FGM Report - Hirda by Bárbara Neves

HIRDA

FGM REPORT FEMALE GENITAL MUTILATION

CONTENT 01

ACKNOWLEGEMENT

FOREWORD

INTRODUCTION

BACKGROUND

METHODOLOGY

CONCLUSION

ANNEX A

ACK NOW LEDGE MENT

This report was produced at HIRDA headquarters with support of Oxfam Novib. For the equipment of world citizen panel application. HIRDA is diaspora organization founded in 1998 by Somalis in the Netherland. The preparation of the Research was initiated, supervised and coordinated by Fatumo Farah (HIRDA director), Sylvanna Rikkerd was responsible for data analyses, interpretation of the results and report writing. Diede sterrenborg Abdishakur Hallane and our partners in somalia contributed to the conceptualization of the research and offered insightful perspectives on its theoretical underpinnings and programmatic implications.

Oxfam novib partners

and HIRDA partners in somalia provided data collection. Mohamed Ahmed, Sulub ismail and Abdullahi (HIRDASomalia)

provided support the partners for

technical

support. Peter Huisman (Oxfam novib) and HIRDA office in somaliland facilitated training of the World citizen pannel in Hargaisa. Valuable ideas, comments and fact-checking support on draft versions were provided by Ismail Bunow (HIRDA Board), Samuel ackah (independent consultant),

also

compiled information useful to guide the development of the report in its very early stages. The report was edited by Abdirashiid sh. Mahamed, proofread by Ismail Bunow and anna popov, and designed by Barbara Neves. It was made possible through MFS II funding to HIRDA andthis report is part of our compaign â&#x20AC;&#x153;Proud of meâ&#x20AC;?.

FOREWORD

HIRDA is pleased to present this research report of female genital mutilation (FGM)/ in Somalia. This report resulted from the work of many organizations and It symbolizes and highlights the high prevelance of FGM in Somalia and the different aspects of how FGM is perceived in Somalia .Moreover, the study explores health, religious, cultural, and human rights perspectives of FGM.

There are an estimated 130 million girls and women alive today whose human rights have been violated by female genital mutilation/cutting (FGM/C). Globally over 3 million girls are subject to this harmful traditional practice annually. Approximately 6.5 million Somali girls and women have undergone female genital mutilation/cutting (FGM/C) -- otherwise known as female circumcision - according to a new report by the United Nations Childrenâ&#x20AC;&#x2122;s Fund (UNICEF). Female genital mutilation/cutting (FGM/C) is aglobal concern. FGM, in any form, is recognised internationally as a gross violation of human rights of women and girls. Somalia is among the countries that has the highest incidence rate of FGM almost 98%.of girls under gone this harmful practice. Even though , Article 15 of the Federal Constitution adopted in August 2012 also prohibits female circumcision but still there is along way to taking positive actions towards abondament of FGM. Banning the practice in the new constitution is a positive step will bring an end to the physical and psychological torture and the suffering of many girls. Obviously,This study will eventually provide our stake holders the required and necessary insight to deal with the FGM problem in Somalia even more effectively. In addition, It will contribute towards the achievement of the goal of eradicating FGM in Somalia. In fulfilling the pledge of the MDG goals related promoting gender equality and empower women; HIRDA promises to execute and accomplish that goal and continue to work and take affirmative actions towards this hurtful and risky practice together we can eradicate FGM globally and nationally.

Fatumo Farah HIRDA Executive Director

INTRODUCTION Female genital mutilation is a human rights violation that is estimated to affect over 100-140 million women and girls around the world .These women and girls have undergone mutilating operations on their external genitalia, suffering permanent, irreversible health damage (WHO 2012a). FGM is considered a severe violation of the human rights of girls and women. The practice is a direct sequel of a blend of cultural and religious perspectives regarding gender roles. It often reflects inequalities between men and women, and is discriminatory against women. It also inflicts severe bodily damage and is mostly practiced on underage girls who are not yet able to make considered decisions (UNICEF 2005; WHO 2012a).

6.5 milion

Somali girls and women have undergone female genital mutilation (FGM) - according to a new report by the United Nations Childrenâ&#x20AC;&#x2122;s Fund (UNICEF).

98%

Somali women between 15 and 49 have been cut or mutilated - the highest per capita percentage in the world.

Somalia has the highest global prevalence (98%) of female Genital Mutilation. And It is one of the countries in the world where women undergo the most extreme form of Female Genital Mutilation, commonly referred to as infibulation.

98%

The WHO/UNICEF/UNFPA Joint Statement classified female genital mutilation into four types:

TYPE I

Often referred to as Sunna or Circumcision involves excision of the prepuce, with or without excision of part or all the clitoris

TYPE II

Often referred to as Clitoris dectomy or Excision. This involves excision of the clitoris with partial or total excision of the labia minora.

TYPEI III

Often referred to as Pharaonic or Infibulations. This involves excision of part or all of the external genitalia and stitching or narrowing of the vaginal opening.

TYPEI IV

Type IV includes different practices of variable severity including pricking, piercing or incision of the clitoris and/or labia; stretching of the clitoris and/or labia; cauterization of the clitoris; and scraping or introduction of corrosive substances into the vagina.

Type I and type II procedures are commonly practiced in Somalia being more severe and disfiguring see figure 1) (UNICEF, 2013). At least 80% of Somali women and girls have been subjected to FGM (WHO, 2008). In the new constitution of Somalia, FGM was prohibited by law in 2012. However, it seems difficult to put the new law into action, as there is no formal authority with widespread legitimacy to enforce this law. A key barrier to the elimination of FGM in Somalia is the widespread support the practice enjoys amongst the community. In a study of 1744 women aged between 15 and 49 in North East and North West Somalia, 90% reported that they preferred that the custom be preserved (UNICEF, 2013). Stigma is attached to girls who have not been cut, and they find it difficult to find a partner. A characteristic of the FGM practice in Somalia is that it is not an initiation rite that marks the transition from one phase of life into the next. It is something that is done in the early childhood of a Somali girl, generally before the age of 11. Outside Somalia, FGM is often practiced after the first menstruation of a girl and, therefore, marks the passage from childhood to adult life. In yet other cases, girls or young women are circumcised when they get married, when theyâ&#x20AC;&#x2122;re 7 months pregnant or even after the birth of their first child. Internationally working NGOs found out that in these situations it proves to be easier to replace the old traditions for new less radical ones than it is in Somalia. This is due to the fact that in Somalia, FGM is not practiced as a rite of passage but more of a condition that a girl has to meet to be perceived as a clean and marriageable woman (UNICEF 2004; UNICEF 2005).

BACKGROUND HISTORY OF ANTI-FGM CAMPAIGNS IN SOMALIA

Programmes aimed at the eradication of

World Bank and UNFPA 2004). Three large

female genital mutilation (FGM) in Somalia

organisations working on the eradication of

were started as early as 1977 by the Somali

FGM worldwide - and specifically in Somalia

Womenâ&#x20AC;&#x2122;s Democratic Organisation (SWDO).

- are the World Health Organisation (WHO),

Their goal was to replace the most severe

UNICEF, and the United Nations Population

form of FGM namely type III also known as

Fund (UNPFA). According to the Oxfam Novib-

infibulation, with type IV - the pricking of

Somalia Human Rights Report, more than 40

the clitoris to extract minimal blood - which

international NGOs, and even more Somali

is less harmful. They also tried to convince

organisations, focus on FGM in Somalia

stakeholders such as parents, religious and

(Novib, 2003). Although there are no reliable

community leaders, and female circumcisers

up-to-date figures, indications are that these

to perform the procedure in a sterile setting

numbers have increased since 2003.

such asa hospital. But desire to elicit attitude change towards FGM was not realised.

According to a report released by UNICEF in 2013 ,the prevalence of FGM in Somalia

Campaigns and programmes aimed at the

remains high at 95%

especially affecting

elimination of FGM in Somalia collapsed with

girls between 4 to 11 years of age. This high

the fall of the Siad Barre government in 1991.

prevalence gives the impression that FGM still

However, since the start of a series of UNICEF

is largely practiced in Somalia.

awareness seminars in 1996, the topic of the

eradication of FGM in Somalia is back on the

Massive challenges abound when it comes

agenda of local and international NGOs, the

to the eradication of FGM in Somalia.

Somali state actors and the international

Operational problems specific to the Somali

community (U.S. Department of State 2001;

context make up the first set of these

challenges. The country is replete with militia,

The subject, therefore, needs a culturally

conducting indiscriminate attacks against

sensitive and holistic approach. This also

civilians,

intervention

explains why a successful anti-FGM campaign

programmes. This makes it difficult to set

in, for instance, Egypt may fail completely

up any kind of development program.

when implemented in Somalia.. Best practices

Secondly, unlike HIV/AIDS and malnutrition,

cannot be transferred just like that; They have

FGM is a deeply rooted cultural tradition,

to be adapted to the local context.

thereby

impeding

attached with complex social undertone.

