Over the past decade, the topic at the forefront of most feminist discourse on the Middle East and Africa has been the issue of female circumcision. Referred to by its critics as female genital mutilation (FGM), the ritual operation is still practiced in several Arab and African nations. However, much of the writings and reports on the ritual have falsely attributed the operation's emergence and perpetuation to Islamic tradition. The Ambassadors published in its last two issues indepth selected studies responding to three of the most frequently asked questions on female circumcision from the Islamic standpoint by Dr.Gamal Badawi, Saint Mary's University (Canada) and Prof.Hassan Hathout, a distinguished gynaecologist's in California (USA). The following article is a continuation of the discussion with distinguished medical figures including H.E. Prof. Maher Mahran, organizer of the UN International Conference on Population and Development (ICPD) held in Cairo 1994 and Prof. Mahmoud Karim the author of the recent book "Female Genital Mutilation."
- The Ambassadors
Tracing an "illegitimate" practice
By Essam Farag
The issue at hand is the practice that has been identified in specific regions in the world commonly known as female circumcision, and recently referred to as female genital mutilation. This non-therapeutic procedure has been internationally defined as a violation of basic human rights and a form of mutilation. In a recent WHO report, the number of circumcised females worldwide was estimated at 130 million, with 2 million others at risk annually. It is very important to understand the dynamics behind such a practice as it is often considered a cultural or religious tradition in the areas where it is practiced.
Female Genital Mutilation (FGM) refers to a group of traditional practices that involve partial or total removal of the female's external genitalia or other injury to the female genital organs for non-therapeutic reasons (Jones et al. 1997: 369). In general, the practice is internationally recognized as a gender-specific form of child abuse, child exploitation and torture (Barstow 1999: 509). In the west, the majority of people use the term FGM instead of female circumcision (FC), a term they consider inaccurate as it implies a minor operation comparable to male circumcision (Black & Debelle 1995: 1590). Others use both terms together (FGM/FC). Egyptian and Sudanese researchers advocate the use of the term female circumcision over that of female genital mutilation when dealing with affected individuals and their parents, to portray respect of the people’s feelings and cultural beliefs, since the use of “mutilation” places a negative connotation to this practice (Toubia 1995).
FC/FGM is still a widespread practice in some parts of the world. This was mentioned in the WHO/UNICEF/UNFPA statement with a map showing the areas of the world in which female genital mutilation/female circumcision (FGM/FC) occurs (Shaw 1985: 685, WHO 1997: 5-6). During the past four decades, immigrants of different ethnic backgrounds were reported to practice FGM in Britain, France and the USA (Black & Debelle 1995: 1590, Gallard 1995: 1592, Jones et al 1997: 369).
Areas of the world in which female
genital mutilation has been reported to occur
The commonest type of FGM is what is known as type-2 (clitorectomy and the excision of the labia minora), which accounts for up to 80% of all cases, while infibulation (type-3) constitutes about 15% and was reported in southern Egypt, northern Sudan, Somalia, Ethiopia, Djibouti, Kenya, Mali, and Nigeria. In Egypt, at least 80% of females have undergone circumcision, 89% in Sudan, 90% in Eritrea, Ethiopia and Sierra Leone, and 98% in Djibouti and Somalia (Abdel Kader 1987: 31-36, Toubia 1994: 712, Jones et al 1997: 372, WHO 1997: 5).
The Greek philosopher Herodotus mentioned its existence 700 years before the birth of Jesus, yet there is no clear record in which we might trace the origin of this practice. It was a widespread practice in some areas of the world before the three Abrahamic religions and is still practiced by both Christians and Muslims in rural Egypt today (El-Saadawi 1980: 40). It is difficult to ascertain if it was originally an African puberty rite that came to Egypt by diffusion, or pharaonic survival that meshed with Egyptian cultural patterns and then subsequently spread to other parts of Africa (Abdel Kader 1987: 36). Interestingly, clitoridectomy was performed in Europe and the United States in the 19th century with the mistaken belief that it can cure epilepsy, hysteria, insanity and masturbation! (Shaw 1985: 686).
In Egypt, the subject of FC has been buried in secrecy and taboo for several generations. It has only been brought up to the surface recently by feminists, health practitioners and social scientist, and was thoroughly discussed in the International Conference of Population and Development (ICPD) held in Cairo in 1994. Some proponents of FC believe that the clitoris should be removed to promote hygiene and provide aesthetic appeal that is good for a girl’s health and conductive to cleanliness and “purity” (accordingly, the operation's name in Arabic language "tahara" means cleansing or purifying) (El-Saadawi 1980: 34). There is also a myth that FC leads to increased fertility and promotes child survival (WHO 1997: 4). Another claimed reason for FC is to promote morality. An example of that would be the belief that if the clitoris is excised this would minimize female sexual desire providing protection during the “dangerous age” of puberty and adolescence; thereby maintaining chastity and virginity before marriage and fidelity following marriage.
