By Fuambai Ahmadu,USA.
I am not surprised that the women of Kailahun have taken to the streets to protest what is now becoming a brazen attack by anti-FGM activists against female initiation and excision in Sierra Leone.
As a Sierra Leonean/American scholar who has devoted the past fifteen years to the research and study of the symbolic and cultural meanings of both female and male initiation practices in West Africa, I have witnessed first-hand the proliferation (and invidiousness) of this alarming multi-million dollar “development” industry, financed largely by western countries and international agencies such as UNICEF, WHO, UNFPA and so on.
Faced with a global media onslaught depicting the most insidious and racist types of representations of African men and women witnessed since colonial times and the downright force of anti-FGM campaigns to shame, more and more circumcised African women have come to see and define themselves through these media lenses as “mutilated”. With utter disregard for differences in cultural, social, and historical contexts and experiences of womanhood, the bodies of circumcised African women are measured and devalued (by anti-FGM activists and increasingly by our own women) against a Euroamerican universal prototype.
Among the reasons for this global action against female circumcision is purportedly the protection of the health and well-being of girls and women. As some researchers have been debating for the past three months now in the New York Times (Tierneylab blog) much of this so-called medical evidence is based on media/activist hyperbole often dramatized by horrific anecdotes and video clips of seemingly hapless girls being held down “against their will”. The anti-FGM movement is given further weight and justification by the highly publicized, sensational, usually ghost-written best-sellers of individual African women who recount their trauma of “mutilation” and victimization as “child brides” traded for cattle and the like; their lurid individual experiences are made to typify those of all circumcised girls and women.
However, most reliable, independent studies show that there are hardly any notable long-term health differences between uncircumcised and circumcised women, especially those who have undergone excision, which is the practice most prevalent in Sierra Leone. Here, I refer to the important works of Carla Obermeyer, an epidemiologist and anthropologist, who challenged the scientific rigor of most studies of female circumcision in her exhaustive reviews of the existing literature.
Another important study was conducted by medical researchers at the Medical Research Council in The Gambia. According to a recent commentary by Rick Shweder, an anthropologist at the University of Chicago, the Morison et al Gambia study systematically compared circumcised with uncircumcised women. More than 1,100 women (ages fifteen to fifty-four) from three ethnic groups (Mandinka, Wolof, and Fula) were interviewed and also given gynecological examinations and laboratory tests. Overall, the study found no significant differences between circumcised and uncircumcised women concerning the prevalence of specific reproductive and sexual health problems. Forty-three percent of uncircumcised women reported menstrual health problems compared with 33% for circumcised women but the difference was not statistically significant.
Fifty six percent of women who were uncircumcised had a damaged perineum compared to 62% for circumcised women, but again the difference was not statistically significant. There were a small number of statistically significant differences - slightly more syphilis among uncircumcised women and a slightly higher level of herpes and one particular kind of bacterial infection among circumcised women. No dramatic differences that warrant the type of claims made by anti-FGM activists.
Two Sweden-based studies led by medical doctor Birgitta Essen further challenge any link between the “most extreme” form of female genital modification, infibulation, and prolonged labor and between infibulation and perinatal mortality. These studies are particularly relevant because they demonstrate that when circumcised African women have access to high standard or first-rate medical care they are no more likely to experience long-term obstetrical problems than their uncircumcised counterparts. Further, an Italian gynecologist, Lucrezia Catania, has also conducted studies on sexuality among infibulated women: in one study, the Somali women in her sample reported more experiences of orgasms than her control group - uncircumcised Italian women (with a different cultural background but fully comparable in all other characteristics).
Despite all this brow-raising evidence contradicting received information about female circumcision and long-term health consequences, only a single study, which happens to be one that was funded, designed and implemented by WHO and published in the Lancet has gained widespread or global publicity. Despite the serious methodological concerns of this study, its dubious findings are now heralded by anti-FGM activists as their post-facto justification for WHO intervention and policies to abolish FGM worldwide. Shweder has also questioned the findings of this study:
“not a single statistically significant difference was found between those who had ‘type 1’ genital surgery versus no surgery; no statistically significant difference between those who had types 1,2, and 3 genital surgeries for the best predictor of infant health, namely birth weight; the perinatal death rate for the actual women in the sample who had ‘type 3’ surgery was in fact lower... than those who had no surgery at all and only became statistically significant in a negative direction through non-transparent statistical manipulation of the data; the study collected data on women across six nations but never displayed the within nation results; there was no direct control for the quality of health care available for circumcised versus uncircumcised women; the sample was unrepresentative of the whole population, and in general any increased risk of genital surgery was astonishingly small and hardly a mandate for an eradication rather than a public health program”.