FGM AND THE ROLE OF WOMEN IN SOMALIA

Somalia is a patriarchal society in which men

increasing. Women in Somalia also continue to

and boys are more important and valuable than

be subjected to high levels of conflict-related

women and girls. In a patriarchal society, there’s

sexual and domestic violence, where rape is

a great deal of emphasis on the importance of

often used as a weapon of war.

female sexual ‘purity’. Interestingly, women – just like men - perceive FGM as part of being

Last year, the U.N. recorded at least 1,700

a ‘proper’ woman, which means sexually

rapes in 500 camps in the capital Mogadishu.

controlled, and a necessary condition for being

Human rights groups say many cases of rape

able to marry. Girls who have not been cut

go unreported because women fear being

are regarded as ‘loose’ women with the same

stigmatized and victims of reprisals.(United

sexual appetite as men. Cut female genitals,

Nations). A new report notes during the first

therefore, represent the traditional standard of

half of the year, from January to June, some

beauty and refined femininity.

800 cases of sexual and gender-based violence were reported in the capital, Mogadishu,

Attitudes that accept and excuse violence

alone. Neverthless , Rape or domestic violence

against women and girls are deeply entrenched

incidents is

in Somalia. Although there is lack of prevalence

the payment of -money or a forced marriage

accurate data, sexual and domestic violence

between the victim and the perpetrator. No

is reported to be a serious problem in

national decree/legislation banning FGM/C.

often resolved through either

Somalia and recent reports suggest that it is

HIRDA’S CAMPAIGN AGAINST FEMALE GENITAL MUTILATION

HIRDA has contrived and made anti-FGM

equal opportunities, and women’s role in

campaign one of its top priorities. We aim to

peace building., the empowerment of women,

reduce the stigma associated with girls and

which is a key importance to the elimination

women who have not undergone FGM (‘uncut’

of the practice. We work closely with the youth

women). Besides HIRDA’s ultimate goal is to

and other influential stakeholders, such as

eradicate completely the practice of female

local elders, and religious leaders and involve

genital mutilation/cutting. As a matter of fact

them in the discussions the discussions of this

,HIRDA

have been recognized as the prime

harmful practice and. Traditional and religious

Netherland based organisation campaigning

leaders are powerful and greatly respected in

against female genital mutilation, and key actor

the community .Hence they play an important

in designing and implementing programmes for

role in the abandonment of FGM.. They have the

the abandonment of female genital mutilation.

capacity to influence decisions within families

Furthermore, HIRDA instigated in promoting

and to build consensus within communities.

innovative

Their position against the practice intensifies

strategies

and

approaches

the prevention and eradication of FGM.

the credibility in ending FGM

Such approaches include raising awareness ,advocacy training , information campaigns,

Bringing an end to the practice of FGM,HIRDA

social mobilization, and women empowerment

In cooperation with the youth theatre group

,HIRDA organized various

workshops and

‘New Era’, . has produced a series of eight films

and invited women and girls

addressing FGM and promoting girls’ education.

affected by FGM to these meetings in order to

The films were broadcast on Universal TV, a

receive vital information on the health risks

Somali TV channel popular among the Somali

of FGM. In addition They are able enables to

diaspora. The film was intended to send a

discuss and re-evaluate the cultural meaning

strong message that Female Genital Mutilation

of FGM. Given that FGM is a complex socio-

is an extreme form of violence against girls and

cultural issue is a deeply rooted tradition, widely

women and must be ended as soon as possible.

conferences

practiced in Somalia,. In another project, HIRDA provided retraining other

for female-circumcisers as traditional birth

conferences for women organizations to

attendants (TBAs). Between 2008 and 2011,

discuss FGM, Manifestation of gender inequality

HIRDA re-trained 40 female circumcisers in

Additionally,

HIRDA

organized

Abudwak as Traditional Birth Attendants, and

It might, therefore, be concluded that if the

persuaded them to abandon their profession as

number of circumcised women in Somalia has

circumcisers. They received assistance in setting

changed at all, the figures have only diminished

up their own practice. By creating an alternative

marginally in the last 15 years.

profession for female circumcisers, the former FGM practitioners can still eke out a living

Apparently, the change in attitude towards FGM

through a profession which aids - not harms -

is sluggish, and is hard to capture in exact data.

women. In the coming five years, HIRDA aims to

It is, therefore, difficult to capture if - and to what

train 10 circumcisers annually, and engage them

extent - programmes take a sustainable hold

as ambassadors in the anti-FGM campaign. The

within the community. To effectively improve

Impact of Anti-FGM Programmes.

not only HIRDA’s strategy on the eradication of FGM but those of all current anti-FGM actors

Even though anti-FGM programmes have been

as well and to get a clear insight into current

carried out for 15 years in Somalia, the question

FGM practices in Somalia, we have conducted

is whether it has achieved the desired effect of

a thorough impact evaluation study. 16 NGO’s

reducing the prevalence of FGM. HIRDA and

joined efforts to interview their beneficiaries to

other NGOs monitor their results in order to

evaluate the impact of their programmes, and,

implement findings..Obviously, It is difficult to

to gain insight into the current attitudes towards

obtain reliable figures, but most studies claim

FGM practices across Somalia. By comparing

that prevalence of FGM in Somalia stands at

these results, NGOs will be able to establish

around 96-98% (UNICEF, 2013). The lowest

more effective methods/strategies to battle and

percentage found is 90% (UNHCR, 2001).

eliminate FGM.

FGM AND ISLAM

Although,

Somalis

consider

FGM

quintessentially Islamic, no references on FGM

societies as well, and that majority of Muslims do not practice it.

– let alone justification - can be found in the Quran. (UNICEF, 2011). In fact, , research has

The overwhelming majority of Muslims in

shown that in a lot of regions , FGM predates

Southeast Asia follow the Shafii school of law,

Islam.Flying in the face of this proprosition also

which declares FGC as wajib, or obligatory.

is the fact that FGM is practiced in non-Islamic

In contrast, the other three Sunni schools,

together with the Shia schools, consider FGC

1000 respondents found that over 90 percent

a sunnah or a recommended act. Just like

of Muslim women reported being circumcised.

male circumcision, there is no mention of it in

By asking female students from the University

the Quran.( Sya Taha is historically Javanese,

of Jakarta and Kuala Lumpur whether they

politically Malay, and accidentally a migrant

were circumcised, they were able to establish a

to the Netherlands whose interests include

large number of 86…% of Indonesian females

Quranic hermeneutics, gender, disability, and

who have probably undergone a form of FGM.

race in the Nusantara (Malay archipelago).

Because of this new data, it becomes hard

However, the NGO … published a report

to deny that FGM is linked to Islam. In our

in 2014 showing that FGM in large Muslim

research we will also pay specific attention to

countries such as Malaysia and Indonesia, have

the possible connection between Islam and

been overlooked by leading institutes such

FGM in Somalia.

as UNICEF. In Malaysia, a university survey of

THE IMPACT OF ANTI-FGM PROGRAMMES

Even though anti-FGM programmes have

hard to capture in exact data. It is, therefore,

been carried out for 15 years in Somalia,

difficult to capture if - and to what extent -

the question is whether it has achieved the

programmes take a sustainable hold within

desired effect of reducing the prevalence

the community. To effectively improve not

of FGM. HIRDA and other NGOs monitor

only HIRDA’s strategy on the eradication of

their results in order to implement findings.

FGM but those of all current anti-FGM actors

Obviously, It is difficult to obtain reliable

as well and to get a clear insight into current

figures, but most studies claim that prevalence

FGM practices in Somalia, we have conducted

of FGM in Somalia stands at around 96-98%

a thorough impact evaluation study. 16 NGO’s¹

(UNICEF, 2013). The lowest percentage found

joined efforts to interview their beneficiaries

is 90% (UNHCR, 2001). It might, therefore, be

to evaluate the impact of their programmes,

concluded that if the number of circumcised

and, to gain insight into the current attitudes

women in Somalia has changed at all, the

towards FGM practices across Somalia. By

figures have only diminished marginally in

comparing these results, NGOs will be able to

the last 15 years. Apparently, the change

establish more effective methods/strategies

in attitude towards FGM is sluggish, and is

to battle and eliminate FGM.

¹ ADO, AGAD, CED, Dial Africa, GECPD, Hardo, Hijra, HIRDA Gedo, HIRDA Somaliland, HIRDA Mogadishu, Kaalo, Karaama, Nagaan, TASS, WASDA, WAWA

RESEARCH OBJECTIVES

Firstly, this research has two objectives.

into the effectiveness and the impact of

to provide statistics on current (attitudes

different FGM programmes. The results is

towards) FGM practices in Somalia through

hoped to contribute to the improvement of

an extensive study. We will be able to show

the working methods of NGOs working on

ideas on, prevalence

and practices of

the eradication of FGM in Somalia. Moreover ,

FGM. Secondly, to compare the data from

enabling them to be part of a greater voice to

beneficiaries and non-beneficiaries of anti-

end FGM, locally and internationally.

