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‘MY MOTHER STILL THINKS FGM WAS GOOD FOR ME’

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The summer holiday is known as ‘cutting season’ – when thousands of migrant families travel with their young daughters to their native countries to undergo female genital mutilation. ELLE speaks to one Somalian survivor about her experience, changing cultural attitudes and fighting back.

After Sophia* was cut, her legs were fastened together and she was told not to move.

In her rural Somalian community, however, animals are free to roam and out of nowhere an ox charged. Despite the searing pain, she ran.

The then-9-year-old fell to the ground and started to bleed. Her stitches had reopened. Sophia’s mother, Lesha*, came rushing over, saw her daughter on the floor, and dragged the little girl back to their house – an area designated for female circumcision. Clearly something had gone wrong the first time round. She asked the cutter who had performed the original procedure to do it again.

The result?

Sophia wasn’t just mutilated once, but twice, before her tenth birthday.

‘I was terrified,’ she tells ELLE, ‘but I was too young to do anything about it.’

In Somalia, 98% of women and girls between 15 and 49 have had their genitals forcibly mutilated. Female genital mutilation (FGM) is a procedure that intentionally injures or alters young girl’s genital organs for non-medical reasons. The procedure also comes with a whole host of risks, including childbirth complications, urinary tract infections and even death.

Some, like Sophia, were cut in their birth place. Yet the NHS recorded more than 5,000 new cases of FGM in England this year, and while a third were born in Somalia like Sophia, some 112 individuals were UK-born nationals.

The statistics highlight what FGM campaigners are sadly already very familiar with: ‘cutting season.’

During the months of July, August and September, thousands of girls – especially from Europe and America – are sent overseas for what’s sold to them as a ‘rite of passage.’

Migrant families, often traveling with their young daughters during summer vacations to their native countries – most commonly in Guinea, Nigeria and Somalia – have the procedure performed at grave risk. The break from school means they have time to undergo, and recover, from FGM.

‘This is the peak season,’ Asha Ali Ibrahim, 41, told the United Nations Population Fund (UNFPA), in a recent interview. She has been performing female genital mutilation on girls in Diaami, Hargeisa and other parts of Somalia since 1997.

Yet survivors are often shamed into silence. Girls and women are told to never mention what happened, and that doing so will humiliate the family. They’re also taught to never look at or touch their genitals. In many cases, women who were cut very young don’t even know they’ve been mutilated.

In Sophia’s case, her mother filled her in a year later. Now 20, she can’t recall the event vividly, but details begin to bubble to the surface as we talk.

‘My mother invited a woman to our house, the person who was doing the mutilation, along with the village neighbours,’ she explains. ‘They used a rope to tie me down so I couldn’t move. I couldn’t see much because there were a lot of women in the room – maybe eight or nine – but they had a blade which they used to cut me. The whole thing took about an hour.’

She says they ‘sliced off pieces off her flesh’ and that she could then see them lying on the ground.

Sophia was subjected to what is defined by the World Health Organization (WHO) as ‘type three’ mutilation. Essentially, her labia were cut off and she was stitched together, leaving a tiny matchstick-sized hole.

Now a student, she lives in Hargeisa – a town 90km west from the rural Idhanka village in which she grew up – with her Aunt. She moved there for two reasons: better education and, due to the after effects of FGM, much-needed access to health care services.

‘Every time I go to the toilet and every month, during my period, I feel pain,’ she explains. ‘There’s a lot of pressure and discomfort. It’s not only in my vagina area but in my back and waist area, too. I get sick a lot, and usually stay at home because I can’t move around easily.’

On top of the physical pain, Sophia’s relationship with Lesha, her mother, has also suffered. They talk on the phone, and she visits Sophia once every three months, but it’s complicated.

‘When I talk about the problems I have been through [as a result of the procedure] she tells me it was good for me. She was cut, and made the decision I should also be cut, but still to this day believes she made the right decision. My mother thinks FGM is a good and necessary thing.’

How does that make her feel?

