Female genital mutilation (FGM), quite apart from being a violation of the integrity of the person, can have very serious medical consequences. Yet, it has been practised for generations in many African countries and the phenomenon persists despite all the campaigns organised to fight against it. Such is the case in Central Africa and particularly Cameroon.
Officials of the Cameroon Red Cross explain that parents who adhere to this practice advance various reasons for doing so. For many, it is not a question of harming their children but, on the contrary, of wanting to ensure that their daughters are socially integrated and to save them from misfortune and disease. Others think that FGM enables them to control the sexuality of their daughters, to preserve their virginity up to marriage and to predispose them to conjugal fidelity. The adepts of this practice believe that it marks the transition from child to adult. For people of this category, it is excision that transforms a girl into a "real woman" who is ready for marriage.
In Cameroon, FGM is carried out in a barbarous manner by traditional midwives with no medical training, without anaesthetic and using rudimentary instruments. It can give rise to serious complications, sometimes resulting in death. Fatimé, a woman of 39 that we met in Maroua, recalls as if it were yesterday the awful moment at which she underwent excision: "My mother had spoken to me about this practice before. I was nine years old when I was excised. The pain that I felt at that precise moment was indescribable. I am in agony just thinking about it."
According to official estimates, Cameroon currently has a population of some 17 million, 52% of them women. The United Nations figures suggest that around 20% of these women are victims of FGM, an experience that can occur at various ages - at birth, during adolescence, just before marriage or after the birth of their first child. The time of excision depends on the particular community and varies, even for the same ethnic group, from one generation to another. In Cameroon, the provinces most affected by FGM are North, Far North, Adamaoua, South-West and East. Mr Banda Gbo Oya is the president of the local committee of the Cameroon Red Cross at Garoua-Boulaï, an arrondissement of 60 000 inhabitants in East province.
He is convinced that the practice is widespread: "In just a few weeks, our volunteers have been able to identify 15 practitioners and around 30 excised girls and we have not yet covered even a third of the territory of Garoua-Boulaï," he explains.
FGM is often followed by complications. The excision and infibulation result in painful scarring, the formation of keloids, sterility and the like. Moreover, the mutilated women are generally prone to anxiety and depression and children born of them often present signs of fetal suffering.
The girl is laid out on her back, legs apart, feet bent back. As the excision is conducted without anaesthetic, five or six assistants, depending on the age of the girl, are needed to keep her pinned down. The same instrument is used to excise a number of girls. Despite the sometimes dramatic consequences, those responsible are never punished. And yet, the rights to health and physical integrity are enshrined in Cameroon's constitution and in its penal code. Furthermore, Cameroon is a signatory of several international conventions intended to promote the rights of women and girls, such as the Convention on the elimination of all forms of discrimination against women, the Convention on the rights of the child, the African Charter of human and people's rights and the African Charter of the rights and welfare of the child.
At the present time, the practice of FGM by groups is tending to decline, albeit slowly. This is due to its condemnation by the state, the discreet but effective influence of the NGOs including the Red Cross, and the threat of HIV. However, prohibition has not put an end to the ritual but has driven it underground, so that it is now conducted secretly or on an individual basis.
The Cameroon Red Cross believes that the law alone is not sufficient to put a stop to FGM or even to limit the practice. Instead, other means must be found to persuade people to abandon excision. Accordingly, the Cameroon Red Cross has initiated a campaign against HIV/AIDS and FGM, with the support of the Regional Office of the International Federation of Red Cross and Red Crescent Societies and the Canadian Cooperation service.
FGM is an old-established practice that is closely linked with tradition and religion. As Mrs Ashandi, a practitioner in the village of Massil Al Kanan in Kousseri, Far North, relates: "I have been carrying out circumcisions for 40 years. My grand-parents did the same. It's the tradition from generation to generation." While it is true that circumcision is forbidden in Cameroon, due to reasons of religion and tradition, it is very difficult to persuade people to stop. It is also very difficult to discuss the question of female sexuality without incurring the wrath of the community. That is why the Cameroon Red Cross is making use of the campaigns to raise awareness of the AIDS pandemic to draw the attention of the population to the ill effects of FGM as well.
The project has been implemented since March 2006 in the districts of Kousseri and Maroua in Far North province, as well as in the district of Garoua-Boulaï in East province. It relies on a number of activities, including particularly advocacy at all levels from the bottom to the top, raising the awareness of the parties concerned (parents, young people, opinion makers, etc) and, not least, activities to generate alternative income for the practitioners.
To date, two information days have been organised for 100 traditional and religious leaders. They were provided with training enabling them to disseminate information on AIDS and FGM more effectively.
The work of advocacy is backed up by awareness-raising sessions in the community, with parents, practitioners, young people and the administration being informed of the ravages of AIDS and FGM. To improve the transmission of this information, fifty volunteers have been trained in education campaigns and have received support materials such as posters, leaflets and picture cards.
In the course of these various encounters between practitioners and Red Cross volunteers, those who carry out the excisions have admitted to being aware of the risks to themselves and to the women. For example, we have the testimony of Zeneba Terap, an practitioner at Garoua-Boulaï: "We acknowledge certain consequences that you have enumerated but we did not know that it was possible to catch AIDS and other diseases from blood-soiled instruments. We understand that it has become dangerous with AIDS lurking all around. We are going to try and stop even if it means losing our livelihood."
One of the main reasons for carrying out excisions is economic. Depending on their means, parents give the practitioner presents and money (between FCFA 10 000 and FCFA 50 000 - euro 15 to euro 75) for each girl excised. Moreover, Mr Banda told us that some of the practitioners do not hesitate to travel from the neighbouring Central African Republic to excise girls for money.
The officials of the Cameroon Red Cross are convinced that the majority of practitioners would give up FGM if they were offered a financial alternative. Thus, there is an urgent need for the national society to raise funds to finance the micro-projects proposed by the practitioners themselves.