U.S. Doc's Specialty Is Women with Cut Genitals

Monday, June 7, 2004

Women who have undergone female genital mutilation can be made to feel like clinical curiosities. But at the African Women's Health Center at Boston's Brigham and Women's Hospital, treatment is delivered with cultural understanding.

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Not only did the women say they wanted a clinic, but they told Nour they wanted it at Brigham and Women's Hospital, "because that is where the rich women went," Nour said. Nour also set up seminars to educate doctors around the country about treating genitally cut women.

Last year, Nour won a MacArthur "genius" award in recognition of her work with survivors of female genital mutilation. She makes no secret of her opposition to the practice.

"I am dedicated to eliminating female genital mutilation," she said.

Right of Passage

Nour grew up in the Sudan, the daughter of two professors. She remembers genital mutilation as "something that happened to the girls I knew in Khartoum." Starting in elementary school, her friends would casually report: "Oh, I got circumcised. Did you?"

Nour's parents opposed the practice. But genital cutting was so common for girls that Nour recalls her 8-year-old sister asking their father, "When is my circumcision?" When he told her she would not have one, her sister cried, Nour said.

"It was something she looked forward to, like a rite of passage," she said. "For me it was a mystery. I wondered why we could do this practice in a country that I loved so much."

No one knows when or where female genital cutting originated, Nour said. No religious doctrine ordains it and the extent to which it is practiced varies from region to region in Africa, she said.

It continues because so many cultures believe their daughters will not get married if they are not cut, Nour said.

"They think that if you want to hold on to her chastity, you circumcise her," she said. "It is done out of love."

Hidden Practice

The mythology around female genital cutting also serves to perpetuate the practice, Nour said. Some groups in Africa believe, for instance, that if a baby's head touches a mother's clitoris, the baby will die, she said. Others say that if the clitoris is not removed, it will continue to grow until it touches the ground.

"To women who have been circumcised, it may be seen as beautiful," she continued. "And if you talk to the majority of women who have been circumcised, they are leading healthy and productive lives, just as their mothers did. They do not want to be seen as victims--and they are not victims. They are very healthy, happy human beings. And they look just like every other woman they know."

Yet the procedure carries risks. Women can bleed to death. They can experience menstrual problems such as heavy monthly flows. Infection is common. Sterility also can result. Sexual pleasure also is compromised.

Nour is convinced that one reason genital cutting continues is that it is so hidden. She thinks attention and education could reduce the practice, and possibly bring it to a halt.

"If you think of how foot-binding ended, it basically stopped overnight," she said. "I think the same could happen here."

Nothing would make her happier, she said, than for her medical specialty to become obsolete: "That is my goal."

Mona, her Somali patient, pledged to help Nour attain that goal.

"I will never do this to my own daughters," Mona said.

Elizabeth Mehren, a writer based in Boston, is the New England bureau chief for the Los Angeles Times.



For more information:

Brigham and Women's Hospital--
African Women's Health Center:

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