National Geographic Daily News
Lunsar, Sierra Leone. Rugiatu Turay strokes the hair of Isattu Jalloh, 11, who was circumcised at the age of 6 and then raped by her uncle. Turay fights against female genital mutilation and maternal health in the district.

A woman strokes the hair of a young girl who was circumcised in Sierra Leone.

Photograph by Jan Grarup/laif/Redux

Efua Dorkenoo is the Advocacy Director, FGM programme in Equality Now’s London office.

Photography by Brendan Wynne, Equality Now

Rachel Hartigan Shea

National Geographic

Published July 26, 2013

In Egypt, 91 percent of women between the ages of 15 and 49 have undergone female genital mutilation, the partial or total removal of their external genitalia. In Somalia, the figure is 98 percent. More than 125 million women and girls living in Africa and the Middle East have endured the procedure, with 30 million girls at risk over the next decade.

But the practice of female genital mutilation is gradually declining, according to a report issued this week by the United Nation's Children's Fund (UNICEF). Younger women are less likely to have undergone the procedure than women in previous generations, and they are less likely to support it for their daughters.

To find out more about female genital mutilation, National Geographic spoke with Efua Dorkenoo, advocacy director for Equality Now and a recipient of the Order of the British Empire for her campaign to stop the practice.

You have been working on the issue of female genital mutilation since the 1980s. Why did you first get involved?

I was working as a midwife in the U.K. [and delivered] a woman who had the most radical form. There were various complications.

When you say the most radical form, you mean that her clitoris had been removed and the outer lips of her labia had been sewn shut?

Yes.

Did she survive?

Yes, but it introduced me to the subject in terms of trying to understand as an African what the practice is about.

Does female genital mutilation cause immediate health problems?

Most of FGM is done by traditional practitioners with crude instruments and no anesthetic. Girls go through traumatic pain, they may develop infections, they may lose blood, and sometimes it leads to death. We don't actually have figures for the number of girls who die from the operation—it is often done in rural areas where deaths are not recorded—but when you speak with families, they always tell you about one family member who died from it.

If the girls survive, later on they have long-term complications like pain during intercourse, loss of sensation during intercourse, and childbirth problems. They develop cysts, keloids, and psychological complications, a risk that's quite neglected but is coming up quite a lot.

How long has this tradition been in existence?

We don't know exactly when it started, but in some communities they would trace it back 3,000 years. It's been in communities for a very long time.

What are the reasons that people give for subjecting their daughters to female genital mutilation?

One of the most common reasons given for FGM is that it enforces virginity, chastity, and fidelity in women. Muslim groups that practice it say that it's a religious obligation, although it is not in the Koran and most Muslims in the world do not practice it. (It's also practiced among Christian or indigenous religions.)

Others might say that it's at the core of initiation rituals, that it's part of what makes you a woman. That is quite common in West African countries—for example, in Sierra Leone and Liberia.

In some places like Egypt, they also link it to aesthetics: The external genitals are dirty, they don't look nice, it looks so ugly that it needs to be taken out. In some areas, they say that if you don't take the clitoris off it will elongate and become like the penis of a man.

In the areas where they do the most radical forms—where almost everything is taken off and the place is closed up, like in Sudan, Somalia, Djibouti, parts of Ethiopia, parts of Mali—the main reason is to make sure that nobody touches the girl until she is married. Then that place has to be widened for sexual intercourse.

The UNICEF report found that there's been major reductions in female genital mutilation in a few countries like Kenya, Burkina Faso, and Tanzania. How are those countries halting the practice?

In Burkina Faso, for example, there is leadership from the government, which openly acknowledges that it is a women's rights and a children's rights issue. They are trying to address it from different angles, one that incorporates education, protection measures, and also prosecution. They have put quite a few people in prison for it.

In the areas where FGM is going down, it has been addressed in a violence against women framework. It's a gender power control issue, and it is not something you can just educate people out of. It requires people to think that if they do it, there are ramifications. We cannot just rely on people's good will.

The practice doesn't seem to have declined in Senegal, the site of a much-touted program. Why is that?

You would expect that after heavy, heavy investment by United Nations agencies, we should have seen some significant drop, but we haven't. It just shows that community mobilization and education are not enough to stop FGM.

You've been working on this issue for the last three decades. How optimistic are you?

When I started, we couldn't even discuss this issue. Now there's a growing voice, particularly among younger people, which is very, very satisfying.

This interview has been edited and condensed.

Follow Rachel Hartigan Shea on Twitter.

17 comments
Nia Imman
Nia Imman

no they still mutilate vaginas and rectums because the men can feel it

Michael Tsark
Michael Tsark

[Edited: Typo-errors corrected.]

