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Female Genital Mutilation

Worldwide, an estimated 130 million girls and women have undergone female genital mutilation. At least two million women a year are “at risk” of undergoing some form of the procedure. These numbers equal out to approximately 6,000 women at risk per day. The World Health Organization (WHO) defines Female Genital Mutilation as all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons. Female circumcision is another term for the procedure as well.

Part I: History & Types of Female Genital Mutilation Female Genital Mutilation (FGM) has been an ongoing worldwide debate. Awareness as well as legislative activity have had an incredible amount of benefiting effect. However, it’s been around for so long that its history is hard to determine. Although evidence of FGM can be found dating back several thousands of years where Egyptian women mummies have been found mutilated, the specific origin of FGM is obscured by time. It’s practice has been cited in almost thirty African nations.

In addition, the proof of FGM has been seen in the middle east and to a lesser extent, in parts of Asia. Most often, the historic reasons cited are marital fidelity, controlling a women’s sex drive, and “calming” a woman’s personality and hygiene. More modern justifications for this procedure are custom and tradition. Some tribes and groups maintain and preserve their cultural identity by continuing the practice. Religion is also cited but it is important to note that FGM is a cultural, not religious practice.

Although practiced by Jews, Christians, Muslims, and members of other indigenous religions in Africa, none of these religions require it, but it is commonly considered an important right of passage. One last reason is social pressure. In communities in which most women are circumcised, family and friends create an environment in which the practice of circumcision becomes a requirement for social acceptance. In industrialized countries, genital mutilation occurs predominately among immigrants from countries where mutilation is practiced.

FGM can be classified into four separate groups. Type I, termed clitorectomy, involves the excision of the skin surrounding the clitoris, with or without excision of part or all of the clitoris. When this procedure is performed in infants and young girls, a portion of or all of the clitoris and surrounding tissues may be removed. If only the clitoral prepuce is removed, the physical manifestation of Type I FGM may be subtle, necessitating a careful examination of the clitoris and adjacent structures for recognition. Type II is referred to as excision.

It is the removal of the entire clitoris and part or all of the labia minora. Crude stitches of catgut or thorns may be used to control bleeding from the clitoral artery and raw tissue surfaces. Patients with Type II FGM do not have the typical contour of the anterior perinea structures resulting from the absence of the labia minora and clitoris. In addition, the vaginal opening is not covered. Type III, known as infibulation, is the most severe form in which the entire clitoris and some or all of the labia minora are excised, and incisions are made in the labia majora to create raw surfaces.

The labial raw surfaces are then stitched together to cover the urethra and vaginal introitus, leaving a small posterior opening for the urinary and menstrual flows. The patient will have a firm band of tissue replacing the labia and obliteration of the urethra and vagina openings. It is estimated that 15% of all mutilations in Africa are Type III. Type IV includes the different practices of variable severity including pricking, piercing, or incision of the clitoris and or labia.

Stretching of the clitoris and or labia, cauterization of the clitoris, and scraping or introduction of corrosive substances into the vagina all fall under Type IV FGM as well. Around 85% of genital mutilations performed in Africa consist of clitoridectomy or excision, while the least radical procedure consists of the removal of the clitoral hood. A list of African countries and type of procedure dominant in each country is included for reference. Part II: Procedures, Consequences, & Legislation Some girls undergo this type of mutilation alone, but more often, undergone as a group.

For example, sisters, other close female relatives, or neighbors might be included all at once. The procedure may be carried out in the girls home, the home of a relative of neighbor, in a health center, or sometimes at specially designated sites, such as a tree or a river. It is performed in these unsterile surroundings with the girl forcibly restrained. It is carried out with instruments such as broken glass, tin lids, scissors, rusted razor blades, etc. In a more modernized society, or in a wealthier tribe or environment, the procedure may take place in a hospital under local or general anesthetic.

