It is a ritual that is supposed to keep women “pure,” but an increased understanding of the severe health risks of extreme forms of female genital mutilation (FGM) appears to be slowly rolling back its prevalence in Somalia’s northwest.
In the self-declared Somali republic of Somaliland, most women older than 25 have undergone the most extreme form of FGM, known as “pharaonic.” This entails removal of the clitoris and the labia minora, cutting out flesh from the vulva and sewing up the outer labia, leaving only a tiny orifice for the passage of urine and menstrual flow.
The procedure is normally done with a razor blade when the girl is between five and 11 years old, without any painkillers. They remain sewn up until marriage, at which point they are either opened up during sex — causing pain and distress to both partners — or cut open with scissors.
“I cut girls for 15 years. My grandmother and mother taught me how and it was a source of income for me, but I stopped doing any cutting four years ago,” Amran Mahmood said. “I decided to stop because of the problems. The worst time was when I was cutting a girl and she started bleeding. I injected the muscle to stop the bleeding and I cleaned the area, but she kept on bleeding.”
As well as social status, being a so-called “cutter” brings in good money. Cutting one girl takes 30 minutes and brings in between US$30 and US$50, a large sum of money in Somaliland.
Amran’s daughter was cut, but she swears her granddaughters will not undergo the full procedure.
After attending awareness programs set up by Tostan, an anti-FGM non-governmental organization funded by UNICEF, Amran has become an anti-cutting advocate.
The medical consequences of the stitching — urine retention, blockage of menstrual flow, pain, bleeding, infection and childbirth complications — have brought the practice into disrepute.
In the urban setting of Hargeysa, Somalia, the generation who are adolescents today have largely abandoned it in favor of less extreme forms, which still involve the removal of the clitoris.
Their mothers, mindful of the pain they themselves endured, support the change.
“Things are changing. There are now men willing to marry uncut girls,” said village headman Mohamed Said Mohamed, who like most Somalians, is a Muslim. “I am totally against cutting. It is not accepted by our religion.”
FGM is concentrated in about 29 countries in Africa and the Middle East, according to the WHO which says cutting has no health benefits and brands the practice a violation of human rights. It says that more than 125 million girls and women today have undergone the procedure, whose roots are a mix of cultural, social and supposedly religious factors. The UN General Assembly adopted a resolution to eliminate FGM in December 2012.
At Sheikh Nuur primary school, the girls sit on one side of the classroom in long beige skirts topped by a black hijab, with the boys on the other in beige trousers and white shirts.
“People are beginning to see how dangerous the extreme form is,” 14-year-old Sagal Abdulrahman said.
“The first type involved stitches and is the painful one, because there are many times when the woman gives birth and has pain, and ... when she has her period, it causes pain. The second type is not that painful,” classmate Asma Ibrahim Jibril said.