Gender Inequality and Reproductive Health
Female genital cutting (FGC, also known as female genital mutilation or female circumcision) threatens the sexual and reproductive health of millions of girls in sub-Saharan Africa and the Middle East.
In the Sudan, infertility resulting from infibulation may be associated with higher rates of divorce.(70) Men’s attitudes, particularly about controlling female sexuality, are an important factor in the perpetuation of FGC.(71)
Worldwide, about 130 million girls and young women have experienced FGC and an additional 2 million are at risk each year (6,000 every day). FGC is practised in about 28 countries, with prevalence rates ranging from 5 per cent in the Democratic Republic of Congo to 98 per cent in Somalia, the Arabian Peninsula and the Gulf Region.(72) Studies done in 1995 found 97 per cent of married women in Egypt aged 15 to 49 had been circumcised; in Mali, this figure in 1998 was 94 per cent.(73)
Most procedures are done by non-medical personnel—including traditional birth attendants, midwives, and “old women”—using unsterilized blades or string, increasing chances of infection; usually post-operative or emergency treatment is not readily available.(74)
WAYS OF REDUCING FGC Many countries have passed laws banning FGC, including Burkina Faso, Djibouti, Egypt, Ghana, Senegal, Togo and the United Republic of Tanzania. While these laws call for fines and jail terms,(75) enforcement is often lax and the practice continues, cloaked in greater secrecy.
Efforts are under way to reduce the incidence of FGC and to change underlying attitudes about female sexuality and worth. In Kenya, the United Nations Development Fund for Women (UNIFEM), the NGO Maendeleo ya Wanawake Organization (MYWO) and the Program for Appropriate Technology in Health have promoted “Circumcision through Words”, an alternative rite of passage that preserves positive aspects of the cultural tradition.(76) Kenya’s Children Act, passed in 2001, prohibits FGC.(77) A week-long programme of seclusion, traditional teachings, health education and counselling is followed by a community-wide celebration with food, dancing and singing, all affirming the joyous transition to womanhood.
In addition to community leaders, the project has involved men and boys, especially fathers and brothers; boys have refused to marry girls who have undergone FGC, reassuring parents about the future marriageability of uncircumcised daughters. In January 2000, UNFPA and several other UN agencies signed an agreement to extend this effort to other communities with high rates of FGC.
In Senegal, the organization Tostan has worked to raise awareness of health and rights, resulting in group decisions in 938 villages (18 per cent of 5,000 registered communities) to abandon FGC and early marriage.(78) In Mali, Healthy Tomorrow takes a more explicitly critical approach, using music to educate people about the harm done by the practice.(79)