Aloha, Michael here, I represent our original source family who created the psych-System which has been secretly governing the future welfare-destiny of our entire family species for the last tens of thousands of years and I most humbly as well as so very deeply apologize to everyone on earth for all of the harsh and drastic measures our family ancestors much needed to forcefully implement upon us in order to safely constrain our family species' breeding growth-rate from ever out-breeding our global food supply. Please help us to respectfully inform all of our practitioners world-wide that their source family fully and respectfully recognizes their steadfast devotion and that all of their wonderful dedication has been duly noted. Then please further inform our practitioners that the family has finally and currently managed to successfully sustain a safe global breeding growth-rate to a safe-zero thereby making many of our standard traditional medical treatments around the globe no longer valid nor necessary. Then finally please let them know that on behalf of their source family I respectfully wish to personally extend our sincerest gratitude to each and every one of our practitioners on a job well-done for all services rendered in helping towards protecting the serious interests of all of our entire family species including our future descendants as well.

Mahalo to all for helping us get the word out and your cooperation is greatly needed and appreciated.

Most sincerely and very truly yours , aloha from Waianae, Hawaii,

Dr.(h.c.) Michael Tsark

Michael Tsark
Michael Tsark

Aloha, Michael here, I represent our original source family who created the psych-System which has been secretly governing the future welfare-destiny of our entire familly species for the last tens of thousands of years and I most humbly as well as so very deeply apologize to everyone on earth for all of the harsh and drastic measures our family ancestors much needed to forcefully implement upon us in order to safely constrain our family species' breeding growth-rate from ever out-breeding our global food supply. Please help us to respectfully inform all of our practitioners world-wide that their source family fully and respectfully recognizes their steadfast devotion and that all of their wonderful dedication has been duly noted. Then please further inform our practitioners that the family has finally and currently managed to successfully sustain a safe global breeding growth-rate to a safe-zero thereby making many of our standard traditional medical treatments around the globe no longer valid nor necessary. Then finally please let them know that on behalf of their source family I respectfully wish to personally extend our sincerest gratitude to each and every one of our practitioners on a job well-done for all services rendered in helping towards protecting the serious interests of all of our entire family species including our future descendents as well.

Mahalo to all for helping us get the word out and your cooperation is greatly needed and appreciated.

Most sincerely and very truly yours , aloha from Waianae, Hawaii,

Dr.(h.c.) Michael Tsark

Claudia Cappa
Claudia Cappa

My name is Claudia Cappa, and I am the author of the UNICEF report.    
    We found that the main reason why girls are cut was rather surprising.   While it is true that some people  reported  the preservation of  chastity and fidelity as reasons to cut,  our analysis shows that the practice continues because people feel that they must, out of a sense of social obligation.And the data shows that the practice persists, even though most people think the practice should end. (see p.117)  
   In fact, among girls and women, the most common reason given for continuing FGM/C is to gain social acceptance. The data also suggests that female genital cutting persists in part because of a lack of communication between men and women around this topic, with people assuming that support for the practice is more common than it actually is. (p. 64).
  In addition, the statement about the effectiveness of efforts to abandon the practice in Senegal is incomplete. Due to the time lag in the measurement of the practice, when the next nationally representative household survey is undertaken in Senegal in a few years, we will be able to assess the outcome of the last decade of efforts more fully.UNICEF is undertaking further research to examine the situation in Senegal at sub-national level and across different ethnic groups.

Andrew Riley
Andrew Riley

 @Nicole Brown  @Nicole Brown Such a strong response Nicole.. There is a contiuum in female genital cutting that goes on one end from a nick in the clitoral hood to the other end where major parts of the external genitalia are removed, and the vaginal opening is sewed shut. As far as I can tell your post condemns all of these as the same, when there is, in fact, a major difference from one end of the continuum to the other. The other thing to keep in mind is that this practice is being carried out by women who have also gone through female genital cutting. Just as some experience the practice as a torturous event others experience it as an event with great meaning. Either way women are handing down this practice to their daughters. 

My point is: Even though female genital cutting may be bad for the female condition, it is too large of an issue to make un-nuanced polarizing statements about what should or shouldn't be done. Before we condemn cultural practices dialogue needs to be initiated with the women who perform and the girls who go through this ritual. Then intervention and education can begin.

Nicole Brown
Nicole Brown

I certainly hope that there is an end in sight for both female AND male genital mutilation. It is an abhorrent, barbaric, and permanently damaging practice, a human rights violation like no other. Thankfully, and due in large to the internet and the ability to research and connect with others, there ARE people speaking out against circumcision. And there should absolutely be NO DOUBLE STANDARD. ALL circumcision is genital mutilation. There is zero health benefit to amputating healthy, FUNCTIONING body parts. But there are a myriad of problems that can and do occur... men, women, and babies die, and we falsely believe that it is something which must be done for health reasons or religious reasons. 

It will come to an end, that is for sure. Too many people now know the truth and more and more people are protesting this atrocity. If not in my lifetime, I certainly hope genital mutilation will be put to death in my children's lifetime. 

Ty Gurr
Ty Gurr

So, why has it just been FGM?? Has there ever been the call to remove a scrotum or tie down a penis so (boys) don't get "touched" until they're married???

