Paleki Ayang, Gender Advisor for the Middle East and North Africa, Equality Now

By Paleki Ayang
JUBA, Feb 27 2024 (IPS)

Female genital mutilation (FGM) stands as one of the most egregious violations of human rights, particularly affecting women and girls worldwide. However, when conflict and forced displacement enter the equation, the horrors of FGM are exacerbated, creating a dire situation that demands urgent attention and action. Where instability and insecurity prevail, the prevalence of FGM often intensifies, exacerbated by factors such as displacement, poverty, and the breakdown of social systems.

On April 15, 2023, war erupted in the Sudanese capital, Khartoum, between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF), plunging the country into an intense political and humanitarian crisis with unprecedented emerging needs. As of December 2023, over 7.4 million people were uprooted from their homes by the 9-month conflict, of which about half a million fled to neighboring Egypt, a country that also has similarly high records of FGM cases.

Equality Now and the Tadwein Center for Gender Studies are currently commissioning a study in Egypt among select Sudanese families in Cairo and Giza to understand the particularities of cross-border FGM, to analyze the attitude of Sudanese families in Egypt towards FGM and to assess possible changes in the practice, such as the type of cutting, and the age of girls when they are cut.

Nexus between conflict, displacement, and FGM

Although Sudan legally banned the practice of FGM in 2020, women and girls continue to face heightened risks of violence, exploitation, and abuse, including FGM. Ongoing conflict has led to the breakdown of the rule of law and governance structures in Khartoum and a few other states.

Declaring a state of emergency permits the government to prioritize security and stability over individual rights and the rule of law. In some locations with relative stability, there is selective enforcement of laws driven by social polarization, exacerbating discriminatory practices and inequalities.

Additionally, in the chaos of displacement, traditional practices may persist, perpetuating the cycle of FGM and denying women and girls agency over their bodies and futures.

The nexus between conflict, displacement, and FGM underscores the urgent need for holistic, multi-sectoral approaches that address the root causes of the practice and provide comprehensive support to affected populations.

However, it is critical to redefine how the multi-sectoral approach could roll out within the context of conflict, specifically where legal protections for women and girls are minimal or non-existent.

The usual activities undertaken by activists and civil society organizations—such as advocacy campaigns, community outreach programs, and legal reforms—may be hampered by the chaotic and unpredictable nature of conflict environments, making it challenging to mobilize support and raise awareness about the harms of FGM.

Strengthening responses to FGM during conflict and displacement

Conversations about new and innovative ways where legal frameworks and policy measures need to be strengthened to prohibit FGM must happen, and perpetrators must be held accountable for their actions, even amid conflict and displacement.

A report on Female Genital Mutilation (FGM) in Humanitarian Settings in the Arab Region, published by UNFPA in 2021, discusses the challenges and barriers to addressing FGM in such contexts and offers recommendations for stakeholders involved in humanitarian response and protection efforts.

This is critical, as the prevention and response to FGM are not prioritized in humanitarian settings due to lack of funding and political will. The report underscores the importance of culturally sensitive approaches, community engagement, capacity building, and partnerships to combat FGM and support survivors in humanitarian settings effectively.

Medicalization of FGM requires urgent attention. Prior to the start of the current conflict, Sudan had the highest rate of medicalized FGM globally, accounting for 67% of cases in the country.

The collapse of healthcare systems and infrastructure brought about a different reality that necessitated changing health priorities. It could be argued that the medicalization of FGM diverts already strained resources, attention, and expertise in-country away from essential healthcare services, especially sexual and reproductive health services, including responding to conflict-related sexual violence and maternal and child health.

Women’s rights groups in Khartoum and other towns have established Emergency Response Rooms (ERRs) and other community-driven mutual aid efforts that could be used to mainstream FGM-related interventions as they respond to emerging humanitarian needs. Additionally, efforts to integrate FGM prevention and response into broader humanitarian assistance programs are essential in reaching displaced populations with life-saving interventions and support.

Engaging communities, religious leaders, and key stakeholders in the ‘new social structures’ shaped by conflict and displacement can foster much-needed dialogue, dispel myths, and promote alternative rites of passage that celebrate womanhood without resorting to harmful practices.

