Muslim groups call for female circumcision to be medicalised

Daily Mirror

A number of Sri Lankan Muslim groups have called on the government to medicalise female circumcision.

In representations made to the Parliamentary Committee on Women and Gender, members of the All Ceylon Jamiyathul Ulama, All Ceylon YMMA Conference, Centre for Islamic Studies and United Religions Initiative urged the Health Ministry to withdraw a recent circular prohibiting medical professionals from carrying out female circumcision.

In their submission, the joint Muslim groups stated that the Muslim community is very concerned about moves to ban this obligatory Islamic duty on the grounds that it is Female Genital Mutilation (FGM).

“We wish to categorically state that the practice of female circumcision is an obligatory Islamic duty, that it confers numerous benefits and is not Female Genital Mutilation. As such we condemn all moves to ban the practice of female circumcision by legislation and/ or by government bodies and urge that no moves be taken in this direction which we will regard as an unwarranted intrusion on and infringement of our religious duties guaranteed by the law and constitution of the Democratic Socialist Republic of Sri Lanka”, the Muslim representatives said in their submission. “We also request the Ministry of Health to withdraw a recent circular it issued prohibiting medical practitioners from performing the procedure and to issue a fresh circular excluding Islamic female circumcision a.k.a hoodectomy from the definition of FGM”

Joint Spokesperson Noor Hazeema Haris said that although Muslims wholeheartedly support the abolition of traditional practices harmful to women and children such as FGM, in case it is shown to exist in Sri Lanka, the Islamic practice of female circumcision is vastly different. She pointed out that this religious obligation practiced by the Muslims of the country for centuries in keeping with the requirements of the Islamic faith is not FGM. This was evident from the Joint Ministry of Health (MOH) and WHO report on Violence and Health in Sri Lanka in 2008, which states categorically that FGM does not exist in Sri Lanka.

She pointed out that while countless Sri Lankan Muslim Women have undergone childbirth deliveries in Governmental and Private Hospitals over the past decades, not a single case has arisen where Muslim women have been shown to have  undergone FGM. It is therefore very clear that Sri Lankan Muslim women have never experienced FGM.

She further pointed out that female circumcision practiced by Muslims is a very minor procedure similar to male circumcision where the prepuce of the clitoris is removed. This is the same as hoodectomy which is a legal cosmetic procedure chosen by women to improve genital hygiene and enhance their sex lives. 

“It is something that is arranged and done by women. Those who say this is male oppression against women are mistaken. It is we who do it just like our mothers and grandmothers and countless generations of our women have done. We continue to practice it because we know it benefits us. Even educated Muslim women support it wholeheartedly”, she added.

The submission concluded that female circumcision like male circumcision is a religious obligation for Muslims and that their religious rights as Sri Lankan citizens are safeguarded by the Constitution of Sri Lanka. Since this is a religious obligation, almost all Muslim Women and girls would have to undergo the procedure by hiring the services of traditional female circumcisors known as Ostha Mamis in case doctors refuse to perform this procedure citing the above mentioned circular. This could lead to serious medical complications which would amount to FGM.

If as medical complications have arisen among some women circumcised by Osthamaamis as alleged by Women’s Rights groups, it is all the more reason to medicalise the procedure instead of prohibiting it, which will only drive the procedure underground and put girls and women at unnecessary risk.

“We therefore urge the Parliament of Sri Lanka to reject any legislation drafted with a view to prohibit the practice of female circumcision as it will be infringing on the rights of Muslims to the free practice of their faith.We also urge that the Ministry of Health immediately withdraw  the said circular and if needs be, issue a fresh circular prohibiting FGM, but exempting the Islamic procedure of female circumcision from the definition as done in other Muslim countries like Indonesia” concluded the submission.

The Muslim Representatives included M.N.M.Naphiel, President of the All Ceylon YMMA Conference, Asiff Hussein, Vice-President Outreach, Centre for Islamic Studies, Noor Hazeema Haris, Co-ordinator of United Religions Initiative, Sheikh M.F.M Farhan, Manager, All Ceylon Jamiyyathul Ulama and Sheikh M.A. Haris, Co-Ordinator of the Fatwa Committee of All Ceylon Jamiyyathul Ulama.

The committee agreed to give them a hearing and requested that medical evidence be submitted to prove that female circumcision of the type prescribed in Islam causes no harm and benefits women as stated by the joint representatives.

Aid agencies decry decision to encourage FGM in Somaliland

Source: Xinhua  

MOGADISHU, Feb. 24 (Xinhua) -- Three international aid agencies on Saturday expressed concern over a recent ruling by the government of Somaliland in Somalia that encourages female genital mutilation (FGM).

In a joint statement, Save the Children, CARE International, and International Rescue Committee (IRC), said the Feb. 6 ruling goes against the commitment to abandon female cutting and eliminate all harmful practices.

