By Juliet S. Sorensen

Tuesday, August 26, 2014

This fall our pilot project in a town in Mali will test the premise that the women who perform female genital mutilation are also ready for a change. But first they need a new line of work.


 A woman wears a fabric with the message: Zero Tolerance to Female Genital Mutilation (FGM).Credit: Oxfam International on Flickr, under Creative Commons

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NEW YORK (WOMENSENEWS)–This fall, the Northwestern Access to Health Project will conduct a pilot project in Douentza, a town in Mali, with the women who perform female genital mutilation.

We hope it will provide a missing piece to the puzzle of eradication efforts. Often these initiatives to end a brutal cultural practice focus on changing cultural norms. But female genital mutilation, known as FGM, is also a business practice, governed by the laws of supply and demand.

And that’s where this project comes in.

In Douentza , where I direct the Northwestern Access to Health Project, 75 percent of women and girls have undergone some form of FGM. The health dangers are apparent. The international campaign has garnered awareness at the government and grassroots levels alike. So why does the practice persist?

Could it be the cutters are perpetuating a practice that would otherwise be dying out?

For a six month period, the cutters–a dozen or so–will be provided with tools to run a small business that will provide a substitute source of income that is the rough equivalent of income earned by cutting.

Our initial assessment in Douentza indicates that if the cutters were provided with the opportunity to earn a substitute source of revenue, they would set aside their knives and razor blades.

In interviews conducted last year by a women’s advocate in Douentza, Laya Ongoiba, the cutters said they would cease performing the excisions if they had an alternative source of income. One woman reported that she would like a freezer to sell cold drinks in the market; another woman said she would buy several goats to raise for meat and milk.

Such women will also receive necessary training to run the business. At the same time, Ongoiba will educate the women on the dangers of FGM and its impact on health, well-being and basic human dignity.

The cutters must commit as a condition of participation in the project to no longer perform FGM and also to educate women who come to them seeking their services about the dangers of the practice. If they are found to be performing excisions, they will forfeit their substitute source of income.

Growing FGM Efforts

Our project comes at a time of growing visibility of efforts to end FGM.

British Prime Minister David Cameron in a summit earlier this summer co-hosted by UNICEF, called for a ban on FGM and child marriage “everywhere for everyone.”

Last month, dozens of members of Congress joined the campaign to prevent U.S. citizens from being taken abroad for what the United Nations has declared to be a violation of international human rights.

Also referred to as vaginal cutting, the brutal practice occurs in a swath of countries from Africa’s Atlantic Coast to its Horn of Africa. At least 3 million women and girls face FGM/C every year, while 100 to 140 million have already undergone the practice, according to the United Nations Population Fund.

In addition to the shock and pain inflicted at the time the gruesome act is performed, the potential health consequences of FGM are dire: incontinence, infection, hemorrhage and infertility when all or part of a girl’s genitalia is removed.

But what if stopping the practice was as simple as community-based education and economic opportunity?

In recent years, international campaigns by the United Nations and nongovernmental organizations around the world, including a December 2012 General Assembly resolution and criminalization of the practice in many countries, have sought to raise awareness about the dangers of this ritual.

Nonetheless, while a comprehensive assessment of the practice released last year by UNICEF shows a gradual decline in the practice in many parts of the world, FGM remains perniciously prevalent.

The market for such cutting depends on both supply and demand. The demand for cutting is addressed by nongovernmental organizations such as Tostan, which has headquarters in Senegal and aims to educate entire communities on the dangers and fundamental indignity of FGM and seeks a community-wide abandonment of the practice.

To understand the reasons for the demand, the UNICEF assessment asked multiple generations of men and women whether and why they agreed with the practice. The responses indicated that even in countries with high rates of FGM, such as Mali, the level of support for the practice among women and girls is lower than the actual prevalence level, suggesting that merely lowering demand for the practice is not sufficient to stop FGM altogether.

The UNICEF study also measured household wealth and found that an increase in wealth was correlated with a decrease in FGM. On this basis, the authors speculated reasonably that improvements in economic status included increased participation of women in the labor market, which changed their economic and social roles as well as their dependence on FGM to obtain economic security through marriage.

The Supply Side

In other words, an improved economy leads to decreased demand. But what about the supply?

Typically, FGM is performed by traditional female circumcisers. These women, and the medical professionals who are also asked to perform the practice, supply their services in exchange for payment. In a poor country such as Mali, there are few ways to earn a living, and this is one of them.

The UNICEF assessment didn’t survey the cutters, nor did it ask families of the victims how much they paid the cutters. But just as an improved economy leads to decreased demand for the cutting because of increased opportunity for women, it should also lead to decreased supply of FGM services, for the same reason.

We hope our pilot project will prove this so.

In designing the project, we considered whether the demand for FGM is so high that new cutters would enter the marketplace to perform the service. However, our assessment suggests not. Instead, it indicates that the women who perform this practice in Mali occupy a role through age, status and experience that may not be quickly or easily filled if these women cease to do so. Moreover, the widespread public condemnation of the practice poses a barrier to entry into the cutting “market” that may deter prospective cutters.

FGM not only presents lifelong risks of infection, disfigurement and hemorrhage, but is widely regarded as a violation of international human rights to life and health.

This pilot project, focused on a single community, proposes to address not only the cultural aspects of this practice through education and outreach, but also to eliminate the economic incentives it offers to women who perform the excisions by providing them with a sustainable, culturally appropriate, alternative source of income.

If successful, the project will not only empower girls who would otherwise be victims of FGM, but will also equip the women who perform the brutal act with a new, sustainable means to earn a living.

Human dignity demands as much.


Juliet S. Sorensen is a professor at Northwestern Law School, where she teaches health and human rights and is a director of the Northwestern Access to Health Project.