Sahiyo Staff Spotlight: Lara Kingstone

Lara Kingstone started her career in community organizing in a UK-based program designed to integrate London communities and empower youth to become active and engaged citizens. Lara earned a BA in Political Communications at IDC Herzliya, an Israeli University, while working as a journalist at The Culture Trip and producing and hosting a human rights radio program. She then worked at an educational center which aimed to help Palestinian and Israeli young people learn English together, and get to know each other as peers and partners in peace. After graduating, she moved to the Thai-Lao border where she volunteered at Child Rights and Protection Center, a small non-profit which aims to prevent human trafficking and gender-based violence, while providing a safe and confidence-building living environment for at-risk young women. Lara then moved to Boston, and interned with Big Sister before starting her part-time role at Silver Lining Mentoring as an Outreach Coordinator, where she aims to find volunteers to become long-term mentors for youth in foster care.

She joined Sahiyo in August 2018.

When and how did you first get involved with Sahiyo?

In August 2018, I applied for the role of Communications Assistant, thrilled to see that an organization that so closely aligned with my interests was hiring. I have a background in non-profit work, and working to ensure dignity and human rights for women globally. I’d been interested in Female Genital Cutting, and the work to end the practice for years, doing a thesis paper on it in college, and had actually heard of Sahiyo a few years prior, whilst learning about global efforts to end FGC.

What is the nature of your work at Sahiyo?

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I’m now the Communications Coordinator. The work is constantly different, which I enjoy. It varies from working on grant applications and event reports, to supervising our lovely social media interns, to providing administrative assistance to the team. And anything else that pops up!

How has your involvement in this work impacted your life?

Joining Sahiyo has been incredible. I’ve been hit with a rush of motivation and energy, because I feel intensely passionate about the work and organization. I find myself truly inspired by our global team, and all the partners we connect with. I’m confident in the leadership as they have experience and knowledge of the community and practice we’re focusing on. I trust this team of brave, resilient and hard-working women, and I’m so honored to be able to support the work in any way I can. From day one it’s been intense and challenging, and I find myself constantly learning and growing with it. It’s very exciting being with such a fast-growing organization like Sahiyo, and getting to see the rapid changes and progress the team makes. I’m a big fan, and hope to be onboard for a long time.

Is there any advice you would like to share with others interested in joining or supporting Sahiyo’s work?

Do it! Sahiyo has so many different opportunities for being involved, even offering anonymous ‘Private Activism’ for those who are more comfortable in that capacity. If you have skills to bring to the table and feel passionately about Sahiyo’s goal, joining is definitely a worthwhile move, that will leave you feeling connected, empowered and proud to be part of this whirlwind movement.

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Sahiyo U.S. Advisory Board Spotlight: Maryum Saifee

As Sahiyo’s U.S. operations and programs have grown, in 2018, we invited various individuals from a host of backgrounds and professions to join our inaugural U.S. Advisory Board. The advisory board provides strategic advice to the management of Sahiyo and ensures 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.

This month, we are pleased to highlight Maryum Saifee, who has graciously agreed to serve as the Chair for our inaugural U.S. Advisory Board. photo3_maryumsaifee

1) Can you tell us a bit about your background?

I was born and raised in Texas and the product of Indian immigrant parents. Like many South Asian-Americans, my parents were baffled when I strayed from the script (pursuing a medical degree to eventually take over my mom’s practice) and opted for an unpredictable career in public service.  My first act of rebellion was joining the Peace Corps at nineteen. I worked in a small village just north of the Dead Sea in Jordan. In my two years there, I became interested in the impact of U.S. foreign policy in the Middle East. When I came home from Jordan, I served as an AmeriCorps volunteer working with South Asian survivors of domestic violence and educating school administrators in Seattle on the impact of post 9-11 anti-immigrant backlash. Just over ten years ago, I joined the U.S. foreign service where I spent more time in the Middle East serving in Cairo (during the 2011 Arab uprising), Baghdad, and most recently Lahore. I was also proud to serve as a policy advisor in the Secretary’s Office of Global Women’s Issues leading the U.S. government’s efforts to address and respond to gender-based violence (including bringing about an end to Female Genital Mutilation) globally.

