(WOMENSENEWS)--On a day she will never forget, Soraya Mire expected to receive a "gift" in her native Somalia. She was only 13 years old and anxiously awaited her mother's promise.
The present turned out to be her worst nightmare. What she saw upon entering the doctor's house was a surgery room. Shock froze every bone in her body, yet she couldn't flee.
"How can you run away when the person who loves you the most--and is supposed to be protecting you--is right there allowing this to happen?" says Mire, who is now 40 and lives in Los Angeles, where she's working on her second feature film about female genital mutilation. "So, at the moment, you say, 'Maybe what she's doing is right.' But then you know that deep down in you, something awful is going to happen."
The pain under local anesthetic was so horrendous that she wanted to die. Infibulation, the extreme form of female genital mutilation, involved removing the entire external genitalia and stitching together the vulva, leaving only a small hole.
Practice Prevalent in Somalia
In Somalia and Sudan, 98 percent of women in Mire's generation were mutilated, most by age 5 because their mothers and grandmothers believed the younger the better, thinking the torture would be easier to forget. Mire's family waited so long because her father, who had seen the suffering inflicted upon his three older daughters, wanted to spare the other three. Her mother, driven by peer pressure, wanted it nonetheless.
Slowly but surely, cultural norms are changing. Although more than 90 percent of girls in Somalia, Egypt and Mali are mutilated, the practice is declining in other countries. In Kenya, only about 40 percent of women are mutilated. Most undergo Type I, which is the partial or total removal of the clitoris, or Type II, which is the removal of the entire clitoris and the cutting of the labia minora.
In northeastern Kenya, where the ethnic groups are the same as those in Somalia, Type III, infibulation, is very prevalent, says Ian Askew, senior associate at the Population Council's office in Nairobi, the country's capital. In other parts of Kenya, Type III is extremely rare, and the past two decades have seen a trend moving from Type II to Type I. More commonly, people are ceasing the practice altogether. Finally, the messages about dire physical and emotional scars are sinking in.
"In the past, a lot of messages were oriented around saying how dangerous it is to people's health," Askew says. "The problem with that is, people will practice a less severe form rather than stopping it. There's far more emphasis these days that it contradicts basic human rights for good health and bodily integrity."
Victims Taken by Surprise
Girls in communities where female genital mutilation is practiced often have no choice. It's a prerequisite to marriage, a rite of passage that renders them viable members of their society. On a chosen day, a circumciser might come to the village, or the girls are brought to a neighboring village for local festivities or traditional celebrations during which the mutilation can occur.
There's often no warning or means of escape, and girls tend to accept the tradition because it's culturally ingrained. However, an increasing number of girls are mobilizing to stop female genital mutilation and rejecting the practice within their communities.
More than an estimated 130 million girls and women around the world have undergone genital mutilation, a practice some say began 5,000 years ago. At least another 2 million are at risk every year. The mutilation, generally performed without anesthetic, may have lifelong health consequences, including chronic infection, severe pain during urination, menstruation, sexual intercourse and childbirth and psychological trauma. Some girls die, often from bleeding or infection.
Female genital mutilation is practiced in at least 28 countries in Africa, as well as in Indonesia, Yemen, in a few communities in other regions of the world and in countries with African immigrant communities. Many countries, including those that take in these immigrants, have outlawed or are working to ban the practice.
Women known as female circumcisers overwhelmingly perform genital mutilation. In Sudan, midwives typically carry out the tradition, and in Egypt, barbers often do it.
"It's a harmful traditional practice," says Taina Bien-Aime, executive director of Equality Now in New York City, which works to protect the human rights of women and girls worldwide. "People sometimes attribute it to religion. It's not mandated by any religion. It's not sanctioned in the Koran or the Bible. It's very important for people to understand that it's a human rights violation."
Coming Up With New Adolescent Rituals
To help end the practice, midwives and traditional healers are encouraged to look into other avenues of generating an income. Also, new adolescent rituals in parts of Africa are replacing mutilation. Ceremonies continue to honor a girl's induction into womanhood, teach her to cook and become a wife and mother, but without the cutting.
In Senegal, a holistic and nondirective education program called Tostan, founded in 1991, has empowered villagers to lead a movement against female genital cutting. A staff of more than 600 Senegalese teach democracy, human rights, hygiene, health and management skills in national languages, said Tostan's director, Molly Melching. Since the first village made a declaration in 1997, 1,271 villages--more than 25 percent of Senegal's practicing communities--have abandoned the cutting.
"Many more declarations are scheduled within the coming five months in all regions, involving many different ethnic groups," Melching says.
Assistance from abroad goes a long way, too. The Godparents Association Inc. takes care of 40 to 50 girls in Uganda each year, says Rebecca Salonen, who coordinates the volunteer organization from her home in Bridgeport, Conn. By writing letters and offering monetary support, men and women of goodwill serve as "godparents" to young women at risk of genital mutilation. For $375, a sponsor provides for a girl's basic needs: medical care, uniforms and school fees.
In some communities, it will be another generation before the practice dies out, activists say. In others, it will take much longer. The shift has happened through grass-roots movements. "Outside pressures and intervention only strengthen people's determination to protect their special traditions, like FGM," Salonen says. "The culture can only be changed from within."
So it's best to make gradual but long-lasting changes. "Society is like a herd of cows," says Marilyn Milos, a registered nurse, founder and executive director of the National Organization of Circumcision Information Resource Centers in the San Francisco Bay area. "The only way to turn the herd is to move the cows, one cow at a time. The herd changes direction when every cow is turned. That's what it takes for society to change."
Susan Kreimer is a Houston-based journalist who specializes in health and medicine.