Female Genital Mutilation Performed by US Doctors?

On 4/26/10, the American Academy of Pediatrics (AAP) released a statement which sent shockwaves around the world. A portion of the policy statement essentially sanctioned Type IV FGM, by suggesting that doctors be allowed to make a ritual pinprick or nick on a girl's clitoris, if it would prevent the girl's family from sending her to their home country where a more severe and dangerous type of FGM would be performed. This statement completely reversed the organization's 1998 statement, in which it condemned all forms of FGM and urged its members not to perform it, noting "its cultural implications for the status of women."


I understand that the intentions of the AAP were good. Dr. Friedman Ross, a member of the committee which drafted the statement explained their thinking this way: “If we just told parents, ‘No, this is wrong,’ our concern is they may take their daughters back to their home countries, where the procedure may be more extensive cutting and may even be done without anesthesia, with unsterilized knives or even glass,” she said. “A just-say-no policy may end up alienating these families, who are going to then find an alternative that will do more harm than good.” Dr. Ross said that the committee does “oppose all types of female genital cutting that impose risks or physical or psychological harm,” and consider the ritual nick “a last resort,” but that the nick is “supposed to be as benign as getting a girl’s ears pierced. It’s taking a pin and creating a drop of blood.”


But international reaction was strong and swift in opposition to the measure. It was viewed as a major concession, and the top of a very slippery slope. You can read an excellent piece by Equality Now's director, Taina Bien-Ami, here:
Huff Post: Do No Harm


A month after it issued the statement, the AAP had been persuaded to retract it, after hearing from the UN, the World Health Organization, Unicef, V-Day (Eve Ensler's organization), Equality Now, among many, many others.  There are ways to fight FGM, in this country and abroad, but concession is not the way to go about it. Lawmakers are currently drafting more effective legislation, such as HR 5137, which would make it illegal to transport a minor girl living in the U.S. out of the country for the purpose of FGM. According to Equality Now, "the bill will hopefully also call for the launch of culturally sensitive outreach programs in FGM-practicing immigrant communities in the U.S. to educate parents about the lifelong harms of FGM."

The new AAP statement opposing all forms of FGM can be read here:
AAP Anti-FGM Statement

"Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has." - Margaret Mead

More re Kenya Experience

As I indicated in my last post, the work I signed up to do in Kenya and the work I ended up doing turned out to be rather different. The title of the project was, and I quote, "Impact of harmful cultural practices - Female Genital Mutilation (FGM) and Early Marriages for the Girl Child." So you can imagine my surprise and disappointment when I got to the project site and learned that the project actually had nothing to do with that topic, and that the primary activity would be making bricks out of mud. Now mind you, brick-making is very important in Kenya. Nothing gets built until the bricks are made. The community group with which we were working, the Mowankwe Women Group, has a long-term goal of building a health clinic, as there is none nearby and most people go without any type of medical care except for major emergencies (and even then it's not always possible). Many women birth at home, unattended, and while I'm all in favor of home birth here, in rural Africa it often leads to very unfortunate outcomes, including mother to child transmission of HIV.

So brick making is an important activity, but not what I had signed up for, and definitely not one for which I'm particularly well-suited. (The fact that I had recently had surgery for a broken and dislocated thumb did not help matters.) But as several friends with development experience had told me before I left, when attempting to do any kind of development work in Africa, it is very important not to have fixed expectations, and to go where the flow takes you. That advice served me well. They wanted bricks; we would make bricks. We managed to make a few thousand of them, despite the daily rain. (It was the rainy season, arguably not the best time to make bricks out of mud.) It was unclear when we left whether the bricks would be sold, to raise income for the community, or whether they would be used to expand the one room building that currently serves as church, school, and community meeting place.

Mudmaking photos lifted from my friend Malcomb's Facebook page. Here you can see mudpit at rear, and Hitomi and Oska transferring bricks from mold onto ground.

In this photo I'm on the left. Mineshi (center) and I are trying to mix the mud that Oska is making, with

our legs. Way harder than a Stairmaster.

But I had done a ton of preparation regarding FGM, and here I was in Kuria, an area with an extremely high prevalence rate of FGM, so the Mowankwe group and I decided that I would give a presentation, during the last of our 3 weeks there. Mind you, this community has no electricity and no running water, so although I had been told that I would be able to show a dvd (Africa Rising), I was truly astonished when I saw that they had in fact procured a generator, a dvd player, and a tv. They even had a chalkboard and chalk. So with the help of 2 translators, I was able to give a presentation about FGM.

When one is a white person talking about FGM in Africa, one needs to be very cognizant of the complexity of the issue, including the history of it. Attempts to eradicate FGM have largely come from outside Africa, and from outside the cultures which practice it. A lot of resistance to change centers on this fact. I structured my talk in such a way that I left room for arguments in support of the practice. My intention was to have a discussion, not to give a lecture. I used the term Female Circumcision, rather than Female Genital Mutilation, so as to leave open as fully as possible the doors to dialogue. I was fully expecting to encounter the Cultural Imperialism argument. In the end, I encountered no resistance whatsoever. The women (and men) who attended my presentation expressed a pretty uniform opposition to FGM. I think this is because these women are activists within their community, working together to improve their own lives and those of their families. They are poor and in many cases of limited education, but they are engaged. Although most of them had themselves been circumcised, they seemed committed to not inflicting the same damage on their daughters. They lamented the lack of sexual desire/pleasure and were aware of the health risks. I realize that the people continuing the practice were not at the presentation, but it was heartening to see that the tide is in fact turning in Kenya, and to know that these women who are working to bring about change in their community are set against FGM. I hope that they will spread the message to their fellow villagers and lend them, especially the girls, the support they need to resist the tradition.

