બધા નુક્શાનો શારીરિક નથી હોતા અને દરેક ધર્મ સંપૂર્ણ રીતે નૈતિક નથી હોતો

(This essay was originally published in English on September 21, 2018. Read the English version here.)

લેખક : ઝીનોબીયા

ઉંમર : 27 વર્ષ

દેશ : ભારત

આજે સોશિયલ મીડિયા પર અન્ય બાબતોની સાથે-સાથે મહિલાઓને સશક્ત કરવા, પોતાનો નિર્ણય પોતે જ લેવા, વ્યક્તિની ગોપનીયતાના અને તેના શરીરના ઉલ્લંઘન વિષે અને સંમતિની ભૂમિકા વિષેના વિચારો અને અભિપ્રાયો સાથે ગુસ્સો વ્યક્ત થતો જોવા મળે છે.અમુક લોકો એવી વાતો કરે છે કે બળાત્કારીઓને ફાંસી દઈ દેવી જોઈએ છે તો અમુક લોકો જાતિય છેડછાડ અને મહિલાઓની છેડતી કરતા લોકોને સજા કરવા વિષેપણ વાતો કરી રહ્યાં છે જેથી, જમીની સ્તર પર યોગ્ય પગલાં લઈ શકાય અને આવા લોકો છોકરીઓને પરેશાન કરતા પહેલાં બે વાર વિચાર કરે.

પરંતુ, જ્યારે એક 7 વર્ષની અસહાય છોકરીનો બીજું કોઈ નહિં પણ તેમનું પોતાનું કુટુંબ અને સમાજ ગેરલાભ ઉઠાવે ત્યારે શું થાય છે? તેના માટે કોણ જવાબદારી લે છે?હું અહીં મારી પોતાની તકલીફો રજૂ કરવા નથી ઈચ્છતી પરંતુ, તમારી માહિતી માટે થોડી મૂળભૂત હકીકતો રજૂ કરવા ઈચ્છું છું. હું ભારતમાં મોટી થયેલી એક બોહરા મુસ્લિમ છું. જ્યારે વિશ્વ આપણને શાંત, શાંતિપ્રિય, વ્યવસાયમાં સમૃદ્ધ એવો સમાજ માને છે ત્યારે આપણે 6-7 વર્ષની નાનકડી છોકરીના અંગછેદનની એક ગુપ્ત પરંપરાને અનુસરીએ છીએ, જેને આપણે ખતના કહીએ છીએ.

આ પ્રથા પુરુષો માટે કેવી રીતે આરોગ્યની દ્રષ્ટિએ “જરૂરી” છે અને અંતે, તે તેમના સેક્સ જીવનમાં મદદરૂપ થાય છે તે વિષેની ઘણી દલીલો કરવામાં આવે છે પરંતુ, અધિકાંશ શિક્ષિત અને સંસ્કારી લોકો એ બાબત સાથે સહમત છે કે આ પ્રથા એક બૈરીના શરીરિક, માનસીક અને ભાવનાત્મક આરોગ્ય માટે નુક્શાનદાયક છે, ખાસ કરીને એટલા માટે કે તેના પર કોઈ દેખરેખ રાખવામાં આવતી નથી અથવા અધિકાંશ આવી પ્રક્રિયાઓ બૅસમેન્ટોમાં એક અશિક્ષિત બૈરી દ્વારા કરવામાં આવે છે.આ પ્રથાને વિશ્વના અન્ય પ્રદેશોમાં આધિકારીક રીતે “ફીમેલ જેનિટલ મ્યૂટિલેશન (એફજીએમ)” કહેવામાં આવે છે અને તેને અસહાય છોકરીઓ પર થતા અપરાધ તરીકે માનવામાં આવે છે.

શા માટે? શું કારણ છે?

અમુક લોકો પવિત્રતા વિષે તો, અમુક લોકો પિતૃપ્રધાનતા વિષે વાત કરે છે. અમુક લોકો તેને એક આદેશરૂપ પરંપરા હોવાને કારણે માને છે અને જો એક મૌલા તેને ફરજિયાત કહે તો તેને નામંજૂર કરવાની હિંમત કોણ કરે? અમુક લોકો દબાણને વશ થઈને માને છે તો, અમુક લોકો બ્લૅકલિસ્ટ થવા અથવા વીરોધીનું લૅબલ લાગવાના ડરથી માને છે.જે લોકો ઉત્તર માગે છે તેમના માટે એવો પ્રચલિત જવાબ આપવામાં આવે છે કે તે એક બૈરીની જાતિય ઈચ્છાઓને નિયંત્રણમાં અથવા અંકુશમાં રાખવા માટે કરવામાં આવે છે. એ બાબત સાચી હોય શકે કેજ્યારે આપણે રણોમાં અને સમૂહ (ટ્રાઈબ્સ)માં રહેતા હતા અને લોકો હંમેશા અન્ય વ્યક્તિની બૈરીને ઉપાડી જવા માટે આતુર રહેતા હતા તેવા યુગમાં, કદાચ આ પ્રથા મદદરૂપ થઈ હશે.

