FGM in Somalia: It’s About More Than Awareness

Karoline Kemp

Somalia has the world’s highest prevalence of Female Genital Mutilation/Cutting (FGM/C). To date, most interventions aimed at ending the practice have focused on awareness raising around its harmful effects, and small but notable shifts have taken place. However, targeting only this “demand” side is not enough. The women who carry out the actual circumcisions, that is, the practitioners, have been neglected in these interventions. Any lasting impact will need to include this “supply” side of FGM/C.

Puntland: A Case Study

A study carried out in 2010 by the Puntland Centre for Human Rights and Democracy[1] found that over 92% of girls and women in Puntland, a semi-autonomous region in the north-eastern part of Somalia, had been circumcised, with the majority (72%) undergoing the most severe form of infibulation.[2] The same study notes a number of reasons for the practice, practiced over centuries, including religious, cultural and health factors. A quarter of respondents (25.8%) said that FGM/C was performed for religious reasons (some noted this as a requirement), while 17.3% believed that the practice preserved a girls’ virginity; 13.1% believed it was a positive traditional practice to be maintained and 12% said that it kept a girl clean. Respondents also believed that FGM/C increased a girl’s’ chances in marrying, and that girls who have been circumcised are considered more religious or holy. At the same time, the majority of respondents of the same study recognized that there were harmful effects of FGM/C, including painful menstruation and intercourse, urinary infections and other health complications. Respondents also noted that FGM/C could lead to early marriage.[3] In rural areas, FGM/C is generally performed at certain times during the year: 51.1% are carried out in the dry season (June to August, and December to February) – and 32.1% in spring (March to May); girls are often pulled out of school to coincide with these times.

This same study found that the percentage of respondents in favour of the continuation of FGM/C was high, at 81.6%. For those 18.4% of respondents who supported the eradication of the practice in their communities, 31.3% thought FGM/C to be against Islam, 37.3% thought FGM/C to be harmful to girls, 16.9% said that it was a negative aspect of culture/tradition, and the remaining 14.5% based their wish for the elimination of FGM/C on information received from awareness-raising campaigns. These statistics point to a number of interesting factors, such as the wide range of opinions that exist within a single community, where there may be more liberal families that do not support the practice but feel pressured to conform, or staunch traditionalists who even refuse to concede that the practice is harmful. In addition, it also shows some effectiveness of the awareness raising campaigns that have targeted the “demand” side of FGM/C; while it is difficult to know the extent to which these campaigns have reached the grassroots level across the different (and predominantly rural) locations across Somalia, efforts to raise awareness on the issue have been ongoing since at least the 1970s.[4] Edna Adan, a well-known Somalilander, was involved in many such initiatives and was the first Somali to publically denounce FGM/C. The Somali government then based in Mogadishu worked with groups such as the Somali Women’s Democratic Organization, the Academy of Arts and Sciences, the University of Mogadishu’s medical and nursing faculties and campaigned for the eradication of the practice on health and religious grounds. The early focus was based on the health-related implications of FGM/C, as human rights concerns were seen as too likely to fail. When the Siad Barre regime fell in 1991, these efforts also ended. In the following years, UN agencies and local non-governmental organizations stepped into this work, but increasingly, government bodies are again addressing the issue in partnership with these other groups.

In 2011, the Government of Puntland passed the Prohibition of Female Genital Mutilation Act, which defines FGM/C as “all procedures involving partial or total removal of the female genitalia or other injury to the female genital organs, or any harmful procedure to the female genitalia, for non- medical reasons.” The government is currently focusing its energy on community-level awareness raising on FGM/C, in support of the policy. Local and international organizations complement this work with campaigns targeting religious and traditional leaders (as opinion shapers), men (who often demand that their future wives be circumcised) and women (who generally decide what form of circumcision their daughters will receive). In 2012 the United Nations passed a resolution banning the practice of Female Genital Mutilation/Cutting (FGM/C)[5]. But, resolutions like this one and laws and awareness-raising campaigns only go so far. All these actions fall short of responding to the “supply” side of the practice – that is, targeting those who actually carry out the practice.