Despite having different priorities as displaced women and girls—such as humanitarian, livelihood, and other urgent needs— empowering them with knowledge and agency is essential in enabling them to assert their rights and resist pressures to undergo FGM.

Addressing FGM amongst Sudan’s displaced communities

Community-led initiatives to end FGM among Sudanese communities displaced from Khartoum into neighboring states or neighboring countries must take into consideration the diverse ethnic groups in Sudan—each with their distinct cultural traditions and practices relating to FGM, with some communities practicing different types of FGM. This requires an in-depth understanding of the sociocultural factors that drive it.

Although wealthier households in Sudan and people in urban areas were previously less likely to support FGM’s continuation, conflict highlights the intersectional impacts on different groups of women and girls, and forced displacement could result in the practice being carried to host countries that may lack effective legal frameworks or enforcement mechanisms to address cross-border FGM.

Considering anti-FGM interventions transcend geographical boundaries and ethnicities, they must be carefully tailored to community needs. Cross-border FGM could also be driven by a sense of struggling to maintain a cultural identity and uphold perceived social status in a new society.

Reaffirming commitments to end FGM

At the international level, concerted action is needed to address the intersecting challenges of FGM, conflict, and forced displacement. The United Nations and other multilateral organizations must prioritize the issue on the global agenda, mobilizing resources and political will to further research, support affected populations, and strengthen efforts to eradicate FGM in conflict-affected areas.

Moreover, partnerships between governments, civil society organizations, and grassroots activists remain essential in driving a collective response that transcends borders and builds solidarity among diverse stakeholders.

As Sudanese women bear the brunt of violence and displacement, women-led organizations are instrumental in fostering resilience and actively rebuilding their communities. Supporting and financing these organizations should be prioritized, as it is not only a matter of promoting rights but also a pathway to peace and stability.

As we confront the grim reality of FGM amidst conflict and forced displacement, we must reaffirm our commitment to the fundamental rights and dignity of every woman and girl. We cannot stand idly by as generations continue to suffer the devastating consequences of this harmful practice.

Now is the time for bold and decisive action guided by principles of justice, equality, and compassion. Together, we can break the chains of FGM, offering hope and healing to those who have endured untold suffering and paving the way for a future free from violence and discrimination for all.

Note: Paleki Ayang is Equality Now’s Gender Advisor for the Middle East and North Africa

IPS UN Bureau Report

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Photo Credit: @islamicrelief

By Siddharth Chatterjee
Mandera County, Kenya, Oct 19 2015 (IPS)

For many women in Mandera County – a hard to reach, insecure and arid part of North Eastern Kenya – the story of life from childhood to adulthood is one about sheer pain and struggle for survival.

As little girls, they undergo female genital mutilation (FGM), a painful carving out of the external genitalia that leaves them with lifelong physical and psychological scars.

Most girls will be married off when barely into their teens, forcing them to drop out of school, their immature bodies thrust into the world of childbearing.

As a result, Mandera – just a two-hour flight from the dynamic, modern East African hub of Nairobi – has maternal mortality ratio of 3,795 deaths per 100,000 live births, a rate that surpasses that of wartime Sierra Leone (2000 deaths per 100,000 live births) and far above Kenya’s national average (448 deaths per 100,000 live births).

Mandera is an example of a marginalized community rife with internecine conflicts, pockets of extremism, poor human development and cross border terrorism, where residents are trapped in poverty, misery and desperation. Cultural norms like status of the women, FGM and child marriage makes it worse. Among the poor, inequities hurt women and girls most.

However, things are looking up. Kenya’s decision to devolve government, putting much more power in the hands of local authorities, is having an impact on the ground. Indicators such as number of health facilities offering basic maternal and child health, and the number of women giving birth in a health facility, are improving.

Just as critical to these improvements is the recently established private sector’s coalition to transform the health landscape of this county, long considered a lost frontier. The goal of this coalition is to develop new products and service delivery models, like community life centers (CLCs) to improve maternal and new-born health among most vulnerable populations in Kenya.

An inter-agency team consisting of the Office of the President of Kenya, Ministry of Health, Kenya Red Cross, UNOCHA, Save the Children, technology company Philips, Amref, Safaricom, GlaxoSmithKlein and UNFPA, visited Mandera on 13 October 2015 with the ambassadors of Turkey and Sweden to Kenya, to launch a Ministry of Health-UNFPA–Philips innovation partnership.