આજે કોઈપણ કારણ હોય તો પણ, શું તેનો કોઈ અર્થ છે ખરો? તમારો ઉદ્દેશસારોહોય તો પણ,એક બૈરીની સંમતિ વિના તેણીના શરીર સાથે શું કરવું એ નક્કી કરવાનો તમને કોઈ અધિકાર નથી.તમે કોઈપણ હો, તમારો ઉદ્દેશ કોઈપણ હોય તો પણ, નુક્શાન થયું છે અને તમે કોઈ ગુનેગારથી ઓછા નથી.

પિડીતો માટે તેનો અર્થ શું છે?

આપણા દ્વારા અનુસરવામાં આવતી પ્રથા આક્ષેપ અનુસાર ‘ટાઈપ 1’ પ્રકારની છે અને તે આફ્રિકન સમુદાયો દ્વારા અનુસરવામાં આવતી ‘ટાઈપ 2’ અને ‘ટાઈપ 3’ થી (ગંભીરતાના સ્તરના આધારે) અલગ છે.વર્લ્ડ હૅલ્થ ઑર્ગેનાઈઝેશનની માન્યતા મુજબ, ટાઈપ 1 પ્રકારના એફજીસીને ક્લિટોરલ હૂડ અને/અથવા ક્લિટોરિસ કાપવા તરીકે વર્ણવવામાં આવ્યું છે, જેના ઘણાં શારીરિક અને માનસિક દુષ્પરિણામો જોવા મળે છે જેમ કે, ચેપ લાગવા, વધારે પડતો રક્તસ્ત્રાવ થવો, પેશાબ કરતી વખતે બળતરા થવી વિગેરે. ઘણી જુવાન છોકરીઓ વિશ્વાસઘાત, અસહાય અને મૂંઝવણ મહેસુસ કરતી હોવાના કારણે,આ પ્રથા માનસિક આરોગ્ય પર પણ વિપરિત અસર કરી શકે છે. તેમજ, આ આઘાતના પરિણામે, બાળક જાતિય સંબંધ બાંધવામાં પણ ડર અનુભવી શકે છે અને તેમનામાં સમાજના સભ્યો પ્રત્યે અવિશ્વાસનું નિર્માણ પણ થઈ શકે છે.

પરંતુ, હજારો બૈરીઓએ આ પ્રથાને અનુસરી છે અને દાવો કરી રહી છે કે તેમને કોઈ જાતિય સમસ્યાઓનો સામનો કરવો પડ્યો નથી?

જે રીતે અધિકાંશ લોકો તેમના બેડરૂમમાં શું થાય છે તે વિષે અન્ય લોકોને વાત કરતા નથી, તેમ એફજીએમના સર્વાઈવરો પણ તેમની સેક્સ લાઈફ વિષે જાહેરમાં વાત કરતા નથી. તેમાંની ઘણી બૈરીઓ પીડાથી ચીસો પાડતી હોય છે અથવા “બેડરૂમમાં”એક આરોગ્યપ્રદ જીવન જીવી શકતી નથી.તેમાંની ઘણી બૈરીઓ ડૉક્ટરો, સેક્સોલોજિસ્ટ્સ, કાઉન્સેલર્સ અને થેરૅપિસ્ટ્સની નિયમિત દરદીઓ હોય છે.હાં, તેઓ ગર્ભવતિ થવાનું (જે આજે મરદ સાથે અથવા મરદ વિના કરવું વધારે મૂશ્કેલ નથી) મેનેજ કરી લે છે પરંતુ, શું એ પ્રક્રિયા પીડા મુક્ત છે? નહીં.

બધા લોકો ડિવોર્સનો દર વધવા વિષે વાતો કરે છે પરંતુ, આ દર શા માટે વધી રહ્યો છે તે કોઈ સમજતું નથી. તેઓ એ જોતા નથી કે બૈરીઓ પર તેમના ઉછેર દરમિયાન જ ઘણાં બધા નિયંત્રણો લાદવામાં આવે છે. મરદ હોય કે બૈરી, તેને સંબંધી બધી બાબતો પહેલાંથી જ નક્કી કરેલી હોય છે, આ એવું નથી લાગી રહ્યું કે આપણે એવા સમાજમાં મોટા થઈ રહ્યાં છીએ જ્યાં નેતાઓ અથવા સ્વતંત્ર નિર્ણયકર્તાઓને ઉછેરવામાં આવી રહ્યાં હોય. આપણે બ્રેઈનવૉશ કરેલા શિષ્યોના એક ટોળાં જેવા છીએ અને હાલનાં, #metoo ની ક્રાન્તિને કારણે બૈરીઓએ તેમનો અવાજ ઉઠાવવાની એક શરૂઆત કરી છે.

મારી સ્ટોરી

હાં, મારા પર પણ ‘ખતના’ પ્રક્રિયા કરવામાં આવી હતી. મને બધું તો યાદ નથી પરંતુ, અમુક બાબતો યાદ છે. મને “કોઈ આન્ટી” ને મળવા લઈ જવામાં આવી હતી અને મને યાદ છે કે ત્યારે મને કોઈ સારી લાગણી નહોતી થતી પરંતુ, આપણને જેમ કહેવામાં આવે તેમ આપણે કરીએ છીએ. અમે કલકત્તાના તેના અંધકારમય ઘરમાં ગયા અને તેણીએ મને ભારતીય શૈલીના શૌચાલય પર પહોળા પગ કરીને ઊભા રહેવા માટે કહ્યું અને મને લોહી નીચે પડતું દેખાયું. બસ મને આટલું જ યાદ છે.