"Female genital mutilation is a harmful procedure regardless the level of mutilation. It must be discouraged at all levels," said Timothy Bishop of Save the Children Somalia/Somaliland on behalf of the other organizations.

However, the organizations welcomed the banning of extreme forms of FGM but insisted that the decision should apply to all forms of FGM.

On Feb. 6, Somaliland announced a new fatwa, or religious edict, banning two of the three types of female cutting.

The edict by the Ministry of Religious Affairs allows FGM victims to receive compensation but it does not say whether the compensation will be paid by the government or by violators of the ban.

According to the organizations, the ruling made a certain type of FGM/C "mandatory" for every girl in Somaliland and at the same time banning the most extreme forms.

The religious edict came barely a month after Somaliland's parliament approved a bill criminalizing rape and requiring prison terms for those who are convicted.

Female cutting, according to the World Health Organization (WHO), is also often performed on girls under the age of 15, resulting in complications that range from bleeding and infection to problems with urination and complications with childbearing.

Somalia is among countries in which FGM is most prevalent. An estimated 98 percent of Somali females ages 15 to 49 have undergone the procedure.

The aid agencies said the decision to encourage FGM will erode decades of investments made in ending FGM in Somalia/Somaliland and undermines the mobilization, awareness-raising and prevention work undertaken by communities, national and international organizations and the government aiming at total abandonment of FGM/C in Somalia/Somaliland.

The organizations said they will continue to engage with the government of Somaliland to explore ways in which decisions made will be for the best interest of a child in Somaliland.

Feds drop bombshell: Up to 100 girls may have had their genitals cut in Michigan

By: Tresa Baldas
Detroit Free Press
Published 4:01 p.m. ET June 7, 2017

A federal prosecutor dropped a bombshell in court Wednesday, telling a federal judge that the government estimates that as many as 100 girls may have had their genitals cut at the hands of a local doctor and her cohorts.

Assistant U.S. Attorney Sara Woodward disclosed the information while trying to convince a judge to keep a doctor and his wife locked up in the historic case. It involves allegations that two Minnesota girls had their genitals cut at a Livonia clinic in February as part of a religious rite of passage and were told to keep what happened a secret.

"Due to the secretive nature of this procedure, we are unlikely to ever know how many children were cut by Dr. (Jumana) Nagarwala," Woodward said, referring to the lead defendant in the case,  later adding, "The Minnesota victims were not the first victims."

Against Woodward's wishes, U.S. District Judge Bernard Friedman granted bond to two other defendants in the case: Dr. Fakhruddin Attar, 53, of Farmington Hills, who is accused of letting Nagarwala use his clinic to perform genital cutting procedures on minor girls; and his wife, Farida Attar, 50, who is accused of holding the girls' hands during the procedure to keep them from squirming and to calm them.

The government believes the three defendants, all members of a local Indian-Muslim sect, subjected numerous girls to genital cutting procedures over a 12-year period. To date, the government says it has identified eight victims -- including the two Minnesota girls -- though Woodward said the government estimates there could be as many as 100 victims. She said that's a conservative estimate, and that it's based on   Dr. Attar's alleged admission to authorities that he let Nagarwala use his clinic up to six times a year to treat children for genital rashes.

Attar's lawyer, Mary Chartier, scoffed at the claim.

"I think the government has overstated so many aspects of this case and this is one more example of overreaching," Chartier said after the hearing, during which she and another lawyer convinced the judge to set the Attars free.

The defense has argued that the Attars did not engage in any criminal  act and that the procedure at issue is a protected religious rite-of-passage that involves no cutting, but rather a scraping of genital membrane. They also argued the Attars  are not a danger to the society and have no reason or desire to flee, convincing U.S. District Judge Bernard Friedman to release them on bond.

Friedman, who stressed that he believes the case involves "serious" charges, issued the following conditions in granting bond to the defendants:

•        They have to surrender their passports.

•        They will be on house arrest, on GPS tethers, and are not allowed to communicate with anyone except family members or their lawyers.

•        They will only be allowed to leave the home to visit their lawyers or for doctor's visits -- both of which have to be approved first.

"I think he is thrilled," Chartier said of her client, Dr. Attar. "He is anxious to fight this case and clear his name."

The Attars will likely not be released from jail until Thursday, when their lawyers surrender their passports to authorities. At issue for the Attars is their parenting rights. Currently, they are not allowed to live with their minor daughter as the state is trying to terminate their parenting rights.

Chartier said a hearing is scheduled on the parenting-right issue for next week, and she is hoping that the Attars will be allowed to live with their daughter again.

The Attars have been jailed for more than a month since getting charged in April in an explosive case that has captured international attention and planted a bull's-eye on a small Muslim sect known as the Dawoodi Bohra.

