It’s Beautiful & Should Be Left Intact
This paper was written during my nursing studies and published in the
New Zealand Nursing Journal
I am a third year nursing student originally from Somalia and have been living
in New Zealand for the last five and a half years. Nursing has been my
childhood dream. I am lucky that I have two cultures, my native one that I was
brought up in and my adopted "kiwi" culture. I have had the
opportunity to compare the two and expand my knowledge. The reason that I
wanted to write this article is that I want to share my knowledge and
experience with other nurses and health professionals. My professional interest
in the future is that I would like to work with women and young children.
HISTORY
I would like to introduce you briefly to the past and present history of
Somalia and the Somali people in general. Somalia is an East African nation
which has borders with Kenya and Ethiopia. 98% of Somalis are Muslim and speak
one language which is Somali. They belong to six main clans and approximately
75% of the population is rural or nomadic. The other 25% live in big cities
such as Mogadishu and small towns such as Hargeisa and Kismayu.
Somalia was colonised by the British in the north from 1905 and in the
south by the Italians. Independence was gained from both colonial powers
in 1960 with the formation of the Somali Democratic Republic. The civil war
broke out in January 1991 with the ousting of Mohammed Siad Barre after 21
years of dictatorship. The war has had a huge impact on the Somali people but
more particularly women because of the patriarchal nature of the society. The
reason for this is that although intermarriage is practised between the clans,
the children automatically belong to the husband’s clan. Women were therefore
caught in the middle trying to keep their families together as the clans fought
over power and access to resources.
Family law was introduced in 1975 under Barre’s regime, that permitted
women to inherit equally with men, but the pressure from fundamentalist
religious leaders with the support of Islamic law, which states that women can
only inherit half of what men can, led to this being unsuccessfully enforced.
Islamic law also permits polygamy which was always the rule rather than the
exception. Under Islamic law, divorce may be granted to a man with relative
ease but a woman must have her husbands consent
Somali customs are interwoven with Islamic traditions and this has a
significant influence on the role of women. Women and men interact freely in
public places such as markets, universities and social gatherings etc. so long
as the interaction is verbal only.
FGM
A custom which has a major effect on the health of women, is female
genital mutilation (FGM), sometimes referred to as female circumcision. FGM
affects the lives of more than eighty million women in Africa and around the
world. Ritual circumcision as it is performed in many African countries, is
clearly designed to desensitise and to weaken women’s sexual desire in order
for men to have control over women’s bodies and sexuality.
This custom is no longer one that concerns only "other parts of the
world". It is also becoming a home grown problem here in New Zealand
because of the acceptance of Somali refugees as part of the global quota
programme.
The exact origin of FGM is unknown even though it has been practised for
at least 5000 years. It is thought to have originated in ancient Egypt and is
often called pharonic circumcision. FGM predates Islam but many people believe
that there is a religious obligation to circumcise girls although it is not
mentioned in the Koran. Islam puts high value on chastity and that is possibly
one reason why it did not attempt to abolish the practice when the religion came
into the African continent.
Mutilation or circumcision in varying degrees of severity, is routinely
inflicted on girls and young women, depending on the custom of the tribe. In
Somalia, circumcision is often accompanied by a small ceremony, which is anticipated
by the participants. FGM may also be considered as a rite of passage.
There are different types of mutilation. Firstly there is clitoridectomy
which involves the removal of the clitoris. This is commonly referred to as
sunna circumcision. Excision is the removal of the clitoris together with some
parts of the labia minora and two thirds of the labia majora. The two sides are
scraped and the vulva pinned together leaving a small opening that permits the
passage of urine and menstrual blood.
Equipment used, varies from modern medical equipment to kitchen knives
and scissors. The immediate complications include excessive bleeding (shock),
because the clitoris contains a lot of blood vessels. Infection of internal
organs such as the uterus and the fallopian tubes can also follow and may
result in infertility. Tetanus is another common complication together with the
risk of transmitting infectious diseases such as hepatitis and HIV.
Later in life, women may face further complications including dysmenorrhoea
and menstrual retention due to the small vaginal opening. Difficulty can be
experienced during the first intercourse, which may last from a few days to
several months. Childbirth complications as a direct result of reduced vaginal
passage and the formation of keloid scarring may necessitate women needing an
episiotomy to enlarge her vaginal opening for delivery.