Traditionally, FGM/C in Somalia’s north-eastern semi-autonomous region of Puntland is the profession of the women of the “Madhibaan” clan (considered a minority clan in Somalia). These women have been FGM/C practitioners for generations, trained by their grandmothers, mothers and aunts from a young age. Learning the practice by assisting and observing their mothers and grandmothers in action, the women consider it to be a skill or profession unique to their clan. Most of these women have limited education, expecting that they would carry out the practice that their mothers and grandmothers passed on, handing down the skills from one generation to the other. There is, however, some underlying tension: while the women in this clan are generally seen to elicit some form of respect, prominence or status from their roles as circumcisers, they are also a minority group in the larger community and the work they carry out has some stigma attached to it.[6]

In all cases, however, these women earn their livelihoods from this practice, and the income generated from this practice can be relatively significant. Anecdotally[7], some of these women report earning up to USD 2,500 in some months. In a region where the annual GDP is USD 284[8] (according to the most recent Human Development Report for Somalia[9]), this is a huge amount, and goes towards sustaining not only the immediate family of a practitioner, but also her extended family and clan members.

A Promising Trend?

Increasingly, FGM/C practitioners are coming to realize that their work is perhaps in danger of dying out, providing a key opportunity for the Government, the United Nations and other organizations to target them; these women have clearly seen the awareness-raising campaigns in their communities[10], and all of them are aware that the practice is not, in fact, Islamic —advocacy campaigns generally make use of local religious scholars/leaders, as well as medical practitioners and women’s rights advocates. One woman said, “It is a sinful act, but in the past we never knew. Since now we are aware of it, we are committed to stopping and ending this “haram” (forbidden, or “not done”) thing.” They are also well aware of the health risks, and some even going so far as calling it a “crime against humanity,” seeing first-hand the harmful effects of the practice. Dhudi, a practitioner from Bosaso, shared a story highlighting these risks, in which she was called to come and “open” a girl so that she could consummate her marriage. When she arrived, she realized that a medical procedure was required and that this was a direct result of FGM/C: “I refused to help because I knew that if anything went wrong she could die from loss of blood, and I didn’t want to be the one to kill her. So I referred them to the hospital in Bosaso. Before I left they told me they would never circumcise their daughters.”

These shifts in thinking and understanding have led more than one practitioner to call FGM/C a “dying practice.” Cosob, from Buhoodle in Puntland’s Ayn region, who has been a FGM/C practitioner for 22 years, said, “I used to circumcise 22-30 girls on average per month, but in the past few months (May and June, 2013), I have only circumcised eight girls.” In the urban areas, they said that mothers were increasingly asking only for the lesser form of sunna (clidoridectomy) to be performed. One woman said “Nowadays we don’t get to perform “gudniinka fircooniga ah” (the form of infibulation practiced most frequently in the past). The gudniinka fircooniga ah is more pricy than the sunna version.” The practitioners, from all over Puntland, said the same thing – that there was a decreasing demand, that soon they would not be asked to perform the procedure anymore.

Targeting demand…. And supply

The FGM/C practitioners said that they had been left out of discussions about how to successfully eliminate the practice in their communities. They pointed to the importance of campaigns, especially those led by religious leaders, using media, mosques, community gatherings, mothers, as well as male and female youth. They also highlighted that effective laws, with strict punishment for violation, would help. But the practitioners also noted that they themselves could play a vital role in ending the practice, despite the fact that anti-FGM/C campaigns had so far not taken them into consideration, or even approached them to support campaigning efforts. If practitioners were to be targeted, this “supply” side of the practice could be cut, since those providing the service would become scarce. One woman said, “We are willing and ready to act as an example, leading the path for others in the region to abandon the practice.”