The UNFPA and Philips CLC project is expected to bring quality primary healthcare within reach of about 25,000 people through small improvements that enhance the functionality of health facilities like 24-hour lighting that will allow facility deliveries to take place and sick children attended after dark. If successful, this initiative could be scaled-up and transform maternal and child health in Mandera county.

Mandera has long remained out of bounds for most international UN staff and diplomats due to insecurity. Hopefully the visit by the Turkish and Swedish ambassadors , who are ardent advocates of the rights of women and children, will pave the way for more visits to all the country’s North Eastern counties which face similar challenges.

The ambassadors spoke of their countries’ commitment to work with the county to change the narrative, especially to advance the rights and wellbeing of all women and girls.

The broader partnership, which also includes Huawei, Kenya Health Care Federation and MSD, together with the United Nations’s H4+ partners, will focus on the six counties with a high burden of maternal mortality: Wajir, Marsaibit, Lamu, Isiolo, Migori and Mandera.

The main activities in these six counties will include strengthening supply chain management for health commodities, increasing availability and demand for youth-friendly health services, capacity building for health professionals, youth empowerment and research. These activities be complemented by the results-based financing supported through the Health Results Innovation Trust Fund managed by the World Bank.

It is also in line with the full-scale Kenyan government commitment to reduce maternal deaths and the new polices of free maternity care and user fee removal.

Kenya’s First Lady Margaret Kenyatta once remarked that “I am deeply saddened by the fact that women and children in our country die from causes that can be avoided. It doesn’t have to be this way. This is why I am launching the ‘Beyond Zero Campaign’ which will bring prenatal and postnatal medical treatment to women and children in our country.”

The dividend from healthier women will be a more educated and healthy society, with more economic opportunities and reduced exclusion which will engender peace and hopefully reduce the drivers of violent extremism.

It will be a major score for Mandera towards fulfilling the vision of UN Security Council Resolution 1325, which is about empowerment and participation of women, ending discrimination and the scourge of harmful traditional practices like FGM and child marriage.

(End)

Excerpt:

Fatema,15, sits on the bed at her home in Khulna, Bangladesh, in April 2014. Fatema was saved from being married a few weeks earlier. Local child protection committee members stopped the marriage with the help of law enforcement agencies. Credit: UNICEF

By A. D. McKenzie
LONDON, Jul 23 2014 (IPS)

Heightening their campaign to eradicate violence against women and girls, United Nations agencies and civil groups have called for increased action to end child marriage and female genital mutilation.

At the first Girl Summit in London Wednesday, hosted by the U.K. government and UNICEF, delegates said they wanted to send a strong message that there should be “zero tolerance” for these practices.

“Millions of young girls around the world are in danger of female genital mutilation and child marriage – and of losing their childhoods forever to these harmful practices,” Susan Bissell, UNICEF’s Chief of Child Protection, told IPS.“Millions of young girls around the world are in danger of female genital mutilation and child marriage – and of losing their childhoods forever to these harmful practices” – Susan Bissell, UNICEF's Chief of Child Protection

“FGM is an excruciatingly painful and terrifying ordeal for young girls. The physical effects can last a lifetime, resulting in horrific infections, difficulty passing urine, infertility and even death.”

Bissell said that when a young girl is married “it tends to mark the end of her education and she’s more likely to have children when she’s still a child herself – with a much higher risk of dying during pregnancy or childbirth”.

“Without firm and accelerated action now, hundreds of millions more girls will suffer permanent damage,” she added in an e-mail interview.

At the summit, the United Kingdom announced an FGM prevention programme, launched by the government’s Department of Health and the National Health Service (NHS) England. Backed by 1.4 million pounds, the programme is designed to improve the way in which the NHS tackles female genital mutilation and “clarify the role of health professionals which is to ‘care, protect, prevent’,” the government said.

According to British Prime Minister David Cameron, some 130,000 people are affected by FGM in the United Kingdom, with “60,000 girls under the age of 15 potentially at risk”, even though the practice is outlawed in the country.

The prevention programme will now make it mandatory for all “acute hospitals” to report the number of patients with FGM to the Department of Health on a monthly basis, as of September of this year.