Psychologically, young girls go through anxiety prior to the operation
with no psychological support or therapy being offered based on the assumption
that they will forget and get over it. It is not considered that psychological
harm will result. The practice also shortens children’s growth as the operation
is a rite of passage that introduces them to the adult world very early,
impairing the freedom of childhood. Children are often told regardless of age
"you are circumcised now, you are grown up".
My understanding of this practice and why it is still practised in the
twentieth century, is that is a source of cultural identity that binds communities
together for example at social gatherings; it is a passport to social
acceptance. An uncircumcised woman is considered unclean and unmarriageable. A
woman’s marriageability is sometimes determined by the size of her vaginal
opening which is used as an indicator of premarital chastity.
Some cultures in Mali and Nigeria believe that the clitoris is poisonous
and possibly fatal to any baby touched by it. There is frequent mention of the
clitoris being an aggressive organ and a threat to the penis. It is difficult
to determine exactly how much a woman may feel sexually as this is a taboo
topic and not easily discussed. Lightfoot’s book "Prisoners of
Rituals" mentions that some women experience some form of pleasure or
orgasm while others have never experienced nor expected that sexual pleasure is
for both women and men. In their understanding, sex is for men and
reproduction.
NEW ZEALAND
New Zealand has been involved in refugee resettlement since 1944. The
New Zealand Woman at Risk Programme started in 1989 when the United Nations
High Commissioner for Refugees (UNHCR) requested the New Zealand Government to
allocate places for women within the Refugee Resettlement Programme. In 1991
the government decided to accept as part of that programme, 91 Somalis which
consisted mainly of women and children. These people settled in Auckland
Christchurch Hamilton and later Wellington. Further Somali women have arrived
as part of the family reunification process.
Nurses midwives and other health professionals are likely to become
involved with Somali women through antenatal, gynaecology, obstetric and family
planning centres. It is very important that health professionals are aware of
the legal and ethical considerations and recent laws that have come into effect
in New Zealand. Many immigrants from Africa who have settled around the world
and New Zealand still want to continue practising FGM as part of preserving and
keeping the culture alive. Sweden passed a law in 1982 that prohibits all forms
of FGM. The United Kingdom followed shortly after. New Zealand has also made
FGM illegal as from 1 January 1996. This law protects young innocent children
who do not understand the difference between culture and torture.
It is our responsibility as nurses to educate both "kiwis" and
Somalis about FGM. Kiwis may not understand the meaning and significance behind
it and just condemn it as barbaric. Somalis need to be educated about the short
and long term complications: it may seem a private and internal issue but it is
not private any more. I personally do not support this practice and believe it
must be stopped once and for all.
Over the last ten years, nurses and midwives have been trying to educate
people about the practice of FGM as part of the World Health Organisation (WHO)
campaign against female genital mutilation.
FGM is a very sensitive, painful, complex and difficult issue and
involves privacy. When I use the word privacy, I mean the parts of the body
that most people do not feel comfortable talking about. Cultural and national
identity is closely associated with it even though most Somali children in this
country will grow up as Kiwi kids.
I would like to see Somali women feeling comfortable, safe and being
able to use the health services available in New Zealand without feeling alien
to other people such as doctors nurses and midwives. Nurses and other health
professionals need to be able to understand more about Somali culture without
feeling insensitive or intrusive towards it.
I would like to conclude
with a quote from Efau Dorkenoo who is a nurse and social worker from the
Gambia but lives in the UK. I appreciate and admire her work, which is the
campaign against female genital mutilation. "The female body is beautiful
and should be left intact"
BIBLIOGRAPHY
Refugee Women, The New Zealand Quota Programme 1994
Human Rights Briefs, Women in Somalia,
Research Directorate, Immigration and Refugee Board,
Ottawa Canada.
Lightfoot-Klein H. Prisoners of Rituals.
Howorth New York.
Links
Knuckleheaded
Islamic Thought: Female Circumcision
UNICEF and the
Medicalization of Female Genital Mutilation
