The Female Genital Mutilation / Cutting (FGM/C) News Blog: Are fears of legalization of female genital mutilation in Egypt real?

The Female Genital Mutilation / Cutting (FGM/C) News Blog: Are fears of legalization of female genital mutilation in Egypt real?

LAUNCH OF THE ACADEMIC NETWORK ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS POLICY (ANSER)

About

The Academic Network on Sexual and Reproductive Health and Rights Policy (ANSER) aims to become a global resource for SRHR policy research, education and service delivery by establishing an international platform for research on SRHR policy related topics; by developing a portfolio of education and training programmes on SRHR policy; and by fostering interaction between SRHR researchers and policy makers.

During the United Nations Sustainable Development Summit September 2015, 193 governments formally approved 17 Sustainable Development Goals (SDG) as a follow-up to the Millennium Development Goals (MDG) that expired last year. During the meeting governments were tasked to come up new policies for the upcoming years in order to achieve the targets for the set goals. Sexual and reproductive health and right (SRHR) lies at the immediate intersect of SDG3 (ensuring health lives), SDG5 (achieve gender equality) and SDG10 (reducing inequalities), and has a direct link to the achievements of many other goals (such as ending hunger and addressing ecological challenges) The development of these new policies necessitates an evidence base to ensure their adequacy and effectiveness. The SRHR is seen fit to have the central position in these goals as they can make important decisions to be followed by governments. Also, the success of their implementation is closely linked to reliable follow-up and monitoring by professionals with the required training and expertise. As a result it will ensure that there is good communication and feedback among the network team formed hence exchange of knowledge and experiences which will contribute to the achievement of these goals.

On Board

This set the stage for the setting up of an International Thematic Academic Network on Sexual and Reproductive Health and Rights Policy (ANSER). The strategic plan of the ANSER is anchored on high commitment to linking academia and policy through research, training and service delivery paying particular attention to translating results into practice and policy. These components of the ANSER strategic plan were emphasized during its official launch on Wednesday 30^th November 2016, at the New Zibra Hotel, Ghent, Belgium at 5 PM. Presenct during the launch were distinguished guests and speakers including: Secretary of State for Science Policy: Dr Elke Sleurs; Dr Moazzam Ali of the Human Reproduction Programme (WHO); Director UNFPA Brussels: Mrs Sietske Steneker and Secretary of the European Parliamentary Forum on Population and Development, Mr Neil Datta. ACCAF was well represented by Prof. Patrick Muia Ndavi an Associate Professor of obstetrics and gynaecology and epidemiologist, at The University of Nairobi, and consultant Obstetrician and Gynaecologist.

Main Messages

In her presentation, Dr. E. Sleurs stated that SRHR policy should be anchored by scientific research and not based on political intuition and considerations while emphasizing that politics and science must not be isolated or practiced in isolation, from each other. On his part, Dr. M. Ali summarized the: WHO/HRPs core functions of capacity building, global leadership and research for attainment of the highest standard of SRH; WHO/HRPs results framework that includes impact, outcome and outputs which require activities and inputs and finally the nine key areas for research.

The ANSER coordinator, Dr. Olivier Degome, provided the intertwining of policy research, training and service delivery as the aim of the network. This would be achieved through the operations and or activities of five thematic working groups viz: abortion, contraception and family planning, SRHR monitoring and evaluation, adolescent SRHR, sexual health (including sexual-well being, sexual identity, gender identity), interpersonal violence, gender and rights. To be included in the conceptual framework are online modules, policy makers and internship programs, and the community.

Interactive Dialogues

A debate followed involving Dr. Mozzammi Ali, Mrs. Steneker, Mr. N. Datta and Ms. De Rycke (Medical Student University of Gent) and moderated by Mr. S. Spanoghe. The issues that informed the animated debate and considered as the biggest challenges were reliable information, good translation into policy, limited funding and resources, whether innovation was having impact, gender equality between countries, that policy makers are looking for information, digestible results,  what the expectations are, evidence based policies, benefits for working together, and evidence to policy. With unfinished work on all these issues the role of ANSER is defined.

