Female Circumcision – Yes it really does still happen!
Just a few months ago I was honored and overjoyed to attend
the birth of a beautiful baby girl. The parents were naturally
equally ecstatic at the birth of this precious girl, and I
followed them through their post natal visits. At the 4 month
check her father, a very pleasant man from a town in West
Java asked me if I would pierce the babies ears, and I was
happy to oblige. On hearing that the family would soon travel
to Java to visit relatives I assumed that the ear piercing
was something special so as the baby could show off some pretty
earrings on their travels. I was shocked when I heard the
real reason for the earrings. Apparently it was customary
in the father’s village for baby girls to have their
ears pierced at the same time as the clitoris was ceremoniously
sliced off! I was horrified at this and this little girl was
lucky that her parents were equally as horrified and had declined
to have the procedure performed. However to keep the family
at large satisfied that the procedure had been done they would
tell family and friends that the circumcision had been done
in Bali when I had pierced the ears! For those of you that
thought that female circumcision was a thing of the past,
think again. Female genital mutilation (FGM) occurs in 20
African countries, in parts of Asia and South America and
some Middle Eastern countries. It is also known to have occurred
in western countries.
What is female genital mutilation (FGM)?
There are 3 main types, some much more serious than others.
- Removal of the fold of skin around the clitoris and of part
or the entire clitoris. This is the least common and is called
sunna or clitoridectomy.
- Partial or total removal of the clitoris and nearby tissues
- labia minora. Also called sunna or clitoridectomy.
- Complete removal of the clitoris, labia minora and often
labia majora. Both sides of the vulva may be joined with catgut
or thorns (infibulation) with a small opening for menstrual
flow and urine (wee). Called Infibulation or Pharaonic circumcision
or Somalian circumcision.
- Other types include pricking, piercing or stretching of
the clitoris and or labia, burning of the clitoris and sur
rounding areas, scraping the opening to the vagina (angurya
cuts) or cutting the vagina (gishiri cuts) and putting corrosive
substances or herbs into the vagina to cause bleeding and
scarring to tighten or narrow it.
- It is done at different ages in different communities, across
a range of ages from infancy to puberty.
-In some places (usually rural and remote areas) it may be
done without anesthesia (and is extremely painful), and usually
in unhygienic conditions so that the risk of infection and
bleeding is high.
Reasons for FGM
It is usually done out of love or concern for the child and
for one or more of the following reasons. Different communities
will have different emphasis or different combinations of
these reasons.
- One of the main reasons is that of “belonging”
to a group.
- To make the girl less interested in sex.
- Protection from rape.
- To make sure the girl is a virgin when she gets married,
because in some groups there is no bride price if the girl
is not a virgin.
- It can be an initiation into adulthood.
- Some groups think it is more hygienic.
- Some groups believe that female genitals are unsightly so
they are removed for aesthetic reasons.
- Fear that the clitoris is dangerous to the man, and during
childbirth.
- It is important for social acceptance or social recognition.
- There is a myth that the clitoris will grow to the size
of a penis if it is not cut.
- Fear that the woman will not be able to have babies or will
turn into a man.
FGM is deeply embedded in some local traditional belief systems,
is older than Islamic, Judaic and Christian religions and
is practiced by followers of a number of different religions
including Muslim, Christians, animists and also non-believers.
Neither the Bible nor the Koran prescribes female genital
mutilation although it is often mistakenly believed that it
forms part of the Islamic faith. Scholars of the Islamic faith
say that it is not required by their religious doctrine and
that it is almost never performed in many major Muslin countries
such as Saudi Arabia, Iran and Pakistan. While there are many
reasons for undertaking the practice of female genital mutilation,
humanitarian groups in certain countries where female genital
mutilation is practiced are leading international efforts
to stop this practice.
Health problems from FGM
Girls and young women who have had this done can have any
or all of the following problems.
- Difficulty in passing urine and menstrual blood if the hole
is made very small. Going to the toilet takes a long time.
Schools may need to know about this.
- Menstrual pain (period pain). (Many women have some pain
with their periods, so this may not be due to female genital
mutilation).
- Urinary (bladder) infections.
- Incontinence - wetting pants during the day and night.
- Embarrassment and fear about sexuality.
- Kidney infections.
- Lower abdominal pain due to infections.
- Fistulae (holes or tunnels) can occur between the bladder
and vagina or the rectum and vagina which can cause ongoing
incontinence and serious social problems for the young woman.
- Abscesses - infections in the skin and lining of the vagina.
- Sexual problems and painful intercourse.
- The vaginal opening may have to be cut open at marriage
and again enlarged at childbirth.
- There can be infertility because of the infections.
Emotional problems from FGM
Female genital mutilation is commonly performed when girls
are quite young and it can be associated with intimidation,
forcing, lies and violence by people they trust such as parents,
relatives and friends. As they are usually conscious for the
operation many girls have severe pain. For many it can have
serious effects on their emotional development. It must be
remembered that many girls and women have no acceptable way
of expressing their fear and pain and they suffer in silence.
- Emotional distress and anger - especially in adolescence.
- Post traumatic stress and flashbacks where what happened
to them keeps coming back over and over again.
- Sleep problems - nightmares and difficulty sleeping.
- Panic attacks.
- Mood swings.
- Difficulties in concentrating and learning.
- Loss of self esteem.
- Ongoing anxiety or phobias.
If you have relatives, staff or friends that you think may
still be practicing FGM please make an effort to educate them
against this barbaric procedure, or call me and I’ll
do it for you!
“Kim Patra is a qualified Registered Nurse and Midwife
that has been living and working in Bali for almost twenty
years. She now runs her own private practice and medical referral
service from her Kuta office. Kim is happy to discuss any
health concerns with you and she may be contacted via e-mail
at info@chcbali.com”.
