An Inter Press Service Feature

By Laurie Critchley

London, Jun 08 (IPS) -- El Ham, a young Sudanese mother, can still remember the day when she was infibulated. As a young girl, her external sexual organs were all cut and she was not even anaesthetised.

Her daughter now faces the same fate. El Ham's mother insists the family's honour is at stake. She believes that without the operation her granddaughter will be 'unmarriageable' and a target of ridicule.

El Ham says although she and her husband want to protect their daughter, ''most people still believe my mother is right''.

The practice has no benefit to the women themselves, and there is a lot at stake. The victims risk infertility, haemorrhaging, organ damage and even death. There is a possibility of being infected by the HIV virus; it could also cause complications in childbirth, not to mention the psychological trauma.

Yet an estimated 74 million women, mainly from Africa, suffer from the irreversible effects of female genital mutilation. And according to a recent report by Britain's Minority Rights Group, the numbers are growing.

While political instability and lack of political will are held responsible for this trend, the report criticises ad hoc reform programmes and the lack of long-term strategies or goals.

It is particularly critical of the United Nations Children's Fund (UNICEF) and the U.N. Educational, Scientific and Cultural Organisation (UNESCO) which it says ''maintain a total silence on the subject''.

The report calls on U.N. agencies to allocate 0.5 percent of their total expenditure from 1992-2000 to combating the custom.

''Mutilation is so entrenched that only an effort of these proportions will affect grass roots practices,'' says Efua Dorkenoo, co-author of the report and director of 'Forward', an African women's health group.

Women in Africa are the worst affected. More than 20 countries in an uninterrupted belt across the centre of the continent practise one or more forms of this mutilation. With the exception of Egypt, this belt includes those countries with the highest infant mortality rate -- over 30 percent of children under four.

Infibulation is the pinning together of a woman's vulva and the amputation of the clitoris, labia majora and labia minora.

It is the most severe form of genital mutilation, is currently reported to affect nearly all the female population of Somalia, Djibouti, Sudan, southern Egypt, the Red Sea coast of Ethiopia, northern Kenya, northern Nigeria and some parts of Mali.

Elsewhere, excision (the removal of the clitoris and the labia minora) is practised in Oman, South Yemen and in the United Arab Emirates. Circumcision of the clitoris is also prevalent among the Muslim populations of Indonesia and Malaysia, and the Bohra Muslims in India, Pakistan and East Africa.

Dorkenoo says the practice is also rapidly increasing among migrant communities in the West. Even where the practice is illegal, families may go to enormous expense to ensure their daughters get operations.

El Ham recalls that when a British-born cousin stayed with them for a few days, she was also infibulated, without anaesthetic.

Sweden, Belgium, Britain and some U.S. states have banned the practice, but no country other than Britain has incorporated strategies for prevention into broader child protection frameworks.

Among the African states, only Sudan has legislated against genital mutilation, although it is not an offence ''merely to remove the free and projecting part of the clitoris''.

Parents responded to the new law in 1946 by hurrying to have their daughters infibulated before it came into effect, resulting in a higher level of medical complaints and deaths.

When violent disturbances greeted the first arrests of practitioners, the law was amended and few prosecutions have since been made. Today, 90 percent of Sudanese women continue to be infibulated.

Researchers in the field acknowledge the counter-effectiveness of legislative change unaccompanied by broader campaigns for education and reform. While stressing the need to educate all health workers about the medical risks involved, Dorkenoo says the cultural roots of mutilation need equally urgent attention.

In many communities, women remain the staunchest upholders and practitioners of mutilation, continuing to enforce the practice among following generations.

It is for this reason that the report lists the need for counselling and care to help women find a new identity outside the context of mutilation, thereby breaking the generational cycle. The problem of an alternative source of livelihood for operators, again often women, must also be addressed.