મને બરાબર યાદ છે કે ત્યારપછી અઠવાડિયા સુધી મને પેશાબ કરવામાં પીડા થતી હતી. આ ચર્ચા રાત્રિભોજનની ચર્ચા જેવી ઔપચારિક ના હોવાથી, ત્યારપછી તે વિષે ક્યારેય વાત કરવામાં આવી નહિં. 16 વર્ષની ઉંમરે, જીન સૅસનની બૂક – પ્રિંસેસ દ્વારા મને આ ‘મુસ્લિમ પ્રથા’ વિષે ખબર પડી. સાઉદી અરૅબિયામાં બૈરીઓ સાથે કરવામાં આવતી ભયાનક બાબતોની સાથે-સાથે આ પ્રથાનું વર્ણન કરવામાં આવ્યુ હતું જેણે મારી યાદ તાજા કરી દીધી હતી.

પહેલાં તો હું ડરી અને ભયભીત થઈ ગઈ અને મને સમજાતું નહોતું કે આ માહિતીનું શું કરવું.મને એ બાબતસમજાઈ નહિં કે શા માટે કોઈ મારી સાથે આવું ભયાનક કૃત્ય કરે? તેનો ઉદ્દેશ શું હતો? શું કોઈ ધાર્મિક કારણ હતું? શું કોઈ તબીબી કારણ હતું? ધીમે-ધીમે હું મારી ઉંમરના અન્ય લોકોને તે વિષે પૂછવા લાગી.ઈન્ટરનેટ મારી મદદે આવ્યું અને મેં આ ‘જંગલી’ પ્રથાને વધારે સમજવાનું શરૂ કર્યું કે કેવી રીતે તે આપણા પિતૃપ્રધાન દુનિયાની એક બીજીસાઈડઈફેક્ટ છે જ્યાં કોઈપણ મરદ એ નક્કી કરી લે છે કે બૈરીઓએ કેવી રીતે જીવવું અને તેમના માટે શું યોગ્ય છે.

મને એ બાબત સમજાઈ નહીં કે કેમ એક માતા-પિતા તેમના બાળકો સાથે આવું થવા દે છે. જ્યારે તમારી દીકરી નિર્દોષતાની ચરમસીમા પર હોય અને ફક્ત તમારો નિસ્વાર્થ પ્રેમ ઈચ્છતી હોય ત્યારે, તમે તેણી સાથે વિશ્વાસઘાત કરો છો અને અંતે તમે તેણીને એવા રાક્ષસને સોંપી દો છો જે તેણી સાથે આવું કૃત્ય કરે છે?

તમારો ધર્મ તમને તેણીના શરીર પર અંગછેદન કરવાનું કહે છે અને તમને તેમાં કંઈ ખોટું નથી લાગતુ?અને તેના કારણે ઉત્પન્ન થતા શારીરિક, માનસિક અને ભાવનાત્મક પ્રત્યાઘાતોનું શું? જીવનભર તેણીએ આવી પીડાનો સામનો કરવો પડે છે. અને જો તમને ખરેખર આ બાબત ખોટી ના લાગતી હોય તો પછી શું કામતમે તેને આમ ગુપ્ત રાખો છો? શા માટે તેખાનગી રીતેકરવામાં આવે છે? તેના વિષે બધાને વાત કરો, તમે જેમ મિસાક ઉજવો છો તેમ તેની પણ ઉજવણી કરો? ફક્ત મિસાકની ઉજવણી જ શા માટે કરો છો? ખરેખર, કેટલાક અપવાદરૂપ લોકો પણ હોય છે. મારૂં સારૂં ઈચ્છતા ઘણાં લોકો મને સમજાવવાનો પ્રયત્ન કરે છે કે તેમાં મારો કોઈ દોષ નથી અને મારે એ બાબત વિષે ચિંતા કરવી જોઈએ નહીં અને મારો ઉત્તર હોય છે કે “હાં, હું જાણું છું કે મારો કોઈ દોષ નથી અને તેમ છતાં, મારે જ તેની કિંમત ચૂકવવી પડે છે”.

સૌથી દુઃખદ બાબત એ છે કે ઘણી બધી એવી છોકરીઓ છે જેને આજે પણ ખબર નથી અથવા યાદ નથી કે તેમની સાથે પણ આવું બન્યું છે. તેઓ એવા ખ્યાલ હેઠળ જીવે છે કે સેક્સ એ ખરાબ અને પીડાદાયક બાબત છે અને કદાચ તેમનામાં જ કોઈ સમસ્યા છે. અધિકાંશ રીતે આપણને આવું જ શિક્ષણ આપવામાં આવે છે. હું સહિયોની ખૂબ જ આભારી છું કે તેમણે બૈરીઓ માટે આવું એક અદભૂત પ્લૅટફોર્મ ઊભું કર્યું જ્યાં તેઓ તેમની સ્ટોરી રજૂ કરી શકે છે, સહાનુભૂતિ મેળવી શકે છે અને મારા જેવી છોકરીઓને કહી શકે કે હું એક જ એવી છોકરી નથી જેની સાથે આવું બન્યું છે અને મારે મને પોતાને એક પિડીત માનવીજોઈએ નહિં. સ્ટોરીટેલિંગ દ્વારા બૈરીઓને સશક્ત કરવાની આ બાબત, આપણી સંસ્કૃતિનો એક ગૌરવશીલ ભાગ હોય તેમ લાગે છે, જેને સહિયો આગળ વધારી રહ્યું છે.

