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Female circumcision still practiced worldwide

Ethnic Newz, News Report, Eduardo A. de Oliveira Posted: Aug 07, 2008

It happened quickly, but it was extremely painful for five-year-old Faduma.

She sat with her legs spread apart, knowing her turn had come. One woman tied the little girl to the back of her chair, as another came with a sharp knife.

In one razor-sharp motion, using no anesthesia or medication, the woman cut off part of Faduma's genitalia, the clitoris as well as the small and large labia. She was paid the equivalent of $10 to perform the ritual.

Outside the small room, people were banging drums. Faduma's entire village in southern Somalia was celebrating the ritual. The village's five- to 10-year-old girls gathered together, as parents exchanged plates filled with rice and goat meat.

The next day, says Faduma, her family drilled a hole in the house, filling it with a small, charcoal fire. Every morning, the circumcised girl sat on the fire to get the only type of anesthesia or healing available.

Faduma's parents were not trying to hurt or mutilate her. Rather, they wanted to guarantee her chance to attract a future husband and be married. By being circumcised, she wouldn't be ostracized, as Somalis believed at the time, more than 40 years ago.

"You can't rebel. When you're a child, your voice is worth nothing," says Faduma, now 49, a clinician at a health center in Boston, Mass., who did not want to give her full name.

Female genital cutting (FGC), or female circumcision, is most common in the African continent, where 18 countries have prevalence rates of 50 percent or higher for the practice, according to the World Health Organization (WHO).

The WHO estimates that 130 million girls and women in 28 African countries and the Middle East have undergone FGC. More than 228,000 of them reside in the U.S., according to the World Health Organization.

In Massachusetts, an estimated 5,231 females are at risk for FGC - because their mothers, who come from African countries where FGC is practiced, may be likely to continue the ritual on their daughters.

The tradition goes back to the days of Egyptian pharaohs, when FGC was done as a sign of distinction. Since then, FGC has been supported by generations of women who believe that partially or totally removing their daughters' external genitalia will purify them.

"Many women believe that those who are not circumcised were possessed by a devil," says Faduma.

As recently as last May, indigenous communities in Risaralda, Colombia, asked the federal government to allow them to continue to practice female circumcision, a tradition they have respected for 1,000 years.

In Colombia, female circumcision is forbidden by law, but the nation's government allows indigenous communities to have their own laws.

In the U.S., Congress enacted a provision criminalizing the practice as part of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996.

The new 1997 law defined that "whoever knowingly circumcises the genitals of another person who has not attained the age of 18 years" will be fined and imprisoned for up to 5 years.

Faduma's fight against her family tradition began when she had her third baby. Faduma's circumcision was severe enough that she suffered enormous pain every time she gave birth.

Nagat Elmahdi, the day is still vivid for when her Sudanese grandparents tried to convince her father that she needed to be circumcised.

Elmahdi's father resisted for a while. What followed was a spectacular clash of generations - her father representing the urban values of Khartoum, Sudan's capital, and her grandfather, who had three wives and 20 children, defending the long-held traditions of the Elmahdi clan.

The Elmahdi senior won the cultural battle, and Nagat Elmahdi was circumcised at the age of 6.

In the early 1990s, during the first years of the civil war in Darfur, government soldiers took kids out of their homes to use them as human shields for the fighting forces. That prompted Elmahdi to join a large group of students who sought exile.

She fled to Egypt in 1993, and worked as a journalist there until 1999.

A survey conducted by the Egyptian Ministry of Health and Population reported in 2003 that 94.6 percent of married women in Egypt had undergone FGC, and 69.1 percent of them agreed to carry out FGC on their daughters.

Elmahdi migrated to the U.S. as a refugee in 2000. Today she lives in Manchester, NH, and became an American citizen just this past Independence Day.

"Here I can fight for the rights of all women. I tell them my story to educate about this unfortunate custom," she says.

For Nawal M. Nour, MD, an obstetrician at Brigham and Women's Hospital and an international expert on FGC, cultural confrontation is not the answer.

"I avoid using the term mutilation, because that's not the way my patients feel. They see themselves as someone who followed a tradition that helped them become a woman, " Dr. Nour said in an interview with EthnicNewz.org.

Dr. Nour is the founder of the African Women's Health Center, the first and only medical center in the U.S. devoted to the needs of African women who underwent FGC.

Talking about FGC has become so ordinary, says Dr. Nour, that a chat with a patient goes like this: "Do you smoke? Do you drink? Have you been circumcised?"

It may not be so easy for other health providers to talk about FGC.

Speaking at the Massachusetts Department of Public Health last week, she acknowledged that doctors show a lingering discomfort when treating women who have been circumcised.

To overcome their strong feelings, doctors need to strike two myths down: FGC is not an Islamic practice, nor does it stem from a male-dominated society.

"This tradition is perpetuated primarily by the women. Men don't get involved [in the circumcision ritual], they see it as woman's business," Dr. Four said.

Born in Sudan, raised in Egypt, and educated in Britain and the U.S., Dr. Nour was awarded a MacArthur Foundation fellowship in 2003 for her work in the field of FGC.

She attacks the misconception that psychological stress affects thousands of circumcised girls. "The majority of my patients don't have post-traumatic syndrome disorder. Those who have it, [it] is because they came from a war-zone area, not [because they underwent] FGC," she says.

Dr. Nour recently treated a girl who was born in Africa, migrated to the U.S., and went back to Africa for FGC after six years of living in the U.S.

"When she came back here, she noticed during her teenage years that no one else has done that (FGC) here. She does not associate with the country where she was born. That was a stress."

Parents support circumcision, says Dr. Nour, for reasons that stem from hygiene, improving fertility or preserving chastity. But, she admits, other long-held beliefs are pure folklore.

"Some parents believe that the clitoris is a toxic organ, and if it touches the baby during delivery, the baby will die. Or that if the clitoris is not removed, it will grow until it touches the ground," she says.

What's her answer to all of that?

"Well, I ask some mothers: What do you think Western women do to prevent their clitoris from touching the ground?"

What Dr. Nour, Elmahdi, and Faduma have in common is a clear understanding that while female circumcision is a custom, it isn't one that needs to be preserved.

And their best contribution is simply speaking up: Faduma spoke for the Refugee and Immigrant Center for Somali Women, in Jamaica Plain in Boston, last month; Elmahdi, for the Center for African Refugees, in Manchester, NH; and Dr. Nour speaks locally and abroad.

"Parents are not trying to kill their kids, but to make sure their daughter will have a clean and healthy life. They are trying to protect them," said Dr. Nour.

Faduma lives in South Boston with her five daughters. None of them has been them circumcised.

When her two daughters who were born in the U.S. suggest that Somali society is not civilized, Faduma, who speaks Italian, Swahili, Somali, and English, says every culture has its own way of being civilized.

"We have made some progress. My generation is fighting this ugly cultural practice," she says.

Related Articles:

African Women Mobilize to Eradicate Genital Mutilation

Female Circumcision at the Summit for Sustainable Development


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