FGM programmes, in a bid to gain insight

CHALLENGES EVALUATION OF PROJECTS AIMED AT ERADICATING FGM

When evaluating anti-FGM programmes in

Work continues to be reactive, with limited

Somalia,Study/assessment show a whole host

contributions

of challenges:

delivery (UNICEF 2010, 3).â&#x20AC;?

[...]

sustainable

service

- Lack of coordination and communication among organisations and actors involved;

However, working on the elimination of FGM

- Absence of a reliable and solid infrastructure;

goes beyond the socio-economic context of a

- Lack of structural funding, and financial

country.. FGM is a tradition that is deeply rooted

insecurity (UNICEF 2010; World Bank and

in certain social practices and behavioural

UNFPA 2004).

systems. In a 2004 report, UNICEF describes

general;

â&#x20AC;&#x153;Aid

coordination

structures

are duplicative and fall short of producing

three different stages of people in Somalia concerning their attitude towards FGM:

the unity that aid effectiveness demands.

STAGE I Complete lack of awareness on the harmful effects of FGM and the fact that it is considered a human rights violation.

STAGE II Minimal awareness but negligible behaviour change.

STAGE III Awareness and behaviour change (UNICEF 2004). A

The view of UNICEF is, nonetheless,not

The ‘awareness in relation to behaviour’

completely supported by UN and the World

debate applies to all countries where FGM is

Bank who argue for a different method of

practiced, but in the Somali context, there are

eradicating FGM. In the report the UN and the

some important dimensions and socio-cultural

World Bank contend that in the eradication of

conceptions that have to be included in a

FGM, behaviour change is essential and that

country specific approach. For instance, the

information, education and communication

general perception in Somalia holds that uncut

will not suffice to provoke this long, difficult

women are unclean and a disgrace. Because of

and complex change in attitude just on

this public opinion, Somali men will not marry

their own.

an uncut woman. Also, taking a girl’s virginity by opening her circumcision on the wedding focus

night is a proof of manhood. “If consensus

on behaviour change communication (BCC)

can be generated that marrying uncut women

and behaviour change intervention (BCI). BCC

is acceptable within the social group and this

and BCI require a multi-pronged approach

decision is then publicized through a formal

because of the culturally sensitive dimension

declaration, then a “social convention shift”

of behaviour change. “The decision by

can happen” (Jaldesa et al. 2005, ii).

Modern

strategies,

accordingly,

anyone to reject FGM encompasses changes

at different levels. It involves recognizing its

The afore-mentioned arguments on the

harmfulness, the power of refusing or making

relationship between awareness and the

desirable choices and being able to act.

eradication of FGM in Somalia raise different

Others eventually emulate them. However,

questions. Firstly,, it is unclear how much

the risk of failure is fuelled by community

knowledge and awareness of the harmful

repercussions” (World Bank and UNFPA 2004,

effects of FGM there exists among the people

25). Although the report states that more

of Somalia at this point. Secondly - and this

action is needed other than awareness raising

is even more important - is the fact that it is

to eradicate FGM, it recognizes that one of

unclear at this stage if projects are powerful in

the cardinal steps that have to be taken in the

creating awareness on the effects of FGM and

anti-FGM campaign is that people must, first

if these projects, indeed, lead to a decrease in

and foremost, appreciate the injurious nature

FGM. This study, sought to answer both sets

of the practice.

of questions.

RESEARCH GOALS

Provide up-to-date insight into current FGM-practices in Somalia

Provide an idea on Somali attitudes on FGM nowadays

Map out \the extent to which anti-FGM programmes are successful

The research questions addressed were:

1. What do FGM practices look like nowadays in Somalia? • To what extent is FGM practiced? • What type of circumcision is most common? • What does the performance of a circumcision look like? • What are the possibilities for after-care for circumcised women? • What do the Somali people know about the harmful effects of FGM? • From whom do Somali people receive information about FGM?

2. What attitude do Somali people have towards FGM nowadays? • Are Somali people in favour of FGM? • Is the attitude towards FGM changing? • What factors influence the attitude towards FGM?

3. What is the impact of anti-FGM projects • Are NGOs effective in eliminating FGM? To answer these questions, an extensive survey had been designed. The survey was conducted alongside an Oxfam Novibdesigned research, known as the World Citizens Panel, implemented with the help of a smartphone application. An extensive overview of the methods used is detailed in Chapter 3.

METODOLOGY THE WORLD CITIZENS PANEL APPLICATION

To gather data on the current state of

disasters and gender related violence, an

(eradication) FGM practices in Somalia, HIRDA

insight can be obtained into one’s quality of

hadcollaborated with Oxfam Novib in a large

life. These results can, in turn, be compared to

impact-evaluation study. Since 2012, Oxfam

the results of the control group. If the projects

has been working on a tool to evaluate the

organised by Oxfam Novib and its partners

impact of their projects worldwide. The

are indeed successful, the target group of the

evaluation tool is called ‘World Citizens

impact evaluation is expected to have a higher

Panel’(www.oxfamnovib.nl/creating-a-

quality of life than the control group.

World-Citizens-Panel-.html). It consists of an extensive survey that measure in different

The World Citizens Panel survey is conducted

terms, the impact of NGO programmes on

through the World Citizens Panel (WCP)

the quality of life of the interviewed person.

application which can be downloaded onto Smartphones that run on Android via the

Both quantitative and qualitative methodo-

Google Play Store’ (play.google.com). In the

logies were utilized in this assessment. The

application, the entire questionnaire can

surveys are conducted on beneficiaries of a

be completed and up to 100 completed

project of (a partner organisation of) Oxfam

questionnaires

Novib in the field, or on people that resemble

application. Whenever the mobile phone is

the beneficiaries in terms of personal

within reach of an internet connection, the

characteristics, social environment and social

completed questionnaires will automatically

economic status but is not in touch with the

be uploaded into a central database. When

NGO (control group). By asking questions

all data is uploaded, a statistical report

about, for example, their source of income,

will be generated automatically through

education level of their children, their

the software in the database. Participating

resilience against malnutrition or natural

organisations have access to an online toolkit

can

stored

the

to assist them during the process of gathering

partners and partner organisations of Oxfam

data through the Smartphone, and they can

Novib in Somalia who participated in the WCP

access the reports for their own organisations

project, to conduct the FGM survey as well.

online as well.

The FGM questions were included in the WCP

In order to gather data on current FGM

application. Partners who agreed to conduct

practices and the possibilities for ending FGM,

the FGM survey, accordingly, get the FGM

HIRDA

questions after they completed the regular

designed a survey. It’s own survey

aside, HIRDA had, in addition, asked her own

WCP survey in the application.

QUESTIONNAIRE

The questionnaire has been designed by

of the survey, an interview guide had been

skilled project officers of HIRDA. A first draft

designed with tips to ensure the validity of

had extensively been discussed at the HIRDA

the data when asking sensitive questions. The

office in Amsterdam. Next, the questionnaire

interview guide (in English) was distributed to

had been sent to HIRDA offices in Somalia for

all participating organisations. The interview

a review. HIRDA Somalia project officers had

guide can be found in Annex II.

provided feedback on the questionnaire and adjustments made as necessary. Finally, the

During the analysis of the data, questions

survey was discussed during training about

about the quality of the translations were

the WCP application in Hargeisa, Somaliland,

raised. It turns out that where the English

during which, feedback had been asked on

questionnaires asked about ‘Female Genital

the questionnaire. The feedback was then

Mutilation’ the Somali questionnaire asked

reflected in the questionnaire.

about ‘circumcision’, because there is no accurate translated term for FGM in Somali.

The questionnaires were translated from

In the data analysis, we find that people have

English to Somali and both sets wereavailed in

a more negative attitude towards the English

the app and online. This gave the organizations

FGM than they do towards the Somali word for

the freedom to decide if they want to use the

circumcision. Because this translation error

English or the Somali version.

might jeopardize the validity of the data, we decided to strictly use the Somali data for the

The survey consisted of 33 questions. The

questions in which this translation difference

complete survey in English can be found

might slant the results.

in Annex I. In order to make optimal use

RESPONDENTS AND PROCEDURE

A total of 17 partner organizations, out of 21

the area in which the organization is based

organizations participating in the WCP project,

or active. Organizations used their own

agreed to conduct the FGM survey alongside

staff members or appointed interviewers

the WCP survey. 9 Organizations also include

to conduct the survey. The main staff

a control group. 15 partner organizations

involved had received extensive training in

have conducted the FGM survey amongst a

Hargeisa,Somaliland. Appointed interviewers

total number of 3081 people Table 1 lists the

also received a training from the staff of

partners involved and , the specific regions in

the organization (according to the â&#x20AC;&#x2DC;train the

which they are based. The number of surveys

trainerâ&#x20AC;&#x2122; principle). In the training, they learned

conducted amongst the target group ranges

how to use the smartphone and the WCP

between 131 and 357 but, on average, the

application on the smartphone. Additionally,

NGOs have 223 respondents.

they learned interviewing skills. The training was based on the interview guide. During the and

interview, questions were administered by the

control group according to the following

interviewer to the respondents while holding

procedure:From a list of all beneficiaries of

the smartphone. The respondents did not fill

the organization, a sample representative

in answers in the smartphone or in the online

of the whole target group was established

application by themselves.