The Attars are Bohras, along with the lead defendant in the case,  Dr. Nagarwala, 44, of Northville, who is accused of performing the cutting procedures on the two Minnesota girls.

Nagarwala, meanwhile, remains locked up pending the outcome of her trial. Her attorney, Shannon Smith, was in court Wednesday. She declined comment on allegations that her client subjected up to 100 girls to genital cutting, but  noted that she, too, will seek to have her client released on bond.

If convicted, Nagarwala and Dr. Attar face up to life in prison; Attar's wife faces up to 20 years. The two physicians face the most serious charge in the case, transportation of an individual with intent to engage in criminal sexual activity, which carries a minimum of 10 years and a maximum of life in prison.

A trial is set for October 10.

Thousands of Female Genital Mutilations STILL taking place illegally in Britain

THE NHS has seen a shocking rise in the number of case of Female Genital Mutilation (FGM) in Britain - despite the practice being banned for more than 30 years.


March 7, 2017

Medical staff recorded almost 5,500 cases in 2016 alone, according to shocking new statistics.

FGM is a procedure that sees the genitals of young girls deliberately cut, injured or disfigured for “cultural, religious or social reasons”.

A report, published on Tuesday, found 1,286 new cases in the last quarter of 2016 - compared with 1,240 in the previous quarter.

The report also found more than 16,000 FGM-related attendances at NHS hospitals and GP surgeries over the year.

Doctors also discovered that while 96 per cent of women were aged 17 or younger when FGM was carried out on them, almost all – 98 per cent – were over 18 when their cases were recorded.

After the practice was banned in the UK, families began taking their daughters abroad for the procedure.

In 2003, the UK government expanded the law making it a criminal offence for British nationals or permanent residents to take their child abroad for FGM.

It is now also mandatory for healthcare professionals to alert authorities if they come across a case of the illegal practice.

Liberal Democrat shadow equalities secretary Lorely Burt has called on the Government to “redouble efforts” to tackle the issue.

She said: “The figures are astonishing. Whilst clear progress is being made at identifying FGM in a health setting, far more must be done in schools to raise awareness of the practice and help teachers flag children at risk.”

FGM can cause a host of physical and psychological problems - in some cases girls can bleed to death or die from infections caused by dirty blades.

The practice has been illegal in the UK since 1985, and is classified as child abuse.

However, no-one has been prosecuted over the practice since it was banned.

This is widely put down to the stigma attached to the "horrific" operation preventing thousands of victims from coming forward.

The ancient ritual is commonly practised in Africa and pockets of Asia and the Middle East.

It is often deemed in some cultures as a religious obligation - although it is not mentioned in the Koran or Bible.

The country with the highest rate of FGM remains Somalia where figures show 98 per cent of girls and women aged between 15 and 49 have been cut.

Guinea, Djibouti and Sierra Leone also record high rates of the potentially lethal practice.

However, overall FGM prevalence rates have fallen in the last three decades, with Liberia, Burkina Faso and Kenya showing sharp falls.

FGM cases in Birmingham rocket by almost 30 per cent

8 June 2016

ITV Report

New cases of female genital mutilation in Birmingham have rocketed by nearly a third, according to new figures.

The number of incidents increased from 52 between October and December 2015 to 67 from January to March this year – a 28 per cent rise. The statistics were released by the Health and Social Care Information Centre.

In total 1,242 newly recorded cases of FGM reported across the country in the same time period.

Back in February, it was revealed that more than two cases of female genital mutilation were being reported in Birmingham and the West Midlands every day.

A spokesman from the National Society for the Prevention of Cruelty to Children, said the figures showed how widespread the problem in the region was.

“There are no medical reasons to carry out FGM. It doesn’t enhance fertility and it doesn’t make childbirth safer. It is used to control female sexuality and can cause severe and long-lasting damage to physical and emotional health. FGM or female circumcision is usually carried out for religious, cultural or social reasons. But let’s be clear – it is child abuse and it causes long-lasting physical and emotional damage. The practice must stop.”

Fifty girls taken from UK to Somalia for FGM       

17 July 2015

Reports that at least 50 girls were taken from the UK to Somalia for female genital mutilation are being investigated by Scotland Yard.

Liberal Democrat peer Baroness Tonge contacted the Metropolitan Police after spotting a large group of girls on a flight from Heathrow last Saturday.

The girls were said to be aged 11 to 17 and with their mothers or grandmothers.

It comes as Bedfordshire Police secured the UK's first FGM protection order, preventing two girls from going abroad.

The Metropolitan Police said officers from the Specialist Crime and Operations Command were investigating Lady Tonge's report.

'Scattering of grannies'

Speaking to the BBC, Lady Tonge said the girls spoke English and were of Somali origin.

"It was just odd," she said. "They were young girls and mothers and a scattering of grannies."