‘Very sad,’ she says. ‘I don’t think my mother cares about me that much. Whenever I have an issue, I consult with my Aunt. When I fell down, after the ox ran at me, my Mother wasn’t concerned about me or the bleeding – she just cared about the stitches. I was crying and she still didn’t seem particularly concerned. I’m not sure I’ll ever be able to forgive her.’

Herein lies the problem: FGM is so difficult to challenge because its grip on the culture is steadfast. Parents won’t risk complaining because it can result in being ostracised, and FGM is often practiced even when it’s known to inflict harm upon girls, because families think it will increase their respect within the community.

Sophia’s village in Somalia, and others like it, also support female genital mutilation because it keeps girls from experiencing sexual pleasure. There is a perception that intact girls are dirty and by controlling their libido, you can control them, too. In some cases, it’s a prerequisite for marriage. The goal is to prevent them from having pre-marital sex so they’ll remain ‘pure’ for their wedding day.

‘The future husband wants to open your stitches,’ explains Adam Farah, the UNFPA Acting Head of Office in Hargeisa, almost matter-of-factly.

Things are, however, slowly changing. More and more FGM survivors are courageously speaking out, and male relatives who hadn’t even been aware of the practice are also taking a stand. A recent Change.org campaign launched by over a dozen Dawoodi Bohra survivors in India has over 50,000 signatures while Safe Hands for Girls – ‘a youth-powered movement in Gambia’ – is going from strength to strength. The UNFPA has also partnered with local government, health workers, organisations, as well as youth activists to encourage communities and policymakers to abandon the practice.

For the UK, it has been illegal to carry out FGM on British shores since 1985 (not actually that long ago), but so far there has not been a single successful prosecution.

And a case of FGM is either discovered or treated at a medical appointment in England every hour, according to analysis of NHS statistics by a charity. Between April 2016 to March 2017, there were 6,080 newly recorded cases, 1,229 of which the proceedures occurred in Africa and 57 occurred in the UK (though few women actually report the country in which they had the procedure, so those figures are likely higher).

But FGM will only end if it is tackled globally, from the villages of Sierra Leone to the classrooms of Britain. That’s why Sophia would also like to educate women and girls about the dangers from her small Somalian town.

Or rather, educate the parents: ‘The girls have no power in this situation. I would like to tell the people who are meant to be looking after their children to stop.’

At 20, she’s not-yet married, but is nervous about her future husband because she will need to be re-cut in order to have children. ‘I don’t really want to think about it,’ she says.

For now, she’s focused on school. Ask her what her favourite subject is, however, and it’s a surprisingly bittersweet reminder of her past experience: ‘I love biology,’ she says. In fact, Sophia hopes to become a doctor one day to ‘completely eradicate’ FGM – despite the ‘huge’ medical costs.

But it’s her attitude towards the next generation of girls that is perhaps by far the biggest indicator of change.

‘If I do have children, there is no way I will take them to an FGM clinic,’ she says. ‘I don’t want my daughters to experience the pain I have endured. I want them to be free.’

*Names have been changed.

Read more about the UNFPA/UNICEF’s joint programme to combat FGM in 17 countries here.

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Health

Vaccination in Somalia: “It’s my job”

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In Somalia, determined women are the face of polio eradication.

Somalia, polio-free since 2002, is currently at risk of circulating vaccine-derived poliovirus type 2, after three viruses were confirmed in the sewage in Banadir province in early January 2018. Although no children have been paralyzed, WHO and other partners are supporting the local authorities to conduct investigations and risk assessments and to continue outbreak response and disease surveillance.

Underpinning these determined efforts to ensure that every child is vaccinated are local vaccinators and community leaders – nearly all of whom are women.

Bella Yusuf and Mama Ayesha are different personalities, in different stages of their lives, united by one goal – to keep every child in Somalia free from polio. Bella is 29, a mother of four, and a polio vaccinator for the last nine years, fitting her work around childcare and the usual hustle and bustle of family life. Mama Ayesha, whose real name is Asha Abdi Din, is a District Polio Officer. She is named Mama Ayesha for her maternal instincts, which have helped her to persevere and succeed in her pioneering work to improve maternal and child health, campaign for social and cultural change, and provide care for all.

