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06 May 2020Female genital mutilation (FGM) is the partial or total removal of the female external genitalia and is largely perpetuated by harmful cultural norms with lasting adverse impacts on people and communities. Worldwide, 200 million women and girls have undergone FGM; among the victims, 44 million are girls up to 14 years old, and 3.9 million girls are at risk each year. In Sudan, practicing FGM has recently become a crime, with sentences of up to three years in prison. This was announced by the transitional government that took office last year, specifying that the new rules will be in line with a constitutional declaration on rights and freedoms. To find out more, today we interviewed Paola Magni, contact person for the projects to combat FGM of Amref Health Africa in Italy.

What are FGMs?
The term "female genital mutilation" includes all procedures involving the partial or total removal of the external female genitalia. FGMs are forms of gender-based violence and human rights violations, including the right to life, physical integrity, to be free from torture and sexual health. These practices have inadmissible effects on the health of girls and women and on development processes, which compromise girls' ability to self-determine. Such practices strongly damage the mental and physical health of those who suffer them.

In Sudan, female genital mutilation is now a crime. What do you think about it?
In addition to the fundamental internal process, I think that years of pressure and battles, carried out by the international community, by the United Nations, by the European Union, by NGOs and not only, are gradually generating results. To date, rules prohibiting female genital mutilation are in force in about 2/3 of the African countries where the practice is widespread, and the penalties range from three months of imprisonment to life imprisonment. Sudan is one of the states with the highest percentage of mutilated victims, with 87 percent of girls and women between the ages of 15 and 49 undergoing genital mutilation, which is one reason why a government decision to this type can and must be considered a great achievement.

Do you think that one law is enough to put an end to such a widespread and deeply rooted practice?
Unfortunately, it is an identity practice, and I don't think that a law is enough to put an end to FGM. Many times, in history, we have had the opportunity to notice the gap between the existence of a law and its application in the most remote areas. To accompany a law approved by a state, local regulatory plans are needed, aimed at encouraging implementation of the law in question within the counties, regions and rural areas. Furthermore, being a very widespread and deeply rooted practice, the rules that prohibit FGM must be accompanied by training and awareness-raising processes, both within local communities and among those who are part of the legal sector and the police force.

What does the implementation of a law against FGM entail?
There are two main adverse phenomena that could occur on occasions like this. The first concerns the lowering of age. The age at the time of mutilation varies according to the practicing community. According to tradition, FGM is practiced immediately after birth, to small girls, in puberty, immediately before or after marriage or after the first birth. However, in most cases, female genital mutilation is practiced between 0 and 15 years of age. One of the phenomena related to the implementation of a law against FGM concerns the lowering of age at the time of cutting. For example, in Nigeria, tradition often requires that the cut takes place between 3 and 18 months. If, as in the case of Nigeria, mutilation began in Sudan a few months after the birth of the girl, the already low chances of the girls' rebellion against this practice would be canceled. Furthermore, in countries where female genital mutilation has been outlawed, the fear that family members may be prosecuted or accused themselves, as well as social disapproval, can lead many women to deny having been subjected to any kind of mutilation. The second phenomenon that could occur concerns migration between borders. In many cases, on the basis of the rigidity of the law, the possibility of crossing the border and practicing cutting where the law allows, or is less severe, is considered.

What do FGMs involve on a physical level?
The harmful effect of the FGM is immense: in addition to the inhuman pain caused at the time of the "cut", they cause serious and harmful consequences to the mutilated woman, both physical and psychological, both in the short and long term. Some of the immediate physical consequences include bleeding, infections, urinary retention and, in some cases, death following severe post-operative bleeding. In the long term, sexual intercourse is difficult or very painful, and women who undergo "cutting" are forced to face problems and complications during childbirth, which can cause the death of the unborn or newborn baby, and / or the mother. There are also frequent cases of HIV infection. To aggravate the practice itself, are the conditions in which it is performed. In most cases, the environments in which the cut is performed are in anything but aseptic environments and the cut is operated without anesthesia, with non-sterilized instruments, such as razor blades, razors or other sharp objects.

What do FGMs involve on a psychological level?
Unfortunately, the psychological, social, cultural and identity consequences are also many and extremely harmful. An example among many is the fact that the mutilated girl is often forced into a forced marriage at an early age with adult men. Furthermore, the girl or woman in question is, following the cut, forced to abandon any academic path previously undertaken, to devote herself to the domestic outbreak. FGMs are not only a cut of the female external genitalia, but are also a cut of possibilities and of the future.

What is Amref doing to defend girls' sexual and reproductive health?
Sexual and reproductive health is one of the main pillars of Amref's intervention and, for decades, the Organization has been working with communities in Tanzania, Kenya, Ethiopia, Uganda, Malawi, Senegal to combat FGM. In many communities, Amref has worked and works to replace the FGM with Alternative Rites of Passage (ARP), raising awareness among the communities and making them protagonists of their own change, working with the competent governments and ministries. Amref promotes an integrated approach to the fight against FGM by focusing on the whole ecosystem in which this practice thrives, promoting a prevention approach that considers the legal context, community systems, education, health systems, data and research.

What is the "value of the girl" approach?
Women's empowerment is at the heart of Amref's interventions, which in many cases uses an approach aimed at redefining the "value of the girl". Hence the phrase "value of the girl" approach. Amref knows that to change a tradition you have to start by changing the thinking of those who have carried it on for centuries. The redefinition of the "value of the girl" is fundamental to embark on a path of change, which starts from awareness and knowledge. Therefore, Amref promotes an approach aimed at making girls aware of the control of their bodies, what they can become and what their life prospects are. Simultaneously, Amref acts by increasing the offer, so as to ensure that the girls achieve their goals.

What are Amref's plans to combat FGM?
FGMs are a complex ecosystem that includes different spheres (health, social, psychological, legal, identity, cultural), and the Amref Health Africa projects intend to offer appropriate answers for each of them. One of the many projects of Amref, in contrast to FGM and the defense of girls' sexual and reproductive health, is Nice Place Foundation (NPF). NPF is a project born in Kenya in 2019, conceived together with Nice Leng'ete, 27-year-old Amref ambassador who has been carrying on her fight against female circumcision every day for almost twenty years. The project aims to establish a safe place where girls can go when threatened by FGM or by a forced marriage at an early age. The NPF also wants to represent a place where girls can acquire strength and capacity: it will host 50 girls every year (number that could increase over time) and will function as a Reception Center and a Girls Academy under one roof. Here, girls will receive training on life strategies, leadership and entrepreneurial skills, making themselves autonomous and minimizing community addiction syndrome.

What impact is COVID-19 having on FGM?
We at Amref share the vision of a world free from FGM, and we will do everything possible to end the practice by 2030, in line with the Sustainable Development Goals (SDGs). The complication, now that the world is facing the COVID-19 pandemic that we are all aware of, concerns the interruptions and slowdown of FGM prevention projects and programs. According to a UNFPA report, 2 million cases of FGM could therefore occur in the next decade, which would have otherwise been avoided. In addition, COVID-19 is slowing down planned efforts to end early marriages and, beyond the economic consequences, about 13 million early marriages could occur between 2020 and 2030 that would not otherwise have taken place. Finally, the increase in domestic violence should be considered. Indeed, it is estimated that if the lockdown were to continue for another 6 months, it would result in approximately 31 million additional cases of gender-based violence.

The rights of human beings, women and children must be protected and honored, with the aim of protecting the most vulnerable and providing entire communities with the tools to build a better future: hope, change, growth and dignity . Every woman has the right to be free.