2) When did you first get involved with Sahiyo and what opportunities have you been involved in?

I first became involved with Sahiyo when I worked in the Secretary’s Office of Religion and Global Affairs in 2015.  I organized panel discussions at the United Nations during key moments (the Commission on the Status of Women and International Day of Zero Tolerance) as well as at large-scale civil society convenings like the Islamic Society of North America’s annual convening. Sahiyo was (and continues to be) a powerful force for social change. Prior to Sahiyo’s existence, FGM was framed as a faraway problem restricted to sub-Saharan Africa. However, over the last few years there is a greater understanding that FGM is global in scope and not only occurring in South and Southeast Asia but communities all over the world.  I have been honored to serve as Sahiyo’s first advisory board chair and hope to help the organization continue making a strong impact.

3) How has your involvement impacted your life?

Sahiyo is a powerful platform pushing for long-term social change.  Despite backlash and pushback, the organization continues its work and has given survivors like me the opportunity to forge bonds of solidarity with others fighting against FGM.  

4) What pieces of wisdom would you share with new volunteers or community members who are interested in supporting Sahiyo?

I would say to try and stay upbeat even when there are challenges.  Changing mindsets won’t happen overnight, but it will happen in time.  My advice is to be patient and stay focused on the end goal. And in the meantime, make sure to practice self-care to avoid burnout.

 

Sahiyo Stories screened in Washington DC: A survivor’s reflection

by Maryah Haidery

Recently on Facebook, I noted that real social change usually happens when people are good enough to care about doing the right thing, thoughtful enough to figure out the best ways to do it, and brave enough to actually go through with it. On December 4th, in Washington DC, I was fortunate enough to meet a roomful of such people. I was there representing Sahiyo at an event called ‘Using Data and Community Engagement to Better Focus FGM Prevention Interventions’ sponsored by the US End FGM/C Network and The George Washington University Milken Institute School of Public Health.

Photo 2 Maryah at DC
Maryah Haidery talking at the Washington DC screening.

The event included an exceptional presentation by Sean Callaghan from the organization, 28 Too Many on how government agencies and NGOs can use data to track populations where FGM/C may be most prevalent and how best to engage with these populations. It also included a screening of Sahiyo Stories, a series of digital stories by nine different women, including myself, detailing our personal experiences with FGM/C and/or advocacy. I had volunteered to introduce Sahiyo Stories in place of Mariya Taher who was unable to attend the event. Despite some technical difficulties, I tried to summarize Mariya’s history with StoryCenter and the collaboration which culminated in Sahiyo Stories and the short behind-the-scenes video showing how we made the videos and what we hoped to gain from them.

Since this would be my first time seeing the videos with a large audience, I was a little nervous. But when Mariya’s voice came on, the room grew absolutely silent and by the end, quite a few people seemed visibly moved. During the Q&A period following the screening, I was struck by the number of people who wanted to know how they could find out more about FGM/C and what they could do to help even though this was not a problem that affected their communities. Afterward, several people from other organizations working to end FGM/C approached me with interesting suggestions on using Sahiyo Stories in conjunction with their apps and projects in order to make a greater impact on government officials or healthcare workers or educators. As I looked around the room at all these people who cared so passionately about ending this practice – people who were good and thoughtful and brave, it made me more confident than ever before that real social change was a real possibility.

To learn more about Sahiyo Stories, read:

Five things you need to know about the controversial court ruling on FGM/C in USA: Sahiyo explains

by Sahiyo

On November 20, 2018, United States District Judge Bernard Friedman ruled that the US Federal Law banning Female Genital Cutting (FGC, also known as Female Genital Mutilation or FGM) is unconstitutional. With this ruling, the judge dismissed key charges of FGM against two Michigan doctors and six other people accused of practicing genital cutting on several minor girls.

However, in the same ruling, Judge Friedman acknowledged that the practice of cutting a female’s genitalia is “despicable”.

The ruling came as a shock to survivors of FGC and human rights activists advocating to end FGC, not just in the USA but all over the world. But there is more to this complex and controversial court ruling than the news headlines suggest. In order to better understand the ruling and its implications for communities that practice FGC, read Sahiyo’s comprehensive explainer below:

What is the US District Judge’s ruling on Female Genital Cutting all about?

