It happens at night: Genital mutilation in Egypt

Despite being legally banned, female genital mutilation in Egypt is on the rise, causing lifelong pains, health problems and even death for the women who undergo it. Islamists are pushing to legalize the procedure again.

Umm Mohamed lives in a part of Cairo where others dump their garbage. The 47-year-old Muslim woman has experienced many hardships in her life. Putting on a brave face, she says she is used to being daily surrounded by dirt and misery. But what really hurts, she admits, is the pain she personally had to endure 35 years ago.

When Mohamed was 12, nearly all parents from the quarter where she lived brought their daughters of the same age to a hair dresser. "We didn't know why," she says, "but we were all very excited, as each girl had just been given a new, white dress."

In celebration of the day, the girls' hands had been painted with henna. They were ever so proud. But then came the moment of shock: "Suddenly this man, who was really a stranger to us, started to undress us," she recalls. "Then he got out his razor blade." All the girls underwent the procedure which mutilated them for life - without narcotics and without even minimal hygene standards.

'How can my family do this to me?'

Mohamed bled for three days. When it didn't stop, her father went to the local baker for some ashes to cover up the wound. But the dirt only made everything worse. "I still remember asking myself how my family could do this to me," Mohamed says, tears clouding her eyes. Another girl from her neighbourhood, she adds, even died after the procedure.

And that girl was hardly alone. As the number of deaths rose, Egypt banned female genital mutilation (FGM) by law in 2008. Medical practitioners and midwives, who traditionally perform the procedure in the countryside, now do so at the risk of imprisonment. Issuing an Islamic legal opinion, a so-called fatwa, Egypt's Grand Mufti has also clarified that female genital mutilation is against the Islamic value system.

Female genital mutilation now for twice the money

But since the revolution, Umm Mohamed says she has seen a new increase in female genital mutilations.

During the Mubarak regime people used to fear punishment, but these days the medical practitioners in her quarter don't even bother to hide their actions any more: "During the day, they circumcise little boys, and the girls they do at night for twice the money," Mohamed says angrily. "Everybody knows this."

Mustering her courage as a simple woman, Mohamed went to the police station to make a report. "But the officers told me that they had other things to worry about," says the mother of three, who was able to save her own daughter the painful mutilation.

Umm Mohamed openly addresses what for most Egyptian woman is a taboo: Most victims live in chronic pain and have problems with their sexuality, and they also face serious health problems both during pregnancy and giving birth.

Omayma Idris, a Cairo-based gynaecologist, says that more than 90 percent of all married Egyptians today are thought to have undergone mutilation. After the prohibition, she says, one could see a decline, "but since the Muslim Brotherhood and other Islamists are in power in Egypt, the numbers are on the rise again; they encourage families to do it again."

Not even the deeply religious Muslims in Saudi Arabia mutilate girls and women, she adds.

Islamists push for legalization

Salafists and representatives of the Muslim Brotherhood - the political home of Egypt's President Mohamed Mursi - want to see female genital mutilation legalized again. Their push for legalization alerted the German advocacy group for women's rights, Terre des Femmes, which collected 12,000 signatures against the practice in Egypt.

The group presented the signatures together with a petition to the Egyptian ambassador in Berlin at the beginning of November.

In several places around the country, Islamists have already created precedents, according to Mervat Tallawy, president of the National Women's Council for Egypt. A few weeks ago, she learned about the Muslim Brotherhood using buses as mobile clinics in the rural Minia province.

"The mutilation of girls had been offered as a sort of health service, free of charge," Tallawy says. And the buses, she adds, had stickers with the logo of the "Party for Freedom and Justice" - the political branch of the Muslim Brotherhood.

Following the incident, the National Women's Council contacted the local governor and the Ministry of Health in Cairo. But a spokesperson of the Muslim Brotherhood flatly denied all charges and, in turn, accused the villagers of misusing the logo.

Tallawy laughs bitterly laugh about that. Villagers, she says, lead very simple lives and many can barely read. She doesn't think they're capable of such forgery. But what she does believe to be more likely is that the Muslim Brotherhood is funding illegal mutilation procedures in the countryside.

"That's child abuse and a barbaric act," Tallawy says with disgust. "But as long as the Egyptian president doesn't explicitly condemn such actions, the fundamentalists are going to carry on and lead us back into the Middle Ages. I have no idea where their hatred for women comes from."

