Today marks the International Day of Zero Tolerance to Female Genital Mutilation/Cutting, a practice that affects nearly 140 million girls and women worldwide, the majority in Africa, according to the World Health Organisation (WHO). In November 2012, the UN General Assembly adopted a resolution on female genital mutilation/cutting (FGM/C).
The resolution declared a global ban on the practice that came to enthrone years of exerted efforts by civil society organisations. While the UN resolution is not legally binding, it puts international and political pressure on governments to take the necessary steps to end the practice; Egypt included.
After years of women’s rights advocacy and awareness against FGM/C (interchangeable with “female circumcision”) in Egypt, there was a remarkable drop in the prevalence rate of the practice from 97% to 91.1% among women aged 15-49, according to the Demographic Health Survey carried out by the United Nations Population Fund in 2008.
Today, civil society organisations are still working to end the practice in Egypt. Activists complain that political support for the cause has been virtually non-existent since the 25 January Revolution. This is evident since for the Ministry of Health, raising awareness about the issue is clearly no longer a priority.
These concerns were reinvigorated in April 2012 when the residents of a village in Minya reported a medical convoy organised by the ruling Freedom and Justice party (FJP) for conducting FGM/C on female residents in the area. The FJP denied the accusation since there was no evidence, but according to a brochure published by state-run Al-Ahram, the convoy did promote FGM/C surgeries for low prices. Additionally, a former Salafi parliamentarian submitted a draft law to the 2012 parliament before its dissolution to legalise the practice.
Despite the Supreme Constitutional Court (SCC) rejecting a lawsuit calling for nullifying Law 242 which criminalises FGM/C, the calls for legalising female circumcision continue.
Calls for and against the practice continue to shape mainstream public opinion. Nevertheless, the prevalence of FGM/C stems primarily from inherited social traditions, local culture and norms, and religious misconceptions. The reality of local communities in Egypt reflects just that.
FGM/C in Egypt
Friday 10am. Exiting Ezbet El Nakhl metro station and walking towards one of Cairo’s oldest neighbourhoods, Ain Shams. Despite the muddy streets and pavements, the naturally formed ponds from a rainy day, and the absence of street gutters or drains, the neighbourhood is already vibrant. Men in kaftans and women in black glittered galabeyas queued up to buy their baladi bread, fuul and falafel for breakfast.
Heading towards a group of buildings called Masaken Al Gomhuria, the entrance is marked by some homeless dogs sleeping under traditional boat-shaped swings to stay dry. Despite the bleak environment, colourful paper decorations from previous feasts hung between the rows of buildings give the area the authentic flavour of a Cairo neighbourhood.
The Episcopal Institution for Care and Social Services, a community organisation for the area residents, is housed in a first-floor flat of a nearby dilapidated four-story building. The community centre offers a range of services from healthcare to lectures about reproductive health, catering to both women and girls.
Today, 15 to 20 women from different age groups ranging from late 20s to 50s were sitting inside the centre, chatting about their daily chores for a typical Friday. What was not mentioned in this back and forth banter was their shared purpose for meeting with each other today: their experiences with FGM/C.
At first, the women were reserved about sharing their stories, but Om Mohamed seemed forthcoming.
“The details are carved in my memory. I do not remember how old I was exactly, but I remember what happened to me after. I started bleeding intensely and the midwife had to use ice and cotton with oil to stop the bleeding. It did, but it was a painful process that I still vividly remember,” she says.
While Om Mohamed seemed indifferent to her FGM/C trauma, her face cringed and sharpened whenever she mentioned specific details, as if remembering the pain.
Om Mohamed has two daughters. She believes that one of them might need tahara, (“purity”, the common name for FGM/C in Egypt). “I’ll visit a doctor to ask first before I do anything, because we knew from many lectures we attended here (at the institution) that this practice is no longer good, even our daughters learn that in school nowadays and if we said yes to it, they tell us ‘no it’s haram, religiously forbidden,’” she says.
Om David, an Egyptian Christian, is also circumcised, but unlike Om Mohamed, she experienced minimal complications. Om David believes the practice is becoming less common because awareness is currently on the rise. “Our daughters are the ones who tell us ‘no’. Plus, we learnt that the chastityof a girl is not related to tahara; it’s related to the way you’ve been raised, your environment and your home. So many girls are circumcised, yet their behaviour is out of control.”
