Waris Dirie is Somali and has become a victim of FGM: female genital mutilation. A gruesome procedure in which the female genitalia are completely removed or damaged for cultural reasons. This tradition is deeply rooted in the communities that practice it. Dirie fled her community when she was fourteen and she is now committed to combating female circumcision, which takes place in both Africa and Europe.
Female circumcision was originally a rite of passage that heralded adulthood. This thinking behind it has been lost in many areas, but it is still being implemented. Female circumcision causes serious physical and psychological problems for the victims, such as trauma and infections. It is estimated that around 135 million girls in the world have undergone circumcision, many of which are infibulation. This is the worst form of female circumcision and in Somalia the percentage of infibulated women is 98 percent (Fogteloo 2004: 12). Somalis also form a large immigrant group in the Netherlands. Having fled from their native country, they brought their culture with them to the Netherlands, and also their rituals. Since April 1993, any form of female circumcision has been prohibited in the Netherlands (Fogteloo 2004: 12). However, this does not mean that circumcisions are not performed here. It often happens behind closed doors. What also happens is that girls are sent on holiday by their parents to their country of birth to be circumcised there. That is why it is necessary that sanctions are taken. Above all, it is important that information is provided. Young girls should no longer be in danger, both in their country of birth and in the Netherlands.
In order to understand this inhuman ritual, seen from Western eyes, it is important to answer a number of questions. What does female circumcision actually entail and why do Somalis value it so much? What are its consequences for the circumcised woman? Why is female circumcision still practiced within the Somali community in the Netherlands? Finally, we will highlight the prevention options. What measures regarding female circumcision have already been taken and what aspects can still be improved?
The meaning of female circumcision and the socio-cultural backgrounds.
The term female circumcision is a collective name for various genital operations in which the external female genitalia are partially or completely removed. It is therefore a confusing term, because it does not concern adult women but girls. Depending on the ethnic group and the form of circumcision, the age at which this occurs varies. It usually takes place between the ages of five and twelfth (Reyners 1993: 62).
There are four forms of female circumcision. The least serious form is sunna, a prick or cut in the clitoris. This mainly concerns its symbolic meaning. Another related form is circumcision in which part of the clitoris is cut away. A third form is the complete removal of the clitoris and possibly the upper part of the labia minora. This is called clitoridectomy. The last, most drastic form is infibulation. During this procedure, the entire clitoris and labia minora are removed, as well as part of the labia majora. The wound surfaces are then sutured in such a way that a small opening remains, through which urine and menstrual blood can flow (Van der Khaak 1991: 211).
Female circumcision was originally an age-old tradition that became linked to the Islamic faith, but already existed in Africa before Christianity and Islam (Nienhuis 2004: 209). The origins of clitoridectomy and infibulation were long before the birth of the prophet (Reyners 1993: 76). It is therefore a tradition that is strongly anchored in culture. It ties in with thinking about ethnicity, sexuality, virginity, beauty, hygiene and male-female relations. When one talks about female circumcision, one is also talking about a code of decency. A code that combines Islamic and pre-Islamic features and consists of elements related to female sexuality and family honor. The elements of this code are circumcision, chastity before and after marriage, purity, virginity, fidelity, polygamy for men and monogamy for women (Bartels 1995: 11).
This code brings us to Somalia, the country where infibulation is the most common form of female circumcision. Somalia is a 99 percent Muslim country and many Somalis believe that female circumcision is prescribed in the Quran. However, this is not the only reason why this ritual is performed. Controlling women’s sexual urges is another reason. Somalis believe that women should be protected from their own nature. A woman who has not undergone infibulation and is therefore not dense would have many partners (Van der Khaak 1991: 213). When a girl is infibulated, she is made pure and therefore a virgin. For Somali women, being a virgin means that the vaginal opening is closed, not as in the Islamic world that the hymen is still intact (Bartels 1995: 26). The ideal result is an opening that is as small as possible, with the size of a grain of rice or barley. This is necessary because it reduces the chance of rape or pregnancy before marriage. The girl also no longer runs the risk of being seen as an outcast. Her identity has been formed. This means that infibulation can be regarded as an initiation rite. Furthermore, the girl does not receive any form of anesthesia during the infibulation. She will have to overcome the pain of circumcision in order to become a woman, by enduring it courageously. Although the girl is not yet seen as an adult in principle, she is going through a transition in which her identity changes. Now that she is a virgin, she belongs to the women’s community.