Partners

drew

the

sample

target

with help of an online sample size calculator (www.surveysystem.com). If the organization

Some organizations complained that they

showed willingness and had the capacity to

had found it troublesome to work with the

include a control group, the same procedure

smartphone. This was due to either security

was followed as described above, but the size

and/or the lack of technical know how.

of the target group (list with beneficiaries)

Therefore, some organizations decided to

was doubled, because the control group has

conduct the surveys with the help of the printed

to have the same number of respondents as

version of the WCP or the FGM questionnaire.

the target group. Half of the sample was then

Data from the printed questionnaires were

be part of the target group and the other

uploaded into the online version of the WCP

half of the control group. The surveys among

or FGM questionnaire.

target and control groups were conducted in

REGION

CONTROL GROUP INCLUDED

ADO

Hargaisa (Somaliland)

AGAD

Galkaio (South and Central Somalia)

YES

CED

Merca (South Central Somalia)

NAME ORGANISATION

Dial Africa GECPD

Galkaio (Punland)

YES

HARDO

Hargaisa (Somaliland)

YES

HIJRA

Mogadisho (South Central)

YES

HIRDA Gedo

Beledhawo (South Central)

HIRDA Somaliland

Hargaisa (Somaliland)

HIRDA Mogadishu

Mogadishu

YES

Kaalo

Bosaso (Puntland)

YES

Karaama

Abudwak (South and Central Somalia)

YES

Nagaad

Hargaisa (Somaliland)

RMSN

Bosaso (Puntland)

TASS

Bosaso (Puntland)

YES

WASDA

Afmadow (South Central)

WAWA

Mogadishu

YES

Table 1. Overview of participating partners and amount of surveys conducted

DEMOGRAPHIC SEGMENTATION OF THE RESPONDENTS

SEX

PERCENTAGE

AMOUNT

Male

693

22,5%

Female

2388

77,5%

AGE

PERCENTAGE

AMOUNT

0 - 15 Years

119

16 - 25 Years

774

25%

26 - 45 Years

1459

47%

46 - 65 Years

591

20%

> 65 Years

138

LOCATION²

PERCENTAGE

AMOUNT

Rural

101

62%

Semi-Urban

1085

35%

Urban

1895

LITERATE

PERCENTAGE

AMOUNT

Yes

1238

40%

1843

60%

² Because the distribution in location does not match the Somali reality (the percentage of people living in rural areas is actually much higher), it is decided to make a distinction between urban and non-urban areas only.

LEVEL OF EDUCATION

PERCENTAGE

AMOUNT

None

1712

56%

Grade 1- 4

509

17%

Grade 5 - 8

373

12%

Secundary

319

10%

Higher Education

168

MARITAL STATUS

PERCENTAGE

AMOUNT

Single

411

13%

Married

2060

67%

Unmaried Couple

Divorced

349

11%

Seperated

Widower

179

TOTAL

3081

Table 2. Shows an overview of the respondentsâ&#x20AC;&#x2122; distribution demographically.

DEMOGRAPHIC SEGMENTATION OF THE RESPONDENTS

This research had two goals;. To gain insight

displayed in meticulously arranged charts

into the current (attitudes towards) FGM

showing percentages of responses

practices; and: To gain insight into the impact

A comparative analysis was then done to get

of anti-FGM projects.

a glimpse of the impact of HIRDA projects.

given.

Responses of the target and control groups It follows, therefore, that data was analyzed

were then compared using comparative

according to different methods. To gain

(t-tests) in SPSS.

insight into current practices, answers were A

RESULTS OVERVIEW OF CURRENT (ATTITUDES TOWARDS) FGM PRACTICES

Respondents were asked if they were aware of the health consequences of FGM. 50% of women (N=1956), and 42% of men (N=519) said they aware of the health consequences of FGM. Chart 1 shows the responces regarding the complications girls/women are exposed to when they undergo FGM. Circumcisions are - almost always - performed by a female circumciser. However, doctors and nurses form the second most mentioned group to perform FGM. Figure 2 shows the FGM practitioners among Somali communities. The Figure 3 shows the distribution of circumcisers. When this number is split up to locations, we found out that in urban areas, more people believe thereâ&#x20AC;&#x2122;s a decrease in female circumcisers.

What complications are girls exposed to when circumcised? 40

Figure 1. Number of respondents=3081

Ot he r

n m p we lic dd ati ing on nig s in ht Ps yc Tr holo au g m ica at lly ize d

tio ec

In f

U pl rol ica og tio ic ns m Co

pl ica Bir tio th ns m co

ns No eq he ue alt nc h es Id on â&#x20AC;&#x2122;t k no w

Who performs Female Genital Mutilation in your community? I donâ&#x20AC;&#x2122;t know Other Family Member Doctor / Nurse Female Circumcisers 0

100

Figure 2. Who performs female genital mutilation N=3081

Have you noticed a decrease or an increase in the number of circumcisers in your community in the past years?

24%

17%

I donâ&#x20AC;&#x2122;t Know An increase An decrease

20%

40%

The number remained the same

Figure 3. Have you noticed a decrease or an increase in the number of circumcisers in your community in the past years? N=2431

In the majority of the cases, circumcision is performed at homes, but,occasionally, it also takes place in a hospital. Most commonly used instrument to execute the circumcision is a razor blade. In figure 6, the most practiced types of FGM are displayed. The question is posed in different forms. We asked womenhow they were circumcised. We also asked what type of circumcision is common in the community. The type of circumcision the girl will or had, specifically, undergone was also asked. In this way, we were able to get an idea of how girls were circumcised in the past (by asking about their personal experience), how they are circumcised now (by asking about the common type in the community) and how it may be done in the future (how daughters will be circumcised.)There was a unanimous response that Sunah is considered a more favourable way of circumcising than any of the more severe types of circumcision. Most practiced type of FGM is, therefore, currently Sunah, followed by clitoridectomy. Only 2% of the respondents claim that their daughter(s) is/are not and will not be circumcised. The decision to get a girl circumcised is usually made by the mother (53%) and in 37% by both the mother and the father. It is in 5% of the cases only that the father decides whether the girl will be circumcised. It has to be borne in mind that owing to translation, there are differences in the responses given owing to the fact that the respondents answered either the Somali or the English questionnaire. Respondents were also asked why they will circumcise their daughter(s). In figure 7, parentâ&#x20AC;&#x2122;s motivations to have their daughter circumcised are displayed.

Where does circumcision take place in your community? 4% 3%2% 7%

Home Hospital

84%

Figure 4. Where does Female Genital Mutilation in your community take place N=3081

Outside Other I donâ&#x20AC;&#x2122;t know

What instruments are used for FGM in your community? 50 38 25 13 0 Health reasons

Religion

Protection of girls virginity

Figure 5. What instruments are used for FGM in your community? N=2475

Types of circumcision What type of circumcis did you have?

What type of circumcision did your daughters have or will have in the future?

What type of Female Genital Mutilation is most practiced in your community?

60 50 40 30 20

kn on â&#x20AC;&#x2122;t Id

Figure 6. What types of FGM are most practiced N=2475

Da no ugh be t / w ter cir ill s a cu no re m t ciz ed

r he Ot

n io ul at fib In

io n cis Ex

y Cl

ito

rid ec

na Su

Why will you circumcise your daughter? 50 40 30 20 10 0

Religion

Tradition

Health reasons

Social Protection of Pressure girls virginity

Other

Figure 7. Motives to get daughter(s) circumcised.

FGM PRACTICES IN THE COMMUNITY

To gain insight into current FGM practices in the community, the respondents were asked several questions about the girls in their community. Figure 8 shows the age in which girls are circumcised in Somalia. Most girls are circumcised between their 5th and 10th year. Less than 1% of the girls are circumcised when she is older than 15. The circumcision is hardly ever celebrated with a festivity; only 5% of respondents state that in their community, a circumcision is celebrated.

At what age is a girl circumcised in your community? 7% 5% 0-5 5 - 10 10 - 15

88%

>15

Figure 8. Around what age are girls circumcised in your community? N=2475

EXPERIENCE WITH FGM

To get a better insight in the prevalence of FGM, we also sought to know how many female respondents are, themselves, circumcised. Figure 9 gives a depiction of the answers given by women to the question ‘Can you tell us whether you are circumcised?’

Are you circumcized? 7% 13% 3%

Yes Not Applicable

77%

I can’t say No

Figure 9. Number of circumcised women. N= 2388.