According to the WHO, FGM/C covers all procedures resulting in “the partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or other non-medical reasons.”
The WHO classified FGM/C to four types:
“The first is clitoridectomy where the clitoris (the most sensitive part of the female genital that leads to sexual gratification) is partially or totally removed. In some rare cases only the prepuce, the hood of the clitoris is removed. The second is excision which includes partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are “the lips” surrounding the vagina).
“The third is infibulations (commonly known as the Sudanese circumcision) where the vaginal opening is narrowed through the creating a covering seal. The fourth type is unclassified because it includes all other harmful procedures to the female genitalia for non-medical purposes like pricking, piercing, incising, scraping and cauterising the genital area.”
“Only the first and second types are the most prevalent here in Egypt, while the third is prevalent in Sudan and other African countries,” notes Mawaheb El-Mouelhy, a reproductive health and population specialist.
Snapshot of bitter reality
Like Om Mohamed, Om Hossam had a bloody experience with FGM/C after which her marriage life was affected. However, this did not keep her from passing on the tradition. She circumcised two of her three daughters. “We grew up with that tradition, and my husband also wanted them [the daughters] circumcised.”
She narrates one of her daughters’ experiences: “My daughter was circumcised by a doctor who was one of our relatives. Although she [the doctor] refused at the beginning, fearing the penalty, I insisted and she gave in at the end.”
The daughter, 13 years old at that time, bled from the afternoon to the evening.
“After a couple of hours, she went to the bathroom and that’s when I saw her standing in a pool of blood. I was horrified by the scene and trembled. I tried to help her, but I was afraid to take her to the hospital because that would have jeopardised the doctor who I promised confidentiality,” she says remorsefully.
“My situation was very hard. I wanted to save my daughter but at the same time, going to the hospital would have got the doctor, her father and myself arrested. So I called the doctor back and she agreed to come to examine my daughter.
“My daughter’s face went yellow from losing so much blood and I thought for a second that I lost her when she fainted,” she says.
Zeinab Heada is a gynaecologist and a senior technical adviser for reproductive health at Care International in Egypt. She explains why Om Hossam’s daughter experienced intense bleeding.
“The clitoris is the primary erogenous zone in the female genital area. It’s full of muscles, nerves, blood vessels, some arteries and veins. Therefore, any cut could lead to bleeding to death. In an unsanitised environment, stopping the bleeding using stitches or bandages could result in the cut becoming infected. Mistakes down there could be irreparable,” she clarifies.
“We don’t have circumcision for girls in medicine. We don’t have it in our curriculum, nor did we receive medical training for it. When the midwife, or whoever cuts the clitoris, the length is totally subjective, and because there are no surgical instruments for the procedure, unlike male circumcision, she uses razors, which is disastrous,” Heada adds.
Om Hossam regrets her decision regarding her two daughters. She hopes their circumcisions do not affect their future the way she was affected by hers.
“To some extent, I’m cold in my intimate relationship with my husband. If I were to stay a year without it, I wouldn’t ask. But desire drops by age and changing daily problems, so this is not the focus anyway,” she says.
Pitfalls of FGM/C
Most women in the group were satisfied in their intimate relationships with their husbands. They agreed with Om Hossam that with age, sexual desire decreases, at least for them, and other issues come to the forefront like bringing up children, earning a living and marrying their children.
In El-Mouelhy’s study “Female Sexuality and FGM/C in Egypt,” several focus groups of Muslim and Christian women and men in Minya in Upper Egypt declared that FGM/C did not impact their sex lives. Younger men, however, disagreed, saying “it influences sexual responsiveness”. Ironically, these men were also afraid that uncircumcised women would be too active.
Heada explains that the surgery has ramifications: “Psychologically, young girls could be subjected to traumatic experiences especially if they had complications. Sexually, if the clitoris was wholly removed this would prevent women from experiencing sexual pleasure or having sexual desire in the first place. Reproductively, during delivery, women may suffer as a result of the deformities in their vaginas.”