U.N. officials said that the Girl Summit was a significant development because it marked the importance of the issues addressed.

“International leaders came together in one place and said enough is enough,” Bissell said.

While it is difficult to measure the impact of intensified campaigns on the reductions in child marriage and female genital mutilation/cutting over the past few years, the United Nations and other organisations have noted that the numbers of girls affected are in fact decreasing.

In the Middle East and North Africa, the percentage of women married before age 18 has dropped by about half, from 34 percent to 18 percent over the last three decades, UNICEF says.

In South Asia, the decline has been especially marked for marriages involving girls under age 15, dropping from 32 percent to 17 percent.

“The marriage of girls under age 18, however, is still commonplace,” Bissell told IPS.

“In Indonesia and Morocco, the risk of marrying before age 18 is less than half of what it was three decades ago. In Ethiopia, women aged 20 to 24 are marrying about three years later than their counterparts three decades ago,” she added.

Regarding female genital mutilation/cutting, Kenya and Tanzania have seen rates drop to one-third of their levels three decades ago through a combination of community activism and legislation, while in the Central African Republic, Iraq, Liberia and Nigeria, prevalence of FGM has dropped by as much as half, Bissell said.

However, officials stressed that with population growth, it is possible that progress in reducing child marriage will remain flat unless the commitments made at the Girl Summit are acted upon. Flat progress “isn’t good enough”, Bissell told IPS.

Recently released U.N. figures show that, despite the declines, child marriage is widespread, with more than 700 million women alive today who were married as children. UNICEF says that some 250 million women were married before the age of 15.

The highest percentage of these women can be found in South Asia, followed by East Asia and the Pacific which is home to 25 percent of girls and women married before the age of 18, UNICEF says.

Statistics also indicate that girls who marry before they turn 18 are less likely to remain in school and more likely to experience domestic violence. In addition, teenage mothers are more at risk from complications in pregnancy and childbirth than women in their 20s; some 70,000 adolescent girls die every year because of such complications, according to the United Nations.

The statistics on female genital mutilation are also cause for international concern, with the United Nations Population Fund (UNFPA) saying that about 125 million girls and women have been subjected to the practice, which can lead to haemorrhage, infection, physical dysfunction, obstructed labour and death.

According to UNFPA, female genital mutilation/cutting and child marriage are human rights violations that both help to perpetuate girls’ low status by impairing their health and long-term development.

UNFPA Executive Director Dr. Babatunde Osotimehin told IPS that a number of states have adopted legislation against female genital mutilation/cutting but that some perpetrators are still operating with “impunity”.

Participating in the London summit, Osotimehin said that certain governments were facing challenges within their own countries because of long-held cultural beliefs, but like Bissell, he said that the picture is not completely bleak, because civil society and grassroots organisations are amplifying their campaigns.

“Our message for girls who are affected by these practices is that they have support – moral, psychological, physical and emotional support,” he told IPS. “We also want to send a message that those who are affected should advocate to try and stop these practices.”

Meanwhile, U.N. officials said it was significant that the summit saw commitment from the African Union and the deputy prime Minister of Ethiopia, as well as from the United States Agency for International Development (USAID) and the U.K. Department for International Development (DfID). The Government of Canada and several other financial supporters also made commitments.

For the executive director of UN Women, Phumzile Mlambo-Ngcuka, the pledges show support for the message of “zero tolerance” of child marriage and FGM that her organisation wishes to send. They are also a strong signal that the practices can be ended in a generation, she told IPS.

Circumcisers in the Gambia publicly declaring that they have abandoned the practice of FGM. Credit: Saikou Jammeh/IPS

By Saikou Jammeh
BANJUL, Jul 13 2014 (IPS)

Women’s rights activists in the Gambia are insisting that more than 30 years of campaigning to raise awareness should be sufficient to move the government to outlaw female genital mutilation (FMG).

The practice remains widespread in this tiny West African country of 1.8 million people, but rights activists believe that their campaign has now reached the tipping point.

Two years ago, GAMCOTRAP, an apolitical non-governmental organisation (NGO) committed to the promotion and protection of women and girl children’s political, social, sexual, reproductive health and educational rights in The Gambia, and one of the groups behind the anti-FGM campaign, sponsored a draft bill which has been subjected to wide stakeholder consultations.