In April 2017, the US federal government prosecuted Dr. Jumana Nagarwala, Dr. Fakhruddin Attar and his wife Farida Attar — all members of Michigan’s Farmington Hills Dawoodi Bohra mosque — for subjecting two minor girls from Minnesota to FGC. Subsequently, five other women from the Dawoodi Bohra community were prosecuted for performing FGC on at least nine girls in the Michigan area. This historic case was the first time that anyone had been charged under the US federal law prohibiting FGC — a law that had been introduced by the federal government back in 1996.

To understand the US District Court’s ruling in this case on November 20, it is important to understand the federal nature of the US government and its criminal justice system. Under federalism, some laws can be passed by Congress — the federal or central government — and are applicable to all states in the country. Some other laws can only come under the jurisdiction of individual state governments, and cannot apply to the whole country.

In his ruling in the FGC case, Judge Friedman of the federal-level district court stated that “as despicable as this practice may be”, FGC is technically a “local criminal activity”, and Congress (the federal government) does not have jurisdictional authority to regulate it. Even though the federal law against FGC has been in place since 1996, he stated that it is “unconstitutional.”       

Why is this ruling controversial?

The district judge states that the crime of FGC should be regulated by individual states. But the US does not actually have laws against FGC in every single state. At the moment, only 27 out of 50 US states have a state law banning FGC. There is currently a state law in Michigan banning FGC, but the law only came into effect in 2017 after the federal case involving Dr Nagarwala and Dr Attar came to light. The doctors cannot be prosecuted retrospectively under this state law.

Judge Friedman’s ruling declares the federal law against FGC to be unconstitutional based on a technicality. However, the ruling is controversial on at least two fronts.

First, prosecutors and other human rights advocates argue that FGC cannot be considered just a local criminal activity, because it often involves transporting minors across state borders to get their genitals cut by doctors who are paid to perform the ritual. In this case, for instance, two minor girls were transported from Minnesota to Michigan to get FGC done by Dr Nagarwala. Therefore, the federal law banning FGC — which Congress had passed in 1996 under the “Commerce Clause” — should be applicable in this case. Judge Friedman’s ruling does not consider this aspect.

Second, this ruling is insensitive to survivors of FGC and sends out a dangerous message to women from FGC-practicing communities: that their lives and bodies can be put at risk on the grounds of questionable technicalities.

Does this ruling put more girls at risk of being cut?

For the time being, yes: this ruling can put girls at risk of being but. The Centers for Disease Control and Prevention has estimated that 513,000 women and girls have experienced or are at risk of FGC in the United States. And this figure is an underestimation. Many women and girls at risk live in one of the 23 States which have not passed laws against FGC.

Since the ruling puts the onus of regulating FGC only to individual states, many of these girls are at risk of being transported from states that have laws banning FGC to states that currently do not have laws banning FGC, so that they can be cut with impunity. Only 11 of the 27 States with anti-FGC laws have specific provisions banning the transportation of a child out of the State to perform FGC.

Since the US is a strong country with a high degree of influence on global cultures, this ruling also ends up unintentionally condoning genital cutting for FGC-practicing communities all over the world. We are already seeing this in the global Dawoodi Bohra community, where supporters of Female Genital Cutting have taken to social media to celebrate their “victory” in the US FGC case, and to claim that they will continue cutting girls.

Is this the end of the case, or can the ruling be appealed?

This District Court ruling is not the end of the case. This is a lower court decision which can and almost certainly will be appealed by prosecutors from the US Government, and it is possible that over time, this case will be taken to the Supreme Court.

Additionally, two charges remain against Dr Nagarwala, including conspiracy to travel with intent to engage in illicit sexual conduct, and obstruction of justice. Her trial is set to begin in April 2019.

What is the way forward now, for those of us working to end FGC?

Laws are an important deterrent against FGC, and help to reinforce the fact that cutting female genitals is a human rights violation. In light of Judge Friedman’s ruling, activists and communities in the United States should now urge their elected representatives to pass laws banning FGC in every single state of the country. As a global leader in human rights, the US should also do this to set a precedent in many Asian countries where there are currently no laws against FGC.

