Eradicating FGM will be a slow process, experts say

Nooria, 22, (pseudonym) from Lahj, a small city north of capital city Aden, was the only girl in her family subject to the practice known as female genital mutilation (FGM).

As a baby, she said, her grandmother took her from her mother – in secret – in order to carry out the ancient custom.

"I was told it was tradition, and a necessity," Nooria recalled.

Her clitoris and labia minora were removed and her vaginal opening largely sewed up, in an extreme form of FGM thought to be relatively uncommon in Yemen.

When she realised the problems that would result once she was older, including a painful reopening on her wedding night, and again at the birth of each child, she refused to get married.

Now Nooria says she suffers from frequent infections and painful menstruation every month.

A global problem

FGM, or khitan al-inath as it is known in Yemeni Arabic, refers to the removal of all or part of the female genitalia.

In Yemen, the most common reasons given for the practice are cleanliness and religious/cultural tradition. There is also a common belief that the practice serves to temper sexual urges.

Contrary to local perceptions, however, there is no doctrinal basis for the custom, either in Islam or Christianity. Nevertheless, it is often seen as a religiously ordained rite of passage for girls.

Common health consequences associated with FGM are haemorrhaging and infection. At least two local deaths have been attributed to FGM in recent years.

According to UNICEF, FGM it is still practiced on approximately two million girls every year. Amnesty International (AI) estimates that some 135 million girls have undergone some form of FGM worldwide.

The phenomenon is common across much of Africa, where, in some countries, it is performed on the majority of girls. It also occurs, to a lesser extent, in parts of the Middle East and in immigrant populations worldwide, according to reports issued by AI.

The state-run Yemen Demographic Mother and Child Health survey (YDMCH), conducted in 1999 and early 2000 in five governorates, concluded that FGM was performed on 97 percent of girls and women in the Hodeidah district; 96 percent in al-Mahrah and Hadramawt; 82 percent in Aden; and 45.5 percent in Sana’a.

The survey further concluded that in 97 percent of the cases, the procedure was performed at home, usually by a traditional midwife or female relative. Notably, the survey found that the decision to perform FGM is, in most cases, made by the mother.

Many government officials, along with local and international NGOs, however, disputed these figures.

Fatima Saeed al-Murisi, Aden director of the Yemeni Women’s Union, for example, said she believed the 82 percent cited for the Aden governorate was too high. “All the NGOs involved in the survey are certain the numbers are lower,” she said, estimating that only 40 percent of Aden women had undergone the procedure.

In the capital, Rashida Ali al-Hamdani, chairwoman of the National Women’s Committee (WNC), also disagreed with the 45.5 percent figure for Sana’a governorate.

Several leading Yemeni officials said the practice only existed in African immigrant communities, or was relegated to the hot climates of the country’s southern coast.

In Yemen, unlike many other countries where it is performed, the majority of operations are done within the first few month of a girl’s life. The most common form of the procedure in Yemen is thought to be excision, which involves removal of all or part of the clitoris and possibly the labia minora.

A more extreme type, infibulation, refers to the removal of all or most of the external genitalia, followed by the sewing up of the vaginal opening, leaving only a small opening.

A controversial issue

Attempts to convince traditional Yemeni society that the practice is medically dangerous, however, has been an uphill battle.

The first public discussion of the practice in Yemen took place in 2001, at a seminar on women’s health issues sponsored by the Ministry of Public Health and funded by the US-based McArthur Foundation. At that event, FGM was condemned by a broad spectrum of public officials.

The Minister of Health, for his part, labelled the practice an act of violence against women.

Public efforts to eradicate the practice

Despite public sensitivity on the issue, campaigns to eliminate the practice are being carried out across the country. In a departure from the past, some of the largest public and private NGOs devoted to women’s issues run public awareness campaigns on television, radio and in community gatherings to try to discourage the practice.

The Girls Health Project, conducted by the Women’s National Committee in Aden and the International Health and Development Associates (IHDA), for example, sponsored 12 local organisations to carry out awareness campaigns across the Aden governorate between 2001 and 2003.

Projects sponsored by the programme, funded in part by the Dutch government, included seminars and educational materials on the issue, as well as workshops and media campaigns.

Al-Murisi noted that one of the Women’s Union’s most important activities was a series of workshops featuring local religious leaders who both oppose and support the practice.

Religious figures disagree over whether or not the practice is condoned by Islam. This issue “is still being debated,” said Al-Murisi.

Efforts aimed at eliminating the phenomenon appear to have slowed down in the last year, however, as the primary donor, the Netherlands, has dramatically reduced its funding.

Djoeke Koekkoek, gender specialist at the Netherlands Embassy in Yemen, explained that development aid was linked to the country’s economic growth, which has slowed in recent years. In 2003, the gender programme was incorporated into other programmes, all of which saw their budgets reduced.

But for in this conservative Muslim country, aid workers say that merely achieving some public discussion of the issue should be seen as progress.

“When I was first asked to work on FGM five years ago, I refused to speak about it in public,” said al-Murisi. “”Now I speak about them on television – that’s progress.”