How do feminist characterize female circumcision

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Bodily integrity and male and female circumcision. Med Health Care Philos. Wynter S. Benatar D. Why do Jewish egalitarians not circumcise their daughters? Jew Aff. Cohen SJ. Kimmel MS. Silverman EK. Anthropology and circumcision. Annu Rev Anthropol. Grande E. Hegemonic human rights: the case of female circumcision. A call for taking multiculturalism seriously. Arch Antropol Mediterr. Ahmadu FS. Boulder: Lynne Rienner Publishers; Knight M.

Curing cut or ritual mutilation? Some remarks on the practice of female and male circumcision in Graeco-Roman Egypt. Oyewumi O. Conceptualizing gender: the eurocentric foundations of feminist concepts and the challenge of African epistemologies.

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Divine fertility: the continuity in transformation of an ideology of sacred kinship in Northeast Africa. New York: Routledge; Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Brian D. Reprints and Permissions. Earp, B. The World Health Organization describes them in the following types:.

Type II Excision : This is the most common form. Removal of the clitoris and part or all of the labia minora the inner vaginal lips. A very small opening is left, about the diameter of a pencil. Sometimes the legs are bound together from the hip to the ankle so that they cannot move for 40 days. About 15 percent of those who undergo FGM have this form.

In the areas where it is practiced, however, it sometimes affects 90 to percent of those with vaginas. The procedure is usually done outside of a hospital, with no anesthetic. The person performing the procedure uses razors, scissors or knives, sometimes other sharp instruments. There are incidences of FGM being performed in hospitals as well. The number of those who have been subjected to this practice range from million to million worldwide.

Furthermore, there are over 4 million young people at risk of undergoing female genital mutilation every year. The majority are cut before they turn 15 years old. Fistula and subsequent loss of bodily functionalities such as uncontrollable leakage of body wastes, was reported by the women to result in rejection by spouses, families, friends and communities.

Rejection further led to depression, loss of work, increased sense of apathy, lowered self-esteem and image, as well as loss of identity and communal sociocultural cohesion.

Although the practice aims to bind community members and to celebrate a rite of passage; it may lead to harmful health and social consequences. Peer Review reports. This qualitative research was conducted among women living with obstetric fistulas in Kenya. The occurrence of fistula and subsequent leaking of body wastes, resulted in rejection of the women by their spouses, families, friends and communities.

This rejection further led to mental, physical and social suffering. These activities may reduce the prolonged labour cases that may lead to obstetric fistulas in Kenya and beyond.

The procedure is practised in more than 28 African countries, as well as some countries in Middle East, South America and Asia, with prepubescent girls being the main target population [ 4 ].

Although these practices are meant to bring community members together, including celebrating the passage rites of girls to women, they may be associated with harmful health, psychological and social consequences on individuals, families and communities [ 14 ]. Short term health complications include, but are not limited to bleeding, pain and shock [ 3 , 4 ], while chronic pain, genitourinary tract infections, damage to genitalia, postpartum haemorrhage, genital tissue scars and keloids, anaemia, and in severe cases, maternal and foetal deaths being the known long term complications [ 3 , 5 , 15 , 16 ].

A vaginal obstetric fistula occurs when a hole fistula forms between either the vagina and rectum rectovaginal fistulas-RVF or between the vagina and bladder vesicovaginal fistula -VVF following prolonged childbirth complications [ 17 ]. Addressing this and other culturally fuelled social problems requires a deep understanding of the local contexts, including the sociocultural psychosexual, religious and economic factors that perpetuate such practices [ 14 ].

The paper presents only part of findings from a larger dataset collected for the doctoral program of the second author GG. The aim of the larger study was to explore the experiences of women living with fistulas in Kenya, experiences that are hidden, inaccessible, suppressed and ignored.

The study was guided by theoretical frameworks including the Social Network [ 22 ], and the African Feminist Theories [ 23 , 24 ]. These traditional community networks and dynamics are very complex but important, as they provide communities with identity, a medium for shared experiences and a sense of belonging [ 26 ]. However, the same traditional networks and dynamics place superiority on men and expect obedience and submissive behaviours from women, inadvertently causing harm when some actions dictated by men cannot be questioned by women [ 14 , 27 ].

The sexualization and the grooming of girls bodies, for the benefit of men, begins at an early age [ 33 ]. This variation in practice is influenced by factors including socioeconomic status, overall education levels of local people and cultural beliefs, with the prevalence reported to be lower in urban areas where cultural ties and beliefs are not staunchly observed. In this study, participants were from various regions in Kenya and were admitted for surgical fistula repair at the Kenyatta National Hospital in Nairobi—the capital city of Kenya, and in the Gynocare Care Clinic in Eldoret.

Participants were from different tribes, and most of them lived in rural and remote settings where obstetric and medical services are barely accessible if at all they exist. The study participants were women waiting to undergo surgical fistula repair at Kenyatta National Hospital in Nairobi and the Gynocare centre in Eldoret, Kenya. Participants were recruited through a purposive method because the study was centred on a specific research objective.

The researcher was invited to introduce herself and explain the research aims to the medical team in the fistula care wards. The nurses in the fistula clinics then passed the information to all the fistula patients seeking treatment. Those women who expressed interest in hearing more, joined the researcher in a private designated room which had been booked previously so that more information about the research could be provided on a one-to—one basis.

All participants were screened according to the eligibility criteria before they were invited to participate. One had to be in a treatment facility seeking treatment for fistula, be over 18 years and fluent in Swahili The national language in Kenya.