The number of women who said they’d been circumcised (77%) is lower than was expected based on previous research (sources). We realized, however, that this is a very sensitive question to ask and that not all respondents awant to answer this question. A little less than 3 percent of women, said they are not circumcised, but almost a quarter of the total number proffered that they are either not able to tell or that they find the questions not applicable in their situation. It is likely that among these women, a high proportion is in fact circumcised, but does not feel comfortable to discuss this with the interviewer. Therefore, it is probable that the actual amount of respondents that is circumcised is much higher than 77%. The type of circumcision that women had undergone can be found in Figure 5. The majority of women had undergone clitoridectomy; Sunah is the next most common type of FGM. This finding contrasts with previous research in which it had been claimed that Somali women were mainly subjected to infibulations - a more severe type of FGM (bron). Current findings emphasize that there is a visible trend towards less invasive forms of FGM. Women were also asked the complications they had experienced after their circumcision. These are displayed in figure 10. Main complications are infection, difficulty in urinating, problems on the wedding night and during birth. Only 14% of respondents claimed not to have experienced any complications after they were circumcised. While a further fewer percentage – Only 6% - of the female respondents felt they were psychologically traumatized by the circumcision.

What type of complications did you experience after your circumcision? 30 20 10

he r Ot

Co we mp dd lica ing tio nig ns ht in Ps Tr ych au ol m og at ica ize lly d

fe cti on In

Co wh mp bi en lica rth g ti ive on in s g Ur Co olo m gic pl ica tio ns

w no â&#x20AC;&#x2122;t k Id

No ne

Figure 10. Experienced complications after circumcision. N=2729

The last question the respondents were asked was in relation to what they did or would do in case of health issues or other complications as a result of themselves being circumcised or someone they knew. It is troublesome that 13% would choose not to take action at all. However, the majority of the respondents would contact some sort of medical service.

What would you do in case of complications? 40 30 20 10

Figure 11. What would you do in case of complications? N=3081.

Nothing

Contact Female Circumcizer

Contact Schoool

Contact Trusted Family Member

Contact Imam or Religious Leader

Contact Hospital, Medical Center

Contact NGO

Contact Custumary Authority(clan leader)

Contact Custumary Heatlh Services

INFORMATION ON HEALTH CONSEQUENCES OF FGM

Respondents stated that they are informed about the health consequences of FGM by different actors. If they receive information on health consequences, it is mostly by NGOs or CBOs (working in the area) (47%), the hospital (28%) and religious leaders (23%). 25% indicated not to have received any information or markedthis question as not applicable. The last percentage implies that there are still a large number of people that have not received information on the health ramifications of FGM and are, therefore, possibly unaware of the health repercussions of FGM.

ATTITUDE TOWARDS FGM

To analyze the attitude towards FGM practices, it was asked ‘how is a girl/woman treated by the community if she is not circumcised?’. Figure 12,shows the responses. It is, especially, interesting that 21% of respondents feel that the ‘uncut’ woman or girl is not treated differently than if she would have been circumcised. Social pressure to circumcise a girl is proven to ncrease if being uncut is associated with unwanted behavior or uncleanliness. When further exploring this percentage, we find that a few more women than men feel that uncut girls are treated the same as circumcised girls.

How is a girl treated if she is not circumcised? 50 40 30 20 10 0

Marriage See as prospects unclean are not good person

Associated with protitution

Stigmatized within the community

She is not treat differently than she would be circumcised

Other

Figure 12. How is a girl or woman treated by the community if she is not circumcised? N=3081

Is an uncircumcised girl treated the same as a circumcised girl? 25

Women

Men

Figure 13. Specification by sex that think that an uncut women or girl is not treated different

An uncircumcised girl is treated the same as a circumcised girl? 0 - 15 16 - 25 26 - 45 46 - 65 > 65 0

Figure 14. Specification by age that think that an uncut women or girl is not treated different than when she would be circumcised. N=3081

In figure 15, we have specified this question by age category. People in age category 16-25, are likely to be parents themselves (or will be in the near future). It is positive that they feel, â&#x20AC;&#x2DC;uncutâ&#x20AC;&#x2122; girls are not treated different than those who have been circumcised, because this might contribute to their decision not to have their daughter circumcised. An important indicator of the attitude towards FGM is captured by the question if men prefer to marry a circumcised woman. In figure 15, we find that nearly half of the respondents think that men would prefer to marry a circumcised woman (50%). A

Do men in your community prefer to marry circumcised women? Man

Women

60 40 20 0 YES

I don’t know

Figure 15. Do men in your community prefer to marry a circumcised woman? N=3081.

This percentage is the same for both men and women. However, 31% of the women feel that men do not prefer to marry a circumcised woman(meaning that they might marry an ‘uncut’ woman), whereas the men claim to prefer to marry an ‘uncut’ woman in 24% of the cases. This implies that there is indeed a strong social conviction to marry a circumcised woman, but that there is also a group of men that might rather marry an uncut woman. If more men would prefer an uncut woman over a circumcised woman, there would be less social pressure to circumcise. Mothers seem to be the ‘main’ proponents of circumcision in the community. 82% of the respondents claimed thus, while a paltry 13% of the respondents feel that it is the fathers who support circumcision in their community. Thus, as expected, - and in line with earlier research - mothers play an important role in upholding the practice. This also harks back to the fact that support for FGM is highest in the age category of 16-25. Also other female family members are mentioned by 20% of the respondents. 11% of the respondents feel that the society supports circumcision. This percentage is lower than was expected based on previous studies (sources). One of the main questions of this research is if respondents³ are in favor of FGM. 42% of the respondents reacts affirmative to this question and is therefore in favor of FGM. 37% of respondents is not in favor of FGM. 21% is neutral. When we look at differences between men and women, we find that women are more often opposed to FGM then men, but men are more often neutral towards FGM then women.

³ Results are shown only for respondents who answered the Somali questionnaire, because of possible invalidity in the translation for these questions, as is explained in chapter three. A

A recent UNICEF report concludes that although boys’ and men’s support for the practice varies from country to country, in most countries, the majority of boys and men think FGM should end. The same cannot, however, be said of Somali men. The large number of Somali men who are ‘neutral’ about FGM, may form a ‘silent’ support base for FGM. The role of men in the upholding of the practice should, therefore, not be underestimated. We do find it positive that already a large number of Somali women are against FGM, as they are also found to be the major supporters of the decision to circumcise.

Are you in favor of circumcision? Man

Women

0 YES

I don’t know

Figure 16. In favour of FGM per sex. N=1376

Additionally, among age categories, differences in attitude towards FGM are shown. It appears that if a person has an older age, he or she is less likely to be neutral about the issue of FGM and more likely to be against FGM. This could be explained by the fact that older respondents are less likely to answer socially desirable and that they feel entitled to an opinion about the matter. Moreover, mainly the younger people are more in favor of FGM or neutral about the issue and less often against FGM (see figure 17). These youngsters are perhaps more influenced by the prevailing norms on FGM. The finding also might indicate that youngsters do not feel comfortable to speak out against FGM. Respondents have different reasons to be in favor of FGM. These are displayed in figure 18. It appears that religious factors forms the most mentioned reason favuoring the practice of FGM,

followed closely by tradition . These are, basically, the only reasons mentioned. In chapter five, we will elaborate on why people mention religion as such an important reason for circumcision, whereas numerous studies have shown that there is no official link between the two FGM and religion.

Are you in favor of circumcision? Yes

Neutral

60 50 40 30 20 10 0

0 - 15

16 - 25

26 - 45

46 - 65

> 65

Figure 17. In favor of FGM per age category. N=1376

Why are you in favour of circumcision? 30 25 20 15 10 5 0

Religion

Tradition

Health reasons

Social pressure

Protection of girls virginity

Other

Figure 18. Why are you in favour of circumcision?. N=1376

36% respondents claimed that they’dchanged their opinion about FGM in the last year (N=2475). When we split up these among target and control group, we find that 44% of the target group had changed their opinion on FGM versus 32% in the control group. This could mean that projects and programmes against FGM are, indeed, effective Respondents were also asked why they had changed their opinion on FGM. Figure 19 shows the different reasons that inform the change of opinion among both sets of respondents.. We find that respondents in the target group mention receiving information on the consequences of FGM’ more often as the main reason why they’d changed their opinion on FGM, than did the control group. Respondents in the control group, however,often attribute their change of opinion towards FGM to their own personal experiences with the scourge. It is also interesting to note that some of the respondents in the target group have changed their opinion on FGM because community or religious authorities have changed their opinion. This implies that if community or religious leaders speak out against FGM, it might be an effective means to change the attitude of the wider community. These findings shed some light on the

Why did you change your opinion on circumcision? Control Group

Target Group

60 50 40 30 20 10

Figure 19. What made you change your opinion about FGM? N=748

Other

Community authorities changed their opinion

Imam or religious leader changed their opinion

There was a cultural shift in the attitude towards FGM in the community

I experienced the consequences for my health after I was circumcised

I received information about the consequences of FGM

effects of anti FGM programmes. Projects intended to give information on the consequences of FGM or aimed at persuading communityor religious authorities to speakup against FGM, seem to be rather effective in changing attitudes towards FGM. Based on figure 19, it could well be argued that giving information about the consequences of FGM might be an effective method to influence the opinion about FGM. Respondents were also asked what they think is the best strategy to eradicate FGM. Education and Awareness campaign on the effects of Female Genital Mutilation via radio, television or word of mouth have been mentioned as being the most effective ways to eradicate FGM. This rallies for a continuation of the actions taken by the NGOs. It is interesting to note that, in spite of what is often mentioned in research, the Somali respondents do not think that penalization of FGM would be very effective. This means that punitive legislation against FGM might not be the best way to eradicate FGM in Somalia. The fact that the prohibition of FGM ,by law, in Somalia since 2012, hasnâ&#x20AC;&#x2122;t led to a decrease in circumcision, further, lends credence to the proposition that legislation may just not be the panacea. That being said, however, the challenge with the prohibition of FGM by law in Somalia might well be attributable to the authorities not being able to enforce the law.