Marriage and motherhood are regarded as the only possible fulfillment of a woman’s life. Only marriage and children confer status on a woman. Partly for this reason, the girl’s virginity is extremely important. If the girl has been made a virgin through the purification, in this capacity she is also a good marriage partner for whom her family can receive a large bride price (Van der Khaak 1991: 213).
Another explanation for the use of infibulation is for aesthetic and hygienic reasons. The hygienic reasons relate to maintaining cleanliness. By removing the external genitalia, a woman will have less secretion because the number of glands is reduced. This discharge is considered unhygienic by the Somali woman because it spreads a foul odor and therefore makes the woman’s body unclean (Reyners 1993: 73). As for the aesthetic arguments, the main point is that Somali women find uncircumcised women ugly. Many women also believe that infibulation increases their husband’s satisfaction with the small vaginal opening (Cloudsley 1984: 116).
There are also indirect reasons for infibulation. Infibulation contributes to the village economy in several ways. Female circumcision is almost exclusively a female affair and so its practice provides an income to women who perform the circumcisions. These midwives often receive a lot of money for infibulations, as opposed to deliveries (Bartels 1995: 48). In the case of defibulation and reinfibulation, people are prepared to pay large sums of money. Defibulation refers to the act of enlarging the vaginal opening. The infibulation is partially reversed. This is necessary if during the wedding night the man himself is unable to do this through penetration. Reinfibulation occurs when a woman has just had a birth and wants her vaginal opening to return to its original size. Another way in which infibulation affects the village economy has to do with the fact that infibulation and bride price are closely linked. The price paid for the future bride depends on the size of the vaginal opening (Van der Khaak 1991: 214).
The consequences of female circumcision for the circumcised woman.
As mentioned earlier, female circumcision is performed by women themselves. They are often traditional midwives, the ummuliso. Other times it is done by a woman who specializes in performing female circumcision, namely the islaatta waxguda. In cities in Somalia, infibulation is performed during the girl’s school holidays and in rural areas at the end of the rainy season. In both cases, a time is chosen when the girl can best endure the procedure. During the circumcision the girl is held by a number of women. Often without any anesthesia, the midwife begins to cut away the girl’s external genitalia with a knife or razor blade. Acacia thorns are usually used for suturing, during infibulation, because they are said to have an anesthetic effect. After this, the wound is dressed with egg yolk, sugar, oil and tree resin (Bartels 1995: 42).
Immediately after circumcision, the health of the circumcised girl is the most important thing. She is therefore cared for by close female relatives (Kratz 1994: 115). During the first few days, the girl must lie with her legs tied together. She is given little fluid to drink and barley porridge to eat to ensure little stool and she has to urinate lying down. After approximately seven to fourteen days, her legs are opened again. If the girl’s vaginal size turns out to be too large or the infibulation has otherwise failed, the process starts all over again (Van der Khaak, 1991: 212).
Unfortunately, female circumcision is not without problems. Complications can occur both during the procedure and after the procedure. The consequences of female circumcision therefore depend on the type of circumcision, the knowledge and experience of the circumciser, the hygienic conditions in which the circumcision takes place and of course the health of the girl herself at that time (Leye 2001: 167). When talking about immediate physical complications, this includes pain, shock, bleeding, urinary retention and infections. Blood, pain and shock are inseparable. The girl does not receive pain anesthesia, she has to endure horrible pain and, together with seeing and feeling the blood, this leads to shock. After circumcision, the girl will also experience severe pain when she has to urinate. Because of her fear of this pain, she will consciously hold in the urine. Regarding infections, the girl is initially at risk of HIV infection if the instruments are not sterile or if the same instruments are used during group circumcisions. Infections can also be caused by bacteria, because the girl lies with her legs together for a number of days. Infections can possibly ascend to the cervix, uterus or ovaries (Reyners 1993: 30).