Generally, the procedure is performed between the ages of two and fifteen by an older tribe leader (a women), a traditional midwife or healer, a barber, and in those few instances, by a qualified medic. Usually, pastes containing herbs, milk, eggs, ashes or dung are applied to facilitate healing. Its consequences are not only instant but everlasting. The effects can lead to death. At the time the procedure is carried out, enormous pain, shock, hemorrhage and damage to the organs surrounding the clitoris and labia can occur, not to mention the profound amount of blood lost.

Infections develop and risks of acquiring the HIV virus increase due to the same instruments being used on several girls. Long term effects can include chronic urinary tract infections, stones in the bladder and urethra, kidney damage, infertility, and excessive scar tissue. In many cases, childbirth is most difficult because scar tissue is not as flexible as normal tissue. In a study carried out in Sudan, 15% of the women interviewed reported that cutting was necessary before their first sexual encounter is achieved.

The emotional and psychological effects can be very devastating as well. Women become afraid of life and society. Intimacy with loved ones change being that the level of arousal is far less than what a normal women can enjoy. Feelings of anxiety, terror, embarrassment, humiliation, and betrayal, all of which would be likely to have long term negative effects, can be accounted for as well. In instances, women sometimes feel trauma and rejection by society. Legislation against this cruel and inhumane act have become more common through time, but not yet enacted in all countries.

FGM has received increasing attention from the international community during the past twenty years and was raised as a matter of concern at the U. N. Commission on Human Rights in 1981. Most FGM statutes in the U. S. were enacted between 1996 and 1999. In recent years, laws are being used to combat the practice, and legislation criminalizing FGM has been adopted in sixteen countries, including nine in Africa. Federal laws were passed in 1996 against the practice of FGM, making it a criminal offense to practice it inside U. S. borders. Since 1994, sixteen states have passed legislation relating to FGM.

In general, the statutes address FGM in a manner similar to that of the federal law, by prohibiting its practice and instituting criminal sanctions. For example, Minnesota, Rhode Island, and Tennessee prohibit the procedure on adult women as well as on females under the age of majority. Countries as far south as Australia and New Zealand to countries in Europe and Africa like Sweden, Italy, and Kenya have all enacted laws condemning its ways. Time, patience, and awareness will lead to a worldwide commitment to end this tragic act. Part III: Feature Story: Hannah Koroma

As graphic as the nature of the subject has been, its hard to imagine the difficulty it takes for a victim to speak. In addition, their bravery and honesty in reference to their experience is immeasurable as well. Much admiration and respect should be given to the women that speak for the sake of awareness. This particular story I find interesting because it is so detailed. This poor women tells her story and the pictures I get in my head bring chills to my spine. Her name is Hannah Koroma. She is from Sierra Leone, a country on the western coast of Africa, and her experience is saddening.

She talks of being mutilated at the age of ten. Hannah was told by her late grandmother that she was being taken down to the river to perform a certain ceremony, and that afterwards, she would be given a lot of food to eat. She was led like a sheep to a slaughter house. She was taken to a dark room, undressed, blindfolded, and stripped naked. Once again, she is only ten years old. Two strong older women carried her to the site. She was forced to lie flat while four big women applied pressure on her to not move. One was on her chest, one on her arms, and one woman on each leg.

A piece of cloth was forced in her mouth to stop the screaming. She was then shaved, and “operated” on. Hannah speaks of putting up a big fight when the operation began. The pain was terrible and unbearable. She was cut with a blunt penknife by women half drunk with alcohol. They danced, yelled, and stripped while this was happening. She could not urinate unless she stood and would urinate on her wound continuously, infecting it time after time. She was given neither anesthetics nor antibiotics to fight infection. All that was put on her was that cream base to facilitate the healing that lasted months.

She became anemic and suffered for very long from acute vaginal infections. To this day, she calls it witchcraft. The worst part is that this is just one victim of many. Awareness in my opinion is most important because it enforces as well. A person who knows the law and understands right from wrong will think twice about hurting another human being in that way. These girls are all young and innocent, with no defense. The only thing that I can think of is that time brings about change and that change is inevitable. People will soon realize the nature and severity of this horrible, unjustifiable act and will soon end it.

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