By Talha Burki - The Lancet
Campaigns against female genital mutilation have mainly targeted African nations, where most mutilations occur. Now two reports hope to highlight the issue further afield. Talha Burki reports.
Female genital mutilation (FGM) is widespread in Africa but also occurs in Oman, Yemen, and Saudi Arabia; parts of Indonesia and Malaysia; and in specific immigrant communities in North America and Europe. Two new reports—one published by German relief organisation WADI on Feb 6, the other to be issued by Human Rights Watch (HRW) later this year—centre on an arena hitherto neglected by researchers and activists: Iraqi Kurdistan.
Kurdish northern Iraq is an autonomous region consisting of the three governorates of Dohuk, Arbil, and Suleymaniya, with a population of about 5·5 million, and several provinces in neighbouring governorates, one of which, Kirkuk, awaits the result of a referendum to determine whether it will become part of Kurdistan.
“Most girls in northern Iraq are likely to have undergone FGM”, concludes the WADI report, which surveyed more than 1400 women across the region. The average rate of FGM was 72·7%, but in some areas was virtually 100%.
HRW stated that type 1 mutilation—clitorodectomy—
predominated, even though some older women reported undergoing the amputation of their clitoris and inner labia (type 2 mutilation). After the event, infections are common. Sepsis can take hold. Moreover, “recent studies show that all types of FGM carry greater risks for pregnant women during childbirth”, says HRW. “There are also risks for the fetus which may result in stillbirth.”
More than 130 million women worldwide have undergone FGM, including 92 million girls older than 10 years in Africa. Every year an estimated 3 million girls are at risk of the procedure.
The procedure itself is highly traumatic. Girls might be held down by family members and neighbours while being cut. They experience great pain, and heavy bleeding. Deaths have been reported, although data are hard to come by. Undocumented but highly plausible is a sizeable incidence of post-traumatic stress syndrome and other mental disorders among those who have been mutilated.
Thomas von der Osten-Sacken of WADI notes that FGM is widespread in both rural and urban parts of Iraqi Kurdistan. “We found that it is very closely linked to the level of education both of the girls and the parents”, he added. “The more educated people are, the easier it is to convince them to stop this practice”.
“Enacting a law against FGM is an important practical, strategic, and symbolic step”, HRW's Liesl Gerntholtz tells The Lancet. “Legislation alone is not enough”, she stressed, “but it indicates a political will to address this issue”. Unlike other governments in the Middle East and Africa, the Kurdish Regional Government has instituted laws banning “honour killings”. In late 2008, it established the Directorates to Combat Violence Against Women. “We are working with advocacy groups to persuade people that FGM is part of a spectrum of violence against women”, says Gernholtz.
Osten-Sacken points out that there is support for a bill banning FGM among Kurdish Parliamentarians. He has received assurances that such a motion will be brought to Parliament this year. “This is quite a big issue now”, he explained. The past 5 years in Iraqi Kurdistan have seen the subject move from a taboo to hotly debated topic. “There is a lot of public pressure through newspapers and media channels”, says Osten-Sacken. “Among the young, there is very strong support for abolishing FGM.”
A key constituency is clerics. FGM is not even mentioned in the Koran. Proponents cite a couple of passages from the Hadith (sayings of the Prophet) as providing implicit support. This is a moot point. The authenticity of one Hadith—which recommends but does not require FGM—has been questioned, whereas the other does not really endorse the practice at all. Certainly, this is a debate that the anti-FGM movement hopes to win.
Besides, Osten-Sacken points out that culture and religion are inextricably entwined, and the zeitgeist in Kurdistan is shifting. He stresses the importance of mass public-awareness campaigns. There is widespread access to television in Kurdistan, even in poor areas. “I'd say that if one is taking this subject very seriously, we can eliminate FGM in Iraqi Kurdistan in 5 to 7 years”, Osten-Sacken tells The Lancet.