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The above testimony comes from Hannah Koroma, a survivor of female genital mutilation (FGM). At the age of 10, she was led by her grandmother to a coming-of-age ceremony, and genitally mutilated with a blunt penknife. The procedure left her with severe pain, hemorrhaging, recurring infections, and deep psychological scars. Unfortunately, her experience is not rare. An estimated 135 million girls and women have been genitally mutilated. Another two million girls a year, or 6,000 per day, are at risk of undergoing FGM. FGM, also known as female circumcision, is defined as "the removal of part, or all, of the female genitalia." Several different forms of FGM are practiced. Eighty percent of mutilations involve the removal of all or part of the clitoris, and 15% involve infibulation, which is also known as pharaonic circumcision, or FGM III. Infibulation is the most severe form of FGM, in which all or part of the clitoris and labia minor are removed, and the labia majora is stitched together to cover the vaginal opening. Only a small hole is left to allow urine and menstrual blood to escape. FGM is widely performed in 28 African countries and parts of the Middle East (Egypt, Oman, Yemen, and the United Arab Emirates). In some countries, large groups of women have undergone FGM, for example, one study states that in the Sudan, 97% of Arab women and 96% of Nubian women have been genitally mutilated. FGM is also a worldwide concern, since many immigrants from countries where FGM is common continue the practice in their new home. According to a July 26, 2006 article published by Reuters News, an estimated 279,500 women who have undergone FGM live in Britain, and another 22,000 girls are in danger of having the procedure performed on them. Health RisksUnlike male circumcision, female genital mutilation carries serious short- and long-term health risks. In most cases, the procedure is performed by older women with no medical training. Cutting implements such as broken glass, a tin lid, scissors, or a razor blade may be used. The victim usually does not receive any anesthetic beforehand or antibiotics afterwards. Rich families may hire a surgeon to perform FGM in a hospital setting. However, the World Health Organization (WHO) strongly opposes the medicalization of FGM, since it legitimizes and perpetuates the practice. Instead, the WHO believes that all forms of FGM should be abolished. The immediate consequences of FGM include extreme pain, shock, urine retention, and ulceration of the genital region. Severe hemorrhaging and infection can lead to death. Mutilation also causes lasting psychological damage, leading to feelings of incompleteness, anxiety, and depression. Long-term medical complications include the formation of cysts, abscesses, and keloid scars. Other consequences of FGM include urinary and reproductive tract infections, painful sexual intercourse, sexual dysfunction, infertility, and difficulties in childbirth. Removal of and/or damage to the clitoris and surrounding areas caused by all types of FGM also compromises a woman's ability to feel sexual pleasure. For women who have undergone infibulation, the opening that is left after mutilation must be painful dilated, and sometimes even cut, before sexual intercourse can take place. An infibulated woman must be cut to allow the baby to emerge during childbirth, and is usually re-infibulated after birth. The constant cutting and re-stitching of the woman's genitals leads to additional suffering and makes childbirth more dangerous. A 2006 study published in The Lancet found that all forms of FGM increased the risk of complications during childbirth. Women who have been subjected to FGM III were 30% more likely to need a C-section and 70% more likely to suffer from postpartum hemorrhaging. As the severity of the FGM increased, so did the health risks experienced by the mother and the newborn. The death rate among newborns was 15% higher for mothers with FGM I, 32% higher with FGM II, and 55% higher with FGM III. The authors estimated that in Africa, at least 10 to 20 babies die per 1000 births as a direct result of FGM. Why FGM is Practiced and Why it PersistsDespite its many detrimental physical and psychological effects, FGM is an ancient practice that is part of many cultures. A joint statement on FGM from three United Nations agencies (the WHO, UNICEF, and the United Nations Population Fund [UNFPA]) states that "human behaviors and cultural values, however senseless or destructive they may appear from the personal and cultural standpoint of others, have meaning and fulfill a function for those who practice them." The following are some of the cultural beliefs and myths that have allowed FGM to persist. Cultural Identity Custom and tradition are the reasons given most often in defense of FGM. In some FGM-practicing