Others mention social reasons for the practice, since FC is an identification with one's cultural heritage, the traditional initiation of girls into womanhood, and social integration and maintenance of social coherence. Since an uncircumcised female would not be considered marriageable, many parents see no choice but to have their daughters circumcised. In some cultures, there is the wrong belief that the clitoris contains a poisonous-like substance that can harm the husband and that if the clitoris touches the baby’s head during birth; the infant will die! (Shaw 1985: 686).
There is no specific reference to FC in the Torah, New Testament or the Qur’an. One of the common misconceptions is to connect FC/FGM with the teachings of Islam. Some people believe that the practice only started with the advent of Islam, but as a matter of fact, its geographical distribution is different from the geographic distribution of the Muslim population. As the WHO statement on FC/FGM reports, the practice occurred among monotheists, animists, and non-believers. A world map included in the WHO statement (Fig.1), shows the absence of FC/FGM in both Iran, Turkey and Saudi Arabia, the hubs of Islamic belief (El-Saadawi 1980: 39, Hathout 1986: 102, Stewart 1993: 35, Toubia 1994: 712, WHO 1997: 4).
There still remains a genuine belief that FC/FGM is demanded by the Islamic faith and it is a religious requirement of Islam, since it is common in some African-Asian Islamic communities and type-1 of FC is often referred to as sunna circumcision. Though FC was not mentioned in the Qur’an, Islamic proponents of the practice make reference to the prophet’s advice (present in the Hadeeth) to Om Atiya, the tribal lady who performed circumcisions, “Take the minimum Om Atiya and don’t exceed it” (Hathout 1986: 102). Furthermore, thousands of dayas, nurses, paramedical staff and doctors who make money from female circumcision resist abolition of this practice for their economic benefit (El-Saadawi 1980: 41).
The practice of FC should be evaluated objectively, on the basis of whether it is required religiously and whether there are medical or other relevant indications for its practice? Since FC is not limited to any one religion, it is assumed to have connections with cultural practices rather than with Islamic ones and some forms can be considered a violation to Islamic teachings (Badawi 1997: 53). Dr. El-Saadawi, a strong opponent to FC expressed her opinion on the theological contexts of FC,
God does not create the organs of the body haphazardly without a plan. It is not possible that He should have created the clitoris in women’s body only in order that it is cut-off at an early stage in life. This is a contradiction into which neither true religion nor the Creator could possibly fall. If God has created the clitoris as a sexually sensitive organ, who’s sole function seems to be procurement of sexual pleasure for women, it follows that He also considers such pleasure for women as normal and legitimate, and therefore as an integral part of mental health” (El-Saadawi 1980: 41).
In preparation for the International Conference on Population and Development (ICPD) in 1994, FC/FGM was among the issues raised in the discussion table by many non-governmental organizations (NGOs), some from a health perspective, some from a feminist perspective, and some from the perspective of reproductive rights. The walls of silence surrounding the traditional practice of FC/FGM were broken, attracting increasing international attention, activism, and greater NGO focus on the establishment of a strong global consensus against the practice. Issues like reproductive rights, abortion and FC/FGM were the subjects of heated discussions during the conference.
Opponents of FC/FGM debated the practice as an extreme example of child abuse while the proponents asserted it is an important rite that must be preserved in order to maintain cultural identity. There was extensive attack on the “attempts to violate our traditions, our culture, our norms, vis-à-vis a western agenda that wants to negate us as a nation ”(Barstow 1999: 502, Seif-El-Dawla 1999: 130).
During the conference days, CNN broadcast a film internationally depicting the circumcision of an Egyptian girl. This resulted in a lot of tensions in Egypt pertaining to the issue and towards Western imposition of ethics and morals. As a result of the film broadcast, the proponents capitalized on this incident, to raise the cultural, traditional and religious dictate, which others wanted to eradicate. They accused the people who focused their attention on FGM as exposing the country’s dirty-laundry to strangers! The battle between the fundamentalists and the government wasn’t about FGM/FC, but was about power and who was in charge of the country. This created a politicization of the issue (Seif-El-Dawla 1999: 131).