Certainly and regrettably, Sierra Leone has one of the highest infant and maternal mortality rates in the world. The country has also recently emerged from a protracted civil war that has left much of its already limited social and physical infrastructure utterly devastated. It is poverty - i.e. lack of access to resources, clean water, good sanitation, health centers (I recently read that there were about four practicing ob-gyn doctors in the entire country), medicines, the prevalence of malnutrition, diseases such as malaria and high rates of pre-eclampsia in pregnant women - that is the leading cause of maternal and child mortality and morbidity in the country.
It is disingenuous at the very least and an outrageous travesty for development agencies supposedly concerned about the welfare of children and women to suggest, without one iota of medical or scientific evidence from the country, that it is “FGM” and other “harmful traditional practices” that are the cause of these intractable and deplorable health problems facing Sierra Leone. Such attempts to deflect attention away from the actions and policies of previous irresponsible governments as well as endemic structural inequalities in international economic systems and practices (in which diamond rich countries like Sierra Leone are pillaged to meet the insatiable demand of consumers in Western countries) result only in the further division of Africans, and in this case, African women.
For sure, there are some circumcised African women who are against the practice and have their own reasons for it, which should be respected and, in my opinion, legally protected. There are several women in my family who have not undergone initiation and have no plans to have their daughters initiated. Case closed. Nonetheless, the vast majority of circumcised women (as well as men) in Sierra Leone and across the African sub-Sahara belt support their cultural traditions as well as the aesthetics of their bodily modifications. These women’s traditions are celebrated in parallel with male initiation and circumcision rituals and are important expressions of womanhood and female empowerment.
I have written about the differences (as well as similarities) between western cultural interpretations of female sexuality and the symbolic/psychological meanings associated with the external clitoris noting that these meanings have nothing to do with its actual biological functioning in sexual pleasure and orgasm in women. So, while it is understandable given the influence of Freudian interpretations of female infantile sexuality as “passive” and “castrated” that western feminists overtly and implicitly assert the clitoris as symbolic of women’s sexual autonomy, it does not follow that excision of the external clitoris leads to actual or physiological sexual “castration”. Most studies indicate that many circumcised women enjoy sex and experience orgasms. Some do not, but then again many uncircumcised women do not enjoy sex or experience orgasms, despite their clitoris being “intact”.
While I do not deny the freedom of anti-FGM campaigners to attempt to dissuade women to abandon a practice they perceive as harmful or morally objectionable, I must stress that there ought to be some respect and sensitivity to Sierra Leonean women and our culture. The term FGM is offensive, divisive, demeaning, inflammatory and absolutely unnecessary!! As black Africans most of us would never permit anyone to call us by the term “nigger” or “kaffir” in reference to our second-class racial status or in attempts to redress racial inequalities, so initiated Sierra Leonean women (and all circumcised women for that matter) must reject the use of the term “mutilation” to define us and demean our bodies, even as some of us are or fight against the practice. For those Sierra Leonean women who see themselves and wish to define their genitals as “mutilated” they are welcome to do so in private or among those who are like-minded; there are many African-Americans who refer to themselves and each other as “niggers”. For those of us who take pride in our culture, our ethnicity, and our female ancestors, which Bondo represents, we must continue to stand up for ourselves and defy any attempt by others, however powerful they may be, to rewrite their own histories onto our bodies, to negate our particularities as they universalize their own.
When donor agencies use the media to conflate the horrors of sexual violence against innocent girls and women in the aftermath of our war-torn country with the practices of female initiation, it is our duty to educate them that before the various western women’s movements existed, before the all-powerful National Organization of Women, our Bondo ancestors stood against sexual violence and all forms of sexual insult and molestation of girls and women within our various ethnic groups. When our western feminist sisters and activists come into the country and represent us to their audiences as sexually “mutilated” and “castrated” it is up to us to re-educate them about the female sexual anatomy they presume to know so much about: the bulk of the clitoris is beneath the vaginal surface and along with other parts of the genitals and other areas of women’s bodies remain very sensitive and perfectly functioning for most women after excision.
But, even more important, we need to demand of our Government and the international community, not special treatment, but equal rights with other adult men and women the world over. We must demand to know why all sorts of “medically unnecessary” genital surgeries performed on white (or black) well-to-do women in western countries are called “cosmetic” procedures but African women are supposedly subjected to “mutilation” (by the ubiquitous, all-powerful specter of patriarchy). We must demand to know why there is international outrage against the circumcision of African girls yet the circumcision of boys, even under comparable circumstances, continues and moreover is officially encouraged by WHO. What form of patriarchy in Africa competes with the infantilization of circumcised African women by the more militant of our western(ized) feminist sisters who, ignoring their own questionable “cosmetic” practices and hegemonic motives, purport to know better than us what is for our own good. To the Bondo warriors of Kailahun, congratulations for standing up - yet we do have our work cut out for us!
Dr.Fuambai Ahmadu(photo), is Associate professor at the Department of Comparative Human Development, University of Chicago.