They were on an Ethiopian Airlines flight to Addis Ababa on 11 July and according to the Lib Dem peer transferred onto a plane to Mogadishu, the capital of Somalia.

Lady Tonge, along with the Labour MP for Halifax, Holly Lynch, was on a trip to the Financial Development Conference in Addis Ababa.

FGM, also termed female circumcision, is illegal in the UK. It refers to any procedure that alters or injures the female genital organs for non-medical reasons.

It is a painful ritual carried out on women and young girls from certain communities from Africa, Asia and the Middle East.

Lady Tonge said that both she and Ms Lynch felt the presence of so many girls at the start of the summer holidays was "suspicious", given that it was the start of the so-called "cutting season" when FGM is carried out, and she decided to raise the alarm on her return to the UK.

Scotland Yard confirmed that police had been called by a "woman concerned about a large number of girls on a flight from Heathrow to Ethiopia on 11 July whom she believed were at risk of FGM".

That confirmation from the Met came after Bedfordshire Police said it secured a protection court order on the day new powers came into effect.

The civil legislation allows officials to seize passports from people they suspect are planning on taking girls overseas for FGM, and breaching an order is a criminal offence.

The move prevents two girls being taken to Africa, Bedfordshire Police said.

The force said it is estimated that more than 20,000 girls under the age of 15 in the UK are at risk of FGM each year, although very few cases are reported.

Det Ch Insp Nick Bellingham, from Bedfordshire Police's Public Protection Unit, said: "With schools breaking up for the summer holidays today, we will continue to use this legislation where needed to prevent young girls who we believe may be at risk from being taken out of the country.

"This is child abuse, and we will do everything in our power to ensure that children are kept safe and that those responsible are caught."Aneeta Prem, founder of women's charity Freedom Charity, said the use of a protection order was a positive step.

But she warned that the authorities must also look out for "cutters" - people who carry out FGM "for as little as £200 a girl" - entering the UK.

"We can't be politically sensitive. Girls who are mutilated in this way suffer a lifetime of scarring and permanent damage," she said.

The Female Genital Mutilation Act 2003 in England, Wales and Northern Ireland, and the Prohibition of Female Genital Mutilation Act 2005 in Scotland states that FGM is illegal unless it is necessary for health reasons.

The law states that is also illegal to arrange for a UK national to be taken overseas to undergo FGM.

The order secured by Bedfordshire Police, which can be made by courts in England and Wales, was introduced under the Serious Crime Act 2015.

Equalities and Justice Minister Caroline Dinenage said the protection orders have been "fast-tracked... to make sure women and girls facing the awful threat of FGM can be kept safe".

"These orders mean girls and the communities around them now know they will have somewhere to turn, that the law is on their side and help is out there.

"The government is committed to ending FGM."

Study reveals shocking FGM prevalence in Iran

By Hajir Sharifi

A new study has found the practice female genital mutilation (FGM) to be common in areas of Iran, refuting repeated government claims that the practice does not exist in the Islamic Republic.

The comprehensive report about FGM in Iran, released June 25 by Kurdish social anthropologist Kameel Ahmady, identified FGM in at least four Iranian provinces, most notably Hormozgan where nearly six out of 10 women had undergone the practice.

The rate of FGM was discovered to be 21 percent in West Azerbaijan, 18 percent in Kermanshah, and 16 percent in Kurdistan, according to field interviews and research conducted by Ahmady and his team.

The southern Hormozgan province, with a rate of 60 percent, had the highest FGM prevalence in Iran. Hormozgan province is one of the most impoverished and undeveloped provinces of Iran.

In June 2014, the United Nation’s Human Rights Council in a direct letter to the Iranian government asked Iranian authorities to “accept” the existence of the practice in Iran, and take active steps to eradicate the practice in that country. Women's rights groups have for many years condemned Tehran for trivializing or officially denying the issue.

The UN noted that Iranian Shiite authorities justified their inaction by framing FGM as a religiously sensitive issue that would cause anti-Shiite sentiment among the Sunni minority if it were banned.     

Research shows the four provinces associated with FGM also have high rates of other types of violence against women, such as honor killings, child brides, forced marriage and polygamy.

“Religion is used to justify the practice by all practitioners of FGM,” the research found. Among the Sunni Muslims, a branch known as Shafi’i has the highest rate of the practice.

According to Shafi’ie faith, a woman becomes a Muslim only when she is circumcised. Although there are different interpretations of religious directives, Mohammad Rabi’ie, a distinguished cleric in Kurdistan, believes that “FGM is the Prophet Ibrahim’s tradition.”

The followers of the Shafi’ie faith believe that a woman's sexual desire is harnessed after being cut and whatever she does subsequently become halal, or acceptable to Islam.
It is also believed by some that FGM facilitates marriage by reducing the a woman's sexual desire and helps her to remain virtues and pious.  

