The following blog is re-edited with permission from a FGM series published on ‘Inside the intern’s life’.
Written by Sinéad O’Ferrall (Original and Rewrite) @SineadOFGH
Edited by Line Bager & Helen Myrr
As part of my MSc in Global Health program, I got an opportunity to intern with the UNFPA in the Uganda country office. I have been here nearly 4 weeks already and we have just finished working a big marathon event. Partnering with the Church of Uganda in the Kapchowra district, a marathon was organised to accelerate the end of FGM in that region.
It was an impressive day where FGM was highlighted as practice only fit for the history books.The race was organised chaos but we managed to get the runners where they need to be, the t-shirts on said runners and all staff to their locations. With flag offs at the 21km, 12km, 8km, 5km, 2km and children’s sprint everyone could get involved. Between the heat, the hills and the altitude I am so impressed with anyone who ran. There were a few local celebrities such as Stephen Kiprotich and Moses Kipsiro both gold medal runners, Stephen is the current Olympic gold medalist for marathon running.
Once the race was over, there was speeches and dramas from various members of the Church of Uganda, UNFPA and local organisations, all speaking on the harmful practice of FGM and encouraging people to say “No to FGM”.
What is FGM?
FGM stands for female genital mutilation. It is not circumcision. Not cutting or surgery. Mutilation. It is permanently, needlessly and traumatically changing the female body, specifically the genitals.
FGM is defined by WHO as “all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical purposes.”
FGM is classified into 4 categories depending on how exactly the mutilation takes place, but all of them have short and long term consequences on the physical and mental health of the girls and women being cut.
|Type||What is involved:|
|1 – Clitoridectomy||Partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and/or in very rare cases only, the prepuce (the fold of skin surrounding the clitoris).|
|2 – Excision||Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are the ‘lips’ that surround the vagina).|
|3 – Infibulation||Narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.|
|4 – Other||All other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.|
Ref: WHO-FGM report 2012
Who performs FGM and why?
Though it is not performed performed everywhere,, it is deeply rooted in certain cultures and communities.. For example in Uganda FGM has a national prevalence of 1.4% while in the Pokot population, a tribe within Uganda, it is 95% . In Tanzania, again the national prevalence is 14.6%, within certain communities such as the Maasai tribes, FGM has a prevalence of 100%. This demonstrates how statistics can misrepresent the scale of the problem, and how one shouldn’t take them at face value, which can lead to an issue being diluted and lost in the mix.
It is practiced across Africa, and has been seen in Asia as well as in Europe, America and Australia. With the increase in global movement and immigration, it is not surprising that these “localised” practices are popping up all over the world.
Within the cultures that practice FGM, there are various beliefs as to why it is done. But the general theme is, it is a rite of passage for the girl to become a woman and eligible therefore for marriage. It is also used as a means to control a girl’s sexuality pre-marriage to ensure virginity, and, during marriage to ensure loyalty.
There are also many other misled beliefs that it can help in labour, increase sexual pleasure or that it is beneficial to a woman in some way or another.
Just how much of a problem is this?
Aside from the immediate consequences of extreme emotional and physical trauma and pain, high risk of infections including Sexually Transmitted Infections (STIs), HIV and sepsis, haemorrhage, and death, there are long lasting consequences also.
The mutilation is known to heal slowly or not at all which presents continuing risk of infection and pain, Urinary Tract Infection (UTIs) and leads to many complications relating to pregnancy and labour. These can include obstructed and prolonged labour, obstetric fistula, low birth weight and death to mother and/or infant. Also, difficulty having intercourse, pain during the act and reduced libido are often experienced.
But FGM does not only affect your health. It has negative effect on many social aspects of a girl’s life. FGM is often viewed as rite of passage into womanhood, and once a girl is cut she is suitable for marriage. Girls are often married to older polygamous men and encouraged to have children straight away. On top of all of that, they are often unable to attend school and complete their education. This further limits their future opportunities and ability to contribute to society, so the society as whole suffers.
How do we stop it?
There are three broad approaches tha all need to work simultaneously to make an impact – 1. Education and awareness, 2. having a legal framework and enforcing it and 3. support and counselling.
- Education and Awareness
Education: this perhaps is the most important tool we have at our hands to make a lasting change in people’s attitudes towards FGM.
FGM, like most harmful practice survives because of secrecy, myths and uncertainties! People believe it is beneficial or essential and they don’t hear of an alternative point of view, unless we inform them of other options.
UNFPA is heavily involved in supporting education and awareness programs and they work with many partner organisations such as the Church of Uganda who organised this marathon to reach communities that need to hear this message. Check out links 1 & 2 to see some stories from the field.
2. Legal framework and enforcing the law
Uganda made FGM illegal in 2009 which was a huge step forward, however enforcing the law has met major obstacles. Since the practice is performed often in secret, in communities that respect the duty to perform FGM over the law, to report perpetrators would be seen as “betraying” their communities and traditions. Some believe FGM is vital to their community and this is why education is so important, so people are given the tools and information to say no to FGM.
While the law, in its isolation, has not been effective, it has been useful as a tool for organisations campaigning to ⋕EndFGM, as it gives a legal framework to work in.
3. Support and counselling
This is both to help the already mutilated woman, to treat the medical side effects and to counsel communities that want to say no to FGM. It is so important not to just convince communities it is wrong and then leave. We need to give them the tools they need to stand up to harmful traditions of their tribe and overcome the greater cultural pressures.
Support can be in many forms. Some examples include finding alternative incomes and roles for cutters such as enlisting them as advocates for the ⋕EndFGM campaign or offering incentives to cutters to hand over their cutting tool. It can also be providing materials and tools to support events such as the marathon against FGM.
This is just a brief overview of a very complicated and culturally rooted practice. If you want more details please check the full blog series on Inside the intern’s life and you can read the blog entry that talks about the day of marathon here.
It is a horrendous and traumatic practice that needs to end, but thankfully communities are mobilising to say ‘No to FGM’ and it is so important we support them in any way we can.