MADOGO (near Garissa), North East Province, Kenya — In the scorching heat of the midday sun, shaded by the horizontal branches of a dende tree, village elders and women leaders from five communities listened intently as a religious scholar analyzed the religious implications and health problems associated with female genital mutilation/cutting.
"Many Imams have studied this issue thoroughly, and they agree: Islam calls for the circumcision of men, but not for women," Sheikh Abdullahii Gudow explained to the group, who eke out a subsistence from farming and trading with the nomadic pastoralists who make up most of the inhabitants of the expansive and arid North East Province.
Over centuries, the genital cutting of women has become deeply entwined in the cultural fabric of the people who live here. Clarifying that it is not a religious requirement is an important step in opening minds to change.
The Sheikh opened a booklet, and referring to the Koran and the life and sayings of the Prophet, as well as scholarly opinion, systematically refuted arguments that FGM/C is Islamic.
"God created you in the perfect shape, and those who say the clitoris is not supposed to be there – are you questioning the wisdom of God's creation? " he asked.
Breaking the silence
The very fact that a man, a religious scholar no less, is speaking openly about such things represents a major cultural shift in this part of Kenya. "Fifteen years ago you would not hear this debated," said Zeinab Ahmed, UNICEF Kenya Child Protection Specialist, who leads the Joint UNFPA/UNICEF Programme on Female Genital Mutilation/Cutting in the province. "In the mid-nineties, NGOs talking about it in refugee camps had to be guarded. But the hard facts are out now. Now religious leaders are talking about it. It is talked about on the radio. There is tremendous interest in the debate."
The debate is a crucial one, with the health, rights and well-being of young girls hanging in the balance. In this province, home to about a million ethnic Somalis, the most severe form of female genital mutilation – what is referred to as Type III, or infibulation – has been traditionally practiced on girls between five and eight years old, girls too young to understand what is at stake or to effectively resist.
After her external sex organs are cut away, usually with a razor and without anaesthesia, a girl's legs are tied up tightly for two weeks or more so that scar tissue essentially 'seals her up', leaving only a small hole for the passage of urine and menses. The procedure often disrupts her sexual, reproductive and urinary functions for life. Many girls emerge from it psychologically scarred as well. Wedding nights are often a nightmare (see box below). Childbearing is often affected as well.
Severe medical and psychosocial consequences
This 11-year-old has already gone through FGM, but her younger sister may be spared.
"You have seen animals giving birth," the sheikh continued. "God has made the process so simple: the skin stretches during delivery and then contracts. But we are interfering with God's creation." He talked about how FGM/C contributes to the extremely high rate of maternal mortality in North East Kenya – with 1000 to 1300 deaths per 100,000 births in the rural areas – as well as numerous cases of obstetric fistula.
The list of health disorders related to infibulation is so extensive and particular that the Kenyan Ministry of Health has created a reference manual to help health providers identify and address them. In addition to pain, shock and obstructed deliveries, they include haemmorrage, infection, septicaemia, urine retention, anaemia, cysts, keloid scar formation, vulval abscess, pelvic infections, infertility, fistula, menstrual disorders, vulval ulcers, and post-traumatic shock syndrome.
But because the procedure has been almost universally practiced in the province for centuries, the consequences have not seemed out of the ordinary. "Women with these side effects often don't realize it's due to FGM," said Monica Onyango, a local police officer. "They just think it's 'women's problems'."
The group pays close attention as the sheikh continues his talk. "Even we are not allowed to mutilate an animal, now you are mutilating a human being."
At one point, an electronic voice coming from the direction of the audience interrupts: "Excuse me boss, you have a text message." Although cell phones are ubiquitous in much of Kenya, the Islamic communications network of madrassas (religious schools) and mosques is considered the most effective channel for getting messages out across this sparsely inhabited frontier. "When Imams want to pass on a message, it gets around very fast through the mosque," said Zeinab.
Underpinnings of a social convention
Though it has become linked in many people's minds with Islam, the practice of infibulation pre-dates it, probably starting thousands of years ago as a means to ensure the chastity of women destined to become the wives of Pharaohs, then spreading as a way to enhance marriage prospects, reinforce group identity and control female sexuality.
While FGM/C may have begun as a way for men to control women, one of the paradoxes of its persistence is that now the process is essentially owned by women. "I'm proud of it," said one woman office worker in her twenties who was interviewed in town during her lunch break. "I'll do it to my girls as it was done to me. I don't want to be stopped. For Muslims, it's a must. We're ready to face any problems it causes because it's our culture."
For many, discovering that Islam does not require the cut comes as a revelation to some, and opens the door for change.
Maryam Sheikh Abdi, UNICEF Kenya Child Protection Specialist, is a devout Muslim who was cut at a tender age. "I knew it would be painful," she recalls of the experience, which she describes in excruciating detail in her poem, The Cut. "But I also thought I had to go through it to be clean, so that God would hear my prayers."
Halan Munyo Abdulahi is a traditional birth attendant who rejected FGM/C because she saw too many girls having problems during delivery because of the practice
Photo: Winnie Kamau
The big hurdle in getting families to abandon the tortuous practice is that parents truly believe they are doing what is best for their child. "The mother doesn't think she's doing wrong," said Maryam. "She thinks she's protecting her child, she thinks she is making her beautiful."
