Yemen National Plan to accelerate FGM eradication [Archives:2008/1208/Health]

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November 17 2008

Salma Ismail
It is perhaps the single most social, brutal procedure surviving the 21st century that can be inflicted on a female. Internationally recognized as a violation of the human rights of girls and women, Female Genital Mutilation (FGM), or 'khitan' as it is known in Arabic, includes procedures that intentionally alter or damage female genital organs for non-medical reasons. In Yemen, women and children continue to suffer from harmful traditional practices, including FGM.

The procedure, often performed with nothing more technologically advanced than a razor blade, has absolutely no health benefits. The World Health Organization (WHO) estimates that 100 to 140 million girls and women worldwide are currently living with the consequences of FGM.

Ritual cutting and alteration of the genitalia of female infants, some as young as 80 days old, girls, and adolescents has been a tradition since antiquity. It persists today primarily in Africa and among small communities in the Middle East and Asia. The spectrum of these genital procedures has been termed female circumcision, or more frequently, Female Genital Mutilation as a collective name to describe and emphasize the physical disfigurement associated with the practice. In Africa alone, about three million girls are at risk for FGM annually.

Definition and explanation

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. According to the WHO, these are the types:

– Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, rarely, the prepuce (the fold of skin surrounding the clitoris) as well

– Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are “the lips” that surround the vagina)

– Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, and sometimes outer, labia, with or without removal of the clitoris.

– Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area

Health complications

Prohibition has led to FGM going underground, at times with people who have had no medical training performing the cutting without anesthetic, sterilization, or the use of proper medical instruments. The methods can cause severe bleeding and later problems urinating, childbirth complications and newborn deaths. Also, when performed without any anesthetic, these methods can lead to death through shock from immense pain or excessive bleeding and the failure to use sterile medical instruments may lead to infections. Other serious long term health effects are also common. These include urinary and reproductive tract infections, caused by obstructed flow of urine and menstrual blood, various forms of scarring and infertility. The first time having sexual intercourse will often be extremely painful, and infibulated women will need the labia majora to be opened, to allow their partner access to the vagina. This second cut, sometimes performed by the partner with a knife, can cause other complications to arise.

FGM in religion

The practice appears to go back thousands of years and pre-dates both Christianity and Islam. In Saudi Arabia, in the area known as the Hijaz, where Islam originated, FGM was already being practiced during the lifetime of Muhammad. To call a man a “circumciser of women” was an insult among the pagan Arabs at the time.

Female genital cutting is not commanded by the Qur'an and is not practiced by the majority of Muslims. In Egypt, mufti Sheikh Ali Gomaa stated: “The traditional form of excision is a practice totally banned by Islam because of the compelling evidence of the extensive damage it causes to women's bodies and minds.”

FGM in global society

Not only is this practice prevalent in Middle-Eastern and African societies but it can be found in Asia, Europe and even in some Aboriginal communities in Australia.

Eighteen African countries)Benin, Burkina Faso, Central African Republic, Chad, Cote d'Ivoire, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Kenya, Mauritania, Niger, Senegal, South Africa, Tanzania, and Togo)have enacted laws criminalizing FGM. The penalties range from a minimum of six months to a maximum of life in prison. Several countries also impose monetary fines.

According to a 1977 joint statement by the WHO, UNICEF and UNFPA, 500,000 females in the European Union have either been mutilated or are at risk for mutilation. In ancient times FGM was used as a cure for nymphomania, hysteria, insanity, depression and epilepsy. In recent years, it is found to exist in some European countries that have admitted migrants and refugees from countries where the practice still exists.

FGM in Yemen

A 2001 ministerial decree prohibited FGM in Yemen, but attempts to convince traditional Yemeni society that the practice is medically dangerous have been an uphill battle. There are no sufficient studies on FGM practices in Yemen and what little studies that do exist have been disputed.

A national plan of action to accelerate the abandonment of FGM was enriched in June 2008 at an advocacy workshop, organized by UNICEF, in Sana'a. The plan came after months of intensive discussions and consultations by UNICEF with concerned bodies in Yemen. Today, this plan is seeing some progress, with Regional Consultant in Reproductive Health and Human Rights in UNICEF Hashem Al-Serag leading a team of experts and consultants to Hodeidah and Aden where workshops and meetings were organized with concerned communities, Imams of mosques, teachers, and a number of health experts.

Eradication

Behind circumcision lies the belief that, by removing parts of girls' external genitals organs, sexual desire is minimized. However, there is not enough evidence to support that this is true. Moreover, there is research that indicates the contrary, that women that have been subject to this practice have experienced total sexual satisfaction.

Legislation against FGM can be counter-productive in some cases. It might force the practice deeply underground. Women may not seek medical care because their parents might be charged. The importance given to virginity and an intact hymen coupled with the fact that in some countries it is used as a form of resistance against the colonial will is the reason why FGM still remains a very widespread practice despite a growing tendency to do away with it as something outdated and harmful.

Based on the UN, there have been some 'breakthroughs in eliminating' this practice in countries like Burkina Faso, Sudan, Egypt, Djibouti, and Niger.

In spite of the historic 1948 document of the Universal Declaration of Human Rights, which set the standards for the achievement of human rights and which has had a powerful influence on the development of contemporary international law; in spite of the U.N.'s 1952 Convention on the Political Rights of Women; in spite of the U.N.'s 1959 Declaration of the Rights of the Child; in spite of the U.N.'s 1962 Convention on Consent to Marriage, Minimum Age for Marriage, and Registration of Marriages; in spite of the U.N.'s 1967 Declaration on the Elimination of Discrimination Against Women and the 1989 Convention on the Rights of the Child, women and girl children are the victims of continuing and flagrant violations of their human rights. The incomprehensible part of all this is that most of the countries that allow FGM have ratified these conventions.

This article is in tandem with Yemen efforts to save children and women from harmful practices, by formulating a National Action Plan. Despite public sensitivity on the issue, campaigns to eliminate FGM are aggressively being carried out across the country with public and private NGOs running public awareness campaigns on radio, television, and in community gatherings. In this conservative Muslim country, merely achieving public discussion of the issue is regarded as progress.
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