Moreover, a fatal outcome is not unthinkable if one looks at the circumstances under which infibulation is performed. Infibulation differs from other forms of female circumcision because of its long-term medical complications. Accumulation of blood in the vagina and uterus can be the result of the vaginal opening being too narrow. Related to this are painful periods. There is also a high risk of recurring urinary tract infections. Because a girl can never urinate normally again after a successful infibulation, urine often remains in the vagina, which leads to so-called vaginal stones. These vaginal stones can themselves cause discharge and infections. Scarring can make sexual intercourse painful or impossible. This refers to the risk of HIV infection. Circumcised women can also contract this in case of bleeding during sexual intercourse, but also during anal sex. It is generally assumed that the latter occurs more often in infibulated women than in women who have not undergone this form of circumcision (Van der Khaak 1991: 12).
The possibility of becoming infertile cannot be ruled out given the high risk of chronic inflammation in the small pelvis (Bartels 1995: 44). This is also evident from a case-controlled study by the Karolinska Institute in Stockholm (Almroth et al. 2005). The research was conducted in Sudan. The scientists compared 99 women whose infertility problems were not related to hormonal factors, previous surgeries or male infertility, with 180 pregnant women. The infertile women were examined laparoscopically. During a laparoscopic examination, the doctor inserts a fine viewing tube into the abdominal cavity through a small incision in the navel, for a visual inspection of the various organs in the abdominal cavity. A blockage of both fallopian tubes was found in almost half of them. Among infertile women, there were significantly more women who had undergone the most extreme forms of female circumcision, such as infibulation. This led scientists to suspect that genital mutilation, and in particular infibulation, can cause infertility due to an increased risk of chronic inflammation (Almroth et al. 2005: 385).
However, this was not the end of the list. Infibulation also leads to obstetric problems. Many obstetric problems can occur in Somalia because deliveries often take place at home under poor conditions with the help of a midwife. First, there is the fact that an infibulated woman cannot give birth to a child in this condition. If she does not first undergo defibulation , the reversal of the infibulation, she runs the risk of severe rupture during the birth of her child. In addition, the child may experience oxygen deficiency, resulting in brain damage or even death. Secondly, there is a risk of bleeding and puerperal fever, which can cause death for the mother (Bartels 1995: 44). Assuming that the birth went well, the logical next step is for the woman to allow herself to be reinfibulated. With all the new consequences that entails, a cycle has been formed. In addition to
mentioning all the physical complications, it is also important to highlight the psychological and sexual complications. Let’s start with the circumcision itself: a traumatizing and bloody procedure that is performed without anesthesia, while the mother and close relatives hold the girl in question with physical force. This has a certain influence on the girl at the moment itself and it will leave its mark (Reyners 1993: 40). The girl approaches the event with a feeling of excitement and this feeling completely turns into fear on the day of the circumcision. She will initially feel betrayed, but later feel proud that she survived the procedure. The painful memories are suppressed by the community by now socially and morally accepting the girl because of her circumcision (Bartels 1995: 45).
When it comes to the consequences of infibulation for sexual contact between men and women, pain is the key word. Circumcision takes place before a sexual relationship is entered into and in this relationship there is pain for the woman from the first contact. In addition, a woman’s sexual pleasure is reduced. This in turn can be a reason for relationship problems and unwanted childlessness. The man can then decide to divorce his wife or take a second wife (van der Khaak 1991: 12).
Female circumcision within the Somali community in the Netherlands.
In order to provide a complete picture of the situation within the Somali community in the Netherlands in the context of female circumcision, it is necessary to start with the living conditions in Somalia, the refugees and the asylum procedures in the Netherlands.
