Urgent Effort Underway to Prevent Imminent Circumcision of More Than 150 Girls in Uganda

Jodi Jacobson

Advocates are working strenuously to stop or limit the mass mutilation of up to 200 girls now underway in Uganda.

In November, leaders in the Ugandan districts of Bukwo and Kapchorwa made clear their intention to perform a mass genital mutilation this month on over 200 girls despite a new law in the country banning the practice.

This week, it was believed that 150 to 200 girls from the districts had been transported to Kenya to facilitate the mass operation, but amid what may be purposeful confusion on the part of the district leaders, it now appears that the process of mutilation of these girls has begun inside Uganda. One advocate reports:

A news paper reporter is just driving from Kapchorwa here in Uganda. This other story was a cover up. He says they are circumcising them here in Uganda! They have already cut 150 girls! He took photos and videos. He witnessed the circumcision after midnight last night. Two unsterile blades on 8 girls! One poor girl was being cut with a blunt knife and had to be done over and over again.  They are planning to contnue tonight and over the weekend.

A frantic effort is now underway to stop the mass “circumcision” as it is euphemistically called, and advocates report that teams from both UNAIDS and UNICEF are en route to the districts to try and stop it.

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The Ugandan Parliament passed a law last December banning FGM. President Yoweri Museveni signed it into law on March 17, 2010 and it took effect on April 9, 2010.

According to AllAfrica.com:

The law argues that FGM infringes on the rights of the woman and also leads to health hazards, including excessive bleeding, death, birth complications and exposure to illnesses. The law criminalises the practice, calls for prosecution of offenders and protection of victims. Anyone caught doing it faces 10 years in jail or life imprisonment if the victim dies.

AllAfrica.com also reported that last month the elders swore “that the whole tribe would rather go to prison than abolish a custom they inherited from their ancestors.”

Female genital mutilation (FGM) is a tradition among the Sabiny in Uganda. FGM refers to the removal of the external female genitalia, i.e. the clitoris, labia, and other portions of the genitalia. The United Nations Population Fund has extensive materials on the practice, and approaches to end FGM.

The vice-chairman of Bukwo district, John Chelangat, told AllAfrica.com that:

“over 200 girls are being prepared for the practice beginning on December 1 and neither he nor other political leaders are able to stop it. The men like it because circumcised women are less interested in sex and are, therefore, less likely to have extramarital affairs. The girls do not want to be considered outcasts, so they go for the knife.”

As in other countries, including the United States, women’s rights, health, and lives are considered fair game for male political ambitions:

“This is a very sensitive period and no politician will talk about abolishing FGM because we shall lose votes. Myself, I will not talk about FGM because I know this will land me into the political dustbin,” says Chelangat.

Translation: If I step up and do the right thing to prevent 200 girls from being mutilated for the rest of their lives, I might lost my political seat.

Still in some quarters, education and advocacy efforts to stop this horrific practice have taken hold:

Alice Chemutai, 17, another resident of Matibeyi, was convinced by her aunt to undergo female circumcision. But because she is educated she refused and her father supported her.

She recites an endless list of young girls who have dropped out of school to get married after the ritual and those who have had birth complications, bleeding and infections after.

“I will never get circumcised because this will not only infringe on my rights of womanhood but will also expose me to long-term health hazards. I am happy my father and mother support me against other relatives,” adds Chemutai, a Senior Three student at Amananga High School in Suam.

International and Ugandan groups have been working strenuously to prevent this mass mutilation from taking place.  We are in contact with advocates on the ground and will report back as new information becomes available.

Roundups Abortion

Sexual Health Roundup: HPV Vaccinations Work, Circumcision Reduces STDs, and You Should Have More Sex Than Your Friends

Martha Kempner

New research shows that widespread HPV vaccination works to reduce genital warts, at least in Australia. And the key to happiness? Don't just have more sex—make sure you're having more sex than your friends.

Cases of Genital Warts Dive Because of Widespread Vaccination … in Australia

A new study published in the British Medical Journal looks at whether widespread vaccination against the human papillomavirus (HPV) in Australia has affected the rates of related health outcomes, such as genital warts. Australia launched a nationwide HPV vaccination program for women ages 12 to 26 five years ago.

