issue 240 - February 1993
Going to Grannie's
There can be no more grievous assault on girlhood than the
mutilation of female genitalia. Why does it happen?
Can it be prevented? Janie Hampton reports.
It now took a quarter of an hour for her to pee. Her menstrual periods lasted ten days. She was incapacitated by cramps lasting nearly half the month. There were premenstrual cramps: cramps caused by the near impossibility of flow passing through so tiny an aperture as M'Lissa had left after fastening together the raw sides of Tashi's vagina with a couple of thorns and inserting a straw so that in healing, the traumatized flesh might not grow together, shutting the opening completely, cramps caused by the residual flow that could not find its way out, was not reabsorbed into her body and had nowhere to go. There was the odour too, of soured blood, which no amount of scrubbing ever washed off.
The passage is fictional. It might well be fact. It comes from Possessing the Secret of Joy, a new novel by Alice Walker. The black American feminist who writes with candour about culture-charged areas of female lives has chosen to explore the practice whereby millions of African girls arrive at woman-hood with their clitoris wholly or partly cut out. Walker has faced up to the attack that, as an American woman, she has no right to oppose African culture. She has described a young woman's desire, later regretted, to become a full member of her tribe by subjecting herself to genital mutilation.
Walker's renown has helped to raise consciousness about a process many African girls look forward to - inexplicably in Western eyes - as their rebirth as a mature woman.
'Female circumcision', as it is euphemistically called, comes in different degrees of severity. In the mildest form, sunna, the hood of a girl's clitoris is cut off. The most common form is total excision - clitoridectomy. The extreme form, infibulation, involves cutting off both clitoris and labia minora, and scraping out the flesh inside the labia majora. The vulva is sown together or pinned with thoms, leaving a very small aperture. In the village setting, there is no anaesthetic, beyond sitting in a cold stream. The operation is carried out by older women on girls aged from a few months to puberty depending on local custom. Their legs are tied until the wound has healed.
The World Health Organization (WHO) estimates that 90 million girls and women alive today have endured one or other procedure, and that two million more girls do so each year. Most are in Sahelian Africa, especially Sudan, Somalia and Mali; but girls in Arab States and parts of Asia are also mutilated in this way. In Europe and North America some immigrant families persist in the practice, either finding willing doctors or sending their unsuspecting daughters home in the school holidays.
The campaign against female genital mutilation began in earnest around 12 years ago. Originally much of the impetus came from Westem feminists, but African women have become increasingly active and now predominate. The subject is extremely sensitive not only because it concems women's sexuality in so acute a way but because to outsiders the shocking nature of a custom taken for granted in so many traditional African societies represents both African men and the mothers and 'grannies' who insist upon and perform the operation as barbarous.
Whatever the desire to respect other people's cultures, how can such a practice be condoned? More and more African women insist that it cannot. 'I love my culture,' says Hadijah Ahmed of the African Women's Welfare Group, 'but it is not this. This is torture hiding behind culture. Children have no voice - adult women must speak out to protect them.'
Why is genital mutilation performed on African girls? It is seen as part of the ritual passage from childhood to adulthood, carried out at the climax of various rites performed to signify that girls are ready to be passed on from the ownership of a father to that of a husband. Without the hallmark of circumcision', the girl could not find a husband or be treated as a full member of adult society.
The practice, then, is the female counterpart of male coming-of-age rituals. But to this, Efua Dorkenoo, director of the Foundation for Women's Health, Research and Development (FORWARD) responds: 'This is far worse than male circumcision, both at the time and in long-term effects. This can only be described as mutilation.
The practice awesomely exemplifies men's fear of women's sexuality. Cut and restitched, the girl's genital area is under control. If her virginity is lost, and the fleshly seal breached, it will be obvious. Men are guaranteed virgins who are unlikely to stray. Sex for the future woman is to be a duty, not a pleasure.
To some eyes, the results of genital reconstruction are appealing, an improvement on the wet, lumpy natural female genitals, source of uncontrollable desires. After thousands of years aesthetic view conforms with deeply embedded attitudes about sex, virginity and marriage. After the operation a girl is smooth, dry and in control of her body.
Many of the peoples who practise infibulation come from remote desert areas and cling to ancient ways. They fear that an end to the practice would lead to an epidemic of premarital and extramarital sex. The urban lifestyle is seen as shockingly degenerate and immoral. This perception causes many parents to reaffirm the decision to have their daughters 'done' even when they are far from home and the notion that they cannot otherwise find husbands or be socially accepted is hard to sustain. Some believe that there is a religious obligation to operate on their daughters though no established religion endorses this.
Apart from the risks to the girl of the actual operation - haemorrhage, tetanus, septicaemia, damaged urinary tract, severe pain, psychological shock, even death - the health effects last a lifetime. Infections due to trapped urine or menstrual blood may lead to infertility. Sex may be painful, birth complicated. Dr Mary McCaffery, a London obstetrician, was shocked when she saw her first infibulated pregnant woman. 'Somehow a baby had to get out of a tiny hole surrounded by scar tissue. Internal examination is impossible.' McCaffery operates to remove scar tissue several weeks before the birth. 'Even with a general anaesthetic some of the women scream when their genitals are touched. The pain is not just physical - it goes very, very deep and will be with them for ever.'
In the Western world, steps have been taken to outlaw female genital mutilation where it is practised among immigrant groups. In Canada the practice violates the criminal code and a practitioner can get up to 14 years' imprisonment; parents, up to 10 years for criminal negligence. In 1985, it was made explicitly illegal in Britain, and a child at risk can be put on the child protection register.
However, in the Netherlands the Minister of Health has been asked to make the practice allowable in Dutch hospitals. 'The proposers believe that this is safer than illegal operations, and non-racist,' said Berhane Ras-Work, President of the Inter-African Committee (IAC) Against Harmful Traditional Practices. 'But this would put our work back to the beginning.' The WHO concurs. 'To permit the operation in the hygienic conditions of hospitals grants it medical acceptance and effectively legalizes it,' says Dr Liela Mehra.
But the main efforts to prevent daughters from 'going to granny's' must take place in the countries concerned. The leading international organization in this context is the IAC which now has member groups in 23 African countries. The IAC avoids value judgments, pointing instead to the physical and psychological health damage to girls and women. The groups hold workshops and promote training among village midwives - guardians of women's reproductive health in much of Africa.
Education, especially of women, is the single most important factor in persuading parents to abandon the practice. Not only can education impart health dangers, but it provides an alternative context in which precious notions about feminine sexuality and marital responsibility can be upheld. Traditionalists need to learn that virginity is prized in many societies, but does not require that clitoridectomy be performed as a sanction.
Progress is slow, but it is happening. In Burkino Faso, for example, a national committee of politicians and popular associations is active. Prison sentences of up to 10 years are meted out to dissuade practitioners. A Burkinabe film has been made: My daughter has not been excised. 'Many mothers are now proud to show us their daughters who have not been mutilated,' says Ras-Work. 'The practice is definitely decreasing. With effort it should eventually die out.'
Janie Hampton is a freelance writer specializing in women's health issues.