HEALTH-KENYA: Changing Tradition Through Talk

Joyce Mulama

KAJIADO, South-western Kenya, May 29 2006 (IPS) – It is a part of Kenya where prevalence rates for female genital mutilation (FGM) are at their highest, and communities deeply resistant to cultural change. However, Kajiado district is also an area where simple conversations hold out the promise of helping to end FGM.
These conversations are taking place under the auspices of intergenerational dialogue (IGD), an approach jointly supported by the Ministry of Health and German Development Co-operation (Deutsche Gesellschaft für Technische Zusammenarbeit, GTZ): an international body owned by the German government.

The dialogue enables young and old people to talk about the practice of FGM, which persists even though it is illegal in certain instances; the topic is broached by way of general discussion about sexually transmitted infections (STIs), HIV/AIDS, and related issues.

Dialogue is a culturally accepted way of addressing an issue, so we settled on the dialogue approach, Phoebe Mollel, a district coordinator for the initiative, told IPS in Kajiado.

However, we realised that when we called people for meetings on FGM, no one would come. So we focused on STIs and HIV/AIDS as well as reproductive health, in the process bringing out FGM, she added.

Sessions on the effects of FGM on women and girls then follow.
Some discussions have involved old women telling of how they bled profusely when cuts had to be made to widen the openings of their vaginas, to enable them to give birth.

Girls and young women who asked why the incisions were needed heard that this was a consequence of FGM also referred to as female circumcision. The practice involves the partial or complete removal of female genitalia, and the stitching up of the resultant wound to allow just a small hole for the passage of urine and menstrual blood. These holes are often too small for babies to pass through.

Government statistics put national FGM prevalence at 32 percent; but this figure rises to over 90 percent for Kajiado, home to members of the Maasai ethnic group, which has one of the highest prevalence rates in Kenya.

A study conducted last year by the health ministry and GTZ, Female Genital Mutilation in Kajiado District: Findings of a Baseline Survey , found that 93.9 percent of women and girls in the area had undergone FGM. In some parts of the district, a prevalence rate of 100 percent was recorded.

The study led to the introduction of intergenerational dialogue amongst Maasai communities in Kajiado.

This past weekend (May 27), health officials and representatives of GTZ and the Planned Parenthood Federation of America a non-governmental organisation working on reproductive health matters visited the district to check on the progress of efforts to combat FGM.

This came ahead of the second Africa Conference on Sexual Health and Rights, to be held in the Kenyan capital of Nairobi next month. FGM will be one of the main topics of discussion at the event; the first such conference was held in Johannesburg, the financial centre of South Africa, two years ago.

Started last year in three of Kajiado s seven divisions, intergenerational dialogue appears to be bearing fruit. (IGD has also been introduced in Tharaka district in Eastern province, which has a relatively high FGM prevalence, and is scheduled to be implemented in other parts of the country).

At least those who are doing it (FGM) now do it in secrecy, as opposed to before when they would be all over the place shouting about it, Mollel noted.

Besides, some circumcisers have downed their tools after hearing about the ills of FGM.

Mary Kiluso, 75, is a case in point. She stopped carrying out FGM last year, despite earning about 14 dollars for every girl or woman she circumcised. In a country where official figures indicate that 56 percent of people live on less than a dollar a day, this was no small amount.

Even though circumcising girls and women would earn me income, I decided to abandon the trade because after participating in the IGD I realised that FGM had many negative sides, Kiluso, also a traditional birth attendant, told IPS.

Some of the women would experience difficulty when giving birth, while others would develop complications and have trouble even sitting, she added.

Kiluso, who began her circumcision practice in the 1970s, also realised that she was helping to force girls into early marriages and premature sex by performing FGM.

In Maasai culture, female circumcision is seen as opening the door to marriage and sex something that can lead to girls as young as nine being wed, and unwanted pregnancies. This, in turn, typically forces girls to compromise their future by dropping out of school.

Men and boys also participate in FGM discussions, meeting separately from the girls and women, and there are signs of enlightenment amongst men in the battle against FGM. But, the pull of culture remains strong.

I do not subscribe to the practice of FGM, but I was forced to circumcise my three daughters by my mother, who threatened to curse my homestead if I did not comply, said Moses Mokomi.

Similarly, a traditional birth attendant cannot assist an uncircumcised pregnant woman unless the fine of a goat or a cow is paid by the woman s family. Certain pregnant women have reportedly risked their lives giving birth without help, when unable to raise this fine.

A lot of awareness creation is needed, especially about the existence of an anti-FGM law. Many people here are not aware that FGM is illegal, said Mokomi.

The law he speaks of forms part of the Children s Act of 2001, which prohibits circumcision of girls under the age of 18. The penalties for those who do so include prison terms.

However, women s rights campaigners are seeking a complete ban on FGM.

In addition to complicating pregnancy, female circumcision can lead to a variety of problems that include painful intercourse, infection of the urinary and reproductive tracts, and even death. In addition, the use of unsterilised instruments to circumcise several girls or women can cause HIV transmission: apart from knives, razor blades, broken glass and even tin lids are known to have been used during FGM.

According to rights watchdog Amnesty International, female circumcision is practiced in more than 28 African countries, where it is variously seen as a rite of passage into adulthood or essential to hygiene, and even to improving the appearance of the genital area.

Followers of certain faiths are reported to practice FGM.

Furthermore, some believe that FGM reduces a woman s sexual appetite, and that performing circumcision can reduce infidelity on the part of women.