In this blog post, Hilary Burrage reflects upon the causes and consequences of FGM and what can be done about it in the lead up to International Women’s Day.
“It’s been 41 years but the sound of the blade still rings in my head… I started my fight against FGM when my daughter was born.” – Asha Ishmail, Kenya. From Female Mutilation(New Holland Publishers 2016).
Recent estimates by UNICEF suggest that some two hundred million women and girls alive in the world today have experienced female genital mutilation (FGM). Of these perhaps 140-170 thousand live in the UK, and a massive half a million in each case live in the United States and in mainland Europe.
However one looks at it, FGM is a global epidemic; indeed, with overall mortality rates estimated by some as 10% or more, it could be considered a form of gendered genocide. But still FGM remains under the radar of many who work in public service. Neither the health and human rights, nor the economic costs, of this grim practice are widely acknowledged.
It was to challenge this selective neglect that I (a sociologist) have written two books. The first book, Eradicating Female Genital Mutilation, is a textbook or handbook for professionals across the range of relevant services, as well as a thorough introduction to the subject for concerned citizens of all sorts. It has an accompanying website where all of us can debate and add further to the relevant issues. The second book, Female Mutilation: The truth behind the horrifying global practice of female genital mutilation is a collection of seventy accounts (‘narratives’) from survivors, their family members, campaigners, professionals and others who seek to make FGM history. These narrators come from two dozen or more countries in five continents, and their perspectives vary dramatically; but all are agreed that FGM must stop, now.
And what also comes out clearly across the whole spectrum of perceptions about FGM is the oppressive patriarchy underpinning it. Fundamentally, as a number of us have argued in the Statement on Female Genital Mutilation, FGM is about power and economics, the ‘ownership’ of women by men. The rationale / background to this Statement is here. This position and terminology (‘Mutilation’) arises in large part from the previous work of the Inter-African Committee on Harmful Traditional Practices Bamako Declaration of 2005.
FGM is in a very literal sense patriarchy incarnate. It is an extremely effective way of keeping women subservient to, and the chattels of, men. The ‘procedure’ is often (not always) carried out by matriarchs, but the intention is to ensure the ‘purity’ of girls and young women so that they attract good bride price (dowry) and / or are seen as upholding the family ‘honour’.
A girl who has not undergone FGM may be regarded as ‘wanton’ – and, in more recent times, also seen as ‘like Western girls’, thereby ‘betraying’ her own people. She may even be rejected by her community, sometimes with devastating results. But a girl who has had FGM will probably be married off very young, sometimes as an ‘extra’ wife, and at an age where her new ‘adult’ status sits uncomfortably with her capacity to make decisions as an adult, or with her actual level of social as well as physical maturity. There will be no further schooling; once married she will become, as some of my respondents have said, a ‘baby machine’, her damaged* body producing children as an economic outcome / insurance in default of a pension for security in old age.
[* I use the term ‘damaged’ deliberately, as it does not denote the overt intent to cause harm, albeit there are recorded cases of FGM being inflicted, or conducted more severely, as ‘punishment’ for girls who fail to show adequate obedience or subservience.]
But asking communities to recognise FGM for what it is continues to be very difficult. There are even now communities where women believe that all females the world over have been ‘cut’; and it is rare in some settings, even Western ones, for anyone to know that the pain, ill-health and inconveniences which women face are often FGM-induced – we should note here the additional disadvantage of girls who have not been able to learn to read.
And, crucially (as sometimes also with other forms of child abuse and identification with abusers, whether intentional or not) few women are willing to consider that their mothers could have been ‘wrong’ in permitting FGM. The psychological harm which may arise from such a belief is obvious. Surely, if mother had it herself and then subjected her daughter/s to it, it must have been essential?
Albeit far too slowly, however, things are now beginning to change; this cruel custom is at last being acknowledged more openly and in many communities (in Africa at least – less so at the present time in other traditional locations, or in Western diaspora neighbourhoods) attempts are being made to develop Alternative Rites of Passage. These (ARPs) are educational and ceremonial programmes without any human rights abuse which with enough hard work may be accepted in traditional settings as replacements for the act of FGM.
FGM is not ‘just’ a relic of the past practised in a few places, it is increasingly recognised as a threat to the health and well-being of girls and women in many parts of the world, across Africa, Asia and many Western states as well as some parts of South America. And with this acknowledgement has come a greater determination to support the work of those, such as the Inter-African Committee on traditional harmful practices, mentioned above, who have toiled so long virtually alone.
