When culture harms the girls (Audio click)
Female Genital Mutilation (FGM) is a surgical procedure performed on the genitals of girls and women in many parts of the world. The term FGM covers a range of procedures, which are also referred to as female circumcision
FGM is found extensively in Africa and is also indigenous to other parts of the world. The age and time at which FGM is practised differs from community to community, and can be carried out from as early as a few days after birth, to immediately after the birth of a woman's first child. One of the notable trends in global FGM today is the progressive lowering of the age at which girls undergo the practice.
All members of communities practising FGM have a role in perpetuating it. Families of girls or women who undergo FGM support it because it makes their daughters marriageable, others carry out FGM for religious reasons, believing that their faith requires it; this is particularly true of Muslims who adhere to the practice, some other communities consider female genitalia to be ugly, offensive or dirty, and thus the removal of the external genitalia makes a woman more hygienic and aesthetically pleasing, Some subscribe to the notion that FGM enhances a woman's fertility, and the chances of her children's survival
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A victim, Fatima's scream is as blood-curdling as it is heart-wrenching. The little girl, who looks to be about eight years old, screams in a panic, initially in fear and then because she is unable to bear the pain she is experiencing. She is lying on the floor of a dirty hut.. Her body is contorted with pain as she screams, cries and finally lies there whimpering. Her new, green floral dress is soaked in blood. Two men and her mother press the delicate child against the floor and pull apart her thin little legs. An old woman crouches in front of Fatima, holding a shiny razor blade and a thick, threaded darning needle. Today is the day Fatima will become a woman, a decent woman. |
Finally the deed is done. The wound is sewn shut with thorns, leaving only a tiny opening. A straw is inserted into the small opening to prevent it from closing. Then Fatima's legs are tied together with a rope to allow the wound to heal. She will lie in bed, her legs tied together in this fashion, for several weeks.
The old woman completes her barbaric task with a slap on her subject's behind. Fatima is now a woman.
Different Forms of FGM
1. Type I (commonly referred to as clitoridectomy)
Excision (removal) of the clitoral hood, with or without removal of all or part of the clitoris.
2. Type II (commonly referred to as excision)
Excision (removal) of the clitoris, together with part or all of the labia minora (the inner vaginal lips). This is the most widely practised form.
3. Type III (commonly referred to as infibulation)
Excision (removal) of part or all of the external genitalia (clitoris, labia minora and labia majora), and stitching or narrowing of the vaginal opening, leaving a very small opening, about the size of a matchstick, to allow for the flow of urine and menstrual blood. Also known as pharaonic circumcision.
4. Type IV (Unclassified/Introcision)
Pricking, piercing or incision of the clitoris and/or labia:
• Stretching the clitoris and/or labia
• Cauterisation by burning of the clitoris and surrounding tissues
• Scraping of the vaginal orifice or cutting of the vagina
• Introduction of corrosive substances into the vagina to cause bleeding, or introduction of herbs into the vagina to tighten or narrow it
• Any other procedure that falls under the definition of female genital mutilation
Type 1 and type 2 operations account for 85 percent of all FGM.
Type 3 is common in Djibouti, Somalia, Sudan and parts of Egypt, Ethiopia, Kenya, Mali , Mauritania, Niger, Nigeria, and Senegal.
Type 3, also known as pharaonic circumcision, is extremely severe and involves binding a woman's legs for approximately 40 days to allow for the formation of scar tissue. Many of these communities use adhesive substances such as sugar, eggs, and even animal waste on the wound to enable it to heal.
Health complications associated with FGM
The health problems a girl can experience are largely dependent on three factors.
First, the severity of the procedure: girls and women who undergo type II and type III are likely to experience more severe health complications, but health consequences for type I have also been widely reported.
Discussions with a doctor on the possible medical effects of type I FGM found that complications were most evident during childbirth, due to the reduced elasticity of the vagina caused by scar tissue formed as a result of the surgery. To compensate for the reduced elasticity during childbirth, tiny tears are caused around the vagina. These are too small to stitch, and end up forming more scar tissue, compromising the vagina's elasticity even further. Labour becomes longer and more painful with each subsequent birth. The tears themselves predispose the woman to infection, while her ability to experience sexual satisfaction is undermined, as the tearing leads to an ever-loosening vagina.
Second, the sanitary conditions in which the procedure is performed, and the competence of the person who performs it: most circumcisers are professionals with years of experience, but the tools and sanitary conditions of their trade are often rudimentary at best, with knife-like implements or razor blades used as the basic surgical instruments.
Close adherence to traditions that dictate what type of instrument is suitable do not allow for innovation, or the adoption of new, more suitable instruments that may be available. Typically, the circumcision ceremony takes place once a year and all eligible girls within a community are cut on the same day, using the same instrument - without the benefit of sterilisation between procedures - thus increasing the chances of infection, and the risk of exposure through such practices to HIV/AIDS.
Third, the health of the girl or woman undergoing the procedure, and her ability to heal and resist infection passed on by the procedure, is critical: if a woman is prone to infection, or has a poor immune system, she has a greater chance of becoming infected. Literally, only the strong survive.
The secret nature of FGM poses a great threat to the health of girls and women who undergo it. It is highly confidential, and outsiders are strictly prohibited from having any contact with the girls and women during and after the ceremony. Therefore, most of them have no access to a medical professional, should they need one during or after the procedure.
The 40-day isolation that characterises type III FGM, for example, means a woman might die of infection before she ever gets the chance to receive proper medical care. When qualified medical personnel perform FGM in the sanitary conditions of a hospital, the risk of infection may be reduced, but the long-term consequences remain.
Some immediate physical problems resulting from FGM are:
1. Bleeding (often haemorrhaging from rupture of the blood vessels of the clitoris), sometimes leading to death
2. Post-operative shock
3. Damage to other organs, resulting from the lack of surgical expertise of the person performing the procedure, and the aggressive resistance of the patient when anaesthesia is not used
4. Infections, including tetanus and septicaemia, through using unsterilised or poorly disinfected equipment
5. Urine retention caused by swelling and inflammation
Some longer-term consequences include:
1. Chronic infections of the bladder and vagina:
- in Type III, the urine and menstrual blood can only leave the body drop by drop
- the build-up inside the abdomen and fluid retention often cause infections and inflammation that can lead to infertility
- infections and inflammation that can lead to infertility
2. Dysmenorrhoea, or extremely painful menstruation
3. Excessive scar tissue at the site of the operation
4. Formation of cysts on the stitch line
5. Childbirth obstruction, which can result in:
- the development of fistulas
- tearing of the vaginal and/or bladder wall
- chronic incontinence
6. Though yet to proven there is speculation of potential Risk of HIV infection, sensibly when the same unsterilized instruments are used on multiple girls.
7. Re-infibulations must be performed each time a child is born. When infibulations (Type III) is performed, the opening left in the genital area is too small for the head of a baby to pass through. Failure to reopen this area can lead to death or brain damage of the baby, and death of the mother. The excisor must reopen the mother and re-stitch her again after the birth.