3 January 2013

Tanzania: When Grandmothers Take the Lead Against Fgm

Female Genital Mutilation has been a thorn in the flesh for societies the world over. Though the world has taken strides in reducing it, as it dehumanizes women and in turn commodefying them, the war against this social anomaly if far from being won.

In Tanzania, Female Genital Mutilation is traditionally performed in areas such as Arusha, Kilimanjaro, Dodoma, Singida, Mara and Morogoro, Iringa, Mbeya regions, and Zanzibar. According to Tanzania health statistics, FGM affects 18 percent of the female population in Tanzania. In the southern Senegal village of Kael Bessel, female genital mutilation is no longer a taboo subject.

Sexagenarian Fatoumata Sabaly speaks freely about female circumcision and girls' rights with her friends. "We've found it necessary to abandon cutting - abandoning the practice has advantages for women," she said. "Female circumcision has consequences such as haemorrhaging and it can even lead to death." In Senegal, like other West African countries, grandmothers like Sabaly are generally the ones who decide girls should be circumcised.

A 2008 survey in Vélingara, also in the south of Senegal, found nearly 60 percent of older women supported female genital mutilation. But a 2011 survey carried out by the Grandmother Project found fully 93 percent of the same group are now against FGM.

The Grandmother Project, an international non-governmental organisation which promotes community dialogue about cultural issues, has helped organise regular meetings in thirty-odd villages around Vélingara, to enable people to discuss questions relating to local traditions and values, particularly "koyan" - the rite of passage associated with FGM. Religious leaders, traditional chiefs, local officials, youth and elders all take part.

The public debates allow people to talk openly about the pros and cons of their cultural practices. "Since excision has more disadvantages than advantages, people are slowly abandoning the practice," said Falilou Cissé, a community development advisor at the Grandmother Project in Vélingara. "People have stopped the practice themselves. We have never asked people to stop it," she stressed.

The meetings emphasise the educational role of grandmothers in African societies, but beyond that they help break the silence around taboo subjects like FGM. "I was for excision, personally, like many people, but the public discussions have helped me to change my position, to accept that in our culture, there are some values to preserve and others to abandon," Abdoulaye Baldé, the imam of a mosque in Vélingara, told IPS.

Today, thanks to Baldé's participation in the meetings, people around Vélingara know that FGM is not a religious obligation for Muslims. The involvement of opinion leaders has had a huge impact on changing the outlook on excision among grandmothers. Fatoumata Baldé, a nurse-midwife in Kandia, a village near Vélingara, told IPS that she couldn't remember coming across a case of excision in the area since 2010.

"Previously, we were used to handling lots of cases of cutting gone bad at the clinic, because it's done without medical assistance," explained the nurse, also a regular participant in the debates. Boubacar Bocoum, a Malian consultant who has studied FGM in several countries, sees in the Vélingara experience grounds for hope that the practice could be definitively abandoned across West Africa.

"The projects fighting against this practice generally target excisors, while it's really a community problem," he said. "If only one part of the community abandons it, the practice persists because the rest of the people are not engaged." According to a study published by the NGO Plan International in 2006, FGM is practiced throughout the West Africa region. "In Guinea, in Sierra Leone and in Mali, practically all women are excised," said the report.

"In Niger and Ghana, the practice is limited to particular geographic areas and the national prevalence is less than 10 percent." Consequences of FGM Women are left with little choice in the practice despite the physical and psychological harm. The practice is seen as necessary preparation for woman's marital and family responsibilities. There are social stigmas associated with women who are not circumcised.

For example it is thought that a woman not operated on will suffer ill health, disease and be affected by a taboo. Traditionally males are strongly prohibited from marrying into a family where women do not undergo female genital mutilation. Immediate consequences of FGM include severe pain and bleeding, shock, difficulty in passing urine, infections, injury to nearby genital tissue and sometimes death.

The procedure can result in death through severe bleeding leading to haemorrhagic shock, neurogenic shock as a result of pain and trauma, and overwhelming infection and septicaemia, according to Manfred Nowak, UN Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment. Almost all women who have undergone FGM experience pain and bleeding as a consequence of the procedure.

The event itself is traumatic as girls are held down during the procedure. Risk and complications increase with the type of FGM and are more severe and prevalent with infibulations. "The pain inflicted by FGM does not stop with the initial procedure, but often continues as ongoing torture throughout a woman's life", says Manfred Nowak, UN Special Rapporteur on Torture.

In addition to the severe pain during and in the weeks following the cutting, women who have undergone FGM experience various long-term effects - physical, sexual and psychological. Women may experience chronic pain, chronic pelvic infections, development of cysts, abscesses and genital ulcers, excessive scar tissue formation, infection of the reproductive system, decreased sexual enjoyment and psychological consequences, such as post traumatic stress disorder.

Additional risks for complications from infibulations include urinary and menstrual problems, infertility, later surgery (defibulation and reinfibulation) and painful sexual intercourse. Sexual intercourse can only take place after opening the infibulation, through surgery or penetrative sexual intercourse. Consequently, sexual intercourse is frequently painful during the first weeks after sexual initiation and the male partner can also experience pain and complications.

When giving birth, the scar tissue might tear, or the opening needs to be cut to allow the baby to come out. After childbirth, women from some ethnic communities are often sown up again to make them "tight" for their husband (reinfibulation). Such cutting and restitching of a woman's genitalia results in painful scar tissue.

A multi-country study by WHO in six African countries, showed that women who had undergone FGM, had significantly increased risks for adverse events during childbirth, and that genital mutilation in mothers has negative effects on their newborn babies. According to the study, an additional one to two babies per 100 deliveries die as a result of FGM.

The three primary types of FGM include circumcision which entails the removal of the "prepuce" of the clitoris, excision or clitoridectomy which involves the removal of the entire clitoris in addition to the cutting or removal of the labia minora and infibulation, the most extreme form of FGM, which involves the removal of the entire external genitalia as well as the stitching of the vagina so that only a narrow opening remains. It is against this background that some governments have crafted laws to ban FGM.

In Tanzania, the Sexual Offences Special Provisions Act, a 1998 amendment to the Penal Code, specifically prohibits FGM. Section 169A (1) of the act provides that anyone having custody, charge or care of a girl under 18 years of age who causes her to undergo FGM commits the offence of cruelty to children. The penalty for this offence is imprisonment up to fifteen years, a fine up to 300,000 Tanzania shillings or both imprisonment and fine.

The law also provides for the payment of compensation by the perpetrator for the victim of the offence. With this in mind, some societies devised ways to beat the law by employing hide and seek tactics. In areas such as the central zone regions women are now performing female genital mutilation (FGM) secretly, in some hideouts, to avoid the long arm of the law and eyes of human rights watchdogs.

To make matters worse, FGM rites that are traditionally performed openly involving girls are now said to be performed on babies shortly after their births. Though various groups have made inroads in reducing the incidents, it is vital that societies be educated and involved in as far as finding a permanent solution is concerned.

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