To understand the impact of the program, researchers analyzed data collected from eight different sexual health service providers that together had seen over 86,000 first-time patients between 2004 and 2011. They separated the patients by time period—those seen between 2004 and mid-2007 (before the vaccinations began) and those seen from mid-2007 to 2011 (after the vaccination program was in place)—and compared rates of genital warts diagnoses. The researchers found that the number of diagnosed cases of genital warts dropped by 93 percent in young women under age 21 and by 73 percent in women ages 21 to 30. In addition, though the program did not include vaccinating males, cases of genital warts among heterosexual men under age 21 dropped almost 82 percent, while cases in heterosexual men between the ages of 21 and 30 fell by more than 59 percent.

The researchers suggest that the overwhelming success is likely due to what is known as herd immunity—the idea that if you vaccinate a large enough segment of the population, people who are not vaccinated will also be protected. In this case, by vaccinating a large number of women, men also became protected.

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Basil Donovan, the lead researcher on the study, told HealthDay, “All indications are that the program has been an overwhelming success. … But we won’t be certain until HPV-related cancers [also] start dropping.”

HPV has been linked to cervical cancer, penile cancer, anal cancer, and cancers of the neck and throat. While genital warts tend to appear within a few months of initial infection with HPV, cancers can take 20 to 30 years to develop.

We could have similar success in this country if we could achieve widespread vaccination. Unfortunately, as I wrote for Rewire last month, there is a great deal of misinformation about the safety and importance of the vaccine as well as why it is given at such an early age. As a result, parents still seem reluctant to get their daughters vaccinated. In fact, only 19 percent of teen girls in the United States had been vaccinated in 2008 and just 32 percent in 2011. This is far lower than the 90 percent vaccination rate the CDC recommends.

HPV is one of the most common sexually transmitted diseases (STDs) in United States, with about 14 million new infections each year. Australia’s success suggests that with widespread vaccination, we could substantially cut that number as well as the number of people who get genital warts and possibly cervical cancer and other related cancers.  Perhaps we can take some lessons from down under in how to convince parents that this vaccine works and can potentially save lives.

New Study May Explain How Circumcision Decreases STD Risk

Recent studies have suggested that male circumcision decreases the risk for numerous STDs, including HPV and HIV. A new study in the Journal of Microbiology attempts to explain why.

Two possible explanations for these decreases include changes to the anatomy of the penis itself and changes to the bacteria that live under the foreskin or on the head of the penis. The current study used swab samples from two large-scale studies of male circumcision in Uganda. Researchers examined the types of bacteria that existed in a group of men before they were circumcised and then again a year after the procedure. They compared this to a control group of uncircumcised men.

The researchers concluded that there was a significant reduction in anaerobic bacteria (bacteria that live in areas without oxygen) among circumcised men. They theorized that in uncircumcised men, large bacterial loads encourage movement of so-called Langerhans cells in the foreskin, preventing these cells from doing their job of warding off viruses. Another theory is that more bacteria leads to inflammation, which can increase the likelihood of infection.

Ultimately, research is needed to truly understand the biology behind this, but the researchers believe that by gaining a better understanding of the bionome of the area under the foreskin, they may be able to develop non-surgical methods for changing it and preventing STD transmission.

Want to be Sexually Satisfied? Have More Sex Than Your Neighbors

A new study by a sociologist at the University of Colorado Boulder found that Americans are happier when they are having more sex—but we’re even happier if we know (or just think) we’re getting more than our friends.

The study’s author, Tim Wadsworth, analyzed data from the General Social Survey, which asks respondents whether they are “very happy,” “pretty happy,” or “not too happy.” The survey has been conducted since 1972, and in 1989 questions about sexual frequency were added. Wadsworth used data from 15,386 people who answered both questions between 1993 and 2006.

It turns out that it doesn’t take a lot of sex to make us happy, according to the study. Wadsworth found that after controlling for other factors (such as income, education, marital status, health, age, and race), respondents who were having sex at least two to three times a month were 33 percent more likely to report a higher level of happiness than those who had not have sex in the past year. But more sex equals more happiness; compared to individuals who had no sex in the previous year, those who reported having sex once a week were 44 percent more likely to report a higher level of happiness, and those reporting sex two to three times a week were 55 percent more likely to report a higher level of happiness.

