28 October 2013

Tanzania: FGM Remains Quite Dangerous to Health

Photo: IRIN
A group of women has been arrested by Tanzanian police for conducting Female Genital Mutilation.

THE fight against Female Genital Mutilation (FGM) remains long and hard. The latest voice against this harmful practice was raised at the weekend by Ms Imelda Hyera, an activist who works with the Tanga Inter- African Committee.

She says that 25 per cent of the women in Tanga have undergone FGM. Her organisation, she says, has already conducted seminars and sensitisation programmes in rural areas, especially in Tanga and Mkinga districts, targeting the youth, mainly those in schools.

So far, more than 10,000 students and 6,620 community members have been trained to create awareness on the harm caused by FGM. It is imperative to point out here that the ongoing struggle against the diabolical practice remains hard but critical.

Despite government efforts to eliminate the practice some people continue it in a shroud of secrecy mainly in Mara, Dodoma, Kilimanjaro, Singida and Manyara regions where adult women and children aged between six and 20 years undergo the harmful ritual.

Although there are sustained sensitisation efforts and legal curbs that aim at eradicating the practice, incisors (ngariba) are still at work, mutilating children and women secretly. A recent survey shows that the practice is mainly prevalent in ten regions on the Mainland.

The prevalence of FGM in Arusha and Manyara regions stands at 81 per cent. In Dodoma 68 per cent of women are mutilated while in Mara the rate is 44 per cent; Kilimanjaro (37 per cent); Iringa (27 per cent); Singida (25 per cent); Tanga (25 per cent) and Morogoro (20 per cent).

Dar es Salaam appears to have the smallest rate at 5.4 per cent. An anti-FGM activist, who wished to remain anonymous, said in Dar es Salaam recently that the anti-FGM crusade has made headway so far in sensitising elders in tribal settings to shun the harmful ritual.

She said a significant number of incisors in Dodoma, Singida, Ruvuma and Manyara have come forward to surrender their tools of the trade.

She said, however, that despite the vigorous anti-FGM effort, which has made successful inroads into the ritual, some incisors now mutilate day-old babies secretly. "Ninety- eight incisors in Manyara Region have already laid down their tools.

This is a welcome development," she said. She mentioned other regions where incisors have given up their trade as Dodoma (83), Singida (96) and Ruvuma (202). It is highly critical that communities must look for alternative methods of marking the passage of girls to womanhood (unyago).

The contention here is that people do not have to mutilate young girls to get them to graduate into womanhood. In Dodoma Region the practice is known as "kugotolwa" among the Wagogo. Here, the ritual marks the passing of a young girl from childhood to womanhood.

The ritual is also seen as a preventive measure or a cure against an imaginary disease known as "lawalawa." In Mara Region, where the Wakurya refer to the practice as "esaro," and in Arusha where the Maasai know it as emorata, the reasons for the ritual do not differ from those advanced by the Wagogo, although here it is also designed to shoot down sexual desires.

So, in Dodoma and Singida women are mutilated on the pretext that the practice fends off "lawalawa." In fact, investigation by medical experts has shown that such a disease does not exist. Lawalawa is a myth and an excuse to validate FGM among backward tribal settings.

It has been established that what is believed to be "lawalawa" is actually a minor medical complication caused by improper cleaning of the genitals and any "uncircumcised" woman who develops thrush and an itchy feeling in her genitals is believed to have "lawalawa."

Medical doctors say that the so-called "lawalawa" is thrush that is normally caused by dirt. It is an infection that can be prevented by cleanliness of genitalia and cured in hospitals by administration of antibiotics.

Although the government says it has logged a mileage in the crusade against FGM there are pockets of resistance in some regions, especially in Dodoma, Mara, Arusha and Manyara. Some elders in most villages are diehards who have refused to see sense.

The elders' argument is that FGM curbs sexual desires in young girls so that they won't engage in premarital sex. And as mentioned before, the ritual is also a passage from girlhood to womanhood. Whatever the ruse for FGM, the practice is unnecessary and is highly dangerous to health.

The practice is likely to cause life-threatening haemorrhage if carried out without competent surgical control. In the event of massive haemorrhage, serious collapse or sudden death may occur. Major blood loss can result in long-term anaemia.

In fact, losses of lives have often occurred following the crude cut which is normally carried out by elderly village women. With infants (a practice that is uncommon) the incisor or "ngariba" uses fingernails as a cutting tool. The rite is conducted clandestinely under a shroud of secrecy, to avoid the attention of state security agents.

The incisor wanders casually into the baby's home and works in dim light. FGM, which is normally carried out on girls, is performed with crude homemade knives, pairs of scissors, scalpels, pieces of glass or razor blades.

There is often additional unintended damage to the genitals due to crudeness of the tools, poor light or septic conditions.

Infection, due to unhygienic environment and the use of crude, unsterilised tools, is a likely consequence. Infection can also be contracted due to the application of traditional herbs such as crushed tree leaves or roots often used for healing the wound.

In urban centres affluent families prefer eliciting the services of health personnel such as midwives and doctors. However, the government and the WHO have consistently condemned the "medicalisation" of both circumcision and FGM.

The WHO sees the practices as unnecessary as they are likely to carry serious, potentially dangerous complications. In rural Tanzania FGM may not cross many minds as a public health hazard that warrants condemnation as it bears nasty physical, sexual and psychological consequences.

In fact, incisors that carry out FGM on infants must be stark raving mad. Farther afield, in African settings, women are subjected to FGM in most tribal settings because they are likely to bring shame to their families.

Various forms of FGM are carried out in Kenya, Uganda, Ethiopia, Sudan, Djibouti, Mauritania, Nigeria and Mali.

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