The Practice of Female Genital Mutilation- Challenges for Health Communicators.
Today's human rights violations are the causes of tomorrow's conflicts- Mary Robinson (former United Nations High Commissioner for Human Rights)
In Africa a businessman buys a child for a paltry sum, in Asia a baby is sexually abused, in an Oriental country, a toddler dies of neglect and starvation in an orphanage. A comon thread runs through all the scenarios painted above. All the victims are girls and by virtue of their gender, they were considered dispensable.
In many societies, a greater value is placed on boys and girls are not to be taken seriously because they will be married off and will not take care of aged parents or continue the family name. Indeed as an old Asian saying puts it: "raising a girl is like watering a plant in your neighbour's garden".
Other statistics show the unhealty relationship that exists among the genders. Take for instance a United Nations report which indicates that of the 1.3 billion who live in dire poverty, 70% are women. Another report shows that 40% of young women in African and Southern and Western Asia are illiterate. In some countries, twice as many boys as girls are brought to health centres. Little wonder poverty increasingly has a woman's face, leading to such terms as "the feminisation of poverty". Former UNICEF ambassador Audrey Hepburn decried the "dreadful apartheid of gender going on in the developing world."
History is replete with cases of violence against women. From Adam who openly blamed his wife Eve for his disobedience to the man who batters his wife in the comfort of his home. Many share the sentiments of Aristotle who contended that a woman is an unfinished man and therefore stands on a lower plane of development.
Early on in the 20th Century the founding fathers of the United Nations recognized the need to preserve the rights of all humans and presented the 1948 Universal Declaration of Human Rights and in 1950 called on all member states to commemorate World Human Rights day on December 10.
Today marks the World Human Rights Day and has as its theme: "Human Rights Defenders Act to End Discrimination". The day celebrates human rights defenders many of whom are not famous and empowers a new generation to speak up and defend cases of human rights abuse.
I have chosen to remember this day by writing about a form of abuse which largely goes unnoticed both in national and international media-the Practice of Female Genital Mutilation (FGM). Hopefully this will provoke discussions which in turn may someday contribute to an unbiased planet where people can take decisions within the bounds of the rule of law.
Granted, there has been a lot of debate as to what precisely constitutes human rights. A generally accepted definition is thus summed up by Wikipedia the online encyclopaedia:" Rights and freedoms to which all humans are entitled". By this definition, everyone is endowed with some entitlements by reason of being human.
This write-up is not intended to continue the feminist debate that has turned into an intellectual warfare. It is rather based on the fact that FGM has been proven to be a gross violation of a woman's right and has attendant implications on the physical, emotional and psychological welfare of the woman/girl-child. Some of the infringed rights include:
- Right to physical and mental integrity
- Right to highest attainable standard of health
- Right to be free from all forms of discrimination against women (including violence against women)
- Right to freedom from torture or cruel, inhuman or degrading treatment
- Rights of the child, and
- Right to life
What though is FGM? Why has the practice refused to fizzle out in Nigeria in spite of the legal instruments outlawing it? What challenges do health communicators face with regards to orienting people about the human rights abuses inherent in the practice? Most importantly how can you help in wiping out any vestige of this harmful practice?
In 1994, the World Health Organization (WHO) convened a group of experts to reach a standardized definition of FGM. They defined the practice as "all procedures which involve partial or total removal of the external female genitalia and/or injury to the female genital organs whether for cultural or any other non-therapeutic reasons." They further classified the practice into four types.
Type I: Removal of the prepuce or hood of clitoris and or all part of the clitoris itself.
Type II: Removal of clitoris along with partial or total excision of labia minora.
Type III: Removal of clitoris, labia minora and adjacent medial part of labia majora and stitching of vaginal opening, leaving an opening the size of a pinhead to allow for the flow of menstrual blood and urine; a very severe form also known as infibulations
Type IV: Unclassified; includes pricking, piercing or incisions on the clitoris and/or labia, cauterization of burning of clitoris and surrounding tissues, scraping of the vaginal orifice or cutting of the vagina and other procedure which falls under the definitions of FGM above.
Statistics from Amnesty International show that about 135 million women worldwide have been subjected to the practice and yearly 3 million girls and women are mutilated which represents 8,000 girls per day. According to a World Health Organization (WHO) report, in Nigeria an estimated 30,625 women and girls have undergone at least one form of FGM. Various reasons advanced for the practice include preserving virginity, therapeutic reasons, peer pressure, religion and tradition.
For the records, the Convention on the Elimination of all forms of Discrimination against Women (CEDAW) has classified FGM as a harmful traditional practice which represents one of the most serious forms of violence against women. Our country Nigeria ratified that convention in 1985. CEDAW requires that all parties take necessary measures to modify or abolish customs and practices that affront the dignity of women.
Further the 1999 constitution of the Federal Republic of Nigeria states: "no person shall be subjected to torture or inhuman or degrading treatment". To be sure FGM is a serious form of torture as can be seen from the trauma experienced by some on whom it is performed. In fact just viewing some slides of mutilated females tortures your psyche. Other legal instruments that put FGM in a bad light or condemn it outright have been passed at various levels.
Experts show that the physical and psychological effect of the practice are very extensive affecting the reproductive and mental well-being of circumcised women including pain, shock, bleeding, acute urine retention, risk of blood borne diseases, and in the long term recurrent urinary tract infection, sexual dysfunction, Vesico-vaginal Fistula and keloid scars. So much on the effects of FGM!
It is not enough to feel pity for victims of FGM or to pass laws that challenge cherished customs. Here in lies the role of health communication. Direct communication that challenges existing attitudes tends to be less influential. Indeed as argued by dissonance theorists, when confronted by new or conflicting information, we experience some kind of mental discomfort, a dissonance. Resultantly, we try to reduce that discomfort through three interrelated selective processes. These processes help us sieve what information we consume, remember and interpret in personally important ways.
On the other hand persuasive communication works better because people can reach a conclusion on their own. Here lies a great challenge for health communicators who must take the time to reason with people on the dangers inherent in the practice. Since FGM is cherished and even celebrated in some parts of Nigeria, any change in behaviour must start with a change of values; a gradual re-orienting of the mind set. For instance a common reason advanced for the practice is that it prevents promiscuity. An alternative value which could be discussed with perpetrators is the importance of sound moral upbringing. A simple logic like this could be advanced: "would you cut off your child's hands just because you do not want her to steal? Not likely. Would you not rather teach her to avoid stealing?" This perhaps could make people reach a logical conclusion without being coerced.
Alternative rites of passages that have the same symbolic significance like FGM should be introduced.
More media messages should be directed towards the elimination of FGM. Has anyone heard any mention of it lately? Not likely. This therefore is a wake-up call to media experts particularly health communicators. All forms of the mass media should be employed to re-orient the mind set of all concerned especially those who advance it.
Further inter-personal communication and small group communication should be employed since some may not be keen users of conventional media. The topic should be discussed with family and friends in order to mobilize more forces to stop the practice.
Support should also be given to organisations that are committed to the fight. That way those affected as well as those at risk will be helped. It will help also in the re-orienting of those responsible for the practice.
Alternative sources of income should also be given to FGM practioners since the practice constitutes a major source of income in some areas.
An FGM committee could be set up to include circumcisers, religious leaders, community heads, health workers and victims. These will be educating on ways to spearhead the campaign against FGM and will naturally have a good following since they are considered opinion leaders.
In these ways, human rights defenders will take the campaign a step further and hopefully see results for their selfless service to humanity.
Nora Ubek
Lagos, Nigeria
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