Female genital mutilation/cutting (FGM/C) is a traditional practice that ranges from nicking to total removal of the external female genitalia. An estimated 100 to 145 million women have undergone this procedure and at least 3 million girls are at risk of being cut each year, about 8,000 girls a day.1 Though no religion mandates the procedure, FGM/C is practiced across cultures, religions, and continents. It is practiced in 28 countries in sub-Saharan Africa, northern Iraq, Malaysia, and Indonesia, and new evidence is showing prevalence in other Middle Eastern countries, including Yemen, Iran, Syria, Oman, and Saudi Arabia, and parts of South Asia. The practice also can be found in Europe, the United States, Australia, and other countries in the West where immigrants bring their cultural traditions with them.
The reasons given for conducting FGM/C, which is generally carried out between infancy and the teen years, encompass beliefs about health, hygiene, women’s sexuality, rites of passage to adulthood, and community initiation rites. Research has shown that all forms of the practice harm women’s health, causing serious pain, trauma, and frequently severe physical complications, such as bleeding, infections, or even death. Long-term complications may include recurrent infections, infertility,2 and difficult or dangerous childbirth that can result in the death of the mother and infant.3
The U.S. Government has supported FGM/C abandonment efforts since the early 1990s, considering the practice not only a public health concern, but also a human rights issue that violates a woman’s right to bodily integrity. In September 2000, the U.S. Agency for International Development (USAID) officially incorporated elimination of FGM/C into its development agenda, issuing an official policy and strategy on FGM/C that underscored FGM/C as a serious health and human rights issue. The U.S. Department of State emphasizes the need to raise awareness amongst communities at the grassroots level and in humanitarian settings to reduce the practice of FGM/C.
The United States pursues regional, national, and local coordination among international donors, governments, and community leaders. U.S. Government agencies are actively engaged with internationally based working groups address FGM/C and are also active in the Donors Working Group (DWG) on FGM/C,4 which is composed of key international governmental and intergovernmental organizations and foundations committed to supporting the abandonment of the practice. USAID was a co-founder of the DWG and is dedicated to expanding and strengthening partnerships and increasing resources for abandonment of this harmful traditional practice. The group has collaboratively issued a Platform for Action that summarizes the collective programmatic approach that focuses on the community approach to social change.
On the occasion of the International Day of Zero Tolerance to FGM/C for 2012, the U.S. Government is supporting the launch of the Kenya Centre of Excellence, which will be based at Nairobi University, to create an Africa-based center for learning and developing innovative research approaches and training leaders and champions for working towards the abandonment of FGM/C and welcomes support from the international community and others to join in this effort.
U.S. Government Efforts
The Secretary’s Office of Global Women’s Issues (S/GWI) funds community-based approaches involving men, boys, and all members of society in public awareness and education campaigns emphasizing the detrimental consequences of FGM/C on the physical and mental health of girls, their families, and overall community in order to promote long-lasting solutions.
The Office of Population, Refugees, and Migration (PRM) largely supports efforts in humanitarian settings and among refugees with programs designed to prevent and respond to gender-based violence (GBV), which includes FGM/C. These organizations rely on U.S. Government assistance to provide humanitarian assistance to refugees, conflict victims, internally displaced persons, and stateless persons worldwide. This encompasses a wide variety of assistance, including the provision of protection, shelter, health care, water, and sanitation, as well as the prevention of and assistance to survivors of GBV and FGM/C. PRM also supports targeted activities to prevent FGM/C in Somali and Sudanese refugee populations.
USAID supports implementing partners, both from Washington and at the country level, to provide community-based programs in key countries where the practice is prevalent. The agency’s projects have had targeted programs in Egypt, Ethiopia, Guinea, Kenya, Mali, Nigeria, Djibouti, and Burkina Faso, among others. The projects that are supported consider cultural sensitivities and are integrated with health, economic, social, or democracy and governance programs. USAID programs are community-based, involving community and religious leaders as well as women’s groups, men, and youth to advance the quality and effectiveness of abandonment efforts and to improve conditions that will lead to FGM/C abandonment.
Projects in Country
Egypt – S/GWI supports a project working in the community of Al Darb Al Ahmar in Cairo called Creating Attitudes Favorable to the Elimination of the Practice of FGM/C. Through the dissemination of appropriate and relevant information, coupled with education initiatives and public awareness campaigns, S/GWI supports the Aga Khan Foundation to address and prevent violence against women and girls, including FGM/C, in select Cairo communities. Additionally, the project provides training and capacity building in victim advocacy and mental health for health care providers, community leaders, and volunteers.