But there is a catch: The happiness rate can fall if you think that other people are having more sex than you. The research found, for example, that if members of a peer group are having sex two to three times a month but believe their peers are having it once a week, their probability of reporting a higher level of happiness falls by about 14 percent. The research doesn’t prove that people are comparing themselves to others (or explain how people form their perceptions of how often the neighbors are doing it), but Wadsworth notes this behavior makes sense because we are constantly comparing ourselves to others, especially those we think have more. “We’re usually not looking down and therefore thinking of ourselves as better off, but we’re usually looking up and therefore feeling insufficient and inadequate,” he wrote.

So the key to happiness is to either have more sex, or convince your friends to have less.

Forced Gential Mutilation of 120 Women and Girls in Uganda Sparks Public Debate

Jodi Jacobson

Forced mutilation of some 120 young women and girls in Uganda last week has sparked a public debate inside the country about the limitations of a new law and the politics behind the practice.

Late last week, an estimated 120 young women of the Sabiny ethnic group in Uganda were forced to undergo severe forms of genital mutilation despite a new law banning the practice.  The mass “circumcision” involving the removal of the clitoris and other parts of their genitalia took place in public with crowds looking on. The fact that leaders of the Sabiny carried out the genital mutilation despite the new law–in fact in open defiance of it–has sparked public debate about the limitations of legal strategies operating in a vacuum.

In theory, the law poses strict penalties against those who perform or facilitate FGM.

According to the law, “aggravated FGM”–when death occurs or where the victim is disabled or is infected with HIV–results in life in prison. Parents, guardians, health workers, or “persons with control over the victim,” can be charged with aggravated FGM. The law also states that “others who engage in FGM shall be imprisoned for a period not exceeding 10 years.”

In practice, the law is being openly flouted.

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FGM is one of those “cultural” practices the sole purpose of which is to control women.  According to the Sabiny, reports New Vision, “a girl is circumcised to initiate her into adulthood. The clitoris is cut out to interfere with a woman’s arousal process.”

It also interferes with her life and health.  Where FGM does not lead to immediate death due to infection caused by the use of dirty instruments, it is associated with higher rates of pain during sex, sexually transmitted infections and HIV, problems urinating, and complications in labor and delivery leading to higher rates of maternal mortality and morbidity.  Not surprisingly, and complicating the overall picture, is the fact that FGM is practiced in cultures that also promote high fertility, measuring the value of women by the number of children they bear.  More pregnancies lead to higher risks of complications.

Reports from the site of the mass circumcision of Sabiny girls and women are gut-wrenching.  A New Vision reporter writes:

Some cried. Some were confused. Others still traumatised, while many were left speechless.  They looked on in disbelief as a local female surgeon tried in vain thrice, probably using a very blunt knife, to cut off a girl’s clitoris.

She then asked for another, similarly blunt knife and to make it work, applied extra force, going back and forth, the way a saw cuts into timber. The girl struggled not to show fear and to contain her trembling, which is culturally unacceptable and would have attracted scorn and ridicule from the attentive crowd.

As blood gushed from her private parts, the crowd urged the girls: “Be strong! You are almost done! Remain calm!”

Once cut, the girl was pushed aside, like a slaughtered chicken, her legs put together as if to stifle the pain and another descended upon.

Two knives were used to operate on 8 young women (whom the reports characterize as “girls.”)

The girls “wrapped in dirty blankets and strewn all over a compound hosting two huts,” were circumcised by a local female “surgeon.”

The circumciser would first throw fine millet flour into their private parts to reduce friction and wetness. 

She used the same knife to cut each of them. The knife was not sterilized, exposing all of them to the risk of the deadly HIV.

The cuts lasted close to 50 seconds. As the mutilated girls lay helpless, an old woman, threw millet flour over them to appease the spirits and ordered them to kneel so that the blood could pour out.

Most of the girls were barely in their early twenties but someone in the crowd said they were all married. “Girls here marry by their 15th birthdays,” he said.

“A few minutes later, the girls were told to march into a hut where they would spend the next three weeks healing from the mutilation. But they did not march; they staggered.”

These eight are among more than 120 girls who have been mutilated in Sebei region since the “FGM season” kicked off in Sebei in eastern Uganda.

As reported by New Vision, according to Alfred Ayebwa, the LC1 chairman for Kapkorosia village, over 50 girls were mutilated in Kabei and Kortuk sub-counties, 20 in Chesower sub-county, and 34 in Chekwasta sub-county. Another 16 were mutilated in Suam sub-county.