Somalia is the easternmost country in the Horn of Africa. The majority of the population leads a nomadic existence. Ethnically, the inhabitants of Somalia are one people. However, they are divided into clans. These are population groups that trace their descent to the same ancestors or claim a common origin. The members of a clan or family are largely responsible for each other and therefore kinship represents security and security. Somalis therefore derive their status from belonging to a large clan with a long history.
Somalia’s current borders were arbitrarily drawn in the last century by the colonial powers Italy and England. After the opening of the region through the construction of the Suez Canal, this Horn of Africa was divided into Italian, British and French parts. In 1960, the Somali Republic was created by the merger of Italian and British Somaliland. The first independent government was democratically elected in 1969. Shortly thereafter, General Barre seized power (Bartels 1995: 18). Initially, this general seems to represent progress, but after a few years his rule turns into a dictatorship. In both 1973 and from 1977 to 1978, Somalia was at war with Ethiopia over border conflicts. However, Somalia suffered a defeat in this conflict (Van der Khaak et al. 2003: 29). Afterwards, the country is economically bankrupt and many Somalis end up in camps or have fled. A new flow of refugees is the result of drought periods in 1974 and 1978. This disaster leads to resistance against Barre’s regime and a civil war starts. After the fall of Barre in January 1991, the struggle continues. Due to the persistent conflicts between different clans, attempts to reach an agreement between the warring clans failed for a long time (Bartels 1995: 20).
A small minority of refugees were able to flee the dire conditions in the refugee camps or the country’s economic and political malaise. In the period from 1991 to 1994 alone, 16,000 Somalis applied for asylum in the Netherlands. After asylum seekers have been admitted to the asylum procedure, they usually spend a number of months in a reception and examination center and then in an asylum seeker center. After this, you are assigned a home in a random municipality. This is done in the context of the Asylum Seeker Reception Regulations, the ROA. Unfortunately, refugees and asylum seekers have to go a long way before their safety is confirmed because the outcome of the asylum application often takes a long time. This can take months or even years (Bartels 1995: 21).
The group of Somali refugees in the Netherlands consists mainly of young, single men and women. The majority of them have suffered various or sometimes extreme forms of violence. The situation of female refugees deserves extra attention. A single woman or with children lacks the usual protection of her family, her clan, and will therefore have to manage independently in the new environment. The position of women is therefore subject to change, partly due to flight. A woman can feel unsafe because of sexual violence or the threat thereof. This violence or threat can occur both before the flight and during the flight. Before the flight, violence can take place in camps or prisons. During captivity, conditions are equally bad for both men and women, but a female prisoner will always be aware of the threat of sexual violence. During the flight itself, a woman can be exposed to violence by tour guides or roving government troops who abuse her vulnerable position. A woman can often only protect herself and possibly her children by providing sexual services. This is because escape routes are dominated by men and a woman does not have access to financial sources. Once she has arrived in the Netherlands and is placed in an asylum seeker center, a female refugee is still in a dependent and therefore vulnerable position. She may feel threatened by the many men of different nationalities (Van der Khaak 1991: 15).
What follows from such history is a life in exile due to the uncertain position as an asylum seeker and the traumatic memories. In addition, illiteracy and not mastering the Dutch language constitute an additional obstacle. The lives of Somali women in the Netherlands are therefore characterized more than those of men by dependence and isolation (Bartels 1995: 29). The only option for them is to rely on their clan. In the Somali community, problems are dealt with by family or clan members. The clan identity and the ability to ask for help from the members of the clan is an important element of Somali culture. Solidarity between members of the same clan is still great in the Netherlands (Van der Khaak 1991: 15).