The recent study shows that the same religious interpretation dominates the current practice. “They usually believe that FGM was practiced during the early years of Islamic Kingdom when the Prophet’s and Imams’ wives and daughters were circumcised,” Ahmady said.

Among the Kurds in Iran, FGM is mainly practiced by Sunni Shafi’i Kurds who speak the Sorani dialect, but not among Sunni Shafie Kurds who speak the Kermanji dialect. Followers of the Sunni Hanafi sect do not follow the practice, research found. 

The Kurdistan province in Iran is predominantly populated by Sunni Shafi’i but there is a Shiite religious minority.

“The prevalence of FGM in Kurdistan is patchy and varies sharply from one region to another,” the researcher said, adding that FGM is mainly practiced in rural and undeveloped areas.

“FGM stems from men’s desire to subjugate women and is another sign of injustice rooted in imbalanced gender power relationships and men’s power over women’s bodies,” said Iranian Kurdish women and children rights activist Parvin Zabihi.

“Enacting such a practice perpetuates women’s oppression and pushes women to a submissive and inferior position in the society,” Zabihi told Rudaw. 

According to Iranian women rights activist’s, Iranian government either denies the existence of the practice in Iran or considers it as a minor issue that only exists in a handful of villages.  

FGM is locally referred to as “Khatne” or “Sunat” in Iran. In this context, Sunat ("tradition") means "mandatory practice" not Sunat as a voluntarily act. The practice is generally carried using traditional methods by the elder women in the community.

"In some locations,  girls are usually ‘circumcised’ between the ages of three and six with sharp razor or a knife and, afterwards, some ash or cold water is applied to their mutilated genitals,” Ahmady said.    

“The attitude of officials and authorities is that FGM doesn’t exist in Iran. The Iranian public is also largely ignorant about the subject,” he added.

Ahmady said the Iranian government has been reluctant to tackle the problem and has framed it as a practice that exists in Africa not Iran.

The UN describes FGM as “a manifestation of deep-rooted gender inequality that assigns [women] an inferior position in society.”

Based on 2014 UNICEF figures, roughly 130 million girls and women alive today worldwide have undergone some form of FGM. Further UN research indicates 92 million of these women are over the age of 10 and mostly live in Africa. 

According to UNICEF, FGM is most common in 29 countries in Africa, as well as in some countries in Asia and the Middle East, and among certain migrant communities in North America, Australasia, the Middle East and Europe.

Female genital cutting in Thailand's south

FGM is a rising cultural practice in southern Thailand and, with little regulation, concerns are at an all-time high.
Gabrielle Paluch
02 Apr 2015

Yala, Thailand - "Just a little," Dr Patimoh Umasa says, pinching the tip of her finger showing how she cuts the clitorises of small girls.

Dr Umasa runs a small clinic on Yala's main drag, just down the street from a bombed-out building, near the edge of the Muslim quarter.

As one of the few female doctors in the city, she is the one everyone goes to for sunat - the practice of female circumcision, which the World Health Organisation (WHO) classifies as female genital mutilation (FGM).

"Just an incision to leak some blood, no excision of flesh," Dr Umasa says, using her grey cat, asleep at the clinic reception, to demonstrate the way she holds the girls still before she cuts them.

"It takes three people, see? The mother holds the baby up here for comfort, and an assistant holds the legs open like this," she says, spreading the cat's legs apart and pinning them down to the counter.

She adds: "And then with my left hand I spread the labia, and with my right hand I pull back the clitoral hood, and slice."

Umasa uses a sterile size-11 surgical blade, and performs the procedure for free, because she says its a religious procedure.

"The babies cry," she says, "but not much. They don't have any lasting health complications."

Like others, Dr Umasa believes that the procedure, if done by a doctor, should not be considered mutilation.

"If it's done by a trained doctor, they are using the right technique, then never mind!"

In the past, traditional birth attendants performed sunat on the newborn baby girls a few days after birth.

Wamae Tahe is a 65-year-old retired midwife who says in the 23 years she worked in Yala, she performed sunat on almost all female babies whose births she attended.

"But now babies are born in the hospital, so I no longer do cutting, because mothers are afraid to have it done at home," she says.

"It's important to be careful and not hurt the baby's vagina! But I wasn't concerned that I was harming the baby. They cried a little, but it must be done."

She says on two occasions she performed the procedure on girls over the age of 18, which she said made her very nervous.

Off the radar

Dr Umasa says she performs anywhere between 10 and 20 procedures a month, and the figure is rising as women increasingly give birth in hospitals.

The practice of female genital cutting in southern Thailand is virtually undocumented, and the prevalence is unknown as there is no reliable data available. But Dr Umasa believes it is universally prevalent.

Dr Sudarat Teeraworn is a maternal health supervisor for the department of public health in Yala province, and she says the issue of female genital mutilation is completely off the Thai Health Ministry's radar.