Bukwo vice-chairman John Chelangat said the mutilation was done between midnight and two in the morning, behind closed doors.

“This is due to fear of the new law that calls for the ban on FGM and gives harsh penalties to anybody participating in FGM or withholds any information about it,” he said

Critics blame what they contend have been failures to build support for the new law, to conduct effective public education campaigns on the consequences of female genital mutilation, and to enlist support for social change within the communities in question.  And while FGM persists in part because women are effectively seen as property, the women who do the cutting also depend on it for income, further increasing resistance to ending the practice.

A New Vision editorial, for example, argued that “FGM is still treasured by the Sabiny as a cultural practice [and] [n]o one should think that enacting a law against FGM would be enough to stamp it out. A lot more is required, mostly in sensitising the masses about the evils of circumcising girls.”

“[P]rotracted sensitisation, backed by supportive social structures like easy accessibility to schools, mass media and factors of production, is needed in Bukwo, Kween and Kapchorwa urgently. UNFPA accessed funding for this but has concentrated most of its work outside the region.”

New Vision reports on the limited reach of international funding and support for campaigns to eradicate FGM:

The United Nations allocated about $300,000 (about sh600m) for FGM activities but, to-date, people on the ground report no sensitisation activities.

The national gender officer for the UN Fund for Population Activities, Brenda Malinga, said some of the money has been used at the national level to get the law working and the rest was supposed to be disbursed to the districts in November for sensitisation about the law.

She says last year, focus was mainly on enactment and enforcement of legislation against FGM.

“We have been supporting training on community dialogue for FGM abandonment in Amudat, Bukwo and Kapchorwa. We also simplified the new law for them.”

But when Saturday Vision visited FGM districts, no impact was seen. And the FGM season started in July 2010.

Women who make their living by circumcising girls complained that “FGM activists promised them compensation for income lost but up to now, nothing has been done.”

“We shall continue cutting girls because this is where we get our income. They have also not sensitized us and we do not know what is in the law,” said Sunday Kokop, the surgeon in Suam-sub-county. 

Changing deeply ingrained cultural practices like FGM is not easy, though it has been successfully tackled in other places.

In Uganda, rural poverty is a barrier to change.

The lack of sensitisation about the law can be blamed on factors like lack of a radio especially in Bukwo district to carry the message, low levels of education and high levels of poverty.

Alex Cherop, 34, of Chesimat village in Kortek sub-county, said nobody has ever told them to abandon FGM. They hear about a campaign in Kapchorwa but do not know how it fits in their culture and customs.

The police are also unable to enforce the law because they do not have vehicles or other resources needed to patrol rural areas.

“We lack transport and most of the places are vast and hilly for us to reach,” said Bukwo district Police chief, James Wamwenyerere.

Moreover, it is difficult to get victims to help proscecute cases.  Becasue of fear of social censure or violence against them, women and girls who have been mutilated often will not speak out in identifying those involved.

And then there is the curious approach of arresting the victims themselves.  Police told New Vision about a case in which they arrested four girls who had undergone FGM and five of their parents. But, according to the district police chief, “they refused to name the people who mutilated them. They told the magistrate that they mutilated themselves.”

But this is also an issue of pure discrimination of women exacerbated by politics.  District leaders have expressed concerns about campaigning against FGM because they are afraid they may lose their personal political power.

“Local leaders are reluctant to swing into action because… they may lose votes,” reports New Vision.

Still, there is hope that this episode will catalyze more concrete action.  In response to the mass mutilation event among the Sabiny, and perhaps due to international publicity, Ugandan President Yoweri Museveni earlier this week promised to build boarding schools in the region to act as safe havens for girls seeking refuge from being mutilated.

“We are going to build boarding schools so that we protect our children from these local surgeons,” Museveni told the cheering crowds at Kween district headquarters.

He described the practice as backward and ungodly.

“How can you oppose God? God wired human beings the way he wanted them to be. You cannot be more clever than God to change his creation,” he said.

The President also urged the surgeons to form an association so that he could help them find an alternative source of income.  These suggestions have been on the boards for some time.  Last year, the equal opportunities committee of Uganda’s Parliament asked the Government to build model schools, where vulnerable girls will be kept during school days and holidays, until they are of age to resist the practice.