The program of action of the ICPD included recommendations on FC/FGM, which commit governments and communities to “urgently take steps of FC/FGM mutilation and protect women and girls from all similar unnecessary and dangerous practices” (WHO 1997: 11). The Egyptian minister of health, Prof. Ali Abdel Fattah, at the time issued a statement about the dangers of FC/FGM in non-medical hands. Despite being an advocate against FC/FGM, the heated debates resulted in his permission of its practice by medical doctors, claiming that a medicalization of the practice will eventually put an end to it.
In 1996, the new Egyptian minister of health and population Prof. Ismail Sallam issued a ban on the practice FC/FGM completely, yet Sheikh Youssef al-Badri, an orthodox proponent to the practice, managed to overturn the ban by the court emphasizing the Islamic aspect of the practice in July 1997. Five months later, the court re-instated the ban, which was celebrated by FC opponents and feminists (Position paper on FGM/FC 1999: 106). Egypt’s re-imposition of a legal ban on FC/FGM is a major step towards a universal elimination of the practice's horrific, dangerous and indefensible violation of human rights.
In post-ICPD era, signs of optimism are evident in the forward of the "WHO FGM Overview," written Dr. Tomris Turmen, the WHO director of Family and Reproductive Health. In it, she mentioned that, “Much has already been achieved in the last decade, in lifting the veil of secrecy from FGM and developing a strategy to bring about changes. However, there are still major gaps in the extent of the problem, its health impact and kinds of interventions that can be successful in eliminating it” (WHO 1998: v). In Egypt, for its successful elimination, this very sensitive issue must be approached with a critical understanding of the culture and the embedded dynamics (religious, political and economic), and all supporters of the practice.
Karim's book is a recent comprehensive
approach to the issue of FC/FGM.
One of the earliest advocates against the practice of FC was Prof. Mahmoud Karim, the Vice-President of the Egyptian Society for Prevention of Harmful Practices to Women and Children. In 1998 he published a book entitled, "Female Genital Mutilation: Historical, social, religious, sexual, and legal aspects." The preface was written by Prof. Maher Mahran, FRCS, FRCOG, PhD, Secretary General of the National Population Council of Egypt, former Minister for Population and Family Welfare, and Chairman of the Egyptian Organizing Committee for the ICPD 1994. Prof. Mahran mentioned, "Prof. Karim has been very interested in the social aspects of gynecology and obstetrics. He was one of the pioneers of family planning programs in Egypt. Very early, he was interested in the problem of FGM, a serious issue which came to the surface and attracted the attention of the whole world during the meeting of the ICPD held in Cairo 1994. This book covers, in a very balanced way, the medical, the social, the political and the religious parameters of this practice. I have no doubt that reading this book will clarify many unknown and controversial issues."
Regarding the historical backgrounds of FGM, Prof. Karim says, "Judging from the many traditional cultural practices connected to FC in different countries, we have to search for its historical origins in the dim and distant past. However, neither among Ancient Egyptian, nor among Biblical sources can we find any definitive information. The famous French Egyptologist, Maspero in his book, Les Mommies Royales, 1899 describes the dissection of the royal mummy of Queen Anhapon as not being circumcised." Prof. Karim doubts both the nomenclatures of Pharaonic and Sudanese circumcisions. He raised the question of the importation of this practice to Sudan, Nubia and Egypt by slave traders from mainland Africa. He also raises the question, "has circumcision started as a medical problem and latter changed into a myth and ritual to preserve virginity and chastity? Myths and rituals are most probably responsible for the sustained practice in Egypt till the present time."
Prof. Karim studied the motives for the practice of FC in Egypt. He found that ethical, religious, social and sanitary motives constituted 38%, 32%, 21% and 9% respectively. For the cases that he found which did not practice FC, the circumcised mothers did not want the repetition of their suffering for their daughters in 67% of the cases, while parents saw no social or religious justification in 15% and 7% of the cases respectively. He also noted a striking decrease in the practice of infibulation. In his 1994 survey of 800 children from the suburbs of Cairo (aged 6-14) he reported a drop in the incidence of the FC to 81% (88% in low income; 15% in well-off). In his study 96% of illiterate parents circumcised their daughters in comparison to only 10% of highly educated parents. He found that the fathers were decision-makers in only 3% of the circumcised cases, while the mothers and grandmothers were decision-makers in 69% and 28% respectively.
Current data indicates that FC/FGM cannot be directly associated and traced to any Pharaonic, Sudanese or Islamic rituals.
Essam Farag is a 3rd year International Development Studies student at Dalhousie University, in Halifax, Canada. He is a strong advocate of human rights and against the practice of female genital mutilation.
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