Female Genital Mutilation

This column reports on a cruel and dangerous practice – female genital mutilation (FGM). Along with honor killing and bride burning, FGM is a practice to control the female - by taking away her pleasure in sex, making intercourse painful, and thereby ensuring a man’s confidence in paternity. FGM reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. As it is carried out on minors, it is a violation of the rights of children. The practice violates a person's rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

According to Wikipedia. FGM has been going since about 800 years BCE.   UNICEF reports that at least 200 million girls and women alive today have undergone female genital mutilation in 30 countries and 3 million are at risk every year.  The practice is found in many African countries, the Middle East, India and Indonesia, among peoples who follow Islam, Christianity and animism. However, it is not mentioned in the Koran or the Bible and is not part of their religious teachings.

FGM is classified into 4 major types

•                Type 1: Often referred to as clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

•                Type 2: Often referred to as excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva ).

•                Type 3: Often referred to as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris.

. Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

FGM is generally performed by village women using unsterilized instruments and no anesthesia. The terrified young girl is forcibly held down. Bleeding and infection are common results.  When the vaginal opening is narrowed, childbirth is often obstructed.  Extremely long labor can result in death, or an obstetric fistula – an opening between the bladder or rectum and the vagina, causing constant leakage.  This makes the woman a social outcast.  There are a few hospitals in Africa formed to repair obstetric fistulas – their dramatic story is the subject of another column.

Obviously FGM must be stopped, and this long entrenched practice must be stopped by the people in the affected societies.  England has been a leader in supporting an Africa-led movement to end FGM with a program called The Girl Generation – a social change initiative of African collectives working to end FGM in one generation.  In The Gambia, nearly 400 member organizations are working to end FGM.  In 2015 the president enacted a law banning the practice.  There are also active youth networks in Kenya and Nigeria, driving forward their own action plans to end FGM.  Similar programs will take place wherever FGM is practiced, led by young activists.   The United Nations is involved through UNICEF and UNFPA; The Population Council is also involved.

She Decides: In my last column, I wrote about Holland’s plan to make up for the Trump administration’s failure to fund international aid related to family planning. Read about it at sadjascolumns.blogspot.com.
In the week following the Netherlands’ announcement of a €10 million contribution to the Dutch-initiated family planning initiative ‘She Decides,’ 13 more countries have also stated their interest in supporting the fund. Canada, Belgium, Luxembourg, Sweden, and Finland have all formally confirmed their support, while additional countries are likely to on March 2, 2017, during an international conference for the fund hosted by Belgium. According to the Dutch Ministry of Foreign Affairs and Development Cooperation, in addition to government support, private persons have donated over €140,000 to the fund as of February 3, 2017.  You can be one of them – go to shedecides.com.

Sadja Greenwood, MD, MPH

•                 

•                


Having a period is unaffordable in Kenya, yet no one wants to talk about it

ZanaAfrica is fighting to get menstruation on the national curriculum as it’s revealed two thirds of Kenyan women and girls cannot afford sanitary padsHaving a period is unaffordable in Kenya, yet no one wants to talk about it

ZanaAfrica is fighting to get menstruation on the national curriculum as it’s revealed two thirds of Kenyan women and girls cannot afford sanitary pads