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Women Expose Secret Genital Cutting Rite

"It was a dark and dingy room, where an elderly woman asked me to take off my panties, made me sit on a low wooden stool with my legs parted and then did something…I screamed out in pain," recalls Alefia Mustansir, 40, of her childhood experience.

Her friend, Sakina Haider, remembers "putting up a good fight" before she succumbed. "I was told by my grandmother that I was being taken to the doctor to address burning in the genital area when soap went there while bathing!"

Both Haider and Mustansir have refused to have their daughters undergo circumcision or female genital mutilation/cutting (FGM/C), the Dawoodi Bohras’ best-kept secret until young women from the community first began to speak up against it a few years ago.

Bohras, a sub-sect of Ismaili Shia Muslims, are a tight-knit community, with a majority residing in India and Pakistan, and estimated to number two million the world over.

An article in the Dec. 12 issue of the popular Indian weekly ‘Outlook’ says: "Khatna (circumcision) is a tradition the Bohras trace back to their origins in (north) Africa, one they continue with because they see this as an attempt to stay true to their faith."

The Outlook article goes on to say that "most Bohra women and men even today would rather keep this practice a secret rather than question a custom that is now universally seen as a gross violation of a woman’s body."

The World Health Organisation defines FGM/C as a procedure that "intentionally alters or injures female genital organs for non-medical reasons." FGM/C, as practiced in some African countries, may involve removal of the entire clitoris and labia.

The practice persists in 28 African countries, as well as in some Middle Eastern countries with varying degrees of cutting or mutilation. African countries that have banned it include Burkina Faso, Central African Republic, Djibouti, Eritrea, Ethiopia, Togo, Uganda, Kenya and Egypt.

Bohras insist that their practice is not harmful since it is done with care and moderation. Many justify it as a means to curb a woman’s sexual drive and keep her chaste.

Haider finds that argument "highly problematic" and sees it as a way of controlling women.

Dr. Nighat Shah, former president of the Society of Obstetricians and Gynaecologists in Pakistan, finds it hard to believe that a community as "progressive and educated" as the Bohras carries out this practice.

"Medically speaking," she explained, "a little snip or clip (of the clitoris) may not affect childbirth, but it may rob the woman of sexual pleasure. It is a very sensitive tissue."

Another gynaecologist and obstetrician, Dr. Shershah Syed, finds no medical benefit to support female circumcision. "I am no religious scholar, so if a community believes it is an Islamic injunction, I’d suggest the girls should at least be old enough to understand the reason so that they can make an informed decision."

"Why do women’s sexual drives have to be curbed?" Haider asks. "Women who are not circumcised are not necessarily promiscuous!" she says.

A young Indian girl belonging to this Muslim sect, who goes by the name of Tasleem, has now found the courage to initiate an online petition asking the community’s high priest, Dr. Syedna Mohammad Burhanuddin, to have this "cruel, inhuman and undemocratic ritual" stopped.

The petition addressed to the 96-year-old prelate, who is based in the western Indian city of Mumbai, states: "Such a barbaric ritual has no place in a progressive community like the Bohras. So we pray to His Holiness to stop this misogynist ritual." Mustansir and Haider are in a minority among Bohra women who refuse to accept the practice. Most still get their daughters circumcised because it is an order from the community’s high priest.

"I have blind faith in my leader. I believe there must be some goodness in this that there is so much insistence," said Zahabia Mohammad, 38, mother of three circumcised daughters.

Mohammad conceded that her own experience was "gross" and "barbaric", but justifies its continuation because "it is done in a very safe manner today by doctors."

She was present for all of her daughters’ circumcisions. "It takes less than five minutes and the procedure is done under local anaesthesia. Just a very minute bit of the clitoris is clipped off," she said.

She acknowledged she had little information on the rite except what was told her by an aunt "that the foreskin of the clitoris is unclean and circumcision is for the benefit of the women."

She also concedes that today, with a deluge of information circulating against this practice, it is imperative to equip the community with information to enable them to make informed decisions.

"Not everyone will accept this blindly, not the next generation. They will question and prod, so it is important to prepare them," she says of a rite that is kept secret from male members of the sect.

Tasleem told Outlook that genital cutting happens in all strata of Bohra society. "I’d say 90 percent practise it."

Arwa Mohammad, who is in her 20s, signed the petition because "it’s archaic and nonsensical." She was circumcised when she was seven by her grandmother’s doctor friend. "Just goes to show how this ritual perpetuates without anyone questioning!"