 

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Thaal Pe Charcha Launches in California

On Oct 21st in Berkeley, CA, a team of Sahiyo activists organized the first California Bay Area Thaal Pe Charcha (TPC). This Sahiyo flagship program allows Bohra women to come together in a private, informal setting so that they can bond over food and discuss issues that affect their lives, like Female Genital Cutting or Khatna. The program started in Mumbai, India in 2017 and is being piloted in the United States in 2018 in New York and California. For the organizers of the California Bay Area TPC, the weeks leading up to the event were full of excitement and anticipation for what they hoped would the start of new friendships in the Bay Area.

This is what one organizer, Sabiha Basrai, has to say about the program:IMG_2198

“Sharing space with an inter-generational group of Bohra women was healing and inspiring. I was able to embrace my Bohra identity in a new way and celebrate the special bonds that we build in our community, take pride in our cultural and religious history, and of course, enjoy a shared meal around a thaal. It is difficult to talk about the patriarchy that exists within our jamaats and I am grateful that TPC created a safe and confidential space to hear each other’s stories and to remind one another that we are not alone in these struggles.  We are all figuring out how to practice our faith with feminist values. This means challenging certain social norms that are oppressive to women, such as khatna or female genital cutting, while recognizing that empowering women is a very Muslim thing to do.

I am grateful for the patient and supportive work of Sahiyo and look forward to the continued work bringing about gender justice in our communities.” 

Read more reflections on the Bay Area TPC here!

My Reflections on the first-ever California Bay Area Thaal Pe Charcha

By Maria Akhterimg_2212.jpg

On Oct 21st in a cozy home in Berkeley, CA, a team of Sahiyo activists organized
our first Bay Area Thaal Pe Charcha.

Thaal Pe Charcha (TPC) is a Sahiyo flagship program that allows Bohra women to come together in a private, informal setting so that they can bond over food and discuss issues that affect their lives, like Female Genital Cutting or Khatna. The program started in Mumbai, India in 2017 and is being piloted in the United States.

The weeks leading up to the Bay Area event were full of
excitement and anticipation for what we hoped would be the pilot of a new program
and the start of new friendships in the Bay Area.

The team and I spent a few weeks carefully crafting our invitations and considering
whom to include in this informal discussion about the norms and challenges of
being a Bohra woman.

With delicious food displayed on our thaals and a crisp Autumn breeze flowing in
the room, 13 women gathered around a living room and engaged in a unique
conversation.

We went around the circle and introduced ourselves, sharing a memory or item in a
show-and-tell icebreaker. We discussed challenges and conflicts we’d faced in the
Bohra community in the Bay Area and globally as well as various strengths and joys
we’d experienced in the Bohra community.

Familiar faces and new ones surrounded me. My mother, childhood friend, and
fellow Sahiyo activists surrounded me with a comfort in knowing that I had their
support and that I had encouraged them to join me at this event.

The Bay Area is a tough area to operate in. Bohra women are more hesitant to speak
out and form connections with Sahiyo, so I considered this TPC a huge milestone in
breaking the silence around FGM/C in the Bay Area specifically. I could tell from
conversations that rose up that many of the women wanted a space to share their
voices and to connect with other like-minded women.

My hope is that these events continue to occur and that they grow and expand in
ways that benefit the community. There was substantial tentative interest from the
attendees in continuing to meet and my goal is to turn the Bay Area TPC group into
a consistent resource for any and all Bay Area Bohra women with an interest in
open communication and positive change.

Read more reflections on the Bay Area TPC here!

Aarefa Johari and Masooma Ranalvi discuss FGC at We the Women Bangalore

On October 7, Sahiyo co-founder Aarefa Johari and We Speak Out founder Masooma Ranalvi participated in a panel discussion on Female Genital Cutting in India, at the We the Women summit organised by veteran journalist Barkha Dutt in Bangalore. Prominent human rights activist Srilatha Batliwala moderated the discussion.

The event was attended by more than 200 people in Bangalore and was streamed live on social media. Ranalvi and Johari shared their personal experiences of being subjected to FGC and discussed various aspects of the problem from the need to engage with the community to end the practice and the significance of a law against it.

You can watch the complete video of the discussion here.

The event was a follow up to a similar We the Women summit in Mumbai in December 2017, when Sahiyo co-founder Insia Dariwala spoke about the practice along with Mubaraka and Zohra, two survivors of FGC. You can watch last year’s video here.

