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PROTEST AGAINST BILL H22 OUTLAWING "FGM" IN NIGERIA

By Nowa Omoigui, MD, MPH, FACC
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I want to state unequivocally that I do not support the proposed HB22 Bill
sponsored by Janet Adeyemi and aimed at outlawing "FEMALE GENITAL MUTILATION
PRACTICE IN THE FEDERAL REPUBLIC OF NIGERIA."

There is a huge difference between Circumcision and Mutilation. To group all
forms of age old religious circumcision into one large category under the
guise of medical enlightenment and "civilization" is very unfortunate.

The term "female genital mutilation" is mischievous and hypocritical. Why
are we not campaigning to ban "Male Genital Mutilation"? After all, there is
a movement of sophisticated gentile physicians led by Dr. George C.
Denniston in the US who want male circumcision banned too [Doctors Opposing
Circumcision (D.O.C.)]. Let us see who will sponsor that bill in Nigeria-to
ban male circumcision-the main indication for which is cultural preference.

The classification system of Types I, II, III, and IV being used for "female
genital mutilation" is the same as was used in the US congress when Pat
Schroeder was sponsoring that country's bill. It is not true that every type
of genital ritual has the same implication or is practiced consistently
across Nigeria or Africa. I am not aware of any Edo woman-for example-who
has been properly circumcised whose clitoris or labia was amputated. What is
removed is the prepuce - a small piece of the sheath that extends from the
clitoris. That sheath has no sexual function and certainly no reproductive
significance. It is the same sheath that is removed in males. In fact in
many cases the "removal" is symbolic - and is part of a traditional marriage
ceremony.

Our constitution recognizes religious secularity as a principle of state
policy-but accepts common law, Islamic law and customary law as a reality.
It must be tolerant and also respect cultural secularity in a multicultural
nation. Sections 10 and 38 give us the right to freedom of belief and
worship.

There are ethnic clans in Nigeria-Hausas, Ijebus and Itsekiris-that do not
routinely circumcise their women. I respect their right to exercise that
prerogative and expect them to respect my customs too. Female circumcision
among those who practice it did not arise from hatred of womenfolk. In many
clans it is linked to other prestigious ceremonies - all of which will
presumably no longer take place as a consequence of this proposed
legislation.

It occurred to me that in all the years of British rule in Nigeria no
colonial official tried to ban female circumcision - including those who
banned twin killing. So why the sudden discovery of female 'mutilation'? Why
now? What is all this western preoccupation with the genitals of African
women?

Furthermore, there is absolutely no evidence that maternal and child
mortality in Nigeria is independently increased because of properly
performed circumcision. I challenge anyone to come out with prospective
RANDOMIZED data coupled to a logistic regression analysis of multiple
potential factors that proves such a cause and effect relationship. This is
only the latest of a series of frivolous rationalizations that have been
offered.

First the Women's liberation movement in the West said it was a male custom
done to "control" women. Then they discovered that female circumcision was
done for women by women to women. Next they said it limited sexual
enjoyment-a fundamental right. But it is evident that many women who do not
enjoy sex are not even circumcised. There are numerous reasons why a woman
may not enjoy sex-including the competence of her male partner. Many
postmenopausal women suffer such problems. Pessaries widely used for reasons
other than circumcision cause plenty of genital damage to women in Nigeria
and Africa (including gynaetresia) - but I haven't seen any legislation to
ban use of pessaries. Now maternal and child mortality is being blamed on
circumcision. It is just another case of intellectual fraud.

Is this not the same Nigeria where the government sanctions cutting of hands
(that is, mutilation of the limbs) based on religious codes of law in
certain states? As "civilized" as the US is, one of their closest foreign
allies is Saudi Arabia - a country where cutting of limbs and heads is
standard operating procedure. Why are US organizations not leading the
charge against the inimical health effects of amputation? Is oil is greater
than human rights?

What about the 'custom' of killing female children in China - which still
goes on today? What does the WHO or EU or the US have to say about that?

Who advised the World Health Organization to coin the phrase "mutilation"?
Whoever did was cynically manipulating language. We "mutilate" the umbilical
cord by cutting it off at birth and arbitrarily deciding how long the navel
should be. We "mutilate" our bodies with ear rings, tongue rings, tattoos,
nose jobs etc... We "keep" biologically excretory products like nails and
hair-and use them for beautification-and do so differently, I might add,
depending on the cultural environment. Some western women (in the US) begin
to shave their leg hair at age 10. They also shave their armpits. Has anyone
else in the world attacked them for mutilating what God put there for a
reason? We use traditional scarification marks for medicinal and symbolic
purposes... some of which result in disfiguring keloids. Why is that not '
mutilation' of the skin? Why not ban it?

A good example of the tension between conventional medical wisdom and
religion can be illustrated with the Jehovah dilemma. Jehovah's witnesses
all over the world do not accept blood transfusions and organ transplants in
spite of "health data" which suggest that those medical interventions could
be life saving. Should we ban Jehovah's witnesses in Nigeria?

In response to malnutrition in India is the World Health Organization going
to propose that Hinduism - observed by almost a quarter of the worlds
population-be banned since its adherents do not eat cow meat which they
consider sacred? Try getting that bill passed in the Indian parliament-and
give me a call if you succeed.

In India, drinking urine is a custom too. Even Mahatma Ghandi-the great
Indian leader after whom Martin Luther King patterned his protesting style -
used to drink his own urine in the mornings, as did Moraji Desai, a former
Indian Prime Minister. Most Nigerians-brought up with a different
mindset-would consider such a cultural practice unimaginable. Does that
elevate it to a crime?

