23 October 2012

Guest Blog from Lisa Glass, Member of South London Fawcett Group.

Guest Blog from Lisa Glass, Member of South London Fawcett Group.

I recently went to a South London Fawcett Group meeting, where Ann-Marie Wilson, Founder/Director of 28 Too Many spoke about the work of her charity. With a background in corporate HR, she went in 2005 to West Darfur to do some aid work, where she first came across the practice of female genital mutilation (FGM), meeting a young girl who had undergone the procedure at the age of five. This girl was then raped at the age of 10 and became pregnant. This,Wilsonsaid, was a wake-up call and she returned to theUKto find out what anti-FGM work was being done. She found it was virtually nothing and so founded 28 Too Many. The 28 refers to the number of countries that practice FGM in Africa. However, it takes place many other countries such as Russia, Belarus, UK, Netherlands and Canada.

FGM takes place in a complex and emotive cultural context. FGM has been going on for 2000 years, is pre-Christian and pre-Islamic. In 2003,Wilsonsaid, 140 million women had had FGM done to them. Perhaps one of the most difficult aspects of FGM to accept is that this is a woman on woman practice. It is seen as a rite of passage; if women do not have it done they have no chance of marrying, which is the only way for a woman to be valuable in certain societies.

There are three different types of FGM. The first is a clitoridectomy, where the clitoris is cut out entirely; type 2 is clitoridectomy plus the removal of the labia minora; type 3 includes both clitoroidectomy, removal of labia minora plus the labia majora, leaving a large open wound that is stitched with catgut. A tiny orifice is left for menses, copulation and birth. Menses are therefore often retained, causing infection and infertility. The type and prevalence of FGM practiced varies depending on the country. In some countries, nearly 100% of the female population have FGM,Wilsonsaid.

FGM normally takes place in children at the age of nine or 10, but it can be done on babies as young as eight days old. Around three million girls a year undergo FGM and around 10% of these will probably die from haemorrhage or infection. This equates to 300,000 FGM-related deaths a year, or one every 10 seconds. The procedure is often done using cultural instruments, which could be a used or new razor blade, or could be a knife or a piece of glass, which obviously has implications for infection such as septicaemia, haemorrhaging and death. No anaesthetic is used. Aside from the physical pain,Wilson highlighted the psychological trauma this must cause in children who don’t know what has happened to them, only that they have been cut and that this is seen as a good thing for them and their family.

Wilson said that originally FGM was done to protect the value of slaves, who would be sold intact as a virgin so the slave master could have them as a virgin and also, being virgins the girls would not be pregnant and therefore could work longer.Wilsonemphasised that the practice is a cultural practice, not a Muslim practice and in fact does not occur inIran. Christians and Jews in some countries in Africa also practice FGM, however, it is mostly done in majority Muslim communities. Although the Qur’an does not specifically mention FGM as a necessary practice for Muslim women, illiterate women are often told that it is. Furthermore, one myth perpetuated is that women are oversexed. Considering girls in their early teens are often married to much older men who may have other wives already, it begs the question, who is really oversexed?

In some areas, the procedure has been medicalised and is performed by a qualified health practitioner, meaning the risks of infection and haemorrhage are minimised. However, the complications of obstruction in labour and retained menses still occur, aside from the fact that this is a waste of the healthcare professionals’ time and resources, is against accepted medical ethics, and leads to FGM being legitimised and institutionalised. In fact, a third of the 28 countries do have specific anti-FGM laws, a third have laws around the prevention FGM, yet a third have little at all.

The rationale for FGM in many communities is that it is the price of beauty, and in countries that are fixated on chastity and virginity, there is an aesthetic aspect, the clitoris being seen as a remnant of maleness and the ideal to have a flat, smooth area (scar tissue). But in childbirth the vagina needs to dilate 10 centimetres to give birth, meaning that scar tissue is constantly opened and restitched when women undergo multiple childbirths. The social importance of FGM means those who have not undergone FGM are considered ‘girls’, who cannot undertake the work of women, ie drawing water, attending rituals and preparing food. The husband might not be able to work, which has implications for the whole family. Other complications include the time it takes to urinate, which can take 15 minutes, meaning girls miss out on classroom time, affecting their education. There is also the risk of false pregnancies due to retained menses, meaning the girl’s abdomen swells, leading her family to believe she is pregnant.

FGM also takes place illegally in the UK. In the past, girls would go to Africa to be cut during the long summer holiday, but the increasing awareness of UK authorities means that now it is more usual for the ‘circumciser’ to be flown into UK, where ‘cutting parties’ are held. Areas of the UK where this probably occurs include Bristol, London and Birmingham. The UK has had an FGM Act since 2003, making it illegal to aid and abet any UK resident to have it done. However, there have been no convictions as yet, although people have been arrested under these laws as a result of a Sunday Times report. The problem is that FGM is complex issue affecting a minority group in the UK, where there is lack of money, voice and literacy.

It is difficult to get young women to speak against FGM if this impacts their families.Wilsoncited an example of girl who refused to join a class at school, giving as a reason the fact that she had recently been cut. The school contacted the girl’s family, and the child withdrew her case. In fact, theUKis seen as one of the softest European nations regarding anti-FGM measures. InFrancegirls are examined routinely (although there are question marks over the ethics of this) and in Scandinavia girls have a right to be inspected at airports. As with many cultural traditions, such as the wearing of the veil, the practice of FGM is often kept alive when families move to the UK, as a way to maintain a connection with the culture of their home country.

As part of the work of 28 Too Many in the UK, Wilson has held talks with school nurses in areas such as Haringey, Barnet and Essex, to educate them about the practice. She has also contributed to conferences, inviting Mulsim clerics and other religious leaders to try to influence their teachings.

One problematic aspect Wilson addressed is that there is also contradiction inherent in that labiaplasty is legal in this country, as in many Western cultures but FGM is not, and this is an interesting point, especially if a boyfriend has put pressure on girl to undergo labiaplasty to conform to the ‘ideal’ look of female genitalia seen in pornography.

So what can be done to combat the practice of FGM? The approach taken by Wilson and 28 Too Many is based on establishing hard facts, mapping rates of FGM in different countries to see where prevention is working and where not, establishing benchmarks to form the basis of research and subsequent education. The aim is also to build networks with other charities working in this area.

Wilson cited the example of footbinding, which ended in China within 16 years after 1000 years of practice. Hopefully, Wilson said, in five generations the same could be achieved for FGM. To do this, she said, courage and drive are needed.