Protecting all young children

Working as part of the December vaccination campaign, which aimed to protect over 700 000 children under five years of age, Bella explains her motivation to be a vaccinator. Taking a well-deserved break whilst supervisors from the Ministry of Health and the World Health Organization check the records of the children so far vaccinated, she looks around at the families waiting in line for drops of polio vaccine.

“I enjoy serving my people. And as a mother, it is my duty to help all children”, she says.

For Mama Ayesha too, the desire to protect Somalia’s young people is a driving force in her work. A real leader, she began her career helping to vaccinate children against smallpox, the last case of which was found in Somalia. Since then, she has personally taken up the fight against female genital mutilation, working to protect every girl-child.

She joined the polio programme in 1998, working to establish Somalia as wild poliovirus free, and ever since to oversee campaigns, and protect against virus re-introduction. In her words, “My office doesn’t close.”

Working in the midst of conflict

The work that Bella and Mama Ayesha carry out is especially critical because Somalia is at a high risk of polio infection. The country suffers from weak health infrastructure, as well as regular population displacement and conflict.

For Bella, that makes keeping children safe through vaccination even more meaningful.

“Through my job I can impact the well-being of my children,” she says. “For every child I vaccinate, I protect a lot more”.

Mama Ayesha echoes those words when she contemplates the difficulties of working in conflict. For most of her life, the historic district where she works, Hamar Weyne, has been affected by recurrent cycles of violence and shelling. With her grown children living abroad, she could easily move to a more peaceful life. But she chooses to stay.

“This is my home, and this is where I am needed. I am here for my team, and all the children.”

Ongoing determination

Looking up at a picture of her husband, who died many years ago, Mama Ayesha considers the determination and courage that drives her, Bella, and thousands of their fellow health workers to protect every since one of Somalia’s children. Behind her thick wooden desk, she is no less committed than when she began her career. “If I had to do it again it would be my pleasure.”

Bella has a similar professional attitude, combined with the care and technical skill that make her a talented vaccinator. Returning to her stand below a shady tree, she greets the mothers lined up with their children. As she carefully stains the finger of the first small child purple, showing that they have been vaccinated, she grins.

“I am the mother of all Somali children. I am just doing my job”.

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Health

‘You have dark skin and you are beautiful’: the long fight against skin bleaching

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Amira Adawe has just arrived at a Somali-American community radio station in Minneapolis where she hosts a weekly call-in show called Beauty-Wellness Talk. After peeling off her winter jacket, Adawe slides a pair of headphones over her crown of dark, short curls. “Hello? As-Salaam-Alaikum,” she says into the foam mouth of her studio microphone. An anonymous stream of listeners starts calling in to confide about a subject that is deeply personal and also taboo — skin bleaching.

Adawe is a Minnesota-based public health researcher and educator who works as a manager in Gov. Mark Dayton’s Children’s Cabinet. In 2011, while a graduate student and health educator with St. Paul-Ramsey County Public Health, Adawe proposed a study to investigate how Somali women use skin bleaching creams in their daily lives. Growing up in Mogadishu and Minneapolis, Adawe knew that skin lightening was widespread in her community.

“A lot of it ties to colonization,” Adawe says. “Certain skin colors were more accepted in the society. But through the years, it became so embedded in the culture to where it’s become normal. If you’re light-skinned, you’re more accepted,” she says.

She had trouble finding women who were willing to be interviewed. Adawe says there’s a stigma around admitting to skin bleaching. “Women don’t want other women talking about them. They want to pretend that this is their natural color,” she says.

Adawe suspected that the fast-acting creams contained toxic chemicals, and she was right to be suspicious. Out of 27 different creams tested by Minnesota researchers as part of Adawe’s study, 11 contained mercury levels ranging from 4.08 up to 33,000 parts per million (ppm). (The U.S. Food and Drug Administration only allows mercury in amounts of less than one part per million in most cosmetics.)

