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Harmful practices to the female body; part 1 Female Genital Mutilation

“Mama tied a blindfold over my eyes. The next thing I felt my flesh was being cut away. I heard the blade sawing back and forth through my skin. The pain between my legs was so intense I wished I would die.” –Waris Dirie, UNFPA Goodwill Ambassador and spokesperson on FGM

1. What is FGM?

Female Genital Mutilation (FGM) has been defined by the World Health Organization (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 reasons.” Most of the victims live in African countries, some in the Middle East and Asian countries and it is increasing in Europe, Australia, New Zealand, USA and Canada.

FGM is usually performed by an older experienced woman with no medical training. In primitive areas, anaesthetics and antiseptic treatment is not used and the tools consist of knives, scissors, scalpels, pieces of glass and razor blades. A mixture of herbs is placed on the wound to tighten the vagina and stop the bleeding. The age of the girls varies from infants to girls to the age of 10 depending on the community and family.

It is extreme form of discrimination against women and performed on innocent children that are not able to defend themselves. It is nearly always carried out on minors and 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.

2. 4 types of FGM

According to WHO;

a)     Excision (removal) of the clitoral hood with or without removal of part or all of the clitoris. Occurs in 85% of the FGM.

b)     Removal of the clitoris together with part or all of the labia minora. Occurs in 85% of the FGM.

c)      Removal of part or all of the external genitalia (clitoris, labia minora, and labia majora) and stitching and/or narrowing of the vaginal opening leaving a small hole for urine and menstrual flow. Occurs in Djibouti, Somalia, Sudan, parts of Egypt, Ethiopia, Kenya, Mali, Niger, Nigeria and Senegal.

d)     All other operations of the female genitalia.

3. History of Female Circumcision

Female circumcision, also known as Female Genital Mutilation (FGM) is not a recent phenomenon as it has been dated back as far as to 2nd century BC when a geographer, Agatharchides of Cridus wrote about the subject that occurred among tribes residing on the western coast of the Red Sea (today’s Egypt). Based on the current areas practicing FGM, it seems as the tradition has originated from Egypt and spread. Others believe that the custom was rooted in the kingdom of the Pharaohs.

As Islam rose throughout the region, Egyptians raided territories in the south and exported Sudanic slaves. Female slaves were sold at a higher price if they were “sewn up” as they became unable to give birth. After many converting to Islam, this practice was abolished as Islam prohibits Muslims from harming their body and enslaving others.

Today this primitive tradition has reached the coasts of America, Europe, Australia and Canada. Numbers from Amnesty International estimates that 135 million women have experienced FGM and that between 2-3 million girls and infants undergoes this practice every year.  In Africa alone it is about 92 million girls who has undergone FGM.

4. Medical consequence of FGM

FGM have absolutely no health benefits for the girls except doing harm and causing extreme pain. As the healthy genital tissue is being removed, the body cannot function in a natural way. Since this procedure is being practiced by people who have no medical training and without using any necessary anesthetic or sterilization, the FGM can lead to death by shock from bleeding or infections by the unsterilized tools. The first sexual intercourse will be extremely painful who will be needed to be opened and this is being performed by the partner with a knife. Besides bleeding there are several short and long term complications that these girls have to deal with and I have listed them shortly.

Depending on the degree of mutilation, short term health problems caused by FGM;

  1. Severe pain and shock
  2. Bacterial infection
  3. Urine retention
  4. Open sores injury to adjacent tissues
  5. Immediate fatal haemorrhaging (bleeding)
  6. Extreme pain as girls are cut without being numbed and the worst pain occurs the next day when the girls have to urinate
  7. Trauma as girls are forced and held down by several women

Long-term implications;

  1. Extensive damage of the external reproductive system
  2. Uterus, vaginal and pelvic infections
  3. Cysts and neuromas
  4. Increased risk of Vesico Vaginal Fistula
  5. Complications in pregnancy and child birth
  6. Psychological damage
  7. Sexual dysfunction
  8. Difficulties in menstruation
  9. Recurrent bladder and urinary tract infections
  10. Infertility
  11. The need for later surgeries such as to be cut open to allow childbirth and sexual intercourse after marriage. Sometimes it is also stitched again several times after childbirth.
  12. Problems urinating as girls are left with a small opening. This can slow or strain the normal flow of urine and lead to infections
  13. Gynecological health problems as they are not able to pass all of their menstrual blood out and have infections over and over again.
  14. Increased risk of Sexually Transmitted Diseases/Infections (STD/STI) including HIV as the procedure is being performed in unclean conditions
  15. Psychological and emotional stress. A study by Pharos, a Dutch group that gathered health care information of refugees and migrants revealed in February 2010 that majority of these women suffered from stress, anxiety and was aggressive. They were also most likely to have relational problems or fear for relations. According to the study, it is believed that an estimate of 50 girls is being genitally mutilated every year in the Netherlands.

