MIDIRS Essence > January 2010 > Midwifery News

Secret, sacred and unsafe

Originally posted on Jan 2010

Award-winning photographer and film-maker, Nancy Durrell McKenna, untangles the complex thread of issues, viewpoints and justifications for female genital mutilation (FGM).

When Zahara was 15, she was forced to marry her first cousin. It was decreed in the system of ‘absuma’, where according to strict traditional principles a girl has to marry her cousin. Zahara endured nights of agony, heard by the villagers, until her husband succeeded in penetrating her. She had been infibulated as a girl.

I met Zahara during the filming of The Cutting Tradition: Insights into female genital mutilation, which is narrated by Meryl Streep. The project began in July 2008, when I had dinner with Dr Dorothy Shaw, president of the International Federation of Gynecology and Obstetrics (FIGO) and Professor Hamid Rushwan, its CEO. We talked about female genital mutilation (FGM), a practice embedded in African, Middle Eastern and Australasian society for hundreds of years.

Carried out by older women with poor eyesight, using dirty instruments and no anaesthetic, it can cause haemorrhage, infection, and shock. The transmission of Hepatitis B and HIV is quite frequent. And long term complications may lead to incontinence, infertility, and psychological trauma.

To mark the end of her presidency, Dorothy’s vision was to have a film on this subject, ready to launch at their World Congress in Cape Town in October 2009. I knew that with the support of FIGO, making a film about a sensitive, controversial and deeply rooted cultural tradition was a challenge worth embarking on.

SafeHands for Mothers use filmmaking and photography as an educational tool. And we have never shied away from difficult subjects. In 2003, we highlighted obstetric fistula in the film Fistula Pilgrims and in 2008 we investigated child marriage in Child Marriage: An insight to early marriage. But a film about FGM was to prove our most challenging to date. We had one year in which to research, film and edit, before replicating and packing 8000 DVD copies, ready for the FIGO Congress in October 2009.

We chose to film in Burkina Faso, Djibouti, Egypt and Ethiopia because of the prevalence of FGM in those countries. Each country had its challenges and its many rewards. Finding an interpreter who could translate local dialects and national language into English was a constant quest. And in the Afar region of Ethiopia, bordering on Somalia, with its colourful pastoralist traditions, we had excellent facilitators - with little or no English. But my motto is to stay positive. The odd phone call to Addis Ababa (when the lines worked) helped us with our interpreting needs and it would be smiles all round again.

For John Howarth, my cameraman/editor and I, our challenge was to find a wedding, as marriage is one of the justifications for girls being circumcised. We found just the one in a village on the outskirts of Ougadougou, the capital of Burkina Faso. This was the thread which wove its way through the film linking debates with religious leaders, interviews with politicians and villagers alike.

In Harar, a beautiful walled Muslim city in Ethiopia, I met nineteen year old Noella, the only non-circumcised woman in a group of fifteen. Her parents were educators and felt strongly that in spite of local pressure they would not circumcise their daughter. Although appreciative of her parents’ wisdom, Noella admitted that she cannot urinate without checking that her clitoris has not grown. One of the ancient myths is that an uncircumcised woman’s clitoris will continue to grow and eventually look like a man’s penis.

I listened with astonishment to a group of young educated men and women in Djibouti town express their views. One man responded: “When it is cut her urge will be reduced. This is the main reason the cutting has been done. If she’s left alone without being cut, she will have a high urge, and that’s the problem. Mothers will be having a problem because she will not be staying at home. That’s why it has to be cut. That’s why some people call it ‘cutting out the devil’ because that’s the Satanic part that has been cut.”

FGM is practised in 28 African countries, from West to East, as well as several other Middle-Eastern and Eastern countries. Prevalence ranges from below 25% in countries such as Ghana and Niger, to over 90% in Egypt, Sudan, Somalia, and Djibouti, where no class of society is untouched by this practice. According to World Health Organization figures, FGM occurs in women of marriageable age, between 15 and 49 years old. Many reasons are given for why this happens, but the underlying reasons always concern virginity, chastity, purity, marriageability, and fidelity. And these reasons contribute to the mutilation of 6000 girls every day, according to a United Nations estimate.

After listening to her daughter’s screams, Zahara’s mother Medina acknowledged what she had endured and vowed that she would never circumcise her grandchildren. Today she is a spokeswoman against FGM. She lives in the remote, isolated region of Afar, where infrastructure is scarce and access to health care is poor; yet Medina’s voice is a strong and determined one.

But the last voice must remain with Anab, age unknown, a Somalian mother of 14 children, now living in a refugee camp in Djibouti. She says: “We are always in conflict and fighting with our men, because we feel nothing and we don’t know what men are. If we did not get cut we would have loved our men and welcomed them. So I say that girls should not be cut at all - their bodies should be left alone, so they can understand the pleasure and goodness of the family.”

I left these countries with well-defined memories: the beauty of the landscapes with spectacular mirages; families resilient to the daily hardships of eking out a means of survival and the silent sad beauty in the faces of those girls who had begged their mothers to be circumcised, against their mothers’ wishes. Why was it that a practice so deeply rooted in tradition, prevented their mothers from telling them the truth?

Nancy Durrell McKenna is the Founder Director of SafeHands for Mothers. She is an award-winning photographer and filmmaker, www.safehands.org

Nancy Durrell McKenna | Director of SafeHands for Mothers| Photo Credit: Nancy Durrell McKenna

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