CELEBRATION OF THE INTERNATIONAL DAY OF THE GIRL CHILD AND LAUNCH THE NATIONAL NETWORK OF ACTIVISTS AGAINST FGM

Since 2012 the United Nations has marked 11th October as the day to celebrate the International Day of the Girl Child (IDGC). The day is set aside to raise awareness of gender inequalities that the girls face based on their gender, like girl child marriages and Female Genital Mutilation/ Cutting.  It is also with the aim to support more opportunity for girls to be able to access education, stop violence against women, easy access to medical care, legal rights and good nutrition. The theme for this year’s IDGC was Girls’ Progress = Goals’ Progress: What Counts for Girls. This year ACCAF joined the Samburu Girls Foundation’s Girls’ Rescue Centre in Loosuk Ward, Samburu County, Kenya in celebration of the achievements made towards empowering the girl child and outline more opportunities available for the girl. The ACCAF’s participation of Prof. Patrick Ndavi Muia, Dr. Jane Wambui and Dr. Tammary Esho brought the high level of FGM/C in the county to the attention of the local leaders and the community.

The celebrations

The celebrations were very successful with good representation of young girls, parents, teachers, community elders and other community members including young boys. There were also a number of local and national organizations as well as NGOs in the celebrations. The program of the day begun by the guests being entertained. The entertainment was very good and informative with appropriate themes in line with the topic of the day. The young boys and girls sang, acted skits, narrated poems and danced to tunes focusing on the importance of educating a girl child and not subjecting them to harmful practices.

The speeches by various community leaders including men followed. There was emphasis for the community to collaborate and together own Samburu Girls Foundation because it is making a difference in their community. These were followed by speeches from the organizations working for the girl child against child marriage and FGM/C.

FGM among the Samburu

In Samburu FGM is considered as a rite of passage. The Samburu practice the most severe type - infibulation on girls at pre-puberty after reaching 10-years-of-age and sometimes younger mainly as a rite of passage and preparation for marriage. The female cut determines maturity in girls after which the next stage of honour is forced marriage and motherhood. In her speech Dr. Tammary Esho of ACCAF provided the current statistics with regard to FGM/C in Kenya. She mentioned that the Samburu community has 86% prevalence and is ranked second to the 94% among the Somali community in the country. Furthermore, she pointed out that the largest representation in this cluster of women with FGM/C is young girls between the ages of 10-14 years old. Dr. Esho finalized her speech by urging the Samburu people to stop harmful practices and allow girls to get an education which will give them better leverage in their future life hence benefit their families and the community as a whole. She reiterated that the Samburu people are lagging behind because Kenya now has a prevalence of 21%, a steady drop marked over the last two decades.

Samburu’s value their cultural traditions and would like to keep them intact so as not to lose their identity. It is in this view that the efforts towards abandonment of harmful traditional practices towards girls feel strenuous, but with subtle persistence and more evidence based success stories girls and women will be free to embrace what the world has to offer.

Thus the ACCAF’s participation in the IDGC brought the high level of FGM/C in the county to the attention of the local leaders and the community pointing out what needs to be done to prevent violation of the right of the girl. As ACCAF we are more than delighted when we see young girls achieve their education dreams by escaping the cut. We have been able to succeed so far in the communities we are working in. However a lot more still need to be done to fight the tradition that still takes place behind hidden doors. We need to work together to empower the women and men in the community to know that FGM/C is not a measure of maturity but a rogue custom that needs to end.

RESTORING GIRLS’ AND WOMEN’S DIGNITY

In honor of International Women's Day, Prof. Guyo Jaldesa (from the University of Nairobi) wrote about ACCAF’s work with support from the USAID, JSI’s Advancing Community Partners (APC) project .

In many places around the world, the sexual and reproductive health and rights of women are tenuous at best, and years of progress can be washed away instantly by socio-political changes. As we celebrate International Women’s Day, we must remember that preserving—or reclaiming— the dignity of girls and women requires continuous efforts, even when it seems like the battle is already won.

The Africa Coordinating Centre for Abandonment of Female Genital Mutilation/Cutting (ACCAF) supports cultural change and relationships and information sharing between professionals and community members, and strengthens the health care sector’s capacity to care for women and girls who have undergone female genital mutilation/cutting (FGM/C) in Africa.