Sign the #EndFGM petition on change.org

A new change.org petition calling for an end to Female Genital Cutting in the Bohra community was started in September by Ranjana Sehgal and Umi Saran.

The petition is addressed to Dr. Syedna Mufaddal Saifuddin, the spiritual leader of the Bohra community, and was started in response to the Syedna’s visit to Indore to give sermons during the first ten holy days of Muharram.

As the petition mentions, “Although the matter is already in the Apex Court if the directive to end FGM comes from the spiritual head of the Bohra community, it will be easier to put an end to this violent practice. The Government of India’s WCD Ministry has said that FGM is in clear contravention of our laws, the Indian Penal Code and Protection of Children from Sexual Offences (POCSO).”

Over 16,000 supporters have already signed, and the campaign’s next goal is reaching 25,000 signatures.  If you would like to support by signing, click here.

Is the Dawoodi Bohra community truly as progressive as it claims to be?

By Saleha

Country of Residence: Canada
Age: 45

Having lived in South-East Asia, and being exposed to multiple races and cultures, I grew up in a very open-minded family. As a child, my family and I occasionally went to the local Bohra mosque to socialize with others in the community. I loved going to the “masjid” – there I got a chance to meet my best friend and also eat delicious Bohri food. It was wonderful to see all the aunties dressed up in “onna ghagra” which are colourful skirts with matching chiffon scarves draped around the head. After the prayers, everyone congregated outside and chatted into the late hours of the night.

Then suddenly in the early 90s it all changed. The upper echelons of the Bohra clergy instated new rules. The progressive Dawoodi Bohras were no more; instead, women were forced to wear a form of hijab called “rida” and men were made to sport a beard, wear a kurta, and “topi” or a cap on their heads. The clergy, headed by the Syedna, began to exert control over everything. Permission from Syedna was required not only for religious matters but in daily life as well. For example, permission was needed to start a business, get married or even to be buried. Female Genital Cutting or khatna was deemed necessary, even though that act of it is not prescribed in the Koran. If any of the rules were not followed, or if you protested and spoke against them, you were excommunicated or threatened to be. You’d lose all your ties to friends and family forever.

I can never forget the awful day, when I was seven, while on a holiday in India, my aunt asked me to go shopping with her. She took me to a dingy place where a Bohri man and woman took me inside. They asked me to undress waist down, and when I protested, the man held my hands while the woman removed my jeans and underwear and forced me to lie down. I saw the man take out a blade and I struggled and screamed for help, while they proceeded to cut me. I lay bleeding on the floor, unable to comprehend what had happened to me. It was horrific, painful, and demeaning. I hated what was done to me. I hated that my mom was not there. I was angry at my aunt for allowing them to hurt me.

I remember that experience vividly and to this day I am infuriated that I had to go through this ordeal as a child in the name of religion. While the majority of the Muslim communities around the world have spoken against this, the Dawoodi Bohra religious authorities urge continuing FGC under the guise of cleanliness. The worst part is that some women push this practise on vulnerable children too young to give consent, instead of protecting them as adults should.

It was a difficult time for me. Having grown up with all the freedom in the world, it was  suddenly being taken away from me and I grew cynical of my Bohra culture and wanted no part of it. Today, I am happy I decided to leave the fold. It was not hard to leave. In fact, it was liberating. I was not comfortable with the more rigorous path that my community was taking. I am sure there are many other Bohri people out there who are quietly questioning many of the beliefs handed down to them – some so silly, useless, and others very damaging – Bohris must refrain from using Western toilets; Bohris cannot host or attend wedding functions in secular, non-Bohra venues; brides can apply mehndi only an inch below the wrist and cannot hold the traditional “haldi” functions; and all Bohris must carry a RFID photo ID which will monitor attendance to the mosque.

Humanity has achieved such remarkable progress. We have ventured into space, developed cloning and gene editing technologies, and most importantly, the Internet has resulted in globalization and interconnection between various cultures and communities. In this light, I wonder why we are still talking about FGC and the right to choose to do it to our daughters in this day and age? I am thankful that organizations like Sahiyo and We Speak Out have become a voice for children who are being hurt in the name of religion.

I look at my children and I see the most informed, connected, and progressive generation. Imposing impractical, harmful religious rules such as continuing FGM on such a generation will only drive them further from our culture. More and more Bohri women and men are speaking out against this harmful practise because whenever religion becomes too rigid, too corrupt, it begins to crack. My hope is that our community can find the strength to break free from all the rigid practices and once again become the most progressive community among the Muslims.

Introducing Sahiyo’s inaugural U.S. Advisory Board

Sahiyo is pleased to introduce our inaugural U.S. Advisory Board. As our U.S. operations and programs have grown, the advisory board will provide strategic advice to the management of our organization, and ensure that we continue fulfilling our mission to empower communities to end Female Genital Cutting and create positive social change through dialogue, education, and collaboration based on community involvement. Advisory board members will be supporting a human rights driven organization dedicated to creating a world without Female Genital Cutting through dialogue, education and direct community involvement.

Join us in welcoming the team: Maria Akhter, Renee Bergstrom, Alisha Bhagat, Insia Dariwala, Dr. Melody Eckardt, Joanne Golden, Priya Goswami, Aarefa Johari, Zehra Patwa, Maryum Saifee, and Joanna Vergoth.