Once locked in as a social convention, FGM/C was difficult for individuals to resist, without risking social exclusion or stigma for the daughters or bringing shame on the family. Many parents with doubts about the practice succumb to social pressure to conform.
Social conventions can, however, be overturned, once a kind of tipping point in public opinion is reached. In Garissa, the provincial capital, a number of activities sponsored by the Joint Programme are chipping away at the tradition: community dialogues, meetings with government officials, school programmes, news reports, talk shows, forums for religious leaders.
Many people interviewed cited the powerful impact of a video that has been shown widely at community meetings. 'Scarred for Life', produced by Ethiopian Committee on Harmful practices among pastoralist Afar community, shows a beautiful smiling child reduced to screams and sobs as she is held down by several women to undergo the torturous genital mutilation, actions that will alter her life forever. Both men and women are often reduced to tears upon viewing it, Zeinab said.
Religious leaders hold the key
Photo: Janet Jensen, UNFPA
But chiefs, development practitioners and government officials agree that a strong unified statement by influential religious leaders is the key to overturning the convention throughout the province. They point to another social convention – the Somali dress code for women – that changed rapidly in the mid-1990s soon after religious leaders declared that head coverings and garments that hid women's curves were required by Islam.
Toward this end, three regional and national meetings of Muslim religious leaders/scholars have been convened in the last five years. At each forum, after dissecting and debating the religious teachings related to the practice and learning more about the medical harm caused by infibulation, scholars have taken a stronger stand against FGM/C. But they have not yet reached a firm consensus that all forms of FGM/C are prohibited. Some leaders allow that less severe cutting of the clitoris, or pricking to draw blood, may continue.
To a certain extent, the issue has become politicized, said Sheik Barre Ali, who is one of many allies that the programme has enlisted to help lead the community dialogues that are making people question the age-old practice. Some religious leaders do not want to agree to what they consider a Western agenda, he said.
The Sheikh, however, feels duty bound to speak out against something that is clearly not in the best interest of young girls. "We're out to help the helpless, these children who have no power over something that will affect them for the rest of their lives," he added.
Signs of progress
As a result of all of the debate and new information about the impact of FGM/C, prospects for young girls are improving in Garissa, the provincial capital, everyone agrees. In town, according to Zeinab, most of the younger girls are now being spared the severe form of FGM/C that she and others of her generation went through. And some parents of the younger girls are avoiding the cut altogether. Although the most recent DHS data only registers a drop in prevalence of 1.5 per cent (97.5 in 2008/2009 compared to 99 per cent five years earlier), Zeinab pointed out that that includes all girls and women aged 15 – 49 years, and does not highlight changes occurring in the youngest generation.
But it is quite a challenge to penetrate the vast roadless areas of the province, where the pastoralists move their livestock to take advantage of the increasingly infrequent rains, illiteracy is over 90 per cent, and women's rights are not giving high priority. The Joint Programme is working with Womankind, a trusted grass-roots organization, to lead wide-ranging dialogues that frame FGM/C within a much broader context that covers human rights and religion as well as basic needs. Womankind's boarding school serves as haven to 120 girls whose nomadic parents want to educate and keep them safe from community or family pressures to be cut.
"We cannot reach everywhere with the funding from the joint UNFPA/UNICEF Programme on accelerating abandonment of FGM/C," said Zeinab. "But we are trying to refine our approach and have a catalytic effect in pilot communities."
Wedding nights, by all accounts, are difficult for brides who have undergone infibulation. And as FGM/C is becoming more openly discussed, many men wonder whether they, too, are getting shortchanged. Increasingly they are questioning the practice, which many said they did not fully understand until it began to be discussed openly in the last few years. Before that, several said, they considered it 'women's business.'
Infibulation, which is intended, in part, to protect virginity, also makes consummation an arduous process that is considered a test of manhood, but that often leaves both bride and groom frustrated and torn or bruised. Penetration can take a week or more, and might require surgical de-infibulation. Newlyweds are often kept far from the main compound, so that the bride's screams will not disturb others' slumber.
While some women who have been infibulated report they do experience satisfying sexual relationships, for many others, the pain and trauma associated with sexuality never goes away. One woman, who asked that her name not be used, said her first husband divorced because of her inability to enjoy sexual relations. For her second marriage, she said she opted to become a second wife, "so that my husband would not make too many demands."
The fact that several prominent politicians and religious leaders have taken as second wives women from the Coastal region of Kenya, where FGM/C is not practiced, seems to have made quite an impression.
The issue is also discussed in classrooms and in peer groups. In the Garissa district, Red Eagles, the boys' soccer team under Womankind Kenya Programme, and clubs have come out against the practice, and wear 'Say no to FGM' T-shirts.
Social change is rarely a smooth, simple process – it is often contentious and proceeds in fits and starts. But as more light is being shed on the harm it causes, more people, many of them men, are not afraid to make their preferences known, like a 36-year-old man who was approached for a television interview in the marketplace:
"I don't support it. In Saudi Arabia, they don't do it. The Koran does not say it is a must. I'll not take my girls to be cut. And if I have to choose between a girl who is cut and one who is not, I'll take the one who is not."