In 2008, USAID/Egypt incorporated FGM/C into an existing community-level health program, reinforced by select national-level messaging and educational messaging. The program furthered Egypt’s ongoing efforts to bring about abandonment of FGM/C, as it involved training staff at both the Ministry of Health and nongovernmental organizations to broaden the reach and to coordinate with the Government’s National Council of Childhood and Motherhood to create a coherent national strategy.
Iraq – In coordination with the Bureau of Democracy, Human Rights, and Labor, S/GWI is funding a multidimensional program in northern Iraq composed of integrated victim services and a successful educational campaign for village residents and political and religious leaders, leading to the first-of-its-kind declarations of villages being “Female Genital Mutilation Free.”
Kenya – PRM provides resources to nongovernmental organization partners to promote awareness and prevention of FGM/C through community-based institutions and civil society, including men’s groups, youth groups, women’s groups, and religious leaders. Other projects promote social and economic empowerment of women and girls to reduce the risk of exposure to GBV, including FGM/C, while educating participants on the impact of harmful traditional practices, including FGM/C.
USAID conducted studies to better understand the practice of FGM/C among the Somalis in North Eastern Kenya to inform the design and implementation of interventions and to clarify the correct Islamic understanding of FGM/C. The research provided crucial evidence that FGM/C is neither a religious practice nor one sanctioned by Islam, which clearly stipulates provisions for the protection of basic human rights, upholds the sanctity of the human body, and prohibits any practice that violates these rights or causes harm to the body without justification. The conclusions called on religious scholars to collaborate with medical doctors to make verdicts based on scientific facts and to work with their communities to help delink FGM/C from Islam.
Ethiopia – In Northern Ethiopia, the U.S. Government supports an FGM/C awareness-raising program for women and girls living in Shimelba and My’Ayni refugee camps. Specific efforts include coffee discussions with girls, women, boys, and men on GBV-related topics and services and a Girls’ Wellness Week, which will promote adolescent girls’ health through a coming-of-age ceremony without FGM/C.
USAID supported collaboration with the Ministry of Health and the National Committee on Traditional Practices to educate communities on the harmful effects of FGM/C. The program worked on helping women and community leaders to understand the motives of “FGM/C demanders,” respond to their concerns, and provide them with information on the negative impact of the practice. More than 2,250 people participated in FGM/C abandonment activities; a national Anti-FGM/C Women’s Leaders Team was established, and a member of that team drafted a law against FGM/C that the Ethiopian parliament passed in July 2004.
Mali – USAID helped the Ministry of Health develop and pilot a national training curriculum for primary medical providers to increase their capacity to identify, treat, or refer FGM/C complications and educate and counsel clients and community members on the negative aspects of the practice. A network of trained providers was created consisting of extension workers from nongovernmental organizations and community and religious leaders. As a result of their work, the percentage of men and women who said they were in favor of abandoning FGM/C increased from 15 to 62 percent, and the percentage who intended to have FGM/C performed on their daughters decreased from 81 to 33 percent.
Senegal – The Grandmother’s Project (GMP) incorporates FGM/C into a broader girls’ and women’s health and family planning program to bring about positive changes in community traditions by involving grandmothers and elderly women, a once marginalized group, in social change. The project encourages learning and communal decision-making through open discussions about problems confronting the community. The aim for GMP is to have community members identify their problems and reach consensus on possible solutions that best suit their needs, leading to long-term and lasting change.
West Africa – USAID supports Tostan, a participatory education program that works village by village to incorporate democracy, problem solving, basic mathematics, literacy and essential health education, including information about FGM/C, into the learning experiences that ultimately empower the entire community. As a result of this multidimensional approach, thousands of villages in West Africa have publicly abandoned FGM/C and other harmful traditional practices upon completion of the Tostan program.
1. Delinking Female Genital Mutilation Cutting from Islam (2008). Lethome Asman, Ibrahim and Sheikh Abdi, Maryam, FRONTIERS Program, Population Council. http://www.popcouncil.org/pdfs/frontiers/reports/FGM_Islam.pdf.
2. World Health Organization (WHO). (2012). Fact sheet No. 241. http://www.who.int/mediacentre/factsheets/fs241/en/.
3. WHO Study Group on Female Genital Mutilation and Obstetric Outcome. (2006). Female Genital Mutilation and Obstetric Outcome: WHO Collaborative Prospective Study in Six African Countries. The Lancet, 367,1835-41. http://www.who.int/reproductivehealth/publications/fgm/.
4. Platform for Action: Toward the Abandonment of Female Genital Mutilation/Cutting (FGM/C) – A Matter of Gender Equality. The Donors Working Group on Female Genital Mutilation/Cutting. http://www.fgm-cdonor.org/publications/dwg_platform_action.pdf.