However, at Sahiyo, we believe that laws can be effective only when accompanied by social change movements on the ground. We therefore encourage everyone to engage in dialogue around FGC, to break the silence around this taboo topic, listen to women’s voices and recognise that FGC is harmful to girls and women.

 

To learn about the history of the Michigan case, click here

Read more at U.S. Court’s dismissal of FGM/C charge in Michigan case is disappointing but does not condone genital cutting.

Read the Amicus Brief for Dr. Nargawala hearing on November 6, 2018, submitted by Equality Now, WeSpeakOut, Sahiyo, And Safe Hands For Girls in support of the United States.

Read the U.S. End FGM/C Network Statement on Judge’s Decision in Michigan Case.

Female Genital Cutting charges dismissed but our work continues: Global reactions to Michigan case news

By Sahiyo

On November 20, U.S. District Judge Bernard Friedman dismissed the female genital cutting charges in the historic Michigan case involving girls from the Dawoodi Bohra sect, emphasizing that FGC should be regulated by states as a “local criminal activity.” Congress enacted the 22-year-old federal law banning FGC in 1996 — the law Judge Friedman has declared unconstitutional.

Charges were dropped against two Michigan doctors, Dr. Jumana Nagarwala and Dr. Fakhuruddin Attar, and six others accused of subjecting at least nine minor girls to FGC. However, Dr. Nagarwala, Dr. Attar and his wife, Farida, and a mother remain charged with conspiracy to obstruct an official proceeding. Dr. Nagarwala is also charged with conspiracy to travel with intent to engage in illicit sexual conduct.

In light of these developments, we would like to share the responses of many Bohras and other activists working to end FGC.

“What is so disappointing to me is that justice will be delayed in this case. There is a growing, global movement against khafz/FGC and we need positive judgments to send a strong message to our community that this practice is harmful and illegal. We must protect future generations of Bohra girls.”
~ Farzana Doctor, Canada  

“By declaring the federal ban on FGM/C unconstitutional, Judge Friedman opens the door for parents to do exactly what was done in this case — take their daughters from states that ban FGM/C to states that don’t so they can be cut.”
~ Umme Kulsoom Arif, USA

“The ruling on the jurisdiction of this case is giving some folks a perceived green light to proudly say that khatna/khafz/FGM/C is not illegal in the US after being afraid to say it out loud after Nagarwala was arrested. But people should understand that there are many state laws still in place (including in Michigan now) and the judge said that FGM/C is a ‘criminal activity’ so parents beware. This does not give you permission to cut your daughters. It will be a regrettable time in history if there is an uptick in the practice of FGM/C in the US because of this technicality in the jurisdiction of this case.”
~ Zehra Patwa, United States

“Shameful really! While 30 other countries have made FGM illegal, US, the supposed defender of human rights, has just shown the world what American justice is…women’s rights are not just not important for the federal court.”
~ Saleha, Canada

“Shocking judgment. But at the same time judgment gave us more spirit to work hard and achieve the desired goal to end FGC. To bring social change takes time but nothing is impossible. I’m sure through our collective efforts we will achieve our goal one day.”
~ Chandni Shiyal, India

“While on our climb towards the summit, we are going to face slips and stumbles but the climb must go on…..this judgement though disappointing is a mere stumble or slip….”
~ Fakhera, India

“This judgment is clearly based on a technicality of the federal versus the state jurisdiction. Irrespective, FGC still continues to be a violent act against 7-year old girls. Are we disappointed to hear this decision? Most certainly. However, it’s only a matter of time until people open their eyes and see the truth. Tradition without any logic can only hold its ground so long. Sati used to be tradition too, in this very land. Look where we are now.”
~ Alifya Thingna, India

“One of the most disheartening outcomes of this case is the lack of outrage among our elected officials. Two, recently elected, Muslim women representatives from Michigan and Minnesota (the two states involved) have failed to use their platforms to proactively address this issue. FGM is an issue that affects the safety of women and girls, and constituents in their communities. This decision (and the lack of public outrage) sends a signal to communities who practice FGM that there will be no accountability.”
~ Maryum Saifee, United States