How tragic for those little girls and what they have to endure as women.

Ron Bockman
Ron Bockman

"Is the End in Sight for Female Genital Mutilation?"

not as long as there are moslems and Africans

Julieta Guevara
Julieta Guevara

Uff terrible esta costumbre.  Dios quiera que ya paren de hacerlo es una aberración a la mujer y un trauma para siempre...

Gerardo J.
Gerardo J.

@Andrew Riley @Nicole Brown There are scientific studies proving some health benefits for male circumcision. That's a fact. Just like there's no benefit (health or otherwise) in FGM. That's a fact too. I agree with Andrew that saying "Al mutilations are equally dreadful" is, in itself, too simplistic.

Still, that's where the line between study and advocacy becomes blurry. We can't condone practices that would otherwise be considered criminal just because they're "cultural values and cherished traditions" of people around the world. That could make us fall in cultural determinism and solipsism.

Yes, we can study cultures, but we can't justify pernicious practices only because we understand how they came to be and because they might make sense in their context.

Yes, definitions and studies are mostly Western. Yes, this means views are subdued into Western paradigms. Yes, Westerners suffer (and make others suffer) from a Messiah complex. But there's a point to systematic study: to find out universal standards to make humans work better in their groups, with other groups and with the environment. That's the debate that needs other cultural views.

Mrs. Dorkenoo said it herself: you can't just educate people out of (some) things and you can't just rely on people's good will. There needs to be enforcement that overrules simplistic ethnologic respect. If human trafficking is a felony all across the globe because in threatens human rights and safety, we can't excuse it in places where it's become traditional (like some places in Mexico). What about child marriage, adult-child marriage, and anthropophagy? Should we allow these where they're cultural values or where people can make a strong case for them?

There needs to be some standard even if it implies a bit of an ethnocide, because there are some practices that cannot be truly defended and should be regulated.

Blurry, I tell you.

LaVerne Keller
LaVerne Keller

@Ty Gurr The reason for the focus on FGM is that it's largely because of the paternalistic desires of the men in those cultures that it's women who have to be kept virginal. That a man only wants his bride to be a virgin, in such societies the males are the only ones of value, girls and women are strictly viewed as chattel, property nothing more or less then that. That is why if we want to end such barbaric practices as FGM and 'Honor Killings' by the husbands and or fathers of female family members it's going to take an International Law that condemns such practices and lays sufficient penalties that they become undesirable by the men in those societies. The kind of thinking that supports such practices belong in the dark ages with the sort of thinking that pushes the desire for forcefull conversion to their religion Islam.

Sayydah Garrett
Sayydah Garrett

@Ron Bockman Actually, Ron, I'm a Muslim woman who has started a non-profit to end female genital mutilation in Kenya, Africa.  So, your comment is quite incorrect.  The other founders of our organization, Pastoralist Child Foundation, are young, intelligent, educated Africans who want to eradicate female genital mutilation.  The end is in sight!  YAY!!!

Jennifer Vaujin
Jennifer Vaujin

@Ron Bockman Talk about a bigoted response. If you can't even spell the name of the religion right you clearly don't know enough about it to judge.

You obviously didn't read the part of the article that said "it is not in the Koran and most Muslims in the world do not practice it. (It's also practiced among Christian or indigenous religions.)"

Before you make sweeping generalizations and condemn an entire group of people you should actually know what you are talking about.

It's people like you who give Americans a bad name.

LaVerne Keller
LaVerne Keller

@Jennifer Vaujin it's you who is showing a very biased view here Ron is absolutely correct in stating that it's the fundamentalists who support such practices as FGM and 'Honor Killings'. The same one's that throw acid in the faces of young girls in Afghanistan for the 'crime' of wanting an education are the one's who support these barbaric practices. That is because they have an extremely paternalistic view and interpretation of the Koran and Hadith which views girls and women as nothing more then chattel, property to be bought and sold, brutalized repressed and even killed for harming the mans honor. While I agree that it isn't in the Koran it is in the Hadith which are Mohammed's personal ideals in written form, not to mention that while there maybe moderate moslems(muslims) Islamic believers they are oddly silent when the extremists like the Taliban and Al Qaeda commit such attrocities. What it's going to take to bring an end to these barbaric practices is for the moderates in all of these backwards societies to stand up and say NO MORE. So again Ron is correct in his post as for the spelling of Moslem(Muslim) it can be spelled either way and has been over the centuries since it's creation. To be perfectly correct the actual word for the religion and it's followers is Islam.

Sayydah Garrett
Sayydah Garrett

@Jennifer Vaujin Love your response, Jennifer.  Please visit our site at www.pastoralist-child-foundation.org  Not only are we working to eradicate FGM, we are sponsoring girls' education and have sponsored 5 girls!!  We love what we're doing and are confident that we'll have a great success rate in wiping out FGM in Samburu and Maasai Mara, Kenya, eventually expanding to other rural communities. Peace and blessings always.

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