Married a year back, Mohammad was "not traumatised" for life for getting circumcised, but cannot comprehend the reason still. "I have friends who have been circumcised like me but have a high sex drive. On the other hand, she admits to "frigidity" in bed.

"The thought of snipping off a bit of a young child’s clitoris gives me the goosebumps," said 37-year-old uncircumcised Amena Ali. She refuses to put her two daughters, aged six and eight - considered the right age band for circumcision - under the blade.

The petition, put up last October, has opened an animated forum for discussion on both sides of the border, perhaps for the very first time, within the community on a subject that was taboo.

"Initially, only the non-Bohras were signing, but once the media got into the act, many women from the community openly began talking about their painful experience," Tasleem told IPS in an email exchange from India.

So far, Tasleem has been able to collect 1,059 signatures. "I will keep this going till Dr. Syedna bans it. Raising awareness is the first step towards solving the problem."

"Whether the ritual will be abolished by this petition, only time will tell," says Zainab Hussain, 49, but she feels the petition will make a difference. "They (community leaders) may eventually break their silence and give a plausible answer."
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NHS urged to offer circumcisions to avoid botched operations

Senior doctors have called for male circumcision to be offered by the NHS amid fears that unregulated operations are leading to serious injuries among Muslim boys.

A number of public health specialists have urged the health service to overturn its ban on such operations after an investigation into circumcisions performed at an Islamic school in Oxford found that 13 out of 32 boys who had the procedure – at an average age of six – ended up with medical problems.

Three endured what a new research paper describes as "incomplete circumcision" at the hands of an overseas-qualified doctor who only had six months of basic surgical training. They also ended up with urethral scarring or a haematoma – a build up of blood that results from internal bleeding – or both. Six had to be treated in hospital for complications related to their circumcision, and two had to undergo the procedure for a second time. Ten of the 13 needed to take a course of antibiotics.

Writing in the UK Faculty of Public Health's Journal of Public Health, the study's co-authors, Dr Karthikeyan Paranthaman and two fellow public health doctors in Oxford, concluded: "This incident highlights the harm associated with circumcision in young children by unregulated operators due to lack of compliance with best surgical and infection control guidance. There is an urgent need for commissioning circumcision services for religious reasons in the NHS."

In 2006 the three specialists undertook an inquiry for the Thames Valley Health Protection Unit into unregulated circumcisions after an Oxford GP alerted them to a young patient. The procedures were carried out in the library of a faith school, they discovered. They listed a series of concerns about the way the operations were carried out.

They wrote: "All the children in this incident underwent the procedure under local anaesthesia, which is considered suitable only for newborns and infants. The use of physical force to hold the distressed child down [by one of their parents and an 'assistant nurse'] during the procedure, the absence of resuscitation training and equipment, [and] lack of follow-up care indicated the unacceptable standards of care.

"The appropriateness of the facility for conducting surgical procedures, inadequate decontamination of equipment and unsafe disposal of clinical waste were other significant issues of concern," they wrote. The General Medical Council banned the doctor involved from performing more circumcisions after it learned of the harm done to the boys.

The Oxford case was not an isolated incident, however. Tower Hamlets Primary Care Trust in east London began offering the operation to families who sought it for religious and cultural reasons in 2005 after some children were harmed in non-NHS procedures. "It was set up due to community need, and also to counter occasional children presenting at local accident and emergency departments with infections and other problems associated with unregulated operations," said trust spokesman Tim Carter.

The boys of parents who are registered with a GP in the borough can have the operation when they are aged between six weeks and five months. Parents are charged £120-£150. More than 900 boys have been circumcised by the Trust since the service began five years ago.

Most Jewish boys are also circumcised, without anaesthetic, usually when they are eight days old. Procedures are conducted by a "mohel" who, according to the Board of Deputies of British Jews, "is required to be a committed Jew and is very often a qualified doctor as well".

The mohel's duties "demand the highest standards of ethics, religious practice and surgical skills, including strict hygiene", the board says. It describes circumcision, or brit milah in Hebrew, as "the primary symbol of Jewishness for men". It reports no problems arising from the operations.

The Department of Health said it was not going to change its policy, despite the evidence of some boys suffering medical damage as a result of unregulated circumcisions. "On the NHS, circumcision should be carried out only for medical reasons," a spokeswoman said. "However, PCTs are responsible for commissioning services to meet the health needs of local communities. In some areas, particularly where they feel children are at risk from unsafe procedures, PCTs do work with local providers and communities to ensure that a safe and affordable service is available."

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