its interventions in
Kilimanjaro:
The FGM/C prevalence rate was 35%.

The trend has shown reduction to 25% in

2004/2005 according to the Tanzania Demographic Health Survey Report (TDHR) and in
2010, the rate is at 21.7%. In Manyara region when NAFGEM launched anti- FGM/C
interventions in 2007, the prevalence rate of FGM/C was 81%. In 2010 the prevalence
rate is 70.8%; showing some achievements towards total elimination of the
practice (NAFGEM, 2016).

An example of an organization working at the grassroots level is the S.AF.E Kenya. In

Kenya, 90% of Maasai girls are cut and FGM/C affects thousands of Maasai girls annually with

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traumatic physical and emotional consequences. Maasai culture is patriarchal and women are
valued for their roles as mothers and wives, with Maasai women entirely dependent on their
husbands financially. S.A.F.E. says, Once cut at age 12 or 13, girls often quickly marry, leave
school and have children, limiting their own life opportunities. Maasai women do not have
access to any resources without a husband and, without being cut, a Maasai woman is ostracized
from her culture, (S.A.F.E. Kenya, 2014). Many parents believe they are acting in the best
interest of their daughters by perpetuating the tradition. However, prohibiting FGM/C will not
stop its perpetuation; campaigns that enforce its abandonment without respecting cultural
traditions often lead to failure. The fear of ostracism overpowers the fear of prosecution;
therefore, laws do not have a great impact on the tradition amongst indigenous communities.
The reason many projects do not offer a means of solving the problem is that they damage the
potentially strong connections with communities that could cause change. S.A.F.E. possesses a
unique FGM/C abandonment programme that is culturally accepted because it was created and
led by their Maasai team, SAFE Maa. They have developed an Alternative Rite of Passage to
replace FGM/C that allows a girl to transition to womanhood and be fully included
in Maasai society without her being cut. SAFE Maa uses performance and outreach work to
sensitively challenge this tradition. They have reached over 30,000 people and trained half of all
the traditional birth attendants in the region in the Alternative Rite. In 2015, they have had many
other projects regarding FGM/C. They had an abandonment project in the Maasai Loita Hills:
S.A.F.E.s flagship programme is our long-running work to end FGC in the Loita Hills, a
remote and rural Maasai community in south-west Kenya with a population of 35-40,000.
It has no roads or communication infrastructure and its inaccessibility has maintained
relative isolation, limiting the spread of new ideas and attitudes. In Loita, FGC has
remained a deeply entrenched cultural practice maintained by both women and men.
S.A.F.E. has been working in this area to change attitudes towards FGC since 2008 and
2014 marked a critical moment for this programme. With generous support from the JA
Clark Foundation and other donors, throughout 2015 we will consolidate our progress to
date and work to reach a tipping point so that a public declaration against FGC can be
made in the next few years. When this is done, girls and women for generations to come
will be protected against the violence of FGC (S.A.F.E. Kenya, 2014).

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They have another abandonment project in Aitong and the Maasai Mara:
In 2014, with generous support from Kicheche Camps and Exodus Travel, we began to
replicate our FGC-abandonment work with the Maasai community in the Maasai Mara.
Two senior members of SAFE Maa spent a week in the Mara in June to identify
performance sites, meet schools and establish partnerships. Kicheche, who hosted the
team during this time, has one of the most robust community outreach programmes in the
Mara, and their trusted relationships and contacts enabled SAFE Maa to quickly establish
good partnerships (S.A.F.E. Kenya, 2014).
As previously stated, S.A.F.E. has unique projects; members from the organization go into the
community, and perform creative work and deliver in the communitys space. Immediately after
the performance, S.A.F.E. actors come offstage and deliver workshops and services. S.A.F.E.
takes its work and performances to some of the most isolated and under-served communities that
often have no other access to information about public health and the performance typically draw
audiences from 300 to 2,000 people. A bridge between watching a play and moving forward
form the tradition is provided by the bond created between the actors and audience. S.A.F.E.
states, When audiences are immersed they forget themselves, they create relationships with the
characters, they believe in the messages we share, and they have clarity over the solutions
available to them. Good theatre can provide people with the space to be able to re-think their
behaviours and assumptions, and to then take action, (S.A.F.E. Kenya, 2014). The performers
are also more effective because they are from the community; every member of S.A.F.E. comes
from the specific regions in which they work, which means they comprehend the variations of
the issues and they have the trust and permission of the community to discuss change. The
S.A.F.E. teams are the familiar and honest links between the community and otherwise aloof
health professionals. Actors adapt to each audience when performing by collecting a multitude
of stories from the community and developing characters and stories that are entrenched in real
life experiences. S.A.F.E. believes, this is essential because for people to believe in our
message and want to take action, they have to see a mirror of their lives onstage, (S.A.F.E.
Kenya, 2014). S.A.F.E. has a Female Genital Cutting Programme, in which 80% of workshop
participants transformed from believing that FGM/C was a fundamental part of being Maasai to
believing that there are other practical methods of transitioning a girl into womanhood and 67%