Adding to this, Dr Teeraworn says, it's just simply not a topic of discussion: many women do not even know if they are "cut" since most of the procedures are performed during infancy.

"There are no laws or regulations surrounding the practice, and the Health Ministry doesn't say anything about it or study it because it's not harmful - it's a cultural phenomenon. If it's cultural and not harmful, then what can we do about it?"

Dr Teeraworn says there have been no prevalence studies done in Thailand, but believes the prevalence in border provinces is probably similar to the FGM's prevalence in Malaysia.

An unpublished study conducted in 2011 by the University of Malaya's department of preventive medicine in Malaysia found that 93 percent of Muslim women in Malaysia have undergone the procedure.

Though not comprehensive, the numbers for Kelantan state, which borders Thailand, are similar.

The cutting that occurs in Malaysia is similar to the process described by Dr Umasa in southern Thailand. It falls under type IV of the WHO's classification system - the least invasive type, typically done without removing flesh.

Undefined procedure

Malaysia's highest religious authority issued a fatwa, an Islamic legal edict, in 2009 making the cutting procedure required for all Muslim women, unless "harmful".

Many religious leaders in Malaysia, like their counterparts in Thailand, believe the procedure as practised there is so minimally invasive that it should not be called mutilation.

Saira Shameem, who works with the United Nations Population Fund, says the process is never harmless, and the WHO created the type IV category specifically to include the practices in countries like Malaysia.

Because there is such a variety of practices of increasing invasiveness, she says any sort of cutting on a woman's genitals, no matter how small, is harmful and should not be done.

Malaysia's fatwa does not define the procedure, and Shameem says health officials are trying to work that avenue to change the practice to a more symbolic one.

"In order to prevent the procedure from becoming more extensive, we are trying to persuade the Ministry of Health to replace it as currently practicsed with cleansing with an alcohol swab," she says, referring to a routine examination typically performed by obstetricians at birth.

The fatwa poses a dilemma for medical professionals caught between their unwillingness to violate WHO guidelines, and parents who feel pressure to have their daughters cut.

But Shameem says doctors can play a big part in the transition to eradicating the behaviour.

"We don't have as much influence and control over traditional practitioners as doctors, so if you're talking about effectively eradicating the procedure, working through the medical system with doctors would shift the practice more quickly," Shameem said.

The religious and social pressure to have a baby girl cut in Thailand works on practitioners as well. As retired midwife Tahe explained, "If parents come to me to ask me to do it, I can't say 'no'. Can I?"

Accessing 'red zones'

Julia Lalla-Maharajh is the CEO of Orchid Project, a London-based organisation that advocates against female genital mutilation.

She says the biggest problem they face is massive information gaps.

"There is very little data or evidence about the practice outside of African countries, and this is something we absolutely need to address," she says.

"We cannot show how urgent and important this issue is, so we would urge organisations around the world to really keep asking the questions: Is [female genital cutting] happening in your country, and what can be done about it?"

Dr Teeraworn says she and her health teams have no access to so-called red zones in Thailand's conflict-stricken south, areas where bombings and attacks occur regularly.

She is unable to directly supervise health stations there.

Thailand's deep south was part of the independent Malay Pattani sultanate some 200 years ago,and the practice of sunat dates back to that era.

Today, ethnic Malay Muslims who inhabit the region speak Bahasa Melayu and consider themselves to be culturally Malay, though they are Thai nationals.

Since 2004, over 6,000 people have died in sporadic bombings and attacks that are part of a violent insurgency, which has an apparent but unclear demand for increased autonomy.

Imam Abdullah Abu-Bakr of the Committee of Islamic Council of Yala says Muslims in the south are more observant than their co-religionists in Bangkok, because there are more foreign-educated imams and fewer distractions, such as the entertainment hub of Bangkok.

He himself was educated in Syria and Malaysia.

Thailand's fatwa committee has not issued a fatwa surrounding the practice of sunat, but Imam Abdullah says everybody knows the practice is required for boys, typically in a public ceremony around age seven, and though is not absolutely required of women, it is something all women should do.

He says the way it is currently practised is not harmful, and is key to a Muslim's cultural identity.

"You must peel a banana before you can eat it," Abu-Bakr says, "and for women, it will reduce their wildness, making them clean and strong."

Female Genital Mutilation and African AIDS

By Marion D. S. Dreyfus June 8, 2005

In Frontpage’s recent symposium, The Radical Lies of Aids, I was dismayed and surprised that, in a roundtable discussion on the current state of HIV/AIDS, no mention was made of Islamic cultural habits and African tribal customs.