Om Hossam shares the blame with her husband for circumcising her daughters. She says: “He also wanted it. He thinks it’s religiously good and he cited one hadith about it once.”
A religious controversy?
Om Hossam’s husband believes female circumcision is part of Islam’s teachings. He is like many others confused between the opinions of religious scholars on the issue.
Ahmed Ragab, a professor of reproductive health at Al-Azhar University, attempts to clear any confusion about FGM/C from an Islamic point of view: “the practice takes place in 28 African countries and some Asian countries. As for Islamic countries, the practice only exists in Egypt, Somalia, Sudan, Djiboutii, Iraq and some parts of Yemen. The rest of Islamic countries rarely exercise the practice.”
He further explains: “Religiously, it’s known by any student studying fiqh, Islamic jurisprudence, that we depend on the Quran, the sunnah (the Prophet’s sayings and actions), ijma’ (consensus), qiyas (deductive analogy). In all four sources, there isn’t any mention for mandating circumcision for women.”
“However, the controversy comes from the opinions of some scholars who deem female circumcision permissible, jaaez, since there isn’t any ban on it and others who call it an honouring practice, makrama, citing three hadiths, used to justify khafad (the Islamic term for female circumcision).
“Nevertheless, these hadiths are weak and not supported by Quranic verses or even ijma’ from imams,” he adds.
Ragab goes on interpreting the core value of Islamic jurisprudence. He says: “it aims primarily to bring benefits to worshipers and keep away corruptive deeds. So when an action results in harming health, it is only logical that it would be forbidden.”
Sheikh Mohamed Tantawi, the former Grand Mufti of Egypt, has repeatedly said that “there is no legitimate document mandating the practice for girls”.
Sheikh Ali Gomaa, the current Grand Mufti of Egypt, has also said: “the more medicine advances, the more we’ve been led to how harmful the practice is for females and there has been a consensus among doctors about it.”
Though mainstream Islamic scholarship deems the practice forbidden in Islam, sheikhs of the Shafi’i school of fiqh believe in the correctness and the strength of the hadiths. They would forbid all types of FGM/C except for the first type. They believe that hoodectomy (removing the hood of the clitoris) is in line with what the hadiths say regarding female circumcision, not calling it mutilation.
It is important to point out that culture and tradition, not religion, is the primary motive for carrying out FGM/C. In Egypt, both Christians and Muslims are circumcised. The women at the Episcopal Institution in Masaken Al Gomhuria are a stark example. Half of them are Christians and everyone but a young woman in the group was circumcised.
Om Hossam justifies circumcising her daughters by saying that bringing up teenagers is a “hard mission”. She says that teenage girls become stubborn and out of control and that pressure from other girls could lead them down the wrong path. They interact with people from higher social classes and they want to dress and wear make-up like them.
“Tahara is a way to ease their wild behaviour. There is the internet and the computer and girls talk with each other so you won’t know what they see, do or discover. We teach them to conserve the honour of their family, mother and father,” she asserts.
Randa Aboul Seood is the head of the NGO Coalition against FGM/C which aims at unifying efforts with other NGOs to combat the practice. The coalition works on unifying the messages and narratives regarding FMG/C to have a stronger impact on society.
Aboul Seood says the coalition is currently targeting schools, saying education has proved to be the best way to raise awareness about FGM/C: “We are reaching out to schools located in poor and slum areas where the quality and level of education is already low. We have been working in 30 schools and the results have been promising.”
She says: “The parents are responsive with the different NGOs carrying out the program. We believe that if people were taught correctly they will naturally reject FGM/C as a practice, but our biggest hurdle is political support.”
Aboul Seood is like other FGM/C activists waiting for the results of the upcoming Demographic and Health Survey scheduled in 2014 to evaluate the status of FGM/C since 2008. They are concerned that with the lack of political support, the prevalence of FGM/C may be rising again.
As for Om Hossam, she pledged she would not repeat the same mistake for her third daughter: “I learnt the lesson the hard way, even though her father still wants her circumcised like the rest of her sisters, I won’t allow it even if we ended up being divorced.”
After a moment of silence among the women, Om Mohamed courteously asked to be excused. The rest followed too, eager to leave and buy baladi bread before their husbands finished the Friday prayers.