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of men attending the workshops said they would encourage their sons to marry uncut girls.
S.A.F.E has had a profound impact over the last decade. The organization allows people to see
their own lives and choices performed in front of their eyes, so they can reflect on their actions
and be galvanized to make a difference to their and Kenyas future, (S.A.F.E. Kenya, 2014).
S.A.F.E. has been able to achieve success where others cannot because the members go directly
into Kenyas most under-served and hard-to-reach communities and speak to people using
effective methods. They are able to engage with people on typically taboo topics because all
their performers come from the communities in which they work.

In turn, this helps the

audiences to feel connected to their performances because they are regarded as the children,
brothers, sisters and friends of their target audiences (S.A.F.E. Kenya, 2014).

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Canadian Connection
To explain the Canadian connection in FGM/C, it is important to understand the laws
concerning the procedure in Canada. FGM/C is against the law in Canada. The Criminal Code
categorizes it as aggravated assault, except in situations exempted under section 268.3:
Aggravated Assault
268. (1) Every one commits an aggravated assault who wounds, maims,
disfigures or endangers the life of the complainant.
Punishment
(2) Every one who commits an aggravated assault is guilty of an indictable offence and
liable to imprisonment for a term not exceeding fourteen years.
Excision
(3) For greater certainty, in this section, wounds or maims includes to excise,
infibulate or mutilate, in whole or in part, the labia majora, labia minora or clitoris of a
person, except where
(a) a surgical procedure is performed, by a person duly qualified by provincial law to
practise medicine, for the benefit of the physical health of the person or for the purpose of
that person having normal reproductive functions or normal sexual appearance or
function; or
(b) the person is at least eighteen years of age and there is no resulting bodily harm.
Consent
(4) For the purposes of this section and section 265, no consent to the excision,
infibulations or mutilation, in whole or in part, of the labia majora, labia minora or

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clitoris of a person is valid, except in the cases described in paragraphs (3) (a) and (b)
(Government of Canada, 2016).

According to the Society of Obstetricians and Gynaecologists of Canada (SOGC), the

problem of FGM/C affects women here in Canada too.

Canada takes in many immigrants

annually. Dr. Victoria Davis, a Canadian expert on FGM/C who has worked with hundreds of
immigrant women, says a high percentage of these women will have undergone FGM/C.
However, there are no reliable statistics because of the secrecy of the practice. Dr. Davis
examined a pregnant immigrant from Somalia who had undergone FGM/C. In order to have the
baby, the woman had to be defibulated (her vagina fully reopened). Dr. Davis saw the woman
again for her second pregnancy and discovered the woman had been reinfibulated (sewn up
again).

The woman admitted she had returned to Somalia to have the procedure done

(Keilburger and Keilburger, 2016).

Dr. Davis says some immigrants take their adolescent

daughters to their native countries to have FGM/C performed, even though the act of
transporting a child outside of Canada for the purpose of obtaining the procedure is prohibited by
section 273.3 of the Criminal Code (Keilburger and Keilburger, 2016; Government of Canada,
2016). In addition, there is evidence provided by members of the communities at risk, which
suggests that FGM/C is practised in Ontario and across Canada (Ontario Human Rights
Commissions).