Several previous attempts to legislate against FGM have failed, with no fewer than three pro-women laws having had clauses on FGM removed from draft bills. But activists now appear determined to make the final push and hope that when introduced this time round, the bill will go through.“We’ve caused lots of suffering to our women ... if my grandparents had known what I know today, they would not have circumcised anyone. Ignorance was the problem” – former circumciser Babung Sidibeh

The time has now come for final action, says Amie Bensouda, legal consultant for the draft bill. “There can be no half measures. The law has to be clear. It’s proposed by the law that FGM in all its forms is prohibited. This discussion cannot go on forever. The government should do what is right.”

“The campaign has reached its climax,” Dr Isatou Touray, executive director of GAMCOTRAP, told IPS. “A lot of work has been done. I am hopeful of having a law because women are calling for it, men are calling for it. I know there are pockets of resistance but that’s always the case when it comes to women’s issues.”

“In 2010, we organised a workshop for the National Assembly,” she continued. “They made a declaration, pledging to support any bill that criminalises FGM. I am happy to report that, since 2007, more than 128 circumcisers and 900 communities have abandoned the practice. This trend will continue to grow.”

Seventy-eight percent of Gambian women undergo FGM as a ‘rite of passage’. However, after more than three decades of the anti-FGM campaign in Gambia, a wind of change is blowing, sweeping even conservative rural communities.

Sustained awareness-raising programmes have resulted in public declarations of abandonment of FGM by hundreds of circumcisers. Babung Sidibeh, custodian of the tradition in her native Janjanbureh, the provincial capital of Central River Region, 196 kilometres from Banjul, was one of them. The old woman assumed the role after the death of her parents, but she has since “dropped the knife”, as no longer practising FGM is known here.

Sidibeh did so after receiving training in reproductive health and women’s rights. “Soon after we circumcised our children in 2011,” she told IPS, “Gamcotrap invited me for training. I was exposed to the harm we’ve been doing to our fellow women. If I had known that before what I know today, I would never have circumcised anyone.”

With a tinge of remorse, she added: “We’ve caused lots of suffering to our women. That’s why I told you that if my grandparents had known what I know today, they would not have circumcised anyone. Ignorance was the problem.”

Mrs Camara-Touray, a senior public health worker at the country’s heath ministry confirmed to IPS that her ministry has since taken a more proactive role on FGM.

She explained: “The ministry has created an FGM complication register. We’ve also trained nurses on FGM. Until recently, when you asked most health workers about the complications that can arise with FMG, they would say it has no complications. That’s because they were not trained. Since 2011, we’ve changed our curriculum to include these complications. After we put the register in place, within three months, we’d go to a region and see that hundreds of complications due to FGM had been recorded.”

In March, Gamcotrap organised a regional religious dialogue that sought to de-link FGM from Islam. Touray said that the workshop was a prelude to the introduction of the proposed law in parliament.

“Islamic scholars were brought together from Mali, Guinea, Mauritania and Gambia,” she told IPS. “We had a constructive debate and it was overwhelmingly accepted that FGM is not an Islamic injunction, it’s a cultural practice. It was recommended that a specific law should be passed and a declaration was made to that effect.”

However, there is resistance in some quarters. An influential group of Islamic scholars, backed by the leadership of the Supreme Islamic Council, continue to maintain that FGM is a religious injunction.

With a large following and having the ears of the politicians, these clerics have in recent times also intensified their pro-FGM campaign.

“It will be a big mistake if they legislate against FGM,” Ebrima Jarjue, an executive member of the Supreme Islamic Council, told IPS.

“Our religion says we cut just small. We should be allowed to practise our religion. If some people are doing it and doing it bad, let them stop it. Let them go and learn how to do it. If circumcising the girl child when she’s young is causing problems, then let’s wait until she grows up. That’s what used to happen.”

Meanwhile, the Women’s Bureau, the implementing arm of the Ministry of Women’s Affairs, is hesitant about legislating against FGM.

“As far FGM is concerned, the position of the Women’s Bureau is that there’s need for more sensitisation and dialogue to push the course forward,” Neneh Touray, information and communication officer of the Women’s Bureau, told IPS. She declined to comment on whether the bureau thought that the bill was premature.