The experts on the panel parse the “puzzling” absence of causes for the widespread HIV pandemic in Africa, legitimately dismissing the foolish, politically correct notion of heterosexual HIV transmission -- fostered so fatally for the past 25 years and which has led to the needless deaths of so many thousands. Indeed, once upon a time, the self-appointed HIV disease handlers had to pretend that various populations were at risk who were not at risk at all. They could thus belabor and wheedle reluctant funding out of the government and the Centers for Disease Control. President Reagan, remember, pretty much ignored the phenomenon for more than four years. The “next risk group,” however, has never been ordinary heterosexuals with no IV drug or promiscuous sexual habits, which is what the ballyhoo remained for too long, while the real culprits never got proper attention.

As the Frontpage symposium indicates, homosexual-rights interest groups refused to consider closing bath-houses and notorious sex-parlors in the three disease hotspots -- New York, San Francisco and LA. They refused to advocate the historically tried and true containment methods of behavior modification or contact tracing, insisting on the far weaker alternatives of “safer-sex” and universal condom usage.

The problem is that condoms are hardly foolproof in the best of times, and HIV/AIDS has been one of the toughest tests they have had to weather. Dismissing the hocus-pocus of healthy partners in penile-vaginal transmission, or vagina-penis disease transfer – it is much harder to transfer disease entities from females to males, for a variety of reasons -- the experts in the symposium seemed oddly unclear as to what can be reliably pointed to as plausible explanations for the continued spread of HIV. Yes, they did acknowledge the well-documented and well-understood actions of accidental pin-sticks and poor technique, office-based error, non-professional insertions, “barefoot doctors” and the like, which are called “iatrogenic” causes. Needle punctures, from dirty or used syringes or application error, are a prime vector of transmission -- but this cause is responsible primarily for medical personnel becoming infected. Not, usually, actual patients or nonmedical people.

In other words, dirty needles and bad medical technique can hardly -- especially in the case of Africa -- be considered the primary cause of fatal HIV transmission. After even one visit to Africa -- I have made six -- one learns that sexual custom for men in many tribes, in urban as well as rural areas, includes extramarital sex with non-local females, prostitutes, as well as with boys, often, and even with animals, when females are unavailable. The male then returns to the bed of his wife or common law mate.

All viruses and sexually transmitted diseases (STDs) picked up from the unfaithful sexually active mate find a hospitable environment in the misused wife and incubate into various forms of sexual disorder or, of late, especially into HIV. Sadly, the now visibly-ill women are frequently blamed for initiating the disease: beaten, divorced or otherwise abused. This is a frequent Islamic reaction from husbands, brothers, fathers, even sons, to the perceived ‘dishonoring’ of the family or rape of their (innocent) women.

More relevant in this cultural inplication is that more than 100 million, even as many as 140 million -- that is correct -- African girls and women are estimated by WHO and (among many others) as victim/recipients of female genital mutilation (FGM, also called infibulation). Infibulation in the medical literature or public arena is so widespread and so taboo that it assumes a special place in the history of hushed-up critical problems in the world. Like not mentioning that woolly mammoth smack in the middle of your living room.

Because it is considered a private, 'social' or often a “religious” issue, one that riles up many Muslim (male) “authorities” and average healthcare practitioners, infibulation –FGM -- is a major third-rail political agenda, one vociferously denied and hotly “debated” in outrage with anyone intrepid or foolhardy enough to bring up such a detonating topic.

The existence of virtually ubiquitous FGM in African tribal cultures guarantees long-term vaginal tissue damage, as the genital mutilation has been performed --without anesthesia or sterile tools of any sort-- by lay non-physician practitioners, usually female, acting on shanghai’ed and unprepped preteen girls. After “stitching” with rough thread or twine, the local medicine woman leaves an opening the width of little more than a matchstick head. Barely enough to expel ureic wastes or menstrual fluids.

At marriage -- or rape -- the force of intercourse on this wrecked and nearly nonfunctional site instigates massive tissue damage, and initiates a wound site that is continually subject to infections, bleeding, bacterial fester and disintegration of various sorts, including the proliferation of bacteria and viruses from prior sexual encounters and new diseases foisted on them by their men.

The use of barrier prophylactics, condoms, which some say is effective as anti-STD-transmission, is firstly, frowned upon in black African (often Muslim) or animist societies as “unmasculine” and suspect; secondly, haphazardly practiced, if the woman is lucky enough to be with someone willing to use one; and thirdly, widely acknowledged to be tragically undersupplied in the third-world regions where HIV casts its longest and darkest shadows.

Add two other salients: condoms cost money, even in Africa. And prostitutes cannot charge unsympathetic customers the going rate if they try to use such fanciful flourishes.

In concert with a disregard for safe or practical concepts of sex, or with animal-human sexual encounters that are still a sometime-habit in Africa to contend with, intimacy with a sexually wandering mate often provokes painful and persistent gynecological disfigurement and exacerbation as well as the flourishing of any lurking HIV. Normal sexual intercourse with healthy females and non-HIV-carrying mates is known to be a safe bet in relation to contagion in every other circumstance, so there is no reason to think that, given similar circumstances--healthy male-female intimacy in Africa--there would be an upsurge in reported cases of HIV/AIDS.