societies, mutilation is part of an initiation ritual, and a girl cannot be considered an adult woman until she has undergone the procedure. For some immigrants who have relocated to another country, FGM is seen as a part of their cultural heritage, and necessary to maintain the identity of their community. Some Muslim communities that practice FGM cite religion as one of the reasons. However, the practice of FGM predates Islam, and has been denounced by some Islamic religious leaders. FGM is also practiced by people of other religions. Control of Women's Sexuality and Reproduction Although the age at which FGM is performed varies, it is usually done to girls under the age of 10. The procedure is believed to reduce her sexual desire, and thus prevent premarital sex and infidelity. In some cultures, FGM is also believed to enhance a man's sexual pleasure. However, many men have stated that they prefer unmutilated women as partners. Beliefs About Femininity and Fertility In most FGM-practicing cultures, the female genitalia are seen as unclean, ugly, masculine, or dangerous. Some societies believe than an unmutilated woman's clitoris would make sex unpleasant for the man. In extreme cases, some groups even believe that a woman could kill a man if her clitoris touched his penis. Contrary to medical fact, many cultures believe that FGM increases fertility and eases childbirth. For example, some believe that an un-mutilated woman cannot conceive children, or that a baby will die if its head touches the clitoris during birth. The belief that FGM makes a woman more feminine and fertile helps explain why many supporters and practitioners of FGM are older women who have undergone the procedure themselves. Secrecy Until the 1990s, FGM received little international attention. As with other forms of violence against women and children, it was seen as a "private" issue that was rarely discussed outside of the family or the community. Since FGM is a traditional practice, some international organizations were slow to get involved due to concerns that their actions would be seen as a form of cultural imperialism. What's Being Done to Stop FGMThe UN has declared that the practice of FGM violates basic human rights enshrined in the Universal Declaration of Human Rights. It is a practice that violates the rights of girls and women to "security of person," and the right to be free from "cruel, inhuman, or degrading treatment." In 1997, the WHO, UNICEF, and the UNFPA announced a joint plan to bring about a major decline in FGM within 10 years, and to completely eradicate the practice in three generations. Laws specifically prohibiting FGM exist in several Western countries, including the USA, UK, Sweden, and Switzerland. In Canada's Criminal Code, FGM is specifically cited under section 268(3) as a form of as aggravated assault. In other countries, such as Australia and France, existing child protection or assault laws have been applied to protect girls from genital mutilation. Surprisingly, FGM is also illegal in many nations where it is commonly performed. However, legislation alone is not enough to stop the practice. Public education and cultural sensitivity are needed to convince those who support FGM of its harmful effects, and to willingly abandon the practice. A joint statement from the WHO, UNICEF, and UNFPA says, "people will change their behavior… when they realize that it is possible to give up harmful practices without giving up meaningful aspects of their culture." International organizations such as the WHO, Amnesty International, the Inter-African Committee, and many others are working to eliminate FGM around the world. At the local level, the cooperation of governments, activists, educators, religious leaders, healthcare professionals, and many others will also be essential in the eradication of FGM. Female genital mutilation is a destructive procedure that has wounded millions of women and endangered generations of children. The fight to end FGM is part of the larger battle against violence against women and children, and cannot be successful until their rights are fully recognized and protected. * * * * *
*Adapted from Female Genital Mutilation, a WHO fact sheet. Discuss This ArticleHave something you'd like to say? Tell us what you think! Read and post comments for this article. Like this article? Read more! Browse our archive of 1,026 articles. Also, see our master index of all MedHunters articles! Find a JobChoose your career: MedHunters is the world's biggest healthcare job board. Our job directory has 16,633 jobs with 2,439 hospitals and other direct employers. We want you to find your next job on MedHunters. Need Help? Call us at 1-888-884-8242, email us at info@medhunters.com or sign up now. Have an article or story for MedHunters? Email us today at submissions@medhunters.com. |
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