FGM - what, why & the future
Female genital mutilation (FGM) is a serious health issue that is prevalent in Tanzania. FGM is defined as the deliberate removal or cutting of any part of the female genitalia, for non-medical reasons. Specifically, there are three types of FGM: the first type is defined as a clitoridectomy, in which the clitoris and/or the clitoral hood is removed. The second type involves removing all external genitalia, including the clitoris, clitoral hood, the labia minora, and/or the labia majora. The third type is called infibulation, in which all external genitalia is removed, and the urethra and vagina are sewn shut. This leaves only a small hole for urine and menstrual fluid to pass through; when the woman is ready to have sexual intercourse or give birth, this hole must be cut open. This practice of FGM is a pressing health issue, because it presents both a biomedical and human rights concern. From a medical standpoint, many complications can arise as a result of FGM. For instance, the cutting and sewing of a woman’s genitalia creates a severe risk of infection. Moreover, when the small opening created by infibulation must be cut open for a woman to deliver, this cutting can lead to complications for both the mother and baby. From a human rights perspective, this practice is violating and dehumanizing. It demonstrates a lack of respect for a woman’s reproductive rights, her right to safety, and her right to freedom from torture. Combatting this devastating practice is essential in improving health and gender equality in Tanzania.
These medical complications associated with FGM are not hypothetical—in fact, they are observed in Tanzania on a daily basis. For example, this can be demonstrated by the case of a woman who came into Machame Hospital earlier this month. This patient intended to have a routine vaginal delivery, but unfortunately this was not able to happen. This woman had undergone type 2 FGM, meaning that her clitoris, clitoral hood, and external labia had been removed. Due to her FGM, a normal vaginal delivery was deemed too complicated and dangerous. As a result, this patient was admitted for an emergency C-section. Undergoing this C-section surgery greatly increases her risk for tearing, infection, and poor maternal and child health outcomes. This therefore illustrates the avoidable, yet serious, dangers that women can be subject to if they are forced to undergo FGM.
FGM is practiced in various areas of Tanzania, with the highest rates observed among the Maasai tribe. In Maasai culture, it is believed that FGM marks a rite of passage for a young woman. To the Maasai, FGM makes a woman cleaner, stronger, and more suitable for marriage. This results in FGM being carried out by Maasai fathers, mothers, and grandmothers on their young daughters. The cultural component of this practice is what has allowed FGM to continue so rampantly. For the girls who are subjected to FGM, it is in their interest to stop the practice, although they are often scared or unable to do so. FGM performed on girls below 18 years of age is currently illegal in Tanzania. Therefore, the national government plays a major role in this issue, with the interest of upholding and enforcing this law.
Many sociocultural and political factors have allowed the practice of FGM to be continued. First, FGM is still deeply engrained in Maasai culture. Although the practice causes pain for the girl, it is not considered inhumane in this tribe. Rather, the Maasai believe that after undergoing FGM, a girl emerges as a stronger, more mature woman who is now ready to be married. These beliefs have been passed down for generations and have therefore normalized FGM among Maasai families. This sense of tradition surrounding FGM is what has allowed the practice to be perpetuated. Furthermore, gender inequality still permeates the Maasai culture. In this society, fathers are often feared or revered as the head of the household. This results in young girls feeling too intimidated and frightened to challenge their patriarchs and speak up against FGM. With their fathers as their sole providers, these young girls often have nowhere to turn to escape FGM, further allowing the practice to persist. Additionally, failure to properly uphold national policies has perpetuated the problem. Although it is illegal to perform FGM on minors, this law is not being effectively enforced throughout Tanzania. There is a lack of governmental officials posted in communities where FGM is most commonly observed. As a result, these cases of FGM go unnoticed, unreported, and are thus allowed to continue.
For the Maasai men, performing FGM on their daughters allows them to garner respect and potentially a larger dowry, since it is believed that they have proven their daughters to be the worthiest of marriage. Conversely, young Maasai girls suffer grave losses as a result of FGM. Due to the invasive and painful nature of FGM, these girls can feel stripped of their sexuality, humanity, and dignity. FGM can also result in a loss of sexual sensation, infertility, and even cause severe infection. It is therefore evident that this practice is multifaceted: on one hand, it gives some communities a sense of tradition, yet it also comes with undeniable psychological and medical consequences.
Luckily, there are resources in place to combat FGM. The Network Against Female Genital Mutilation (NAFGEM) is an NGO based in Moshi, aimed at stopping FGM in the Kilimanjaro region of Tanzania. NAFGEM reaches out to communities where FGM is most prevalent, in order to spread awareness regarding the medical and ethical consequences of FGM. Through education and communication with Maasai elders, NAFGEM hopes to change the cultural acceptance surrounding this harmful practice. Moreover, NAFGEM serves as a safe shelter for girls who are most at risk of experiencing FGM. If it becomes clear that the girl is not safe in her community, she can seek shelter at the NAFGEM site until it is deemed safe for her to return home. While staying at NAFGEM, the girls are empowered and encouraged to take a stand against the practice. They are still able to attend school, and also learn skills such as jewelry making, and computer use in order to earn their own income. This type of economic empowerment is a crucial resource: it allows the girls to break free of their community and live their own lives that are free, independent, and safe. By earning capital of their own, these girls now have the funds to run away and start new lives if their own communities become too dangerous. Through these combined efforts of education, sheltering, and empowerment, NAFGEM hopes to improve the lives of women and children, and finally put a stop to FGM in Tanzania.