Thursday, 21 December 2006

2006 - The year of circumcisions

For sure, the two greatest advances of humankind this year, as far as can be judged on this day of winter solstice, were on the genital front, although in opposite directions for the two genders involved.

The international public health establishment, still dominated by men, paid most attention to male circumcision. In fact, the publication of data indicating a clear protective effect of around 50% of this operation in relation to the risk of HIV/AIDS is wonderful news. Very good that WHO in its press statement[1] also draws attention to the downside which could perhaps be oversimplified as: DON’T go and get circumcised in order to double your sexual contacts afterwards. For more general information about male circumcision, its origins, consequences, risks, benefits and how to do it, I recommend the Wikipedia article.[2]

As expected, the general press (at least the pathetic Swiss tabloid I subscribe to) was more interested in the female side, but it really was heartening to see the headline news on the condemnation of female genital mutilation (FGM) by a meeting of leading Muslim clerics in Cairo on 22-23 November 2006. Der Spiegel published a good article online in English.[3] Female genital mutilation encompasses clitorodotomy (removal or splitting of the clitoral hood), clitoridectomy (removal of the clitoris), and infibulation (removal of the vulva) also known as pharaonic circumcision. The practice seems to have had its origin in ancient Egypt and is nowadays widespread in a number of African countries. It also occurs in some countries in Asia, but much less frequently. It has been estimated that 2 million girls and women are subjected to it every year, although it is possible that a decline has started. The severe effects of FGM on the health of the girls and women subjected to it as well as their offspring have been well documented in a multi-country study.[4] The Muslim scholars made it clear at the meeting in Cairo that not only is this practice not supported by Islam; it “contravenes the highest values of Islam and is therefore a punishable crime.”

The purpose of FGM is in general to prevent sexual desire in girls thereby improving marital fidelity. I would consider it one example of the cruelty systematically inflicted by men on women in so many cultural settings. It is akin to burning of witches in Europe, honour killings, burning of widows in
India and, most strikingly, binding of feet in China. Most of these practices have been abandoned, but only after inflicting suffering beyond imagination on millions of victims.

The meeting in Cairo was instigated by a German non-governmental organization, Target.[5] . Although I find this NGO to be driven too much by one person, zum Überfluss a man, I find the intentions and results so laudable, that I have sent them a donation. Now I hope stronger local movements and networks will emerge, and that they can muster the right persons with the necessary willpower and understanding of local cultural and economic contexts to set and achieve targets for FGM elimination.

[4] WHO Study Group on female genital mutilation and obstetric outcome (2006). Female genital mutilation and obstetric outcome: WHO collaborative study in six African countries. The Lancet 367, 1835-41