Acupuncture was once derided in the West-because the "biologic basis" was
not explainable using western models of physiology. But once they realized
that China was not going to change its ways anytime soon-and a few
westerners actually went there and came to appreciate its efficacy,
acupuncture centers began springing up in every corner of the West.

Talking more about the politics of nomenclature, I want us to imagine for
one second what it would be like to change the way we describe and use the
phrase "abortion"-which is performed left, right and center in Nigeria [in
spite of laws against it]. Rather than "abortion" or "termination of
pregnancy"-as my colleagues like to say - let us call it "fetal mutilation"
(FM). Many of the so called advocates against circumcision who cry out
against the loss of a small piece of tissue-and call it mutilation-have no
qualms with the "right" to have abortions involving the barbaric crushing
and scooping of body parts of an unborn fetus. Neither do I hear a worldwide
campaign against episiotomy-the slashing (or shall I say mutilation) of a
woman's perineum to widen the passage for childbirth-sometimes necessary,
but more often not. The scar is permanent and the functional characteristics
of the vault as a sexual organ may be altered forever.

Since we were children how many doctors and women have we seen (or heard)
charged to court for abortion in Nigeria - as unhealthy as it can turn out
to be and as dangerous as it could be whether in the hands of quacks or
specialists? And many women have become infertile or even died from sepsis.
But it rides on in broad daylight while we are worrying about circumcision.
How many Nigerian Gynecologists - including those who propound safe
motherhood in public - can look you straight in the eye and say they have
not been making money from D & Cs including partial birth abortions (i.e
fetal mutilation)?

A common argument among proponents of HB22 and similar legislation is that
children (rather than their parents) be allowed to make the decision whether
to get circumcised when they get to age 18. In my view, this suggestion
amounts to a pervasive interference in the right of families to rear their
children in their own cultural and religious likeness. The "let children
grow up and decide" argument can equally apply to all other aspects of life.
Let them grow up and decide whether and what schools to attend; what
religion to practice; whether to cut their hair, pierce their ears, shave
their armpits, shave their legs; what foods to eat; what language to speak,
etc... They might even have the right to divorce their parents - as occurred
in Florida recently! But the more one travels along this curious line of
reasoning the farther away from our essence as Africans one gets.

Another common rationalization is that modern African women want to "control
their bodies." But those who claim such motivations show no interest in
getting male circumcision banned the world over. Are males exempt from the
requirement to be "in charge of their own bodies"-if that is what is denied
by circumcision? What gives a little girl more right to 'control her body'
than a little boy? What 'control' does a little

girl have over her body when her bath water, soap, lotion, clothes, shoes,
perfume (if relevant), skin marks, length of her navel, ear (or nasal)
holes, armpit hair length, leg hair length, pubic hair length, head hair
design, eye lash length, body odor, sex education, menstrual sanitation
practice, tooth care, nail length and colour, jewelry (if relevant) and
other paraphernalia are predominantly determined by her parental and family
upbringing?

When an American child is told by her mother to shave the hair on her legs
or armpit "because that is the decent thing to do in our custom" what
control is she exercising over her body? The excuse, therefore, that African
women now want to 'control their bodies' by rejecting their own customs is
tenuous. What we all do with our bodies is a function of culture and
environment. What is really happening is that one culture-which has captured
the minds of some of our people-is trying to force its way down the throats
of others using health and safety as a Trojan horse.

The cultural war against female circumcision is led by the same western
human rights crowd that classifies same-sex marriages as okay (in some parts
of the US) and puts pictures (of same sex couples) in books for little
children to read and learn from. I have the right to invoke my ancient
customs and look askance at such a policy-and protect my kids from it-at the
risk of being called conservative. Even the Pope in his wisdom, saw fit to
apologize to traditional African religions recently for the value judgements
that led to the destruction of their systems.

If inimical health outcomes of female circumcision are the concern of those
who oppose it, let them tell us how to make it safer-just as male
circumcision these days is often accomplished using a special device. The
number of neonates with neonatal tetanus from unhygienic cutting of cords in
Nigeria has generally been addressed by measures to prevent tetanus-not to
ban cord cutting.

The latter point highlights one of the biases in female circumcision
discussions-the fact that female circumcision was never taught to 'modern'
Nigerian doctors and not offered in hospital when a child is born.
Therefore, the alleged relative safety and low risk of complications that
attends male circumcision performed by trained physicians (not to mention
the new plastic bell technology for doing it) creates an unfair yardstick
for comparison. And many of the best original experts in the villages are
dying. Only recently I accidentally discovered the analgesic effects of
snail juice-used during circumcisions-from an old villager.

What the Health ministries in Nigeria should be doing in respectful
consultation with traditional leaders-is restricting themselves to improving
the safe performance of circumcision, or conducting randomized controlled
studies to evaluate various traditional approaches to the matter, not
dabbling into making jaundiced value judgements (through an arbitrary
western prism) about an ancient blood ritual. That decision is for villages
and clans to make, not the country as a whole.

Our children do not speak our language, do not wear our clothes, do not
practice our religion, and our ancient customs are under assault. In 50 -
100 years we will be unrecognizable as a distinct cultural entity - all
under the guise of globalization. Is this beneficial? To who? This rush to
western judgement will have to be slowed down at some point.

In conclusion, criminalizing our customs is a dangerous and unwise
undertaking. The National and State Assemblies should stay out of
legislating African traditional religion. I do not support HB22.

RETURN

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