It is difficult for affected women to access appropriate health care in Canada because of
their lack of knowledge and reluctance to overcome social, cultural, financial and psychological
barriers. Difficulty also arises when they do seek health care; this may be because of incomplete
training of health care providers and/or incomplete services, such as a lack of translators
(Women's Health Bureau Health Canada). The SOGC says, FGM/C should be included in the
medical school curriculum, teaching doctors and nurses not just about the medical aspects of
FGM, but about its cultural roots and how to start a respectful conversation with their patients
concerning the serious health risks, (Keilburger and Keilburger, 2016). It is also necessary for

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education and conversation about FGM/C to occur within Canadian communities, especially for
the young women and mothers who need to be empowered by knowing their rights and how to
maintain their health. When dealing with the complexity of cultural issues and childrens right,
conversations must include parents, doctors, legislators, and community leaders (Keilburger and
Keilburger, 2016).

In Canada, there have been several community and government based initiatives
regarding FGM/C. A prominent example is the initiative created by the Canadian Centre for
Victims of Torture, family physicians and the Department of Health, which is a mutual support
outreach program for women who have undergone FGM/C (Ontario Human Rights
Commissions). In addition, a National Consultation concerning FGM/C was held in 1999. The
purpose of the National Consultation was to develop recommendations for a dissemination
strategy, to initiate and continue to build collaborative relationships among people committed to
the issue, and to identify the next steps that should be taken at the national level regarding
FGM/C in Canada, (Women's Health Bureau Health Canada). This event is significant because
it was the first time in Canada that affected women, community groups, health care providers and
government representatives collectively discussed possible improvements for the health of
affected women and how to guarantee that FGM/C does not occur in Canada. Although there has
been progress, for collaborative efforts undertaken by individuals and groups to continue, more
resources, networking support, and program development are needed in Canada (Women's
Health Bureau Health Canada).

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Solutions
Female genital mutilation has complex causes, yet simple solutions, (Hill, 2014). The
practice leaves mental and physical scars. It is a tradition that continues, despite the laws passed
by government, UN and native leaders. However, given the laws passed, the increased education
and campaigns to have the practice stopped. FGM/C is not as common as was previously.

An achievable solution to the issue of FGM/C is to pass more severe laws. Although
many African communities have laws against FGM/C, the practice remains because the laws do
not get at the cultural and social core causes that maintain its viability:
If individuals continue to see others cutting their daughters and continue to believe that
others expect them to cut their own daughters, the law may not serve as a strong enough
deterrent to stop the practice. Conversely, among groups that have abandoned [female
genital mutilation and cutting], legislation can serve as a tool to strengthen the legitimacy
of their actions and as an argument for convincing others to do the same (ABC News,
2013).

According to Liesl Gerntholtz, director of womens Rights Division of Human Rights

Watch, laws are not a magic bullet, but they have provided improvements in places, such as
Kenya and Kurdistan (ABC News, 2013). The health and justice sectors of a community should
have more accountability. They need to provide education and training to midwives and police
instead of an outright ban. Laws provide a foundation that speaks to the governments approach
and enforcement. As such, in regions such as Somalia that have no central government, it is
doubtful that major gains can be made without assistance to enforce laws (ABC News, 2013).

Another attainable solution is education. In places where FGM/C is practiced, girls and
women are not given the same educational and political opportunities.

Since FGM/C is

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entrenched in gender inequality, female empowerment needs to be a significant area of change in
order to address the problem.

Traditionally, women are not in positions of power and have little to no authority. Even if
they decide to end the cycle of FGM/C, they may become outcasts in their community. The fear
is that if girls do not have the procedure completed, they will not be viewed as suitable for
marriage, therefore destined for a life of exclusion and poverty. Due to the lack of education and
methods of financially supporting themselves, women are cemented in a nefarious cycle of
injustice and impoverishment. According to Gerntholtz, more has to be done to advance the
rights of women by governments, non-profit organizations and others (ABC News, 2013). They
need to work together to eliminate cutting.