In this new society and strange culture, many women struggle with adjustment problems and encounter changing gender roles. Some of these factors are the confrontation with a different culture, the lack of the usual women’s networks, unemployment of the husband and the difference in the speed of adjustment between parent and child, which creates a generation gap. Some Somali women are able to adapt and therefore become more assertive, make demands and gradually become more independent. However, the majority still clings to the prevailing Somali Islamic norms and values. To prevent alienation, they still want to teach their children obedience and respect for their elders, despite the new living conditions. The rules regarding chastity, care and honorable behavior continue to apply to their daughters (Bartels 1995: 35).
These rules still involve the circumcision of girls. You would expect that living in this modern Dutch society, where this practice is prohibited by law and where Dutch society itself despises it, that people would no longer practice it or at least reduce it. However, it has the opposite effect. Despite migration, Somali refugees generally maintain close family ties. The Somali clans in the Netherlands continue to maintain social control over their members and the family that remains in the country of origin also emphatically requests that the migrated family members retain their identity (Nienhuis 2004: 11). It is precisely this identity that is equivalent to circumcision for Somali girls. The Somali community in the Netherlands still believes that female circumcision is typical of being Somali. It still determines the social acceptance of the daughters. What also counts is that they now see it as a marking ritual with which Somalis can distinguish themselves from other refugees and migrant groups in Dutch society (Van der Khaak et al. 2003: 31). Moreover, it is rare for Somali women to enter into a relationship with a Dutch man. If this does happen, it is met with a lot of resistance from the family or clan members. That is why it remains important for young women to guard their own virginity so as not to rule out a later marriage to a Somali man (Bartels 1995: 37).
Somali women often indicate that female circumcision is a women’s issue over which men have no influence, but men do have that influence by rejecting uncircumcised women as marriage partners (Kers 2005: 21). The decision to proceed with circumcision or to refrain from it is somewhat complex, because the decision is not made by one person. Firstly the above mentioned, the Somali men preferring real Somali woman weighs heavily in the choice. This means a closed infibulated woman. Secondly, there are the clan members and especially the dominant influence of the older women. If a Somali woman does not choose to have her daughter circumcised and let her family know, she can find herself in a difficult position. She will be pressured by her family or excluded from her own community. Moreover, she will not receive any information about circumcisions and if she is visiting family in Somalia, she will be forced to keep a permanent eye on her daughter (Van der Khaak et al. 2003: 32).
It is therefore a difficult choice for many Somali women. They often have conflicting ideas about female circumcision. On the one hand it is an element of a cherished identity, on the other hand it is a traumatic intervention with adverse health consequences that they want to spare their daughters. However, these women yield to the pressure of the clan so that they still have their daughters circumcised. The positive aspects of female circumcision such as tradition, religion, virginity and beauty often win out over the negative aspects. What is also important to remember is that reducing female circumcision is not a priority for the Somali community in the Netherlands. They see adjustment problems, isolation, coping with violence, the loss of family members and the dramatic situation in the country of origin itself as the biggest problems. What this quote from a Somali woman also shows:
Our situation is no better than in Iraq. But we are poor. Somalia has no oil. Our country is not economically worthwhile and so no one cares what happens to us. We have been living with female circumcision for centuries. That’s old news. We have other things on our minds now. (Bartels 1995: 38).
The prevention options regarding female circumcision.
The previous chapter shows that the desire to have daughters circumcised is still great within the Somali community. Female circumcision is difficult to discuss among Somalis, because Somali women are not supposed to talk about it, but it is certainly not denied. The serious consequences of infibulation on the physical and mental well-being of women is taken for granted.
The Somali community knows that female circumcision is prohibited in the Netherlands. That’s partly why people don’t talk about it, because they’re afraid of being betrayed. As far as criminal law is concerned, female circumcision falls within the concept of abuse in the criminal code. Female circumcision is therefore not punishable as a separate offense in Dutch criminal law. This should actually be the case, because a specific criminalization of female circumcision creates more clarity for the ethnic groups in the Netherlands where genital mutilation of girls is a cultural custom and tradition (Van der Khaak et al. 2003: 52).