Btw, the video Africa Rising had been donated to me by the makers of the film, and I left it with the Mowankwe group. Thanks to EQUALITY NOW for the support.

Me, teaching.

Carol and Oska translating for me. They are laughing, despite the serious subject matter, because they are NOT used to saying these words out loud! And that of course made me laugh.

Watching the video Africa Rising.

On Female Circumcision (FGM) in Kenya/Tanzania

As you may know, the project in which I was participating in Kenya was supposed to have had a focus on Female Genital Mutilation (called female circumcision in Kenya) and early marriage, i.e. the cultural practice wherein girls are married at very young ages to older men. As it turned out, the project had nothing to do with those practices. More on that later.

The area in which I was working is called Kuria, after the people who populate it. Kenya has dozens of different tribal identities, and Kuria people are found in the southwest of the country, in an area that spans the border with Tanzania. About 2/3 of Kuria people live in Tanzania, and about 1/3 live in Kenya. Although some Kenyan tribes don't practice female circumcision, among the Kuria it is a very strongly held cultural tradition. In that area of the country, the prevalence rate is believed to be over 90%. The good news is that the tradition seems to be slowly waning, and is not as common or accepted among the younger generation. I met many women who said that the practice stops with them; that they will not subject their daughters to it, although they themselves were circumcised. It is very easy to criticize the practice of FGM, especially if you do not understand the cultural context, and hard to understand how difficult it is for women and girls in these communities who counter tradition. Women and girls who resist FGM face enormous pressure and censure from their families and their communities. They may be shunned, or become victims of violence or other human rights abuses. Here is an ARTICLE about the cultural forces at work among the Kuria (here spelled Kurya) people in Tanzania, and how some women are resisting FGM, forced marriage, and other cultural traditions that violate their rights and their endanger their health.

In related news, the Ugandan Parliament officially OUTLAWED FGM on December 15th of this year. Mind you, FGM is illegal in many countries, including Kenya, yet still widely practiced. But having a law on the books, and stiff penalties, is of course an important step.

(links to articles are in caps)

Why You Won't Be Hearing From Me For A While

I think most of the people who read this blog already know this, but for those of you who don't: I am super happy and excited to say that I will be soon be going to Kenya, to participate in a volunteer project. The project is being administered by the Kenya Voluntary Development Association, and the organization with which I signed up is called Volunteers for Peace. The project for which I originally signed up had a focus on "harmful cultural practices" affecting women, i.e. Female Genital Mutilation (FGM) and early marriage. My project was merged with another one, and now the focus is broader, and includes work around HIV/AIDS, and work with children, as well as tree planting and brick making. There should be around 20 volunteers, from 6 different countries including Kenya. Conditions are going to be, well, basic. We need to bring our own eating utensils, sleeping bag, mosquito net, etc, and we will be cooking for each other. The project itself will last 3 weeks, and I plan to stay in Kenya for another week or so after that.

Since I will be away and without much internet access, and since there is a tremendous amount of preparation involved in a trip like this, I am currently on hiatus. I plan to be back to work on Monday, December 7th. (For details re whom to contact during my absence, see below.)

The organizers asked us to bring materials related to the project. Among other things, I will be bringing a few copies of Katie Singer's book(let), Honoring Our Cycles in Africa. From Katie's website: "The book describes what happens during a healthy menstrual cycle, how the traditional practice of Female Genital Cutting affects a woman's reproductive health, and what happens in the male reproductive system." It's a wonderful, simple book, and I only wish that I could bring more copies with me.

I will also be bringing a copy of a film that will soon be having its premiere in the US. It's called Africa Rising, and it focuses on the movement to end FGM in Africa, and the brave women (and men) leading the fight. Although headway is definitely being made, approximately 6000 girls still undergo FGM everyday, primarily in Africa. The people behind the film (see below) very generously sent me a copy. Despite the sadness of the topic, it's a beautiful, inspiring film. I hope you'll be able to see it when it opens in the US. See the website for screenings.

Still from Africa Rising

Africa Rising is brought to you by the amazing people at Equality Now. Their website and newsletters are decidely unglamorous, but they are at the forefront of the movement to stop FGM and other forms of violence against women. I encourage you to support their efforts with your time and/or your dollars.

You may know, or you may not, given the dearth of media coverage, that Kenya has been devastated by drought in recent months, and years. Semi-annual rains have just begun to fall, so I hope that, by the time I go, the situation will have been somewhat ameliorated. But that's not guaranteed, and regardless of how much rain comes, the impact of the last few years will be long-lasting, especially among nomadic communities. I don't know how the drought will affect my trip.

For most of my time away, I anticipate having very little internet access. (The community that I'm going to has no electricity.) So as of now until after my return, I am on hiatus. Two of my colleagues will be covering for me in my absence. Should you need assistance before I return, please get in touch with one of them:

Sarah Bly
graceofthemoon.com

(541) 821-2522

Lisa Leger

fertilityfairy at hotmail dot com

(250) 951-0243

Please note that both Sarah and Lisa are West Coast gals, on Pacific time. Lisa is in Canada and Sarah is in the US.

Thank you to those of you who have supported my trip with your donations of funds and goods. I look forward to sharing stories with you after I return.