The Procedure

Chelle.(2008) Broken Glass (creative commons license) 5 Lwd. (2008) Rusty Razorblade (creative commons license) 6 Asif Akbar. (2008) Knife (creative commons license) 7

Arming Women Against Rape and Endangerment (AWARE) (2011) Crying girl (creative commons license)Female genital mutilation is usually carried out on girls between the age of 0 and 15 years, however it can be carried out at any age and varies according to the traditions in the area. 1 This leads to the ethical question surrounding the practice, as despite cultural roots in the tradition, most of those subjected to FGM are too young to give their consent. 9



“If a girl is older than seven and not circumcised, it is a big shame for the family. They have to circumcise the girl before
she begins school” 10a

The practice is largely conducted by untrained people such as traditional birth attendants and family members; although in some cases a qualified midwife or doctor may perform the surgery. Instruments such as rusty blades, knives and broken glass have all been reported as being used in this procedure, often with no anaesthesia, resulting in a wide range of outcomes for these girls and women, both long and short term. 9

“Usually the girl’s legs are held by the relatives, the mother, the grandmother or aunts that accompany her. Usually she uses the clothes you were wearing as the cloth that shuts your mouth. The midwife uses a needle to give the anaesthetic and puts a cloth in your mouth to stop you screaming. Then the cutting happens” 10b

The cutting is performed according to the level of FGM required by that culture, and haemostasis is attempted by rubbing the wound with remedies such as herbs and salt. The legs are tightly bound together for days or weeks to ensure that the wound heals closed. 9

“As young children in Eritrea they cut the labia majora and minora and do not stitch, they just keep the legs together for three weeks with a stick or something to maintain the hole, but the cut flesh just joins back together-they use butter and hot tea on it” 10a

In rural areas, the girls are usually assembled in a group and brought to the place where the practice is carried out. In some areas, FGM is part of traditional initiation rites (e.g. Sierra Leone) and the girls are taken away for several weeks to receive traditional education. In urban areas, group ceremonies have almost disappeared and FGM is performed individually. This also applies in communities where the law prohibiting the practice is feared: families carry out it out secretly without any ceremony. 11