5. Where is FGM practiced?

Southeast Asia; Indonesia, Malaysia,

Central Asia; Tajikistan

Eastern Europe; Chechnya, Dagestan, Ingushetia

Middle East; Yemen, UAE, turkey, Syria, Saudi Arabia, Palestinian territories, Pakistan, Oman, Jordan, Iraq and Kurdistan, Iran,

Africa; Zimbabwe, Zaire, Uganda, Togo, Tanzania, South Africa, Somalia, Sierra Leone, Senegal, republic of Congo, Nigeria, Niger, Mozambique, Mauritania, Mali, Malawi, Libya, Liberia, Kenya, guinea-Bissau, guinea, Ghana, Gambia, Ethiopia, Eritrea, Egypt, Djibouti, democratic republic of the Congo, cote d’ivoire, Comoros, Chad, central African republic, Cameroon, Burkina Faso, Benin, Algeria

The majority of cases of FGM are carried out in 28 African countries. In some countries, (e.g. Egypt, Ethiopia, Somalia and Sudan), prevalence rates can be as high as 98 per cent. In other countries, such as Nigeria, Kenya, Togo and Senegal, the prevalence rates vary between 20 and 50 per cent. It is more accurate however, to view FGM as being practised by specific ethnic groups, rather than by a whole country, as communities practising FGM straddle national boundaries. FGM takes place in parts of the Middle East, i.e. in Yemen, Oman, Iraqi Kurdistan, amongst some Bedouin women in Israel, and was also practised by the Ethiopian Jews, and it is unclear whether they continue with the practice now that they are settled in Israel. FGM is also practised among Bohra Muslim populations in parts of India and Pakistan, and amongst Muslim populations in Malaysia and Indonesia.

6. Religion or culture?

Although FGM happens in countries with Muslim majority, and people think that it is associated with Islam, FGM is not supported by any religion and condemned by many religious leaders.

In fact FGM is a pre-Islamic tradition and since Islam prohibits humans from harming and mutilating their body, therefore FGM is forbidden in Islam. In Ethiopia, Cote d’Ivoire, Kenya, Senegal, Benin, and Ghana, Muslim population groups are more likely to practice FGC than Christian groups but in Nigeria, Tanzania, and Niger, the prevalence is greater among Christian groups.

Today FGM is a mixture of cultural, religious and social factors. For instance, the social pressure to perform FGM because others in the same community do it keeps the practice strong. As from the religious view, the parents thinks that FGM is necessary to raise the daughter properly and make sure that she is a virgin until she is married even though no religious scripture supports this. It is motivated by the thought of proper sexual behavior.

7. Reasons and justification

  1. custom and tradition
  2. religion; in the mistaken belief that it is a religious requirement
  3. preservation of virginity/chastity
  4. social acceptance, especially for marriage
  5. hygiene and cleanliness
  6. increasing sexual pleasure for the male
  7. family honour
  8. a sense of belonging to the group and conversely the fear of social exclusion
  9. enhancing fertility

8. What can be done to prevent and abolish FGM?

Each community should arrange meetings where they discuss, talk and consider opinions about FGM. Here it would be important to allow the elder generation to speak with the young. It is important to spread out and explain about the harsh health problems FGM causes.

Next important thing is education. Education is the key to everything. As we can see, this is happening in areas where most people is illiterate or doesn’t have the possibility to go to school. The generations repeat themselves and the circle is hard to break. Another important thing would be that Islamic scholars and other religious leaders should change the perception about FGM as people listen to them.