Moving Beyond Cultural Relativism to a Call for Action to End Female Genital Cutting

By Brionna Wiggins

Earlier this year I had no idea about female genital cutting (FGC). None whatsoever. I mean, events happen all the time around the world and I’m not aware of the dozens of happenings that occur day-to-day. But for FGC to go on without so much as a whisper of this harmful practice, I thought was rather strange.

I learned about FGC when I was given an assignment during my junior year in high school. It was a Pre-Senior Project, which was essentially a practice before our year-long project we had to do for our final year of high school. Ideally, we were to choose a topic that pertained to our passions or a problem related to us on some level. I was at a loss for what to choose. Everyone around me jotted down several potential ideas, but my ideas were comparatively vague. By day two or so, I sat with my teacher to make a final decision. My teacher wrenched out my distaste for injustice and helped me narrow the target of people who undergo it. She typed online in the search bar something along the lines of “issues involving women and children” and there it popped up–female genital cutting.

I was appalled when I first learned about it. To reiterate, I had no idea this tradition existed and I wondered how it continued to go on. Why did women and men subject their daughters to this? What was the appeal? I dug deeper, finding out the reasons behind FGC. In some communities, while the intention was to keep daughters clean or marriageable, it was done at the cost of carrying out a potentially traumatic procedure that could leave the woman or girl with a handful of health issues afterward.

However, the concept of cultural relativism impeded criticism and questioning, while justifying the tradition. The idea that because one has not lived in a certain community or society, they can’t truly pass judgment on the cultural practices of others. Two people living in two different places across the world from each other naturally grow up with different experiences. Who is to say that another’s culture and traditional practices are objectively wrong? What is considered wrong when it comes to culture? Outsiders may feel as if they do not have a voice in regard to scrutinizing FGC because it’s an issue beyond their homes. Therefore, proponents of FGC claim that the divide or differences between two groups is too great to judge each other. Admittedly, I initially agreed with the notion of cultural relativism. Who was I to criticize people who carry out FGC in their communities when I knew nothing of their lives? Even so, remaining in place and staying quiet, doesn’t sit well with me, especially if I could be a person who brings awareness to FGC being a human rights violation. The excuse of cultural relativism shouldn’t be used when people are being harmed.

I continued researching FGC for my project the next school year, my senior year in high school. This time, the project had to be more extensive, including a longer research paper, another presentation, and some sort of final product. This ranges from documentaries to creating design plans. With all this work I was doing, I thought maybe I could make some sort of difference. I needed a mentor for guidance, one who is an expert on the topic. I sent out an email or two before finding Mariya, a co-founder of Sahiyo. The organization specializes in advocacy regarding FGC, even working with affected communities to diminish the practice. By sharing the stories of women involved with FGC, a wider audience becomes aware of the issue with a deeper understanding. With the combined efforts of multiple organizations and people from different walks of life, the perception of practicing communities will change. Then, I believe, FGC will become part of the past.

Over the course of my project, I hope to improve my advocacy skills and fully understand the issue that I’ve been invested in for the past couple of months. So far, researching FGC and looking into multiple perspectives has encouraged me to consider my own views on the topic. By the end, I will have figured out my ethical priorities. For the rest of my blog posts, I want to look into a handful of countries where FGC is practiced and talk about the circumstances around them. Until next time!

More on Brionna:

Brionnabiopic

 

Brionna is currently a high school senior in the District of Columbia. She likes drawing, helping others, and being able to contribute to great causes.

Trauma and Female Genital Cutting, Part 6: Effects of FGM/C on the Lower Urinary Tract System

(This article is Part 6 of a seven-part series on trauma related to Female Genital Cutting. To read the complete series, click here. These articles should NOT be used in lieu of seeking professional mental health and counseling services when needed.)

By Julia Geynisman-Tan, MD

Background

FGM/C has no known health benefits, but does have many immediate and long-term health risks, such as hemorrhage, local infection, tetanus, sepsis, hematometra, dysmenorrhea, dyspareunia, obstructed labor, severe obstetric lacerations, fistulas, and even death. While the psychological, sexual, and obstetric consequences of FGM/C are well-documented (refer to prior posts in this series), there are few studies on the urogynecologic complications of FGM/C. Urogynecology is the field of women’s pelvic floor disorders including urinary and fecal incontinence, dysfunctional urination, genital prolapse, pelvic pain, vaginal scarring, pain with intercourse, constipation and pain with defecation and many other conditions that affect the vagina, the bladder and the rectum. Urogynecologists are surgeons who can both medically manage and surgically correct many of these issues.

FGM/C and Urinary Tract Symptoms

One recent study from Egypt suggested that FGM/C is associated with long-term urinary retention (sensation that your bladder is not emptying all the way), urinary urgency (the need to rush to the bathroom and feeling that you cannot wait when the urge comes on), urinary hesitancy (the feeling that it takes time for the urine stream to start once you are sitting on the toilet) and incontinence (leakage of urine). However, the women enrolled in this study were all presenting for care to a urogynecology clinic and therefore all of them had some urinary complaints so it is difficult to tell from this study what the true prevalence of lower urinary tract symptoms are in the overall FGM/C population.