Vaginal intercourse, difficult and painful for African females who have been brutally deprived of their clitori by FGM (whose purpose is to stem their sexual hunger, lust or potential unfaithfulness to future spouses) often leads to male preference for anal intercourse at home. Fragile rectal tissue in all people yields only reluctantly to force, of course. The subsequent lesions and tissue breakage in the female anal tract (no less, of course, than in the male, which is the source of the lion’s share of homosexual transmission) is anything but unfriendly to the blossoming of the virus.

Childbirth of course presents more complicating factors, and often leads to HIV-afflicted infants.

The intransparency of male sexual misbehaviour -- their failure to admit what they have been doing-- in almost all of Sub-Saharan Africa adds to the difficulties scientists and investigators have in discovering the means of transmission of many diseases, especially in viral-origin diseases so much in the news today, but is an open secret to locals, and those who -- equally passionately -- refuse to subject their “private” erotic behaviors of dismissive sexual abuse to their women to the open air of detailed examination and rigorous scientific discussion.

Despite strong medical considerations, many tribal and Islamic councils have consistently voted to continue the primitive practice of clitoral ‘circumcision’ so as to ensure their females' continued “purity” and an unsullied “family honor.” And if, as the literature attests, victims of FGM do have a lower incidence of HIV, the reasons are easy to adduce: Such women have less sex, far fewer sexual contacts; they clearly don't seek out sex as much as their unmutilated sisters, and consequently their risk and their exposure, and thus their incidence of disease, is less.

If this writer has seen such casual abusive treatment of women and ignorance of the transmission modes and loci demonstrated by the Islamic or local animist males in many African cultures, and has heard numerous tribesmen, with some measure of both embarrassment and pride, admit their sexual proclivities in countries as diverse as Sudan, Egypt, Uganda, Zambia, Mali and Zimbabwe, Kenya and Tanzania, these countries, while suffering the difficult societal constraints upon women imposed by the minority religion of Islam or animism, the problem is even more notable in countries where the dominant religion is Islam, or is becoming more Islamo-dominant, such as Nigeria, and tacit prohibition on discussion of FGM (cliteridectomy in more 'advanced' circles) is even more pronounced. Mothers in countries coming under increasing Islamic influence must be constantly vigilant to prevent their daughters from falling into the hands of FGM proponents.

Conversely, women in countries where modern Christianity or other non-Islamic faiths are entrenched or experiencing inroads are likely experiencing a growing, if below-the-radar, resistance to a practice that has come to be regarded as mandatory in order to ensure a good marriage partner, although the Qur’an does not, strictly speaking, order it: Muslims have apparently adopted this modality by themselves, in fervid and random excess against the possibility of female orgasmic pleasure hinted at in the Qur’an, where women are “nine parts of desire” (to men’s single part out of 10).

FGM has been practiced for as little as 1400, and perhaps as long as 2000 years, among the nomadic and African tribes and, since the advent of Islam in the seventh century, by Muslims. In terms of how much mutilation women endure, once the extreme-practice version has been practiced in any region, as seen in many religious arenas, it is difficult to go back to the more moderate, less extremist version. Some practiced only to “minimize” the size of the “outsize” clitoris (Egypt), where others removed all labia plus clitoris under the general rubric of 'less [sexual tissue] is… more secure [against sexual enjoyment and unfaithfulness].'

Current research indicates those females fortunate enough to have mothers educated beyond even the third year of school often escape the predations of this ugly and joy-deadening procedure. Such women, accordingly, will be far freer of HIV/AIDS than will their less fortunate captive sisters under the terrible aegis of a pre-medical faith that has yet to be updated to contemporary standards of hygiene and routine healthcare practice. Of late, several women (a Somali case was in the news some years ago) have notably sought refuge, even the legality of political asylum, as escapees of the procedure in the United States.

That a cautionary symposium, "The Radical Lies of AIDS," would be missing such important and critical elements of the African and, particularly, Islamic experience is unfortunate and in need of a crucial corrective.

There is something all of us can do to make a change in terms of the terrible crime and tragedy of FGM. While FGM, or female circumcision such as that described here, is illegal in advanced countries, some animist religionists and Islamic practitioners occasionally try to foist it on their female children in the United States and the West, by coercing or bribing sympathetic medical practitioners. Such tragic efforts must be strongly resisted, and practitioners brought to the attention of municipal medical authorities. Healthcare practitioners must refuse to perform the operations. As modern healthcare methods are becoming more understood, more educated females are learning of the consequences of such primitive customs, and the practice has, happily, been fading as newer generations become acquainted with the physiological costs, dangers and damages.