Every country and community should work towards changing the attitude as women feels they are being disloyal to their culture for not choosing FGM. This pressure can change if doctors and other health care workers would talk with women about the dangers of FGC and offer other options that don’t involve cutting. Some human rights advocates also suggest that men could help reduce the practice of FGC by openly marrying uncut women. Many human rights organizations are also calling on religious leaders to openly confirm that their religions do not require women to have FGC.

Last, if the countries establish strict laws and investigate cases regarding FGM, then it will have some effect but it will not be enough to abolish it as 18 African countries has laws or decrees against FGM. Even countries with the highest rates of FGM have recently openly noted the need for banning this practice. Fines and jail sentences are typically minor, but most view any sanctions against FGC as a good start.

It is important that everyone is aware of this heinous practice that mutilates the female body. It is hard to understand how parents can perform this on their infant babies who are not able to defend themselves. Every country should implement various strategies to eliminate FGM and it starts with education and communication.

Overview of the violence against women around the world

The situation of women and girls, facts and figures all over the world*


Gender and HIV/AIDS:

  • Nearly a third of all adults living with HIV/AIDS are under the age of 25 and 2/3 of them are women.
  • In Sub-Saharan Africa, girls are getting infected faster and earlier than boys. In the group from 15 to age 24, two girls are infected for every boy. According to surveys that indicate women who have some post primary schooling compared to women with no education are 5 times more likely to lack basic information about HIV/AIDS.
  • In 2002, an estimated 800,000 children under the age of 15 were infected with HIV as a result of parent-to-infant transmission.

Gender and girls education:

  • Over 110 million of the world’s children, 2/3 of them being girls are not attending school.
  • Of the world’s 875 million illiterate adults, 2/3 is women.
  • Half of the girls who live in developing countries (excluding China) will be married before their 20th birthday. Increasing girl’s time in school is one of the best ways for the girls to get married in an older age.

Gender and violence against women and girls and child protection issues:

  • One in every 3 women is a survivor of some form of gender based violence, most often by someone in her family. Between 15 and 76% of women are targeted for physical and/or sexual violence in their lifetime.
  • Girls between 13 and 18 years constitutes the largest group in the sex industry and it is estimated that around 500,000 girls below the age of 18 are victims of trafficking each year.
  • Female Genital Mutilation (FGM) affects around 130 million girls and women globally and places 2 million at risk but the last decades this problem has improved.
  • In some cultures, the preference for boys results in pre-natal sex selection and death of many girls. In India for example; there are 933 Indian women for every 1000 men resulting in 40 million missing women.

Gender and the Maternal Mortality Rate (MMR) and other health issues:

  • 1,400 women die every day from pregnancy-related causes, 99% of them in developing countries.
  • In Sub-Saharan Africa, a woman has 1 in 3 chance of dying in child birth. In industrialized countries the risks are 1 in 4,085.
  • Direct obstetric deaths account for about 75% of all maternal deaths in developing countries.

Emergencies

  • More than 80% of the world’s 35 million refugees and displaced people are women and children.
  • Emergencies put women at risk of extreme sexual violence and abuse. In Rwanda, 2,000 women and many of them are being survivors of rape tested positive for HIV during the 5 years following the 1994 genocide.

Femicide

  • In Guatemala, two women are killed every day.
  • In India, 8,093 cases of dowry-related death were reported in 2007 and unknown number of murders of women and young girls were labeled as “suicides” or “accidents”.
  • Between 40 and 70% of female murder victims were killed by their intimate partners in Australia, Canada, Israel, South Africa and the United States.
  • In Chihuahua, Mexico, 66% of murders of women were committed by husbands, boyfriends or other family members.

Violence and young women

  • Up to 50% of sexual assaults worldwide are committed against girls under the age of 16.
  • An estimated 150 million girls under the age of 18 suffered some form of sexual violence in 2002.
  • The first sexual experience of some 30% women was forced and the percentage is even higher among those who were under 15 at the time of their sexual initiation.

Harmful practices

  • Approximately 100 to 140 million girls and women worldwide have experienced female genital mutilation leaving more than 3 million girls in Africa annually at risk of the practice.
  • Over 60 million girls worldwide are child brides and married before the age of 18. The numbers are divided as; South Asia-31, 3 million and Sub-Saharan Africa-14, 1 million. Violence and abuse characterize married life for many of these girls. Women who marry early are more likely to be beaten or threatened, and more likely to believe that a husband might sometimes be justified in beating his wife.
  • Trafficking
  • 80% from the estimated number of 800,000 people being trafficked across the national borders is women and girls.
  • One study in Europe found that 60% of trafficked women had experienced physical and/or sexual violence before being trafficked, pointing to gender-based violence as a push factor in the trafficking of women.

