The Kenya Demographic Health Survey (KDHS 2014) indicates a slight drop in FGM cases (from 27%to 21%) over the past 5yrs. An indication that the fight to end FGM is yielding. But again, why is the battle so slow?
My recent Meeting with Dr. Jebii Kilimo, Chairperson Anti-FGM board, Kenya, reveals that as much as there is a law in place prohibiting the practice still there are other emerging trends that the practicing communities are adapting to.
Medicalization of the ‘cut’ has resulted in more girls reporting being cut by medical practitioners at the comfort of their homes rather than by traditional practitioners. According to KDHS 2014, one third of all women who had undergone FGM/C reported being cut by medical practitioners. Criminalization of the practice on medical grounds has also led to women willing to seek proper medical care to avoid complications.
Although medicalization decreases the negative health effects of the procedure, this has led to misconception that hospitals/clinic FGM is a benign and acceptable form of practice.
Some of the tools used by traditional cutters
Due to the legislation that prohibits FGM/C many communities are leaving the ceremonial aspects of the practice. Most communities conduct the practice on specific months in the year through festive ceremonies but that is phasing away as they end up being arrested. They now do it in secrecy by accompanying the practice with a common ceremony such as a birthday.
There is also a trend towards girls being cut at earlier ages. Girls are most frequently cut from 7-12yrs old as compared to 12-15 years before. It is thought that the decrease in age is to avoid detection in response to legislation banning the practice. Another factor for why FGM is performed on young girls is that they are independent and less aware of the health implications of FGM. With increased education and Anti-FGM initiatives girls are less inclined to undergo the procedure. These communities are aware that community based organizations and faith based organizations talk to school going girls and educate them on effects of FGM, so they cut the girls earlier enough before they are enlightened.
Reports indicate that there is also a change in the type of FGM conducted across communities. The amount of tissue cut is reducing.A recent study among the Somali for example, shows that all participating women and girls had been cut and most were infibulated, though a gradual decline in the severity of the cut among younger girls from infibulation to a less severe form was reported. Among the Nandi, clitoridectomy is the most common among the young women whereas excision is more prevalent in the older age groups. They attribute the change in cutting to reducing cases of maternal mortality.
The eradication of FGM is pertinent to achieving of four millennium development goals (MDGs). MDG3 Promote gender equality and empower women. MDG4 Reduce Child Mortality. MDG5 Reduce maternal mortality and MDG6 combat HIV/AIDs malaria and other diseases.
Former First lady Somaliland Edna Adan underscores legislation around FGM. She says that legislation only work when the majority of the people respect it. But when the majority are committing the violations, the few that support the laws lack the muscle to enforce the same law.
Dr. Jebii Kilimo advocates for both formal and informal education, sexual and reproductive health education, increased law enforcement and equipping of law enforcement agencies, research and funding on the psychological consequences of FGM.