“It’s a sad day for silent seven-year-old girls when there is no clear US law to protect what is truly theirs!”
~ Rashida Rangwala, United States

“I am so disheartened by this decision! It’s actually shocking. I thought at least USA law would give justice to innocent girls.”
~ Alifya Sulemanji, United States

“No little girl in this world should have to go through the trauma of female genital cutting. Cultures should not be empowered to take away the human rights of their members.”
~ Renee Bergstrom, United States

“I feel angry and deeply disappointed. This isn’t over but it’s incredibly discouraging to see our legal system disrespect and let down girls and women being violated in this country.”
~ Lara Kingstone, United States

“यह केस 23 US राज्यो में FGM कानून के अभाव में जीता गया है। यह एक ही टेक्निकल ग्राउंड है। अब यह केस अमेरिकन सुप्रीम कोर्ट में जाएगा। UN कानून के तहत अमेरिका बाध्य है। अब वहां सुप्रीम के आदेश पर फेडरल कानून बन सकता है। कोई भी संघर्स लंबा समय मांगता है कभी जीत कभी हार होती है। हरेक निष्फलता अगली सफलता का बेज़ (फाउंडेशन) बनता है। भारत के कोई राज्य में ऐसा FGM कानून नही है। मगर हम भी UN के सदश्य है। भारत मे भी ऐसा कानून आज नही तो कल बनेगा।”
~ Ibrahim Patel, India

“There are many practices which have been blindly followed from decades. Some of them have been changed, modified or amended in the course of time, with the advancement of research and scientific development. We are just trying to tell the world the actual fact that women undergo suffering with no fault of their own because of FGC.”
~ Insiya Ganjifrockwala, India

“Regardless of the impending appeal, this decision may inevitably embolden many to continue cutting girls. We should take this opportunity to continue to pressure our leaders to stand against FGC as a human rights violation, to bring awareness to the issue, and to protect our girls.”
~ Jenny Cordle, United States

“I would call this verdict as a legislative failure as no justice has been given to the child, and this gives a loophole to people in that country to keep practicing FGC.”
~ Insiya Lokhandwala, India

“This is horrible! As a victim of FGC myself, I really wanted to see this doctor punished and her punishment to set a strong example for others in the community who practice FGC/ khatna thinking it’s the right thing to do. I feel like we women are never going to get justice for the wrongs done to us. What’s more, these wrongs will continue to go on and little girls will continue to be traumatized. It’s so frustrating and just makes me want to scream.”
~ Shabana Feroze, Bahrain

“I am shocked and deeply disappointed that a Federal judge in the USA has lifted the ban on FGM. It is so, so important that the USA as a world leader takes an unequivocal stand on this human rights issue afflicting women and the girl child.”
~ Zarina Patel, Kenya

“As I was reading, ‘Judge dismisses female genital mutilation charges in historic case.’ My blood was boiling. Where’s the justice for these women? What message is our federal government sending out to all doctors, mothers, and members who carry out this act? That it’s okay for them to violate girls without any real consequences. And what message are they sending out to our young girls? That their bodies are up for grabs? Or that what they’re going through doesn’t matter to us. Sad day to say the least!
~ Aisha Yusuf, United States

“I wasn’t sure what to expect from the  Michigan trial but I never dreamed it would get dismissed on a technicality about federal vs state jurisdiction! I don’t know enough about the law to know if the judge’s ruling was correct but I know I’m not going to let this setback keep me from fighting. Let’s all work together to get legislation passed in the 23 states that don’t yet have a law against FGM so this never has to happen again!”
~ Maryah Haidery, United States

Read more at U.S. Court’s dismissal of FGM/C charge in Michigan case is disappointing but does not condone genital cutting.

Read the Amicus Brief for Dr. Nargawala hearing on November 6, 2018, submitted by Equality Now, WeSpeakOut, Sahiyo, And Safe Hands For Girls in support of the United States.

Read the U.S. End FGM/C Network Statement on Judge’s Decision in Michigan Case.