What do you think is the best strategy to end FGM? Education on FGM Awareness Campaign via radio, television or word of mouth

2% 7%

32%

Training female for

23%

Odious Campaign

14%

Penalization of FMG Offer Mothers a Reward

Figure 20. The best ways to eradicate FGM. N=3081.

ACTION AGAINST FGM

1375 Respondents are in the target group and beneficiaries of anti-FGM projects of HIRDA or of our partners. They participated, among others, in awareness workshops (23%) or in theatre projects (8%) or dialogue oriented projects (7%). Projects implemented by NGOs aim to change the attitude towards FGM, or to inspire people to take action against FGM, with the ultimate goal being to eliminate the practice. Therefore, the question is also posed if the respondents have ever taken action against FGM at personal level and, if so, what did they do? Half of the respondents (50%) have never taken action against FGM. Figure 21 displays the type of actions respondents had undertaken. From figure 21 can be claimed that respondents in the target group are a bit more likely to take action against FGM compared to the target group. This implies that NGOs may indeed be effective in the sense that they have mobilized individuals to speak and act out against the practice.

What type of action did you take against FGM?

3.5

Wrote a letter

Participated in a demonstration

5 Discussed FGM with religious leaders

Discussed negative effecs of FGM within community

Signed a petition

I have never taken action

Target Group

Control Group

Figure 21. What actions have respondents taken against FGM, if any. N=1818

Other

A more progressive way of taking action against FGM is to prevent someone from being circumcised. 21% of the respondents in the target group had tried to prevent a circumcision versus 12% in the control group. 45% of the respondents who tried to stop a prevention from happening actually succeeded in this. 22% managed to change the type of circumcision performed. 20% mentioned that the circumcision still took place, but was performed by someone else or in a different location. Only 8% found that their concern was not taken seriously. Overall, it could be argued that respondents are often quite succesful in trying to halt FGM.

COMPARATIVE ANALYSIS TO ESTABLISH IMPACT OF HIRDA PROJECTS

To establish the impact of anti-FGM programmes, a comparison is made between the control group (N=456) and the target group (N=1362). The target group are beneficiaries of the participating NGOs which mean that they have participated in, for example, education or awareness raising projects on FGM. The control group, on the other hand, consists of people who have not been in touch with activities or projects conducted by NGOs. These comparisons are made with support of T-tests and ANOVA in SPSS. All results mentioned below are significant at p<0.05 level.

THE EFFECT OF ANTI-FGM PROGRAMMES ON KNOWLEDGE OF HEALTH CONSEQUENCES OF FGM

The target group more often claims to have knowledge of health implicationsof FGM than the control group⁵. To the contrary, the control group often claimed that women are not exposed to health consequences after FGM, or that they are unaware of the existence of health consequences of FGM. Further analysis shows that the target group mentions that after circumcision women may experience birth complications, infections, problems during the wedding night, psychological trauma’s and other health complications, more often than is the case for the control group.

⁵ A large part of the control group could not been used because of invalidity of this data. Respondents appeared to have been part of anti-FGM campaigns and actions, which makes them unsuited for the control group.

THE EFFECT OF ANTI-FGM PROGRAMMES ON THE TYPE OF FGM PRACTICED IN THE COMMUNITY There seems to be a difference between the control group and the target group with regard to the type of FGM practiced. Sunah is much more practiced in the target group (57%), than in the control group (37%). Also, the more severe forms, namely, Excision (7% in the target group, 10% in the control group), and, Clitoridectomy are more practiced within the control group (38%) than in the target group (25%). However, we also find that Infibulation is more often practiced in the target group (5% versus 3% in the control group). From the above, it can be concluded that girls in the target communities undergo Sunah more often than the other types of FGM, but the number of girls that undergo infibulation is higher than in the control group. This finding shows that NGOs are able to push back the most invasive forms of FGM (except for the small minority that experience Infibulation).

THE EFFECT OF ANTI-FGM PROGRAMMES ON THE POSSIBILITY TO DISCUSS FGM The target group, more often than the control group, discuss the practice of FGM within their household, either with their husband or wife, teachers, family members and/or doctors and nurses. This finding indicates that it is possible for NGOs to break the taboo thereby rendering the topic of FGM more open to discussion.

THE EFFECT OF ANTI-FGM PROGRAMMES ON HOW AN ‘UNCUT’ GIRL IS TREATED BY THE COMMUNITY There are hosts of prevailing stigmas associated with uncut women. In the target group, more people find that uncut girls are stigmatized by the community, compared to the control group. Furthermore, it is found that in the control group, uncut women are more often associated with being unclean and with prostitution. The target claims that an uncut girl is not treated different than she would if she were circumcised. This finding is underlined by the question ‘Do men in your community prefer marrying a circumcised woman? In the target group, respondents argued that men prefer to marry a circumcised woman, than is the case amiong the control group. This finding might

seem to fly in the face of our expectation that because of the social stigma associated with being uncut are less prevalent among the target group, ‘uncut’ girls in this group ( target group) would have better marriage prospects. However, it is more likely that this finding could again be explained by the heightened awareness on stigma in the target group. In the educational FGM projects, specific attention has been drawn towards the (types of) stigmatization of uncut women. It is likely that respondents in the target group are now more aware of these stigmas and, therefore, also recognize the fact that uncut women have lower marriage prospects than circumcised women.

THE EFFECT OF ANTI-FGM PROGRAMMES ON THE ATTITUDE TOWARDS FGM IN THE COMMUNITY⁶ Two questions have directly addressed the respondents’ attitude towards FGM. The first is ‘Are you in favour of FGM? The second; ‘Has your opinion on FGM changed during the past years?’ It appears that in the control group, people are more in favour of circumcision, compared to the target group. The target group also changed their opinion on FGM more often in the past year. These findings imply that NGOs are successful in changing the attitude towards FGM: Anti-FGM projects and activities do, indeed, contribute to a more negative attitude towards FGM.

THE EFFECT OF ANTI-FGM PROGRAMMES ON ACTION TAKEN AGAINST FGM IN THE COMMUNITY

Several questions address whether or not respondents have tried to take action against FGM. We have asked them directly ‘Have you ever taken action against Female Genital Mutilation and, if so, what did you do?’. Next, we asked them: ‘Have you ever tried to prevent someone from being circumcised?’ ; ‘What did you do to try to prevent the circumcision?’; and: ‘What was the impact of this?. Moreover, on a more personal level, we asked ‘What did you do or would you do in case of complications or health issues as a result of circumcision on yourself or a relative?’ Below, is a discussion of the results. The target group had more often than not taken action against FGM than the control group. In comparison to the control group, a higher number of respondents in the target group have discussed the negative effects of FGM. More respondents in the target group discussed FGM with religious leaders, signed a petition against FGM, and/or wrote a letter to an authority to

⁶ Only the Somali questionnaires have been used for this comparison, as it was found that the English ‘Female Genital Mutilation’ has a more negative connotation that its Somali translation. Target group (N=670), control group (N=165).

underscore their abhorrence of Female Genital Mutilation and participated in a demonstration against the same. A higher number of respondents in the target group have also tried to prevent someone from being circumcised than did respondents in the control group. The target group has more often resorted to taking measures to stem a circumcision. That means that they have tried contacting a traditional authority, legal aid service by an NGO or Community Based Organisation, reached out to mediation service by an NGO or Community Based Organisation, tipped a trusted community or family member, sought the help of the a school teacher/principal), or informed a local cleric (Imam). The target group was also more successful in preventing the circumcision from happening. Respondents in the control group have more often been able to divert the type of FGM performed or the person that have performed the FGM. Furthermore, respondents from the control group find more often that their concern is not taken seriously. These findings are very promising: it appears that NGOs are able to motivate people to take action against FGM and even try to prevent a circumcision from happening. Another action that might be taken is to look for help if complications arise after a circumcision on oneself or a relative. The control group is morelikely not to take any action when complications arise after a circumcision. The target group more often contacts health services or customary authority in the community, an NGO, the hospital, the imam or a trusted family or community member when complications arise.

DO ANTI-FGM PROGRAMMES LEAD TO FEWER CIRCUMCISIONS?