Education allows girls and women to realize full participation in their societies and it
should be utilized as a significant tool to eliminate FGM/C. The leaders of education in affected
countries should establish programs on the issues of FGM/C for all age groups. They should
ensure that these educational programs become a part of the national curriculum and training
provided and experts need to be involved in developing them. To eliminate FGM/C for good,
widespread support of the idea is needed from the whole community. Action on education must
incorporate all member of society, including the little girls that do not go to school (ABC News;
GIZ, 2011).

Schools have the ability to show girls varying views and provide access to different
people and cultures that may contradict the practice. Although many of them may have gone
through the practice by the time they attend school, they may be more inclined to reject the
practice for their own daughters. Education can also be a stepping-stone to the work force,
which could devitalize the customary family structure. Women would have the potential to be

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deemed as covetable companions for their capacity to provide financially to the household and
this may cut down the compulsion to mutilate (ABC News; GIZ, 2011).

Education must also include boys and men. They should be taught about the risks and
consequences of cutting. Some men want the practice to end, but due to social reasons, feel that
they have no choice but to force their daughters to be cut. If in the next decade, we work
together to apply the wealth of evidence at our disposal, we will see major progress, Geeta Rao
Gupta, deputy executive director of UNICEF, wrote, That means a better life and more hopeful
prospects for millions of girls and women, their families and entire communities, (ABC News,
2013; GIZ, 2011).

FGM/C in many cultures is deemed as a rite of passage, transitioning from a girl to a

woman. Creating another rite of passage as a solution may go a long way in changing views and
the need for continuing the practice. Specifically, in southwest Kenya, the Maasai community
developed an alternate rite of passage, which included, shaving her head and giving her a
bracelet that signifies her graduation, but instead of being cut she will have milk poured on her
thighs. When she reappears, she wears the traditional headdress which symbolizes that a girl is
now recognized as a woman (Tenoi, 2014). This new rite of passage is supported by many
because it was established in partnership by members of the community and therefore not seen as
a threat to their culture (Tenoi, 2014). Having the new rite of passage allows for permanent
change, as it replaces FGM/C.

Although reconstructive surgery, namely clitoral repair, may not be a solution to end
FGM/C, it is a solution that will reduce the long-term pain experienced by girls and women. It
enables women to regain clitoral sensations and for some to achieve organisms (African
Renewal, 2013). Clitoral repair was created in 2004 by Dr. Pierre Folds, a French urologist.
The procedure calls for opening the scar tissue, exposing the nerves buried underneath and

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grafting on fresh tissue (African Renewal, 2013). Since 2006, Dr. Folds has trained surgeons
and have been able to provide the surgery in Burkina Faso. Overall, in an effort to make
reconstructive surgery accessible across Africa, seven surgeons from Dakar, Senegal achieved
certification for performing the surgery after receiving training by Senegalese oncologist Dr.
Abdoul Aziz Kass and Dr. Folds (African Renewal, 2013).

For FGM/C to end, it must be ended by the communities subjected the practice. Many,
especially indigenous people, dislike when western ideologies are imposed on them because they
are outsiders. To end the practice, organizations at the grass roots level are important. There is
evidence and precedent that starting regionally works. Bogaletch Gebre, founder and director of
KMG Ethiopia said, yes it is possible to eliminate female genital mutilation this is because of
our experience in Ethiopia, in an area of 2 million population within literally 10 to 15 years, I can
say, we have eradicated, (Tenoi, 2014). Community sanctions have been put in place and they
are working. Their message is that they are encouraging people to change one part of Maasai
culture, but not give up all of what makes them proud to be Maasai. A woman they educated
said to them, you come to us in a proper way, in our own language. You are one of us and you
would not trick us. Our position means we can talk to people about change and that they
listen, (Tenoi, 2014). With the combination of the community and the existence of national
policy framework and laws enforced by governments, it is possible to break the cycle of FGM/C
in this generation. FGM/C cannot be eliminated in this generation because there are still 140
million girls who have undergone the procedure and remain scarred. Although there is
clitoridectomy reconstruction, those girls will never be the same and, therefore they need to be
supported. In addition, breaking the cycle does not just stop with ending FGM/C; gender
inequality is deeply rooted within society and will be a long, arduous battle.

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