Mary Katherine Keown
Sporadic research data over the past 10 years has correlated dirty cutting equipment, hemorrhages requiring blood transfusions and injurious sexual intercourse causing vaginal tearing and lesions with rising rates of HIV transmission among women in countries where female genital mutilation, often referred to as FGM, is widely practiced.
"Because FGM is coupled with the loss of blood and use is often made of one instrument for a number of operations, the risk of HIV-AIDS transmission is increased by the practice," the New York-based United Nations Population Fund says on its website. "Also, due to damage to the female sexual organs, sexual intercourse can result in lacerations of tissues, which greatly increases risk of transmission. The same is true for childbirth and subsequent loss of blood."
Other organizations, such as the London-based International Community of Women Living With HIV-AIDS and the Washington-based Global Health Council, make similar assertions on the immediate risks of HIV transmission. Activists against female genital mutilation in the region express confidence in the link.
A representative from the National Union of Djiboutian Women – who asked to remain anonymous because of the dangers of opposing female genital mutilation – said she believes the practice is the single largest contributing factor to HIV infection in that country, with risks that are immediate as well as long-term.
Meanwhile, a cross-section of data drawn from a 2006 United Nations report on the global AIDS epidemic indicates that in countries where female genital mutilation is common, including Somalia, Sudan, Tanzania and Djibouti, between 55 and 60 per cent of people infected with HIV are female.
Though outlawed in most countries, female genital mutilation continues to be practiced in 28 African nations, as well as parts of the Middle East and Asia, the World Health Organization says. Worldwide, more than 100 million girls have suffered female genital mutilation, with 3 million undergoing it each year.
Of the three major types of female genital mutilation, the most extreme is Type III, also called infibulation or Pharaonic circumcision, in which the clitoris and labia are removed and the vaginal opening is stitched shut, leaving only a small space for the passage of urine and menstrual blood.
Type III is rare in most countries, according to the Human Rights Watch report, but common in Somalia, Djibouti and Sudan, where more than 80 per cent of female genital mutilation cases involved infibulation. Djibouti (population 793,000) has an HIV prevalence rate of about 3 per cent. Sixty per cent of adults living with HIV-AIDS are female and around 98 per cent of Djibouti's women have suffered some form of female genital mutilation.
The National Union of Djiboutian Women lobbied to have female genital mutilation abolished and in 1994 infibulation was criminalized. Even so, it continues, primarily in outlying and rural regions.
"Even well-educated citizens practice FGM," says the representative from the National Union. "It's a traditional practice and a traditional belief.
"It's deeper than the law."
Source: Toronto Star, Sept 01, 2007