The terminus of the FGM programmes of HIRDA and partner organisations are to end all types of FGM. Among the respondents, unfortunately, we find that it is still very unusual for people to leave their daughters â&#x20AC;&#x2DC;uncutâ&#x20AC;&#x2122;. Only 46 respondents, or 2.2%, out of the total number of 2112 that have answered the FGM questionnaire and that have (a) daughter(s), claim that they do not want their daughter to get circumcised. Herein lies no significant difference between the control and target group. However, when the respondents do want their daughter to get circumcised, the target group more often opts for the Sunah type - the milder form of FGM. Respondents in the control group will more often choose Clitoridectomy for their daughter. In the following chapter, we will elaborate more on the implications of this finding.

CON CLU SI ON

In the previous chapter, we have drawn an up to date picture of the practice of FGM. We have found that FGM is still very common in Somalia. Between 78 and 97% of Somali girls are or will be circumcised. It is difficult to determine whether or not circumcision has decreased in the past years. Unlike other studies, we find it important to leave room in our results for a margin of error. We acknowledge the large societal and cultural pressure there still is to circumcise one’s daughter. This, inevitably, has an effect on how the respondents answer the questions. We find it important to respect the respondents’ liberty by according them the volition not to answer the sensitive questions about FGM. Furthermore, we acknowledge that the interviewers cannot be marked as being completely ‘neutral’ on the topic; the fact that they are employed by the very NGOs that respondents turn to, for example, education on health consequences or FGM or other training and educational programmes, will have an effect on how they answer these questions as well. Somewhere between the 78% of women that claim to have been circumcised and of the 97% of parents that claim that their daughter has not - and will not be circumcised - is a large grey area. Many girls in this ‘grey area’ will be circumcised, because their parents are unable to resist the social pressure, and fear that they will marginalize their daughters’ status if they do not circumcise her. Being uncut in today’s Somalia can have severe consequences for the girls’ future, as we have found in the previous chapter; ‘Uncut’ girls are associated with uncleanliness and, even, with promiscuity. To have a chance to participate successfully in Somali society it, therefore, seems mandatory to be circumcised. It is a hopeful sign to see that Sunah option has become a more common type of FGM. As mentioned in the introduction, Sunah is more of a symbolic type of circumcision. Only the top of the clitoris is removed or cut, and the inflicted wound is not larger than two stitches. It is also hopeful that NGOs appear to have a positive effect on the type of FGM. Sunah is much more common among the respondents of the target group than it is among the control group. A

NGOs have a big impact on the practice

cut; self cut, others cut; self uncut, others

of circumcision in Somalia and the

uncut) girls and their families are now

attitude towards FGM. NGOs appear

trapped in the least favourable option;

to be very successful in increasing the

self cut, others cut. The most favourable

knowledge on the health consequences

option would be to have all girls uncut,

of FGM in society.They are also able to

including ‘self’, but to reach this goal,

make their beneficiaries aware of the

social pressure to circumcise should be

stigma associated with being uncut, and

relieved. The UNICEF report continues

the social pressure there is to circumcise

by claiming that this state of ‘self uncut’,

girls. NGOs are also able to move people

‘others uncut’, can only be realised if a

to step up against FGM, by for example,

‘critical mass’ action arises in society; a

discussing it more often in the household

group of families that speaks out against

and in the community. However, the

FGM and, preferably publicly, make the

question remains why NGOs seem unable

commitment not to have their daughters

to lower the number of girls that will

circumcised. It is then in the best interest

receive circumcision.

of these families to convince other families in the community to abandon

There are indications from ‘the field’,

the practice as well. If this proposition

that more and more people feel that

does succeed - UNICEF argues - there will

the

come a ‘tipping point’ in which it becomes

circumcision cannot be justified by the

more favourable not to circumcise your

cultural/religious argument or by social

daughter. As she is no longer stigmatized

pressure. That means that in reality, it is

because she doesn’t comply to the social

possible that a larger number than the 3%

norm (because this norm no longer exists),

of the parents will choose to leave their

her future will be ‘saved’.

physical

injury

inflicted

daughter uncut. They take a risk by not circumcising her, but it is exactly there

Furthermore, there appears to be a strong

that the change starts - by a couple of

link between religion and the occurrence

families deciding to abandon the practice.

of FGM. It is the most mentioned motive for people to get their daughters circumcised

According to a UNICEF study (2011), one

and remains the main reason why people

of the main reasons that it is very difficult

are still in favour of circumcision. Only

to eradicate FGM, is because it is not a

recently was it found, that so far the UN

decision that one individual family can

and WHO appeared to have missed the

make, as this decision could jeopardize

high prevalence of FGM in the Islamic

the daughters’ future. UNICEF turns to the

countries of Malaysia and Indonesia.

game theory to explain that there are four

A study of the university of Kula Lumpur…

options possible in a community for a girl

shows that even 86…% of their female

(self cut, others uncut; self uncut, others

students has been circumcised. These

findings make it impossible to deny the

effective to move people to abandon the

relationship between circumcision and

practice altogether.

the Islam. Interventions could be improved through FGM is not mentioned as a prerequisite

help of religious leaders. If the practice

for being a ‘good’ Muslim. It is not

of FGM remains in place because people

mentioned in the Quran.. So what is the

feel it is the ‘right thing to do’ based on

relationship between FGM and Islam? On

religious terms, it is necessary to involve

the International Zero Tolerance day on

religious

the 6th of February 2014, the results of

designing, planning and implementing

this study were presented at a conference

an intervention that aims to eradicate

in Utrecht, Netherlands. At the end of the

the practice. HIRDA had already asked

presentation this question was posed to

influential Imams to speak out publicly

the audience, among which there were

against FGM, and in the future, we will

many Somali men and women. The best

involve religious leaders even more in our

answer was given by the head of the

projects.

leaders

the

process

Somali umbrella organisation FSAN, Zahra Nalye. She explained that the reason why

will,

invariably,

essential

people still practice FGM can be found in

educate people about the severe health

the very name of Sunah. Sunah is Arabic

consequences of FGM for women and

for ‘path’ or ‘road’ and is often explained

the fact that it is a human rights violation.

the ‘right thing to do’ rather than being an

The stigma’s associated with being ‘uncut’

obligation.

cause a vicious, never-ending cycle that entraps young girls and their parents

The finding that many people decide to

into a situation whereby being uncut is

have their daughter circumcised, to be

actually more unfavourable than being

‘sure’ calls for a reflection upon the type

severely damaged, both physically as

of interventions offered by NGOs. Most

well as psychologically due to FGM.

interventions aim to educate and raise

However, we can no longer ignore the

awareness

obvious

(health

consequences

nexus

between

Islam

and

of) FGM. And, these interventions are

circumcision in Somalia, and we need to

indeed successful in doing just that;

take this relationship into account when

creating awareness and increasing the

intervening in FGM practices. Only through

understanding of FGM, as was found in

engaging religious leaders in our mission

this study. This in turn has probably a

to eradicate FGM, will we be more in

positive effect on the attitude towards

touch with the reality of our beneficiaries,

FGM and helps to create a shift towards

and will our projects have true impact in

the less severe type of circumcision,

making FGM a forgotten history.

Sunah. But the interventions are not yet A

ANNEX I. REFERENCES

Amnesty International. 2010. Ending Female Genital Mutilation: A Strategy for the European Union Institutions. Central Bank of Somalia. 2012. Economy and Finance. Last visited 25th of April 2012. www. somalbanca.org/economy-and-finance.html CIA. 2012. The World Factbook. Last visited 25th of April 2012. www.cia.gov/library/publications/ the-world-factbook/geos/so.html Jaldesa, Guto W., Askew, Ian., Njue, Carolyne., and Wanjiru, Monica. 2005. Female Genital Cutting among the Somali of Kenya and Management of its Complications. USAID. Landinfo. 2008. Female Genital Mutilation in Sudan and Somalia. Norway. Lewis, Ioan M. 2008. Understanding Somalia and Somaliland: culture, history, society. New York: Columbia. Ministerie van Binnenlandse Zaken en Koninkrijksrelaties. 2011. Somaliërs in Nederland: profiel 2011. Den Haag. Novib. 2003. Human Rights Status Report: The Somali Situation. Harper, Mary (2012). Getting Somalia Wrong. Faith, war and hope in a shattered state. African arguments. Hassan Sheikh and Sally Healy. 2009. Somalia’s missing million: the Somali diaspora and its role in development. Report for the United Nations Development Programme for Somalia. The Guardian (17th of august, 2012). Female genital mutilation banned under Somalia’s new constitution.

