By Ginger Adams Otis
Sunday, December 7, 2003
Some 2 million women around the world are subject to female genital mutilation every year. Now, a program is set to eradicate the custom in Senegal and is likely to be replicated elsewhere in Africa.
(WOMENSENEWS)--An innovative health and human rights program in Senegal is on the brink of eradicating a centuries-old custom that involves excising large parts of the female genitalia, a custom which can have a debilitating effect on women's reproductive and general health, as well as their overall quality of life.
It's known to most as female genital mutilation, or FGM, and currently some 2 millionwomen around the world are subjected to it everyyear.
Molly Melching is founder and director of Tostan, a nongovernmental organization based in the capital city of Dakar that has played a crucial role in informing Senegalese about the dangers of genital mutilation. Soon, her innovative programs will be available to other health workers and community leaders.
Melching's staff is putting the final touches on a new training center--scheduled to open in January or February--that will teach other organizations how to use Tostan's methodology in the fight against FGM. Their goal for the first year is to work with Gambia, Burkina Faso, Guinea Bissau, and Guinea. Many organizations in Africa are already asking for or have gotten help from Melching, including groups in Sudan. Recently the World Health Organization recognized the groundbreaking work of Tostan and called for its replication and dissemination throughout Africa.
Nobody's more surprised by the success of Tostan's programs than Melching herself, because by her own admission, she never set out to eradicate female genital mutilation.
"I don't endorse this practice," the Danville, Ill., native says, "but Tostan respects all cultures equally. We never went into villages and said 'That's bad. Stop it.'"
Instead, Melching says, her program initially set out to educate women in basic health and human rights issues. Instructors used song, dance and theater as teaching methods because most women in Senegal have little formal schooling. Tostan students learned the basics of hygiene, preventative health care, problem solving and democracy. Then, in more advanced classes, women were taught writing, reading and arithmetic with direct applications such as writing newspaper articles and campaign speeches.
Melching believes these classes, taught around the country for more than two decades and always in indigenous languages by local instructors, laid the foundation for change that came later when she developed a series of classes that almost overnight changed the way many Senegalese viewed FGM.
"I recently went to a gathering of (nongovernmental organizations) in Egypt," says Melching "and one woman I spoke to said she thinks it will be another hundred years before female cutting disappears from Egypt. A hundred years! We think it could be gone from Senegal in the next two to five years."
In 1995, Melching was approached by the American Jewish World Service, a nonprofit based in New York City that partners with grassroots organizations engaged in education, community building, health care, agriculture reform and economic development, and initiates projects to alleviate poverty. The organization offered to fund a child development program in Senegal, but when Melching began to gather research on the project, she discovered many women had other questions in mind.
She began to talk to women about what they most wanted to learn and they all had inquiries about their own bodies, about things like menstruation and sexually transmitted diseases, Melching says. "I realized a lot of them had never had a reproductive health class and had no information about how their own bodies worked. She recommended the American Jewish World Service that the project should be focused on remedying women's lack on information before taking on child development.
The organization gave Melching and her staff free rein, and before long a health module was drawn up and ready for implementation. Then, Tostan decided to add a human rights dimension. Even though Melching didn't add it with the goal of ending FGM in mind, she believes that's what changed the way local women viewed their right (and the right of their daughters) to physical integrity.
"We made absolutely sure that there was never any negative mention of female genital cutting in any of these classes," says Melching, "but we did explain certain health factors, and many women did come to understand that their chronic pain, for example, was actually linked to the cutting they'd had as a child."
Women also began to understand the link between the practice and the strange fevers that often visited their daughters days after the ceremony, fevers caused by infections that wear down otherwise healthy young girls and sometimes end their lives. As women gained more knowledge about female anatomy, more and more of them came to question the need for FGM.
The exact origin of the tradition is unknown. Some researchers speculate it's tied to an ancient Egyptian ritual from the 5th century B.C. One thing is clear: It predates the arrival of Christianity and Islam in Africa, despite the insistence of some fundamentalist Islamic leaders that the Koran demands that women be cut.
The first sign of a major shift in Senegalese thinking came in 1997, when a group of woman in Malicounda Bambara (population 3,000), located in the center of the country, made a public declaration--in writing--that they would no longer cut girls or women. Since then, more than 1,140 communities have done the same after participating in a Tostan education program. In 2000, the president of Senegal prevailed in passing a law that outlawed all forms of FGM. Currently, there are about 4,000 Senegalese villages out of 13,000 that still practice FGM, but that number is dwindling every day.
"We're extremely proud of Tostan," says Ronni Strongin, a spokesperson for the American Jewish World Service." But we never expected this to amount to what has happened with female genital mutilation there. It happened as a result of the health and human rights decisions made by the communities themselves."
Despite the strides forward in Senegal, pressure on girls and women to go through the process is intense in many parts of the world. The World Health Organization reports that more than 130 million girls and women in Africa have undergone this practice, often seen as a rite of passage from childhood into adulthood. FGM is usually performed by a traditional "cutter" in non-sterile surroundings with the girl forcibly restrained. Cutters use razor blades, knives (in some cases specially designed for the practice) and pieces of glass or scissors.
Forms of FGM range from cauterizing the clitoris, partial or full excision of the clitoris and labia minora, and in the most extreme cases, excision of part or all of the external genitalia and stitching or narrowing of the vaginal opening, also known as infibulation. In many cases, the vaginal opening is reduced to the size of a matchstick and the resulting build up of menstrual fluid inevitably causes ongoing infections. Women who undergo infibulation often must be cut open the first time they have sex and again to give birth.
In Ethiopia, where 85 percent of the population practices FGM (and most commonly infibulation), health workers report that higher-than-average numbers of women suffer from kidney problems and urinary infections. Ethiopia also has an extremely high maternal death rate. Tilahun Giday, a member of Watertown, Mass-based Pathfinder International, a nongovernmental organization working to improve women's rights in 23 countries in Africa, Asia and Latin America, says the legs of young girls have to be tied down for about a month to allow the body time to heal.
Giday's group has not had the same kind of success as Tostan in eradicating FGM, but he is one of many health workers planning to send staff members to Melching for training. Already, Melching has helped train instructors from Mali, Nigeria, Burkina Faso and several other African countries.
For Melching, the cultural transformation in Senegal her classes have engendered is exactly what she hoped to achieve 30 years ago, when she started Tostan.
"I chose that name because it's a Wolof word for something that simultaneously breaks open and spreads, like the cracking of an egg," she explains.
Ginger Adams Otis is a Pacifica Radio correspondent and frequent contributor to The Village Voice.