Female genital mutilation, better known as female circumcision, is always seen as an ancient ritual commonly practiced in a number of countries in Africa and the Middle East, according to data from the World Health Organization (WHO), reported by The Guardian .
The latest global survey from UNICEF for the first time noted that this phenomenon is also widespread in Indonesia. The survey, published in February 2016, reported that 60 million women and girls were estimated to have experienced this dangerous procedure. Quoted from The Jakarta Post, this puts Indonesia in third place, after Egypt and Ethiopia, in terms of the high number of cases of female circumcision. This estimates that the number of women and girls throughout the world who have accepted the ritual practice surged to 200 million (from 130 million previously) in 30 countries that practiced female genital mutilation since 2014.
Tradition and religion are closely related to the practice of female circumcision
Female genital mutilation is defined as any form of procedure that involves removing, cutting, or removing part or all of a woman's external genitals, or causing injury to the female genital organs for non-medical reasons.
The reason why female genital mutilation is carried out varies from one region to another, and from time to time, including the initial combination of socio-cultural factors in family and community values, for example:
- Social pressure to adjust to what people around them have done for generations, and the need to feel accepted as a member of a devout society and fear of being exiled from social relations.
- This practice is seen as part of the celebration of puberty of a girl and is important as a cultural heritage of the community.
- Although the practice of female circumcision is not an obligation of any religious ritual, there are still many religious doctrines that justify and allow this practice to be carried out.
- In many societies, female circumcision is one of the prerequisites for marriage, and is sometimes a prerequisite for having reproductive rights and having children. The community also considers that genital mutilation will increase the fertility rate of women and encourage the level of infant safety.
- Female circumcision is seen as guarantor of women's virginity before marriage and loyalty to a partner during marriage, also increases male sexual arousal.
Female circumcision is commonly practiced in girls under 11 years old, regardless of the danger, because the public views its social benefits as greater than future health risks.
What is the procedure for performing female circumcision?
Female genital mutilation is usually carried out by people in the community (usually, but not always, women) who are appointed by the community to carry out this task, or with the help of a traditional midwife. This practice may also be done by a physician or dukun beranak, a male barber, or sometimes a member of his own family.
In certain cases, professional medical personnel provide services to practice female circumcision. This is called "medicalization" of female circumcision. According to recent UNFPA estimates, around 1 in 5 girls receive female circumcision treatment provided by professional health care providers.
The practice of female circumcision is done using knives, scissors, scalpels, pieces of glass, or even razor blades. Anesthesia and antiseptics are not commonly used in traditional procedures, unless done under the supervision of a medical practitioner. After the infibulation procedure (cutting all parts of the clitoris, labia minora, and part of the labia mayora), the female legs will generally be tied together so that the child cannot walk for 10-14 days, which allows the formation of scar tissue.
Why is female circumcision considered dangerous?
Regardless of people's beliefs and reasons for living it, the procedure for female circumcision is not safe - even when circumcision is carried out by trained health care providers in a sterile environment. The medicalisation of female circumcision only provides false security guarantees and there is no medical justification for doing this.
Female genital mutilation has serious implications for women's sexual and reproductive health. The degree of seriousness of the impact of female circumcision will depend on a number of factors, including the type of procedure, expertise of the practitioner, environmental conditions (sterility and safety of the practice and equipment used), and the level of resistance and general health of each individual who receives the procedure. Complications can occur in all types of genital mutilation, but the most dangerous is infibulation, aka female circumcision type 3.1.
1. Complications that might cause death
Direct complications include chronic pain, shock, bleeding, tetanus or infection, urinary retention, ulceration (difficult to heal open wounds) in the genital area and damage to surrounding tissue, wound infection, bladder infection, high fever, and sepsis. Severe bleeding and infection can be very serious to cause death.
2. Difficulties in getting pregnant or complications during childbirth
Some women who accept the procedure for female circumcision may have difficulty getting pregnant, and those who can get pregnant can experience complications during childbirth. A recent study found that, compared to women who had never undergone a female circumcision procedure, those who received this procedure faced a greater chance of requiring a cesarean section, episiotomy and longer hospital stays, and postpartum haemorrhage.
Recent estimates from WHO, UNICEF, UNFPA, World Bank, and UNDP report that in a number of countries with the highest incidence of female circumcision in the world also having a high maternal mortality ratio, and a high number of maternal deaths.
3. Infant mortality at birth
Women who undergo an infibulation procedure are more likely to undergo a longer and fuller labor process, sometimes leading to infant death and obstetric fistulas. Fetuses of mothers who have experienced genital mutilation have a significant increased risk of death at birth.
4. Long-term consequences
Long-term consequences include anemia, formation of cysts and abscesses (festering lumps due to bacterial infection), formation of keloid scarring, damage to the urethra which results in prolonged urinary incontines, dyspareunia (painful intercourse), dysfunction sex, an increased risk of HIV transmission, as well as other psychological effects.
5. Psychic trauma
Children who receive the procedure for circumcision of women at a relatively large age can experience trauma that causes a number of emotional problems in their lives, including:
- Post-Traumatic Stress Disorder (PTSD), or a prolonged reflection of that experience
- Sleep disorders and nightmares
Psychological stress from this experience might trigger behavioral disorders in children, which are closely related to loss of trust and instinct of affection for caregivers.
Female circumcision is considered an act of child abuse and violates human rights
In some countries, the procedure for female genital mutilation is carried out during the baby's early life, which is a few days after birth. In other cases, this procedure will be carried out during childhood, the period before marriage, after marriage, during the first pregnancy, or before the first delivery.
Dr. Babatunde Osotimehin, executive director of UNFPA, reported from the BBC, stressed that the practice of female circumcision is a violation of human rights to the right to life, body integrity, and personal health. Osotimehin further emphasized that all forms of female genital mutilation are acts of child abuse.
Culture and tradition are the backbone of human welfare, and arguments around culture cannot be used to justify violence against humans, men and women. All forms of female genital mutilation by any method cannot be accepted from a public health perspective, and are a violation of medical ethics.
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