Therefore, given the significant number of women with FGM/C in the United States and the paucity of data on the effects of FGM/C on the urinary system, my research team studied this topic ourselves in order to describe the prevalence of lower urinary tract symptoms in women living with FGM/C in the United States. Publication will be available online in December 2018.

We enrolled 30 women with an average age of 29 to complete two questionnaires on Overactive bladder 1their bladder symptoms. Women in the study reported being circumcised between age 1 week and 16 years (median = 6 years).

  • 40% reported type I
  • 23% type II
  • 23% type III
  • 13% were unsure

Additionally, 50% had had a vaginal delivery; and 33% of these women reported that they tore into their urethra at delivery.

Findings:

A history of urinary tract infections (UTIs) was common in the cohort:

  • 46% reported having at least one infection since being cut
  • 26% in the last year
  • 10% reported more than 3 UTIs in last year
  • 27% voided ≥ 9 times per day (normal is up to 8 times per day)  
  • 60% had to wake up at least twice at night to urinate (once, at most, is normal)

Most of the women (73%) reported at least one bothersome urinary symptom, although many were positive for multiple symptoms:

  • urinary hesitancy (40%)
  • strained urine flow (30%)
  • intermittent urine stream (a stream that starts and stops and starts again) (47%) were often reported
  • 53% reported urgency urinary incontinence (leakage of urine when they have a strong urge to go to the bathroom)
  • 43% reported stress urinary incontinence (leakage of urine with coughing, sneezing, laughing or jumping)
  • 63%reported that their urinary symptoms have “moderate” or “quite a bit” of impact on their activities, relationships or feelings

What’s the Connection Between FGM/C and Urinary Symptoms?

Urinary symptoms like the ones described above can be the result of a number of factors. pee-night-400x322Risk factors for urinary urgency and frequency, incontinence, and strained urine flow include pregnancy and childbirth, severe perineal tears in labor, obesity, diabetes, smoking, genital prolapse and menopause.

However, given the average age of women in our sample and the fact that only half of them had ever had a vaginal birth, the rate of bothersome urinary symptoms are significantly higher than has been previously reported. FGM/C may be a separate risk factor for these symptoms. Interestingly, the prevalence of urinary tract symptoms in our patients closely resembled that of a cohort of healthy young Nigerian women aged 18-30, in which the researchers reported a prevalence of lower urinary tract symptoms of 55% with 15% reporting urinary incontinence and 14% reporting voiding symptoms. The authors do not mention the presence of FGM/C in their study population but the published prevalence of FGM/C in Nigeria is 41%, with some communities reporting rates of 76%. Therefore, it is likely that many of the survey respondents had experienced FGM/C, thereby increasing the prevalence of lower urinary tract symptoms in their cohort. In the study of women in Egypt referenced above, those with FGM/C were two to four times more likely to report urinary symptoms compared to women without FGM/C.

The connection between FGM/C and urinary symptoms can be understood from the literature on childhood sexual assault and urinary symptoms. Most women who experience FGM/C recall fear, pain, and helplessness. Like sexual assault, FGM/C is known to cause post-traumatic stress disorder, somatization, depression, and anxiety. These psychological effects manifest as somatic symptoms. In studies of children not exposed to sexual abuse, the rates of urinary symptoms range from 2-9%. In comparison, children who have experienced sexual assault have a 13-18% prevalence of enuresis (bedwetting) and 38% prevalence of dysuria (pain with urination). The traumatic imprinting acquired in childhood persists into adult years. In a study of adult women with overactive bladder, 30% had experienced childhood trauma, compared to 6% of controls without an overactive bladder. There is a neurobiological basis for this imprinting. Studies in animal models show that stress and anxiety at a young age has a direct chemical effect on the voiding reflex and can cause an increase in pain receptors in the bladder. Additionally, the impact of sexual trauma on pelvic floor musculature has been well described. Women who experience genital trauma often respond with an involuntary contraction of the pelvic floor, which can develop into non-relaxing pelvic floor dysfunction and subsequent urinary hesitancy, strained flow, retention, bladder pain and overflow incontinence.

These Conditions are Treatable

There are treatments for all of the conditions. Urinary hesitancy, strained flow, bladder pain, and urgency are often treated with pelvic floor muscle therapy. That is because many of these symptoms come from an unconscious, constant clenching of the pelvic floor muscles, which then prevents them from using their full range of motion and pinches off the nerves running through the muscles. Pelvic floor therapy focused on lengthening and stretching these muscles can completely change the way that you urinate and the sensation of pain in the pelvis. This kind of physical therapy is done by all female providers in a private room. The therapy consists of a combination of external and internal work on all of the muscles of your core and pelvic floor to release trigger points of tension and teach you how to relax and lengthen these muscles. Sometimes the therapists use biofeedback devices in the vagina to help you to recognize certain muscles groups. The sessions are usually one hour long and last for 6-12 visits. You can obtain a referral to a pelvic floor physical therapist from your local urogynecologist.

