Right of Passage

The practice of female genital mutilation, also known as female circumcision, occurs throughout the world, but it is most common in Africa. Female genital mutilation is a tradition and social custom to keep a young girl pure and a married woman faithful. In Africa it is practiced in the majority of the continent including Kenya, Nigeria, Mali, Upper Volta, Ivory Coast, Egypt, Mozambique and Sudan. It is a cross-cultural and cross-religious ritual, which is performed by Muslims, Coptic Christians, Protestants, Catholics and members of various indigenous groups.

Female genital mutilation is usually performed on girls before they reach puberty. It is a procedure where either part or the entire clitoris is surgically removed leaving a reduced or total lack of sexual feeling. This procedure is an attempt to reduce the sex drive of women, making them less likely to be sexually active before marriage or engage in extra-marital affairs. Although this procedure can be seen as a means to control a woman's sexuality, the act of female circumcision determines the gender identity of women. A circumcised woman is a virgin, ready for marriage and to bear children for her husband, "Girls who are infibulated will probably not find husbands. In most cases they will become outcasts" (Manderson, 2003, p. 290). Female genital mutilation is not a new practice. In fact circumcised females have been discovered among the mummies of ancient Egyptians. A Greek papyrus dated 163 BC refers to operations performed on girls at the age they received their dowries. A Greek geographer reported the custom of circumcision of girls he found while visiting Egypt in 25 BC (Knudsen, 1994). In Africa female circumcision has been reported in at least twenty-six countries and can be viewed as a public health problem "because of its wide geographic distribution, the number of females involved and the serious complications caused by the operation" (Manderson, 2003, p. 296).

Female genital mutilation is practiced in three major forms: "Sunna" circumcision, Clitoridectomy, and Infibulation. Sunna circumcision consists of the removal of the tip of the clitoris and/or the prepuce (covering). Clitoridectomy, also referred to as excision, consists of the removal of the entire clitoris (both prepuce and glands) and removal of the adjacent labia. Infibulation, also referred to as pharaonic circumcision, is the most extreme form. The clitoris is removed as well as the adjacent labia and the scraped sides of the vulva are joined across the vagina. The sides are secured with thorns or sewn with catgut or thread, allowing a small opening for the passage of urine and menstrual blood (Knudsen, 1994). Female genital mutilation is often compared to male circumcision. Both procedures remove all or part of the functioning genitalia and both seek to control the body and sexuality. However, this is where the similarities end. All comparisons aside female circumcision is far more drastic and damaging both physically and psychologically. A more precise analogy would be between a clitoridectomy and penisdectomy where the entire penis is removed.

The traditional performers of the circumcision and the age at which it is performed vary among the different African ethnic groups. The majority are village midwives who perform these operations for a living and enjoy a position of status in the village. Others who perform the operation include gypsies and fortunetellers. These women's knowledge of anatomy and hygiene are minimal. The tools they use to operate with are rarely sterilized and include knives, razor blades, scissors, and in some cases sharp stones and pieces of broken glass. These instruments are used on several girls in succession without being sterilized and the patient is rarely given anesthesia (Kouba & Muasher, 1985). Circumcision among the Yoruba occurs one week after birth while in Ethiopia girls are operated on after they are forty days old. In Somalia individuals or groups of girls are operated when they are between the ages of five and eight. In Kenya, many girls are circumcised between the ages of eleven and fifteen while in the Ivory Coast the operations are performed as a village puberty rite. In midwestern Nigeria operations occur before the birth of the first child. In the Mossi area of Burkin Faso, group Wheeler circumcisions are held every three years for girls between the ages of five and eight (Wheeler, 2005).

Girls line up with their mothers each waiting their turn. Meanwhile, the circumciser "uses a knife-like instrument reserved specifically for this purpose; after each operation she simply wipes the knife on a piece of cloth, sometimes rinsing it in water first"( Van Der Kwaak, 1992, p.782). Before the operation takes place there is a small ceremony where the girl drinks tea and sometimes eats sweets and snacks. Afterwards, the girl is given hot porridge with butter to eat and some water to drink. The female is operated on while in a sitting position or lying on her back with her thighs being held apart. The operator uses a cutting instrument, a collection of thorns for suturing the wound, and a powder mixture of sugar, gum, and other herbs, ashes or pulverized animal manure, which is later applied to control excessive hemorrhaging. The child is in so much pain that some have actually bitten their tongues off. If the child faints, powder is blown up her nose to revive her. When the operation is completed, usually within fifteen minutes, the wound is closed and the women present are allowed to inspect the wound to ensure that the procedure was properly completed. Finally, the girl is sutured and the powder mixture is applied. The girl must then remain immobilized for up to three weeks in order to heal properly. In most recent cases, educated families are choosing to have the procedure done in sterile environments such as hospitals and by paramedical personnel. The child is given a local anesthesia, which reduces the pain but because the child does not struggle more unnecessary tissue is removed (Knudsen, 1994).

This is not the final operation that these women must endure. Re-infibulation is carried out on women who are divorced or who become widowed. When a woman marries or remarries she must be deinfibulated, enlarging the enclosed vulva. In some parts of Africa this must be done by the husband on the wedding night, using a piece of glass or wood. In the northern part of Somalia a midwife opens up the woman on her wedding night in the presence of her husbands relatives (Lightfoot-Klein, 1989). Besides the initial pain of this operation there are long-term physiological, sexual and psychological effects.

Unsanitary conditions result in infections of the genital and surrounding areas and often results in the transmission of the HIV virus. Other side effects