Via

http://www.theguardian.com/global-development/2012/aug/17/female-

genital-mutilation-banned-somalia UNDP. 2001. Human Development Report 2001: Somalia. Kenya: Centenary House. UNDP. 2012. Somalia Human Development Report 2012. Empowering Youth for Peace and A

Development. Via http://hdr.undp.org/sites/default/files/reports/242/somalia_report_2012.pdf UNHCR. 2001. Somalia: Report on Female Genital Mutilation (FGM) or Female Genital Cutting (FGC) http://www.refworld.org/docid/46d5787c32.html UNICEF ESARO. 1996, June. Female genital Mutilation; Brainstorming meeting. Nairobi. UNICEF. 2004. Eradication of Female Genital Mutilation in Somalia. UNICEF. 2005. Female Genital Mutilation/Cutting. UNICEF. 2010. Annual report for Somalia. UNICEF. 2011. Somali religious leaders and high-level officials join hands to put an end to all forms of FGM/C. UNICEF. 2013. Towards abandoning female genital mutilation/cutting in Somalia for once, and for all. http://www.UNICEF.org/infobycountry/somalia_68110.html United Nations Statistics Devision. 2013. 2013 World Statistics Pocketbook, Country profile: Somalia. Via http://unstats.un.org/unsd/pocketbook/PDF/2013/Somalia.pdf U.S. Department of State. 2001. Somalia: Report on Female Genital Mutilation (FGM) or Female Genital Cutting (FGC). World Bank, UNFPA. 2004. Female Genital Mutilation/Cutting in Somalia. World Health Organization. 1997. Female Genital Mutilation: a Joint WHO/UNICEF/UNFPA statement. Switzerland. World Health Organization. 2006. Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. The Lancet 367:1835â&#x20AC;&#x201C;1841. World Health Organization. 2008a. Female Genital Mutilation: The Sixty-first World Health Assembly. Report written on the eight plenary meeting of the World Health Assembly 24th May 2008. World Health Organization. 2008b. Eliminating female genital mutilation: an interagency statement UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCHR, UNICEF, UNIFEM, WHO. Switzerland. World Health Organization. 2009, 10 December. Humanitarian Health Action in Somalia: A Call for Urgent Support. World Health Organization. 2012a. Female Genital Mutilation: Factsheet no. 241. Last modified February 2012. www.who.int/mediacentre/factsheets/fs241/en/ World Health Organization. 2012b. Female Genital Mutilation and other Harmful Practices: Prevalence of FGM. Last visited 25th of April 2012. www.who.int/reproductivehealth/topics/fgm/ prevalence/en/index.html http://www.fsnau.org/in-focus/acute-malnutrition-persists-somalia-while-870000-peopleremain-food-insecure A

II. SURVEY ON FEMALE GENITAL MUTILATION

Interview on the Female Genital Mutilation (FGM) 1. Is Female Genital Mutilation a cultural custom in your area? Yes No I don’t know 2. Is Female Genital Mutilation a religious obligation in your area? Yes No I don’t know 3. Do you know about the health consequences of Female Genital Mutilation? Yes No I don’t know 4. What kinds of complications are girls/women exposed to when circumcised? (multiple answers possible) None I don’t know Increased chance on birth complications Increased chance on urologic complications Increased chance on infection Complications during the wedding night They can get psychologically traumatized Other 5. Who performs Female Genital Mutilation in your community? (multiple answers possible) Female circumcisers Doctor/nurse Family member Other I don’t know 6. Have you noticed a decrease or an increase in the number of circumcisers in your community in the past years? An increase A decrease The number stayed the same A

I don’t know

7. Where does Female Genital Mutilation in your community take place? Hospital Home Outside Other I don’t know 8. What instruments are used during the circumcision in your community? Knife Razor blade Other I don’t know 9. What type of Female Genital Mutilation is most practiced in your community? (Sunah) Clitoridectomy: partial or total removal of the clitoris Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitor Other I don’t know Not applicable 10. By whom were you informed about the health consequences of Female Genital Mutilation? (multiple answers possible) Religious leader(s) Non-governmental Organisation (NGO) /Community Based Organisation (CBO) Non-governmental Organisations working in this area Hospital Local authority Radio/Television Newspapers/magazines School (e.g. teachers) Family Parents Children Peers Female circumciser Friend Other Not applicable/ I did not receive any information on the effects of Female Genital Mutilation

11. In the last 12 months, have you discussed the practice of Female Genital Mutilation with anyone? (multiple answers possible) Yes, I talk about Female Genital Mutilation in my household Yes, I talk about Female Genital Mutilation with my husband/wife Yes, I talk about Female Genital Mutilation with friends Yes, I talk about Female Genital Mutilation with teachers Yes, I talk about Female Genital Mutilation with (one of) my family member(s) Yes, I talk about Female Genital Mutilation with the local authority Yes, I talk about Female Genital Mutilation with the docter/nurse Yes, I talk about Female Genital Mutilation with employers of an NGO Yes, other No, I donâ&#x20AC;&#x2122;t talk about female circumcision 12. How is a girl/woman treated by the community if she is not circumcised? Marriage prospects are not good Seen as unclean person Associated within the community She is not treated differently tha if she would be circumcised Other 13. Who supports circumcision in your community? (multiple answers are possible) Mother Father Other female family member Other male family member Peers Society in general Religious leader/imam Local leaders (village chief, religious authority, clan leader) Other 14. Are you in favor of Female Genital Mutilation? Yes No I am neutral about this issue 15. If yes, why? Religion Tradition/it has always been like this Health reasons Social pressure Protection of the virginity of girl Other A

16. Has your opinion about Female Genital Mutilation changed during the past years? Yes No 17. What made you change your opinion? I received information about the consequences of Female Genital Mutilation I experienced the consequences for my health after I was circumcised There was a cultural shift in the attitude towards Female Genital Mutilation in the community Community authorities (elders, clan leader) changed their opinion about Female Genital Mutilation Imam or religious leader changed their opinion about Female Genital Mutilation Other 18. What do you think would be the best strategy to eradicate Female Genital Mutilation? Education on (the effects) of Female Genital Mutilation Penalization of Female Genital Mutilation Train female circumsizers to be skilled for another job Awareness campaign on the effects of Female Genital Mutilation via radio, television or word of mouth Odious campaign Offer mothers a reward if they prevent the circumcision of their daughters Other 19. Do men in your community prefer marrying a circumcised woman? Yes No I donâ&#x20AC;&#x2122;t know 20. Type of project activity related to Female Genital Mutilation you or a member of your household participated in during the last year: None Traditional Birth Attendants training Awareness workshop on Female Genital Mutilation Theatre on Female Genital Mutilation Dialogue in the community about Female Genital Mutilation Other 21. Have you ever taken action against Female Genital Mutilation and if so, what did you do? I have never taken action against Female Genital Mutilation Discussed negative effects of Female Genital Mutilation within the community Discussed Female Genital Mutilation with religious leaders Signed a petition against Female Genital Mutilation Wrote a letter to an authority to explain that I am against Female Genital Mutilation Participated in a demonstration against Female Genital Mutilation Other A

22. Have you ever tried to prevent someone from being circumcisedÂ ? Yes No 23. If yes, what did you do? (multiple answers possible) Contacting traditional and customary authority (village chief, clan leader) Contacting legal aid service by NGO or Community Based Organization Contacting mediation service by NGO or Community Based Organization Contacting trusted community or family member Contacting the school (e.g. teacher, principal) Contacting Imam or religious leader Other 24. What was the effect of this? The circumcision did not take place The circumcision still took place but in a different type of circumcision The circumcision still took place but in a different location or was performed by a different person My concern was not taken serious Other 25. Around what age are girls in your community circumcised? 0-5 years old 5-10 years old 10-15 years old 15 years or older 26. Is there a ceremony in the community to celebrate the circumcision? Yes No 27. What type of circumcision did your daughters have or will have in the future? Not applicable: I do not have daughters (Sunah) Clitoridectomy: partial or total removal of the clitoris Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. Other I donâ&#x20AC;&#x2122;t know Not applicable: my daughters were not circumcised and will not be

28. If applicable, what is the reason you (will) have them circumcised? (multiple answers possible) Religion Tradition/ it has always been like this Health reasons Social pressure Protection of the virginity of girl Other 29. In your household, who decides whether the girl will be circumcised? Father only Mother only Both father and mother: there is a consensus Other member(s) of the family (grandmother, grandfather, or other family members Not applicable 30. Who supports circumcision in your community? (multiple answers are possible) Yes, I am circumcised No, I am not circumcised --> 32 I can’t say --> 32 Not applicable (only if respondent is male) --> 32 31. What type of circumcision did you have? (Sunah) Clitoridectomy: partial or total removal of the clitoris Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris. Other I don’t know Not applicable I can’t say Not applicable (only if respondent is male)

32.

What type of complications did you experience after your circumcision? (Multiple

answers possible) None I don’t know Urologic complications Infection Complications during wedding night A

Complications when giving birth I was psychologically traumatized Other 32. What type of complications did you experience after your circumcision? (Multiple answers possible) Contact customary health care service in my town or village (nurse, traditional doctor, medicine man) Contact customary authority (village elder, clan leader) Contact aid service from an NGO of Community Based Organisation Contact hospital, medical centre, medical Clinique Contact Imam or religious leader Contact trusted community or family member Contact the school (e.g. teacher, principal) Contacting the female circumciser Nothing

Himilo Relief and Development Association (HIRDA) Wibautstraat 150, 1091GR Amsterdam, The Netherlands E-mail: info@hirda.org Tel: 020 71 63 831 www.hirda.org