Below are extracts of an article on the NPR (National Public Radio, US) website. Substitution of female genital mutilation with non-harmful rituals looks to be increasingly successful. It is notable that traditional cutters are also willingly involved. It’s clearly also important that national health policies are supportive of such efforts.

http://www.npr.org/sections/goatsandsoda/2016/02/23/467687101/can-a-bath-of-milk-and-honey-replace-female-genital-mutilation

‘The new traditions are taking hold in Maasai and Samburu communities in Kenya and Tanzania. After two or three days of preparatory sessions for the girls, the celebration culminates with communal singing and dancing and blessings by the village elders, who pour a mixture of milk and honey and water over the heads of the girls…

‘And at the center of the celebration are the girls themselves. During the two to three days preceding the celebration, participating girls in the alternative rites of passage are secluded, in a school dormitory or village hut, where they learn about womanhood: lessons which now include sex education, information about STDs and violence against women, and presentations emphasizing the importance of continuing education for girls’ and women’s rights. The traditional cutters who had in the past performed the cut also are usually present, discussing their role in the past — and explaining the health reasons for abandoning the practice. “They will say, ‘We did this because we believed in it, but now we want to encourage girls to go back to school,’ ” says Leng’ete.

‘… It can take six months or more of meetings before a community agrees to abandon FGM and accept alternative rites.’

Wikipedia indicates 5 countries with an especially high prevalence: Egypt, Guinea, Mali, Somalia, Sudan. FGM is prohibited by law in Egypt, Guinea and Sudan, but clearly there is a failure of implementation, while Somalia and Mali appear not to have yet banned the practice.

https://upload.wikimedia.org/wikipedia/commons/e/eb/2013_Female_Genital_Mutilation_Cutting_Circumcision_FGM_World_Map_UNICEF.SVG

According to the UNFPA website, it seems FGM is prohibited in fewer than half (23/48) of sub-Saharan African countries.

http://www.unfpa.org/resources/female-genital-mutilation-fgm-frequently-asked-questions#banned_by_law

UNFPA describes FGM as ‘a cultural rather than a religious practice. In fact, many religious leaders have denounced it.’ http://www.unfpa.org/resources/female-genital-mutilation-fgm-frequently-asked-questions#religions

It would be interesting to learn more about health policymaking in different countries on this issue. Who are the main stakeholders that seek to maintain the status quo, and how do they have such influence?

Best wishes, Neil

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