Over the last two years, the centre has been working with a Kipsigis community in Kenya. ACCAF became interested in this community when it heard that married women were getting cut. The Kipsigis have a tradition of cutting young teenage girls, but anti-FGM/C campaigns and efforts to increase girl-child education had significantly reduced the prevalence of this practice. When ACCA F members started talking with Kipsigis women, they were astonished to hear that the women being cut were in their twenties, married, and/or pregnant. Many of these women had basic and secondary education, had escaped cutting during their teenage years,  and married men who accepted them as they were. Yet pressure from the community and these same husbands were contributing to this resurfacing practice.

Community members explained that a change in perception of men’s status led to the reemergence of cutting. After post-election violence hit the region in 2008, the Kipsigis clashed with people from another ethnic background. During the weeks-long civil war, Kipsigis men who wanted the honor of fighting had to fulfill certain requirements, including being married to women who were cut. Men married to uncut women were not considered ‘man enough’ and were left behind in the village. Although the factions are currently at peace, it is likely that fighting will break out again should differences emerge in future political elections. The Kipsigis are maintaining their army and the community is pressuring women to get cut to elevate their husbands’ social status.

In pursuit of its goal of restoring the dignity of girls and women, ACCAF has trained 2,000 Kipsigis community leaders. Training seminars covered aspects of FGM/C including legal; social-cultural; medical, psychological, and sexual complications; and human rights. Deliberate efforts to have gender parity and age variation in these seminars were effective; the youngest participant was 17 and the oldest 60.

After each training, participants developed plans to encourage FGM abandonment in their communities.  ACCAF continued to support these leaders with occasional field visits to monitor progress and challenges. One of the male political leaders who attended the first training has been at the forefront of this effort for two years now, and was even recognized as an anti-FGM champion by the county governor.

ACCAF interventions have been sustainable because they use community resources and operate at pre-existing meetings and venues such as administrative chief barazas, political rallies, schools, and churches. Using community leaders as change agents has resulted in easier acceptance that FGM/C is an unnecessary procedure that causes adverse health consequences, and has raised awareness of the laws around FGM/C and the penalties for those who break them. In fact, some have been so successful in changing attitudes that families who wish to cut girls and women travel to neighboring counties to have the cut done there. This shows that efforts to stop FGM/C must expand to reduce the likelihood of cross-county operations. Accordingly, ACCAF has begun similar efforts in neighboring areas to create a critical mass of converts and home-grown activists who will end FGM/C.

#TogetherForZero

Today is the International Day for Zero Tolerance against Female Genital Mutilation (FGM). FGM is the partial or total removal of female genitalia or other injury to the female genitalia for non medical reasons. 100-140 million girls have undergone FGM within the 28 countries in Africa that practice FGM and about 3 million at risk of undergoing the cut each year. According to the Population Reference Bureau, recent data reflects a decrease in incidences of cutting among the younger women. There are a lot of activities scheduled to mark the day both in the social media and on the ground. In Kenya, the government in collaboration with some of the organizations working against FGM/C, activists and community leaders has converged in Samburu to mark the day.

Samburu during the Zero Tolerance Day.
Photo: Dr. Tammary Esho

The initiative to end FGM came from both who are directly and indirectly affected: women, girls, advocates, doctors, fathers, husbands, and governments have marshaled efforts in various areas to end FGM. When we put efforts towards a common good, we will have fulfilling results in the end. While there are skeptics who want to justify the cut, women should not give up or slow down the efforts. Let’s remain #TogetherForZero.

As we look forward to a world free of FGM, I would like to tell all comrades kudos, for your efforts are not fruitless. We should not tire in this fight. As the Igbo proverb says,“The hunger that has hope for its satisfaction does not kill.”

 http://accaf.uonbi.ac.ke/

Finally, Justice for Suhair al-Bata'a

In one of our first blog posts, we lamented the decision of an Egyptian court to acquit the perpetrator of the botched circumcision that lead to the death of 13-year old Suhair al-Bata'a. How could an entire judicial system overlook the death of a minor, and by so doing, uphold a tradition that it had outlawed on the basis of another minor's death? How could it fail to implement any sanctions when 700 USD had cost the life of a child? In a reversal of fortunes however, the Egyptian courts conducted a retrial of both the doctor and the father of Suhair who had been responsible for the chain of events that led to her demise. The court convicted Dr. Raslan Fadl of manslaughter and sentenced him to two years in prison for the offence and three months for performing the genital surgery. His clinic will be closed for a year. Suhair's father was handed a three-month suspended sentence. Advocates against FGM/C in Egypt and around the world are hailing this development as an important stride in the campaign against the practice, especially in a country that has a prevalence rate of 91.1%. Indeed, the earlier acquittal raised questions about the effectiveness of instituting legislation against the practice. However, national laws against FGM were not encouraged as the only intervention for curbing FGM, but as an attendant to the ongoing efforts of discouraging the practice.