The women were willing to abandon the practice of cutting[11]; however, their reliance on the income from FGM/C is a major barrier to realizing this. A long-term, sustainable approach requires that the practitioners have an alternative livelihood that provides them with a regular income to sustain themselves and their families. With limited education levels and skills that they could apply in income-generating activities, the idea of alternative livelihoods is foreign to the women, and because of their nomadic/pastoralist backgrounds, most are generally not familiar with the skills required to run small businesses (an area where in general, women dominate in Puntland). The increasing age of some of the practitioners also means that “re-training” is perhaps not feasible. Based on the information gleaned from these women, in any intervention targeting this supply side, a number of factors will be important. First, any start up grants or loans would have to ensure that they are significant enough to draw these women away from what is a relatively lucrative business. This is especially important in a post-conflict economy, where work is scarce, and anyone stepping out of any kind of business/trade would be very likely to be replaced by someone else almost immediately (which points to that fact that that there is also definitely a pull factor to the profession based solely on income, and not on moral or religious grounds). Second, cooperative endeavours may be important in order to ensure that older women are also given a chance to earn an income if they are unable to start or manage their own individual initiatives. This could involve setting up groups of women working in the same areas, or even partnering older women with younger ones (including daughters with their mothers). In addition to specific livelihood training in business skills, basic education such as literacy and household financial management would also be beneficial, particularly as basic budgeting, debt management and living hand to mouth are real and prevalent challenges for most women. Many women noted that falling into debt was one of their biggest fears, but also revealed that they had limited knowledge on how to budget for the future. To this end, one-off grants are not enough: on-going business coaching and problem solving as challenges arise should also be provided, especially in an environment where the gap in income between their former practice and new business could be significant, and where new skills have just been introduced, in order to ensure the application of these skills and to be able to trouble-shoot existing or potential problems. Continuing to engage the women as a network and through peer support and encouragement would also be important, as it would ensure that the women do not feel alone in these efforts and would contribute to preventing them from returning to their previous income generating activities related to FGM/C.

This is obviously not going to happen overnight. While anecdotal evidence suggests that the more severe form of circumcision is being less and less practiced, the lesser forms are still being requested, and FGM/C practitioners are obviously responding. Therefore, targeting both the supply and demand sides of the practice makes obvious sense, and needs to happen simultaneously.

[1] Ahmed Abdirahman Hersi: “Baseline Survey Report on Female Genital Mutilation/Cutting in Puntland State of Somalia,” 2010.
[2] The World Health Organization (http://www.who.int/mediacentre/factsheets/fs241/en/) defines four major types:
    –   Clitoridectomy: partial or total removal of the clitoris and, in some cases, only the prepuce.
    –   Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora.
    –   Infibulation: narrowing of the vaginal opening through the creation of a covering seal, formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
    –   Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.
[3] According to FORWARD UK, “there is also a clear link between Female Genital Mutilation (FGM) and child and early marriages. Communities who practice FGM are also more likely to practice child marriages and in some FGM practicing communities FGM is carried out at puberty and then marriages are arranged immediately afterwards. It is also common in FGM practicing communities for a man to refuse to marry a girl or woman who has not undergone FGM, or to demand that FGM is carried out before marriage.” (http://www.forwarduk.org.uk/key-issues/child-marriage)
[4] Edna Adan Ismail: “Female Genital Mutliation in Somaliland: 2002-2009.” Edna Adan Maternity and Teaching Hospital.
[5] UN Women: “United Nations Bans Female Genital Mutilation,” 20 December, 2012 (http://www.unwomen.org/en/news/stories/2012/12/united-nations-bans-female-genital-mutilation/)
[6] It should also be noted that because of the economic situation in the region and the lucrative earning potential of circumcision, women from other clans have begun carrying out this work.
[7] Unless otherwise referenced, the information presented in this paper, particularly when directly related to findings from FGM/C practitioners, was collected during a series of workshops in June 2013, which were held across Puntland and gathered a total of 60 women in six different locations. The purpose of these workshops was to provide training on alternative livelihoods, as well as small grants (in this case, skills for running small businesses), and were carried out in collaboration between UNDP Somalia and Puntland’s Ministry of Women and Family Social Affairs (MoWFSA).
[8] However, this figure does not include remittances, on which up to one third of Somali families, and two thirds of families in urban settings rely exclusively for their livelihoods (see: http://www.irinnews.org/report/54469/somalia-remittances-a-lifeline-to-survival). In addition, the HDR was released in 2012, using figures from 2011, during which Somalia was at the height of famine, thus representing a stressed economy.
[10] Campaigns aimed at eradicating FGM/C have been taking place for many years, but have not been targeting FGM/C practitioners specifically until relatively recently. Regardless, the general advocacy messages do seem to have reached this particular group, according to them.
[11] This information was based on discussions being translated from Somali to English to me, and therefore some room for interpretation and nuance must be left.

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