If you have urinary leakage throughout the day or nighttime, this can also be treated. Your urogynecologist can help differentiate whether you have stress urinary incontinence (leakage with coughing, laughing, exercise, lifting) or urgency urinary incontinence (leakage that follows the urge to go to the bathroom or sometimes sporadic leakage without any urge). These types of incontinence are treated differently but both can be treated with a combination of medicine, office procedures or surgical treatments. To find a urogynecologist in the Unit, you can go to the website of the American Urogynecologic Society and click on patient services.

 

About Julia Geynisman-Tan

Julia is a Female Pelvic Medicine and Reconstructive Surgeon in the Department of Obstetrics and Gynecology at Northwestern. During her residency at New York Presbyterian – Weill Cornell, she founded the Survivor Clinic of New York City, a dedicated clinic for women who had experienced sexual violence, including trafficking, female genital mutilation, and torture in war. Now in Chicago, Dr. Geynisman-Tan has founded the Northwestern ERASE Clinic for survivors of human trafficking and is an asylum evaluator for Physicians for Human Rights. She is currently a co-chair of the American Women’s Medical Association Physicians Against Trafficking of Humans Committee, on the board of the America Hospital Association’s Human Trafficking Consortium and serves on the Cook County Human Trafficking Task Force.

To ban or medicalise? Sri Lanka grapples with debates on Female Genital Cutting

(Please note that a version of this article appears on LankaWeb.com. It has been republished here with permission from the author.)

By Fatima Yasmin  

Country: Sri Lanka

Muslim religious organisations in Sri Lanka have called on the government to medicalise female circumcision to ensure the procedure is done under hygienic conditions. In their submission before the Parliamentary Committee on Women and Gender early in September, the Muslim groups stated that the Muslim community was very concerned about moves to ban the procedure on the grounds that it was Female Genital Mutilation (FGM).  

Spokeswoman Noor Hazeema Haris has reportedly said that although Muslims wholeheartedly have supported the abolition of traditional practices harmful to women and children such as Female Genital Mutilation, the Islamic practice of female circumcision was very different.

She pointed out that the distinction is that female circumcision as practiced by Muslims in Sri Lanka, was a minor procedure, in which only the prepuce or hood of the clitoris was removed.

“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 said. “If medical complications have arisen among some women circumcised by Osthamamis (traditional female circumcisors without medical training) 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.”

The move is a very dangerous one since it could lead to greater acceptability of FGM. There have been many complaints raised against traditional practitioners including the use of unsterile instruments and harming the clitoris in some cases. However, I believe the solution is to ban it altogether rather than medicalising it.

But analysts warn this could lead to an uproar from religious parties and have political implications since parties that come out against FGM risk losing a large and influential Muslim vote bank. The All Ceylon Jamiyyathul Ulama, an organization of religious scholars in the country issued a fatwa in 2008 stating that female circumcision was obligatory, and was among the parties that made representations to medicalise the practice early in September.

It is also a matter of concern to women’s rights groups that the said Parliamentary committee agreed to accommodate the representations and requested that medical evidence is submitted to prove that female circumcision of the type prescribed in Islam, as stated by these religious groups, causes no harm and benefits women.

A female doctor who performed the procedure before a health ministry circular prohibiting medical professionals from performing it came into effect in the country in October, and whose name has been withheld here by her request, said that she welcomed the move to medicalise it:

“I performed about 25 circumcisions a day in a private clinic, mostly infants. But there were women, too. Some were newly married and wanted to be circumcised at their husbands’ request. All I do is remove a little bit of skin covering the clitoris. I use a very fine instrument for the babies. It takes only a few minutes. In the case of adults, I inject an anesthetic before proceeding to circumcise them. My patients tell me it’s only the injection that hurts a bit and that after that they don’t feel a thing. It’s sore for a few days but heals fast. There is a huge demand for this service. It’s a shame that it’s now going back into the hands of untrained women who have no proper medical knowledge and who use unsterilized instruments for the purpose.”

A young mother who had her infant daughter cut by a traditional practitioner also agreed.

“Doctors refuse to do this now, and I was forced to get it done by an Osthamami. She took out a blade which looked as if it had been used many times and made a cut to my daughter’s genitals. Some blood came out. I could not bear to look. Later I checked it and noticed a cut had been made in the skin over the clitoris but the foreskin had not been removed. This is an improper circumcision according to my sister who is an Aalimah (religious scholar) and so I will have to get her circumcised again. Why are these so-called women’s groups against doctors doing it? We will practice it whether they ban it or not.”

However, a member of a prominent women’s organization said that prohibiting the practice is the right thing to do.

“FGM has been condemned as a violation of the rights of women and girl children by the World Health Organisation. WHO makes no distinction between FGM and the type of circumcision practiced here. It’s all the same. How can you cut these girls and call it a religious obligation? I understand there is a strong religious argument for the practice, but we cannot let religion affect the health of girls and women.”

And so the debate goes on – to ban or medicalise. One thing is for sure. It won’t be easy. Not only does the religious establishment in Sri Lanka, unfortunately, support the practice, but many local women are for continuing it, meaning the government and activists working to end FGM will face many challenges ahead before FGM can be abandoned in Sri Lanka.