Sexual harassment

  • Between 40 and 50% of women in European Union countries experience unwanted sexual advances, physical contact or other forms of sexual harassment at work.
  • Across Asia, studies in Japan, Malaysia, the Philippines and South Korea show that 30 to 40% of women suffer workplace sexual harassment.
  • In Nairobi, 20% of women have been sexually harassed at work or school.
  • In the United States, 83% of girls aged 12 to 16 experienced some form of sexual harassment in public schools.

Rape in the context of conflict

  • Estimates suggest that 20,000 to 50,000 women were raped during the 1992-1995 war in Bosnia and Herzegovina, while approximately 250,000 to 500,000 women and girls were targeted in the 1994 Rwandan genocide.
  • Between 50,000 and 64,000 women in camps for internally displaced people in Sierra Leone were sexually assaulted by combatants between 1991 and 2001.
  • In eastern Democratic Republic of Congo, at least 200,000 cases of sexual violence, mostly involving women and girls, have been documented since 1996: the actual numbers are believed to be far higher.

Conservative

  • The following figures are some of the facts of violence done on women compiled by Amnesty International and Feminist.com from various researches done by individuals and/or organizations all over the world;
  • An estimated 50,000 women and children are trafficked into the United States annually for sexual exploitation or labor (US Central Intelligence Agency, 2000).
  • One in five women will be a victim of rape or attempted rape in her lifetime (WHO 1997).
  • In USA a woman is raped every 90 seconds (US Department of Justice, 2000).
  • Somewhere in America a woman is battered, usually by her intimate partner, every 15 seconds (UN Study on the Status of Women, Year 2000).
  • Up to 70% of female murder victims are killed by their male partners (WHO 2008).
  • In Kenya more than one woman a week was reportedly killed by her male partner while in Zambia, five women a week were murdered by a male partner or family member (Joni Seager, 2003).
  • In the Russian Federation 36,000 women are beaten on a daily basis by their husband or partner, according to Russian non-governmental organizations (OMTC, 2003).
  • More than 135 million girls and women have undergone female genital mutilation and an additional 2 million girls and women are at risk each year (6,000 everyday) (UN, 2002).
  • 82 million girls who are now aged 10 to 17 will be married before their 18th birthday (UNFP).
  • In India there are close to 15,000 dowry deaths estimated per year. Mostly they are kitchen knives designed to look like accidents (Injustice Studies, Vol. 1, November 1997).
  • 4 million women and girls are trafficked annually.
  • An estimated one million children, mostly girls, enter the sex trade each year (UNICEF).
  • A study in Zaria, Nigeria found out that 16 per cent of hospital patients treated for sexually transmitted infections were younger than five (UNFPA).

Population and families

  • The world’s population tripled between 1950 and 2010 to reach almost 7 billion.
  • There are approximately 57 million more men than women in the world, but in most countries there are more women than men.
  • There is a “gender spiral” with more boys and men in younger age groups and more women in the older age groups.
  • Fertility is steadily declining in all regions of the world but still remains high in some regions of Africa.
  • Life expectancy is steadily rising as women lives longer than men.
  • International migration is increasing and there are more and more women migrants and in certain areas they outnumber men.

Health

  • Women live longer than men in all regions.
  • 2 out of every 5 deaths of both women and men in Africa are still caused by infectious and parasitic diseases.
  • Women are more likely than men to die from cardiovascular diseases, especially in Europe.
  • Breast cancer among women and lung cancer among men tops the list of new cancer cases globally.
  • Women stand for the majority of HIV positive adults in Sub-Saharan Africa, North Africa and the Middle East.
  • The majority of over half a million maternal deaths in 2005 occurred in developing countries.