After passing the criteria, the researcher explained the informed consent in Swahili and ensured that participants understood the following:. The voluntary nature of research participation and their right to stop at any time they wished without any consequences to them. After communicating the above information effectively, participants were offered an opportunity to ask questions or raise any concerns before being invited to sign the consent form before commencement of the interviews.

Face to face, semi structured, open-ended interviews lasting approximately one hour were conducted. The researcher who collected the data was a Black Kenyan African woman with firsthand knowledge on the cultural practices and spoke fluent Swahili.

Interviews were conducted privately inside a private room in the treatment facilities or outside in a quite garden as preferred by some of the participants. All the interviews were audio-recorded and data files password protected. After the translation by the second author and verification by the first author into English, interview transcripts were transcribed by the second author.

Both authors speak Swahili and English fluently, making it easy to verify for accuracy and the quality of translation. The full 30 transcripts were repeatedly read by both authors and data were analysed using a framework analysis as suggested by Ritchie and Spencer [ 36 ]. The paper presents the stories of three women as a case study. A total of 30 women aged between 18 and 68 years were interviewed.

These women had lived with vaginal fistulas for periods ranging between 11 months to 40 years. Most of the participants developed fistulas due to prolonged and obstructed labour and had lost all or some of their babies. The profile and characteristics of the study participants are presented in Table 1.

The women came from three tribes in Kenya: Kisii, Samburu and Kalenjin. Their narratives are powerfully described, and include heart breaking recounting of two painful events in their lives-the day they were circumcised and the day s of childbirth. Sasha is a year-old woman; she is currently separated from her husband who married a second wife shortly after she developed the fistula. Sasha was first pregnant when she was 11 years and after a traumatic birth and labour which lasted 6 days, she was finally able to birth a dead, macerated baby.

She collapsed after this ordeal, but soon after she woke up, she discovered a pungent smell and realised that her body was now incontinent of both urine and faeces. Sasha reported that doctors at the hospital informed her that her severe infibulation contributed to her difficult childbirth.

They took me early in the morning and poured really cold water on me. Sasha, 22 years old. This is in addition to the fact that Sasha was not sufficiently developed to deliver a child at 11 years. Without access to Emergency Obstetric Care, her baby was stuck in the birthing canal, causing vaginal tissue necrosis [ 37 ]. These assertions can be depicted in such statements as below:. Especially when the urine passes it burns you so much you turn completely red. So every time I was sick people would say that I am lying or that am pretending.

When you say or do something they tell you to go away with your urine or your faeces. My husband would tell me that I would forever leak urine that it would never go away. It would make feel like I wanted to die…..

Moraa is a year-old woman who developed a vesico-vaginal fistula when she was 18 years following a complicated, prolonged, 2-day labour.

She has been married for 23 years and has five surviving children. She says:. I really struggled to push the baby that gave me this problem [fistula]. The doctors said that if I had waited having children and not been cut, I would not have the problems I have now. Even after women are married, keeping their bodies primed and acceptable for their husbands is a lifelong endeavour. She reports that she could not stand or walk without support when the procedure was performed and that it left her with permanent damage that complicated her marriage and the delivery of her two children who were born dead still birth.

It was cold and they held me down and did what they did. First they poured really cold milk on me. They said that would help with the pain. It took me a long time to heal. As such, when women who have undergone this procedure develop such complications, they shun away from the same communities for fear of further harm arising from the lack of understanding and lack of empathy from the people surrounding them.

These arguments can be illustrated by statements such as:. This rejection and isolation of sick community members is counter to the Afro- communitarian ethos, which embraces communalism. Because of their circumstances such as leaking dirty wastes and bad body odours, these women, not only endure the biomedical complications of fistulas, but also undergo loss of multiple statuses including: the loss of loved ones e.

Feminist theories would also suggest that the difficulties experienced by the women, contribute in the oppressive structuring that keeps them subsumed and subordinated not only by patriarchy, but by their own difficult existence [ 11 , 27 ]. The traditional structures operate broadly and reinforce negative attitudes towards women that lead to gendered oppression. This may mean reclaiming the power that women inherently deserve from men.

Reclaiming power is necessary because as it is typical in any patriarchal society, men tend to horde most of the social economic and political power, while women are expected to be submissive and subservient [ 47 ]. As described in the stories of Moraa, Sasha and Chemutai, the value of women with fistula is far below that of other women particularly due to their incontinence. This comes with significant cost to both the community and health care system which loses productive members of the community to preventable conditions and the cost repairing the fistulas [ 9 ].

However, we did not specifically examine this issue. Despite the existence of strong traditions of African communitarian, which provide social networks, identity and sense of belonging to communities [ 12 ], the power inequalities between women and men seem to be problematic in patriarchal communities such as in Kenya.

To redress these issues, there is a need for a strong advocacy and employment of multiple strategies including involving community education and social change. In addition, engaging both older and younger women and improving their affirmative responses towards such socio-cultural norms underpinning these practices, would reduce the likelihood of them romanticising this harmful traditional practice that promotes gendered oppressive negative attitudes towards women [ 50 ].

Additionally, community development strategies and community based participatory approaches such as those developed by Paulo Freire, would encourage critical self-empowerment of women [ 51 , 52 ]. Furthermore, Freire advocates for critical community practice where members of the community are able to identify institutionalised forms of oppression and derive ways of subverting that systemic power. The community participatory approaches will bring together people with a collective objective to empower the most marginalised persons in the community [ 52 ].