International agencies call for end to female genital mutilationBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d832 (Published 07 February 2011) Cite this as: BMJ 2011;342:d832
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I read the article of Weiyuan Cui published BMJ feb 2011 with great
interest regarding the issue of female genital mutilation but at the same
time i would like to mention here that the caption of the picture states
'...in celebration of birth of Prophet'' is absolutely in-appropriate.
There is no relation to the practice of female genital mutilation in
African and Arab countries with Islam or Prophet Mohammed (PBOH).
This shows that although the author has highlighted a very important issue
but at the same time it shows lack of insight in the historical background
of female genital mutilation.
If this practice is carried out in Arab countries it doesnt reflect the
whole Islamic world.This practice is not carried out in Muslim countries
like Pakistan, India ,Bangladesh ,Saudia Arabia etc.
So as healthcare providers we all need to address the issue of female
genital mutilation especially those working in Obstetrics and Gynaecology
but above all bias.
Competing interests: No competing interests
"YES WE BAN"
We read with concern Weiyan Cui article BMJ 2011; 342:382 on 12
Firstly the emotional picture of mass circumcision of young Indonesian
girls and the under title is an adverse publicity as it links this cruelty
to Islam and secondly ; the fact that families are paid to have this
done raises many queries regards the purpose it serves and who benefits
from mutilating these children. These are alarming issues and we would be
grateful if we are provided with information so we can contact the
organisers of this mass cruelty as the likelihood is it will be repeated
unless serious measures are considered to ban it.
The birth of the Prophet coincides with 15 Th February this year and a
strong urgent message has to be sent to condemn this from being repeated
and associated with this day.
As an international society we must come together urgently and stop
cruelty to women and children. Only through a collaborative approach can
we have a genuine chance to achieve the planned millennium goals in these
We need to increase awareness of this harmful practise and as a tribute to
the international day of zero tolerance to female genital mutilation
(Sunday 6th February) a review of history of this practice is highlighted.
The most severe type of genital mutilation is Pharaoh type, the origin of
the practice is when the pharaoh of Egypt was told Moses will be born and
become King, the Pharaoh sent traditional birth attendants (TBA) to stitch
girls and women so that no woman can deliver without help. The TBA would
de- stitch the woman to deliver the baby and report a male birth as boys
were killed. This is why it is mainly in Nilotic countries and sadly
spread to neighbouring countries.
Despite the well-known nomenclature still this origin is concealed and
futile attempts to our day insist of relating it to Islam.
The WHO has classified these into 4 subtypes.
130 million women worldwide have had one or another form of this and each
year 2 million girls/women are subjected to it. (1)
There is paucity of published papers on female circumcision and it is
remarkable how this practice continued. Worse still is misleading simple
people living in poverty into believing it has a religious background and
paying them to perform it in front of reporters or as in this case; in
festive Islamic occasions.
Islam prohibits cruelty and female mutilation is against its teaching.
Saudi Arabia does not suffer from this as Islamic scholars have made it
clear cut there is no evidence from Quran or Prophet Mohammed (PBUH)
teaching to perform this.
The practise is not found in Saudi women and this should be convincing for
any country claiming religious ground.
Islam is the only religion with explicit guidance on marital
relationship and how a husband should approach his wife. This is compiled
in a famous Islamic book Treasures of the bride. (2)
The last words of the prophet on his death bed were treat women well.
Celebrating the prophet birthday is considered an innovation that is
prohibited in many Islamic countries. More so, it is revolting to
celebrate the birthday of the prophet by violating his teaching. No
sincere Muslim finds this plausible. For countries which celebrate the
prophet's birthday it is a festival of joy where children have edible
decorated sweet toys mainly dolls with large colourful fans radiating from
their backs and horses with knights. Children also play on swings and play
games for several nights. Adults wear colourful clothes and drums are
played and crowds dance in jerking moves singing praise to the prophet.
Pious Muslims recite Quran, cease the opportunity to recall the prophet's
teaching and some fast and donate to charities and poor.
It is the first time that such a happy occasion is linked to such
unfounded cruelty to children and as Muslims we are obliged not to allow
this to establish and to retain the happiness of children.
If in Indonesia this cruelty happens then it has to be addressed and
targeted education involving religious leaders is urgently needed. It is
also worthwhile to explore the legal status of this harmful practice in
order to ban it.
The RCOG has a green top guideline on female genital mutilation (1) and
limbs and things has a model for doctors to practice how they can deliver
migrant mutilated women when they are in labour.
The BMA also has guidance on Female Genital mutilation. Caring for
patients and child protection (3)
In UK; The female genital mutilation act 2003 states that those guilty of
offence can be jailed for up to 14 years.
Dr Asmaa Aldareer published a book Woman Why Do you weep and it is
illustrative of the different types of mutilation, differences in culture
and taboos of different tribes in the vast Sudan.(4)
Education and reaching out for people in deprived areas where this
practice is rife is effective in reducing it. From personal experience and
rural visits to areas where girls are circumcision, women needed re-
assurance that they are doing the right thing and actually were relieved
to learn it had no Islamic background and serves no purpose .They just
need professional support to abandon this as it is a haunting experience
for both mothers and children.
In an era of transparency and ease of sharing information worldwide we
should all endeavour to devolve religion from evil and cruelty of mankind.
Terrorism, torture and cruelty cannot be linked to any religion and
ignorance deviates attention from the problem and innocent victims
continue to pay a high price.
The BMA can have a pivotal role in organising a petition in order to ban
this cruel harmful practise and make it illegal in all countries
practising it. The law can be universal, impeccable and should avoid loop
holes easily used by offenders to escape punishment.
This is manmade harm which can be eradicated if targeted with an analytic
international approach aiming at resolving and going beyond just
acknowledging that it is still happening.
We are happy to take the initiative and liaise with legal experts to
formulate a universal law as well as reviewing the legal status for this
act in Sudan.
Volunteers can be sought to explore the legal status in Indonesia,
Egypt, Somalia, Yemen, Ethiopia and any country where it is practised
aiming at banning it in all its forms.
"Yes We Ban" globally and instantly female genital mutilation in all its
Dr Amira Salih MBBS MRCOG
ST6 Obstetrics & Gynaecology
Corresponding Author : amirasalih @ hot mail.co.uk
Mrs Amel Salih
Public Health Specialist, Sudan
1. Female Genital Mutilation; RCOG Green top guideline (53), May 2009
2. BMA; Female Genital Mutilation, caring for patients and child
protection London BMA 2006
3. Treasure of a bride, M.M. Elestamboli sixth edition 1985
4. Women why do you weep? Dr Asmaa Eldareer
Competing interests: No competing interests