Education

  • 2/3 of the 774 million adult illiterates worldwide are women.
  • The global youth literacy rate has increased to 89%.
  • 72 million children of primary school age are not attending school out of which over 39 million (54%) are girls.
  • Women in tertiary education are significantly underrepresented in the fields of science and engineering but remain predominant in education, health and welfare, social sciences, humanities and arts.
  • Worldwide, women account for slightly more than a quarter of all scientific researches that is an increase compared to previous decades.
  • Use of and access to the Internet grew in the past decade as it narrowed the gender digital divide, however, women still don’t have the same level of access as men in most countries whether it is more developed or not.

Work

  • Women are predominantly and increasingly employed in the services sector.
  • Vulnerable employment – own-account work and contributing family work – is prevalent in many countries in Africa and Asia, especially among women.
  • The informal sector is an important source of employment for both women and men in the less developed regions but more so for women.
  • Occupational segregation and gender wage gaps continue to persist in all regions.
  • Part-time employment is common for women in most of the more developed regions and some less developed regions, and it is increasing almost everywhere for both women and men.
  • Women spend at least twice as much time as men on domestic work, and when all work – paid and unpaid – is considered, women work longer hours than men do.
  • Half of the countries worldwide meet the new international standard for minimum duration of maternity leave – and two out of five meet the minimum standard for cash benefits – but there is a gap between law and practice, and many groups of women are not covered by legislation.

Violence against women

  • Women are subjected to different forms of violence – physical, sexual, psychological and economic, both within and outside their homes.
  • Rates of women experiencing physical violence at least once in their lifetime vary from several per cent to over 59% depending on where they live.
  • Current statistical measurements of violence against women provide a limited source of information, and statistical definitions and classifications require more work and harmonization at the international level.
  • Female genital mutilation is the most harmful mass perpetuation of violence against women shows a slight decline.
  • In many regions of the world longstanding customs put considerable pressure on women to accept abuse.

Environment

  • More than half of rural households and about a quarter of urban households in sub-Saharan Africa lack easy access to sources of drinking water, and most of the burden of water collection falls on women.
  • The majority of households in sub-Saharan Africa and South-Eastern Asia use solid fuels for cooking on open fires or traditional stoves with no chimney or hood, disproportionately affecting the health of women.
  • Fewer women than men participate in high-level decision-making related to the environment.

Poverty

  • Households of single mothers with young children are more likely to be poor than households of single fathers with young children.
  • Women are more likely to be poor than men when living in one-person households in many countries from both the more developed and less developed regions.
  • Women are overrepresented among the older poor in the more developed regions.
  • Existing statutory and customary laws limit women’s access to land and other types of property in most countries in Africa and about half the countries in Asia.
  • Fewer women than men have cash income in the less developed regions, and a significant proportion of married women have no say in how their cash earnings are spent.
  • Married women from the less developed regions do not fully participate in intrahousehold decision-making on spending, particularly in African countries and in poorer households.

Harmful tradition practices include;

  • Forced marriage
  • Child marriage
  • Female Genital Mutilation
  • Honour killings
  • Dowry related violence
  • Female infanticide
  • Trafficking of women and girls

Afghanistan at a glance*

  • Only about 15% of births are attended by trained health workers while more than 90% of the births take place at home. According to UNICEF, the maternal mortality rate in Afghanistan is the second highest in the world with an estimated 15,000 women dying each year from pregnancy related causes.
  • The infant mortality rate is 165 per 1,000 and less than 5 mortality rate is 257 per 1,000 with 1 in 4 children in Afghanistan dying before the age of 5 from preventable diseases.
  • Only 23% of the population has access to safe water, and only 12% have access to adequate sanitation which increases the incidents of diseases. 15,000 Afghans die of tuberculosis every year and of this 64% are women.
  • Malnutrition of women which affects pregnancies negatively is caused by the food scarcity linked to the war and drought.
  • The poor health situation has been aggravated by the lack of basic health services and resources, especially in rural areas because of the small number of trained female doctors, nurses and midwifes that remained in the country after the rise of Taliban.
  • 23 years of war have destroyed the infrastructure of the educational system and increased the illiteracy rate in Afghanistan. Only 10% of women are able to read and write.
  • 54% of girls under the age of 18 are married. Families of girls and young women were forced to marriage for several reasons and often for the purpose of dowry for the family’s survival.
  • *Source; Report of the Secretary-General on Discrimination against women and girls in Afghanistan (E/CN.6/2002/5)

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