Legal enforcement is being established in many parts of the world, community education programmes are being set up, Alternative Rites of Passage (ARPs) for girls are being introduced, safe houses are being built to protect girls who run away to avoid FGM, and in some countries such as Kenya serious law enforcement programmes are being introduced.
Likewise, in some places restorative surgery is now offered, both for the direct damage of FGM and eg for the obstetric fistulae which can arise from scarring and obstructed birth. Many different organisations and informal groups around the world are engaged in this work, as I list in my book. And women and men from across the globe are fighting to end this practice as document in my book, here are some brief examples of some of this inspiring action:
Asha Ishmail from Kenya explained: “It’s been 41 years but the sound of the blade still rings in my head… So I am an FGM survivor and activist, though it took time for my family to realise that I was serious… My daughter is the first saved generation and the major reason for my decision to take action. She is 25 years old. I started my fight against FGM when my daughter was born.”
Ahabwe Mugerwa Michael, from Uganda spearheaded the Integrated Community Efforts for Development (ICOD) network which includes the “Barefoot Grannies” programme, which campaigns to end FGM in rural areas such as Karamoja which has high levels of maternal and infant mortality rates. He explains how he came to advocate against FGM after meeting a survivor who suffered from obstetric fistula as a result of FGM and how “In some communities, it’s still unusual to find men advocating for women in matters such as sexual and reproductive rights. I have myself encountered hostility in some villages, but I’ve always found ways to put it aside. I hope this will inspire more men to join anti FGM campaigns.”
Internationally, new agendas such as The Guardian Global Media Campaign to End FGM are engaging technology to spread the message in ways previously unimaginable.
Huge challenges nonetheless remain. Critically, there is a malign trend towards using medically trained personnel to inflict the mutilation. In line with general ethical considerations, the WHO is flatly opposed to ‘medicalization’, but especially in the region around the Middle East it seems this development in now almost the norm, sometimes despite national legislation prohibiting FGM. With few prosecutions, some clinicians are willing to suggest that for a consideration they can make things safer – although evidence suggests that they actually cut more extensively.
As ever with patriarchy, the fundamentals are as we have seen ultimately economic and focus around the influence thereby afforded. The details may vary, but as a general model young women are bought and sold, always dependent on father or husband; no money is ‘wasted’ on their education. (The Guardian EndFGM website offers some real first person accounts of various such issues.) Indeed, FGM makes it even more unlikely that girls will be able in practical terms to continue their schooling; it potentially restricts their opportunities for adult independence both because, albeit unbeknown, it causes ill-health and trauma, and because it is usually followed by early marriage, sometimes as second or other wives, and child-bearing.
But FGM can be big business. Operators – quite frequently matriarchs who gain status and power from their ‘profession’ – often charge to ‘guarantee’ ‘purity’; and fathers are willing to pay both for that and sometimes for elaborate rites of passage for their daughters. (New brides discovered not to have undergone FGM may even be returned to their original families, with a demand for a ‘refund’.) Overtly or covertly, whole communities across parts of Africa and the Middle East etc may traditionally be structured around these sorts of arrangements.
But who is measuring the costs? My own research suggests much remains to be done.
There has been some work on maternal and infant impacts, but we have barely begun to evaluate the lost economic contribution which arises because women with FGM are both poorly educated and subject to life-long ill-health. We don’t really know how much it would cost governments to make well the millions of women with FGM. We are not recognising the lost opportunities, because of FGM, to address other health issues which also require funding and are not the direct result of intentional human agency. Every dollar committed to eradicating and repairing the outcomes of FGM could, if this practice ceased, be put to use much more constructively in programmes for infant nutrition, vaccination, clean water and so forth.
The eradication of FGM is a global emergency in every sense. Everyone has something they can do to make this cruel human rights abuse history, whether their support is financial, as a lobbyist or simply as a generally concerned citizen.
As we approach International Women’s Day once more, it really is time to say, Stop.
Hilary Burrage is the author of two books on female genital mutilation: “Eradicating Female Genital Mutilation: A UK Perspective” and “Female Mutilation, the truth behind the horrifying global practice of female genital mutilation”. Information about each of these books can be found on her website: http://hilaryburrage.com/