However, is this the solution? No, not just specification of the law. Clarification of the law regarding female circumcision has a preventive effect, but it will not eradicate this tradition. What should be kept in mind is that Somali parents and grandparents do not circumcise their daughters to mutilate them, but to give them added value. Preventing female circumcision is therefore not an easy task. It is a complex phenomenon that requires various prevention interventions (Nienhuis 2004: 11). The priority is therefore respect for the views of the Somali community. Change must be brought about within the community itself. Female circumcision cannot be tackled as an isolated problem. It cannot be separated from violence against women and gender inequality. The continued existence of female circumcision is affected by the lack of educational opportunities, a lack of knowledge about human rights and the low status of women. These problems move to the migration country, where they are further reinforced by the poor position in which migrant communities find themselves (Kers 2005: 21). This complex problem therefore requires that all involved, such as care providers and risk groups, are informed about the medical, socio-cultural and legal aspects of this use. However
, discussing women’s berry envy is a prerequisite for good preventive activities. The first step is therefore very important and is that Somali parents learn to talk to an outsider about female circumcision, so that they gain experience with questions and answers and finding the right words and arguments. Care providers will therefore often have to take the initiative themselves. Gynecologists in particular are a direct point of contact. Somali women come to them with their physical complaints. It is then up to the gynecologist to explicitly discuss the problems and consequences of circumcision with the patient. He or she can also ask the patient to bring their spouse with them at a subsequent consultation to discuss their sexual experiences. If the couple has many sexual problems, the gynecologist may be better able to convince them not to perform circumcision on their daughters (Van der Khaak et al. 2003: 87). Youth Health Care also plays an important role in prevention activities. Their task is both prevention and signaling. This organization provides information about female circumcision and also tries to make it a topic of discussion within the risk group. In reality, however, this only happens when a care provider involved is familiar with the phenomenon and considers it important to discuss it. What is needed is involvement with the child in distress, communication with everyone involved, continuity in care, compassion for the girl who has already been circumcised or will be circumcised and control if agreements are not kept (Van der Khaak et al. 2003 : 91).
In addition to these professional care providers, there are also specially trained regional contact persons who mediate, key persons from the Somali community who organize meetings and advisors of their own language and culture (vetcers) who provide group education and information. During information evenings, women are informed about the relationship between their health problems and the circumcision they have undergone in the past. The counselors appeal to people about strength and self-discovery, fulfill the need for information, conduct mutual discussions and try to convince the Somali community with answers based on religion (Nienhuis 2004: 12).
Finally, it is useful to look at the target group to see for yourself. This can also play a role in the change process. Somali girls who have not been circumcised, but who do belong to the risk group, can serve as an example for parents and/or girls who are still deciding whether to undergo circumcision. They are therefore currently seen as the most important target group for the prevention campaigns. The younger people start to receive information about the importance of preserving their own body, the more likely Somali girls will turn away from this ritual (Kers 2005: 16).
This has made it clear that the concept of female circumcision cannot be explained in one word. By first looking at its socio-cultural backgrounds, it soon turns out to be a complex phenomenon that is deeply rooted in Somali culture and traditions. Circumcision is decisive for the girl’s identity and future. Although circumcised women are aware of the negative consequences, it seems impossible for Somali girls to escape this tradition. Looking back at the current situation of the Somali community now living in the Netherlands, this is reinforced even more. Despite the physical and mental suffering, Somali mothers still choose to have their daughters circumcised. It is their tradition and they see it as a religious obligation that they do not want to renounce, especially in the migrant situation. Especially in the new foreign culture, Somali women want to protect their daughters and their future even more against outside influences.
There is hope for change. By discussing the problem and actively involving the Somali community in information activities, there is now the opportunity to prevent female circumcision. However, criminal law is extremely limited in offering options to combat female circumcision. Moreover, the phenomenon of female circumcision is not a criminal problem, but a problem of a socio-cultural nature. That is why care providers must continue to talk to the target group, because this is the first and perhaps only strategy on the long road to preventing female circumcision.