New York — A growing number of rural Kenyan families are turning to an alternative to the rite of female circumcision for their daughters.
The new rite is known as 'Ntanira na Mugambo' or 'Circumcision Through Words'. It uses a week-long program of counseling, capped by community celebration and affirmation, in place of the widely criticized practice also known as female genital mutilation (FGM). Next month, residents of some 13 villages in central Kenya will celebrate the fourth installment of this increasingly popular alternative rite of passage for young females.
The first Circumcision Through Words occurred in August 1996, when 30 families in the tiny village of Gatunga, not far from Mount Kenya, ushered their daughters through the new program. Some 50 families participated in the program in December followed by 70 families this past August.
Circumcision Through Words grows out of collaborations between rural families and the Kenyan national women's group, Maendeleo ya Wanawake Organization (MYWO), which is committed to ending FGM in Kenya.
It follows years of research and discussion with villagers by MYWO field workers with the close cooperation of the Program for Appropriate Technology in Health (PATH), a nonprofit, nongovernmental, international organization which seeks to improve the health of women and children. Headquartered in Seattle, PATH has served as technical facilitator for MYWO's FGM program, providing the methodologies and other inputs to help carry it forward.
FGM is practiced in about half of the rural districts of Kenya, part of a larger international population of more than 100 million women who are believed to be subject to varying forms of FGM across Africa and parts of western and southern Asia.
FGM is generally grouped into three categories: incision, the cutting of the hood of the clitoris; excision, the cutting of the clitoris and all or part of the labia minora; and infibulation, the removal of the clitoris, the adjacent labia (majora and minora), and the sewing of the scraped sides of the vulva across the vagina, except for a small opening.
In rural areas, circumcision rites are usually carried out by traditional practitioners using crude instruments and little or no anesthetics. Urban dwellers and the more affluent are more likely to seek out professional health care providers.
While in some cultures the circumcised include infants a few days old, most of the affected girls are between the ages of 4 and 12, according to a statement announcing a UN joint plan of action against FGM.
The health consequences of FGM can range from serious to deadly. "Short-term complications include severe pain, shock, hemorrhage, urine retention, ulceration of the genital region and injury to adjacent tissue," according to the UN release. "Hemorrhage and infection can cause death. Long-term complications include cysts and abscesses, keloid scar formation, damage to the urethra resulting in urinary incontinence, dyspareunia (painful sexual intercourse), sexual dysfunction, urinary tract infection, infertility and childbirth complications."
Yet female circumcision encompasses more than the practice itself. It is often a deeply entrenched in the culture, wrapped in a complex shroud of assumptions, taboos, and beliefs that impact a woman's social status and personal identity.
Indeed, it seems the central defining achievement of Circumcision Through Words is not that it saves young women from the dangers of FGM but that it captures the cultural significance of female circumcision while doing away with the dangerous practice itself.
"People think of the traditions as themselves," said Leah Muuya of MYWO. "They see themselves in their traditions. They see they are being themselves because they have been able to fulfill some of the initiations," said Muuya in "Secret and Sacred," a MYWO-produced videotape, distributed by PATH, which explores the personal dangers and harmful social results of FGM. The tape explains that female circumcision has traditionally signaled when a young woman is ready for the responsibilities of adulthood.
In answer to that, Circumcision Through Words brings the young candidates together for a week of seclusion during which they learn traditional teachings about their coming roles as women, parents, and adults in the community, as well as more modern messages about personal health, reproductive issues, hygiene, communications skills, self-esteem, and dealing with peer pressure.
The week is capped by a community celebration of song, dancing, and feasting which affirms the girls and their new place in the community. Indeed, after witnessing the community's response to the first celebration, MYWO Chair Zipporah Kittony said she was "overjoyed" and believed it was a critical achievement in their efforts to eradicate FGM.
The original proponents of the new rite have since incorporated and are seeking support from international donors in order to continue and expand their efforts. Indeed, it was such broad-based cooperation that led to the effort's creation in the first place.
In addition to the initiative of the local population, the development of Circumcision Through Words is rooted in cooperation between the national women's group and PATH. Under MYWO's direction, the groups conducted surveys in 1990 and 1991 that examined the dimensions of FGM in four districts of central Kenya. Funding came from several international donors including the Ford Foundation, the Moriah Fund, Population Action International (PAI)/Wallace Global Fund, Public Welfare Foundation, and Save the Children - Canada.
MYWO and PATH have also developed public awareness campaigns that spread information on the harmful effects of female genital mutilation. According to Dr. Asha Mohamud, a PATH Senior Program Officer focusing on FGM, the two organizations agree that information, education, and public discussion are more effective tools against FGM than direct, prohibitive action.
That became clear recently after Kenyan President Daniel arap Moi declared his intent to abolish the practice. "It led to a terrific backlash," she said, including circumcisions in the middle of the night and a rush to circumcise girls at a younger-than-usual age, in an effort to beat the ban.
Accompanying this Kenyan initiative is an international effort to increase global pressure on the issue. In April of this year, the World Health Organization, UNICEF, and the UN Population Fund announced a joint plan to significantly curb female genital mutilation over the next decade and completely eliminate the practice within three generations.
Many governments have outlawed the practice in their own territories, including the United States in September of last year, while they seek strategies to manage the problem. The U.S. Department of Health and Human Services is working through the Centers for Disease Control and the Immigration and Naturalization Service with a host of non-governmental organizations to develop the means to help thousands of African females at risk within its borders. However, such efforts are complicated by criticism from some within the African community who see such actions as racist and intrusions upon African cultural practices.
Efforts like Circumcision Through Words offer a promising approach to resolving this controversial issue, at least within practicing communities, said Dr. Mohamud, since there are many people who would like to end the practice yet are not able to face the social ostracism that would entail. Yet, despite the continuing successes of Circumcision Through Words, proponents of traditional circumcision are still numerous in these communities.
"You cannot change Culture overnight," said Peter Kali, District Officer in the Gatunga area of Kenya, during the recent celebration.