Another FGM/C trial is now ongoing in the UK, where Dr Dhanuson Dharmasena has been accused of performing a reinfibulation in 2012. Reinfibulation is "the practice of re-suturing and thereby creating an infibulation following a procedure in which the infibulation has been partially or fully opened, most commonly to facilitate childbirth" (WHO 2010). In this case, Dr. Dharmasena did not leave the infibulation open as has been recommended as best practice during post delivery care for women who have undergone FGM. Reinfibulating one's patient not only constitutes an offence under the UK 2003 Female Genital Mutilation Act, but it also leads to additional physical and psychological trauma for the woman. It amounts to performing FGM/C all over again. According to Dr. Dharmasena, he was unaware that his actions counted as an offence under the law. He maintains that he was simply following the wishes of patient. While we are yet to see what the UK will conclude on this case, we can consider what this case reveals about the state of healthcare and its relationship to FGM/C.

Dr. Dhanuson Dharmasena
Image Source: mirror.co.uk

Healthcare providers need to be educated on FGM/C. In today's world, and especially in countries where a significant number of the population practice FGM/C, doctors cannot afford to remain ignorant about FGM/C. Indeed, such ignorance can only lead to substandard and insensitive care for pregnant women who are circumcised. Countries need to develop and fully implement training protocols on pre and post-delivery care for women who have undergone FGM/C. Such care should be done within an atmosphere that fosters respect for the pregnant mother, while explaining why a reinfibulation will not be performed i.e it may lead to physical, psychosexual and obstetric complications. Individuals trust their lives to doctors, and doctors should never abuse this trust, whether for financial gain or out of ignorance.

****Read our other blogpost on doctors and FGM/C.
http://accaf.uonbi.ac.ke/ 

The Battle Over Her Body

Late last year, a group of Samburu elders met together to deliberate on insecurity in their community. While discussing interventions that they would initiate, the group declared that FGM/C remained an important cultural practice that needs to continue. One man who was later interviewed affirmed the position of the group, going on to say that any child born of an uncircumcised woman would be killed. Covered by the Kenyan media, the encounter raised serious questions about the extent of FGM/C practice in the community. Even more worrying was the silence of both male and female leaders in the area who did not immediately condemn the stance of the 3,000 men present. However, the most shocking revelation was the callous manner in which the men insisted on the killing of children born to uncircumcised women.

Samburu Elders Endorse FGM as a Critical Cultural Rite.

Source: NTV

The statement may reveal the role of FGM/C in brokering access to sex and reproduction, or perhaps ensuring that children could only be born within a marriage relationship. Nevertheless, such cultural explanations have no place today. Instead, they underscore a double standard. The Samburu do not culturally value virginity, and uncircumcised girls are encouraged to have sexual relations with the Samburu morans. Such fraternizing can only increase the likelihood of an uncircumcised girl falling pregnant. Furthermore, the statement highlights how the Samburu woman's body has become a site for exploitation; for the fulfillment of men's vision for Samburu women. It's a statement reifying one of the feminist theories that has been applied to FGM/C - FGM/C as a sign of patriarchy and control of women's sexuality. 

Indeed, FGM/C, while practiced on women by women, is supported within a societal and cultural framework that includes men. Samburu girls not only undergo FGM/C, but a number are also subjected to early marriage, especially in the marginal areas. Advocating against FGM/C is thus not only mitigating physical and psycho-sexual consequences on the female body, but it's also encouraging the community to allow girls to own their bodies and their futures. It's welcoming women into the conversation around sex and reproduction that culture often deems to be the preserve of men. It's allowing our communities to take part in global conversations on women's rights and liberties, even while maintaining the cultural aspects that we collectively esteem.

http://accaf.uonbi.ac.ke/