 

U.S. Court’s dismissal of FGM/C charge in Michigan case is disappointing, but does not condone genital cutting

By Mariya Taher
Co-founder, Sahiyo

I was sitting in my office, reading a blog post submitted to Sahiyo by a woman doing research on Female Genital Cutting in India, when I received a phone call. I answered it, not thinking twice, not knowing that what I was to hear next would leave me dumbstruck.

The call was from a news reporter, who wanted my reactions to the latest news about the United States’ first legal case on Female Genital Cutting (FGC) — the Michigan case involving two doctors and six others brought up on federal charges of performing FGC on nine minor girls in the U.S. I hadn’t heard of the latest news yet. And then, the reporter dropped a bombshell.

It turns out, a U.S. District Judge has dismissed the FGC charges in the case and declared the federal legislation banning and criminalizing Female Genital Cutting in the U.S since 1997 as unconstitutional!

My immediate reaction was, “That’s crazy.” Then my mind shifted to what had happened to me on October 19th, at the inaugural screening of Sahiyo Stories, a collection of digital stories created by U.S. women who have undergone FGC or who have loved ones who have undergone it. After those videos were shown at the screening, a couple walked in, joined the audience, and began to counter the stories of the survivors. They stated that FGC was harmless, that the survivors sharing their stories must only be trying to get attention. I worry that because of what this U.S. District Judge has ruled, what happened at that screening of Sahiyo Stories, might become all too common when survivors share their FGC stories in the hope of preventing harm to future generations of girls.

As stated in the Detroit Free Press by Tresa Baldas

The U.S. District Judge concluded that “as despicable as this practice may be,” Congress did not have the authority to pass the 22-year-old federal law that criminalizes female genital mutilation, and that FGM is for the states to regulate. FGM is banned worldwide and has been outlawed in more than 30 countries, though the U.S. statute had never been tested before this case.

There is no doubt that the decision will be appealed by the government, but this response worries me because without the law, what can we point to, when parents and families are trying to do the right thing and not succumb to the community pressure they face in having their daughter undergo FGC? And at Sahiyo, we do hear from these parents. We hear from parents who tell us they have spared their daughters as well as parents who regret not doing more to protect their daughters, but felt pressured by the community, by members of their families, believing that they had to get it done. That social pressure is real and threatening and at Sahiyo we understand the fear of being ostracised from your family or your community for speaking against what others believe is a religious necessity.

This decision also concerns me because it will be used by proponents of FGC to further suggest that they are justified in pursuing FGC because FGC has been proven harmless. Even though, the fact remains, that this is not at all what the Judge has said in his decision to rule the FGC federal law unconstitutional. To the contrary, the decision made by the Judge clearly recognizes that FGC is a terrible crime.

What the Judge has stated is the following:

“As laudable as the prohibition of a particular type of abuse of girls may be … federalism concerns deprive Congress of the power to enact this statute,” Friedman wrote in his 28-page opinion, noting: “Congress overstepped its bounds by legislating to prohibit FGM … FGM is a ‘local criminal activity’ which, in keeping with long-standing tradition and our federal system of government, is for the states to regulate, not Congress.”

The Judge has ruled that the issue of FGC falls under state law jurisdiction (intrastate) versus federal (interstate). In other words, the judge’s ruling opens up a jurisdiction question and NOT a question on whether FGC is harmful or not.

If “local criminal activity” must be regulated by the state, then it goes to show just how vital it will be for all states in the U.S. to pass laws banning FGC. Currently, only 27 states in the U.S. have such laws. Massachusetts, the state I live in, does not. (See petition ‘Ban FGM/C in MA’).

Even when laws are passed, I believe that it will be important to remember that FGC will most likely still continue just as other forms of gender-based violence such as domestic violence and sexual assault unfortunately continue despite the presence of laws against them. FGC also continues because as a social norm entrenched in the culture, this harmful practice has been touted as a religious or cultural practice that is needed to control women’s sexuality.

This reality points to the importance of education and community engagement to help create social change within communities and amongst groups where FGC might be happening.

To that end, Sahiyo will continue to organize and participate in community events to educate our friends, family and community about the harms of FGC and why it should be abandoned.

Learn more about FGC in the U.S.

If you would like to write about your views on the Judge’s ruling or the Michigan case in general, send a write-up to info@sahiyo.com

 

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.

 

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.

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.