The FDA classifies skin whitening creams as both a cosmetic and a drug. According to FDA spokesperson Peter Cassell, the “use of mercury in skin-bleaching preparations and other cosmetics, with few exceptions has been prohibited in the U.S.” since 1973.

“The FDA has been aware of mercury as a potential allergen, skin irritant and neurotoxin for decades,” Cassell says.

The seven Somali women Adawe interviewed for her study reported mixing several different creams into one concoction and storing it in the refrigerator. Some slathered the cream mixture over their bodies multiple times a day, even while pregnant or breastfeeding. These findings alarmed Adawe. The possibility that children or developing babies could potentially ingest mercury through breast milk or contaminated food or water was especially concerning.

Skin bleaching products can also contain steroids, which thin the skin, as well as hydroquinone, a suspected carcinogen that is banned in some countries.

“That is a really huge public health issue. That mercury vapor alone can expose everybody in the home, even people who visit. That was really shocking to me,” Adawe says.

Despite FDA regulations, toxic skin lightening creams are accessible in the United States. The products get smuggled past borders through personal luggage and can be found in ethnic markets and also online.

A global market

Globally, skin bleaching is a multibillion-dollar business. According to a 2017 market research study by Global Industry Analysts, the market for skin lightening products is anticipated to exceed $31 billion by 2024, with the Asia-Pacific region representing the fastest-growing market.

Adawe was surprised to learn that skin bleaching is such a global phenomenon. “I was so focused in the Somali community and other African communities that I didn’t know this was happening in other places,” she says.

Seventy-seven percent of women in Nigeria use skin lighteners, more than anywhere else in the world, the World Health Organization reported in 2011. In 2004, nearly 40 percent of women surveyed in China, Malaysia, the Philippines and South Korea reported using use skin lighteners, and in India, 61 percent of the dermatological market is comprised of skin lightening products, according to the same WHO report.

As Adawe continued to sound an alarm about skin bleaching, she realized that warning people about the health risks of toxic chemicals wasn’t necessarily enough to change behaviors. So long as the belief that lighter skin is inherently preferable persisted, women would likely keep bleaching, she thought. So she decided to tackle the issue from another direction.

Radio outreach

Adawe launched her radio show, Beauty-Wellness Talk, in November 2017. It’s a platform where the Somali community can talk openly about skin lightening without fear of being outed or stigmatized. From the beginning, Adawe made it clear that listeners could call in anonymously.

On a recent wintry Saturday afternoon, Adawe’s in-studio radio guest is Hibat Sharif, an educator and outreach worker with St. Paul-Ramsey County Public Health. They’re discussing how parents can build healthy self-esteem in their children, especially girls.

“We’re African, we’re Somali, we have dark skin,” says Sharif in a mix of Somali and English. “Our skin is melanated. It provides us with a lot of benefits. Why are we telling our girls: You’d look so much better if you were lighter? It’s important not to put those toxic stereotypes in your child’s head.”

Sharif cautions listeners about words that reinforce harmful stereotypes, such as cadey, a Somali expression of endearment.

Questioning word choices

“That word is really heavy,” explains Salma Ali, 19, a Somali-American college student who grew up in the Twin Cities area. Her friend, Yusra Abdi, also 19, agrees.

“It means whitey. Like white girl,” Abdi says. “You will never hear anybody say madoowey, which is ‘darky.’ If anything, that would be an insult in the Somali language.”

Colorism is personal for both Abdi and Ali, who describe themselves as dark-skinned. “Growing up, if somebody in my family was mad at me, they’d call me koor madow, which means, ‘Hey darker-skinned,’ ” explains Ali. “And it was an insult,” she adds.

Family members pressured Ali and Abdi to use lightening creams. When Abdi was in middle school, her mother gave her a lightening gel to help with acne scars. After about a month, she noticed her complexion had lightened and her acne marks had worsened. She decided to stop.

“When women use these products, it comes from a very deeply ingrained place of insecurity,” Ali says. “It’s because of what society pushes on us to believe. Across all cultures, darker-skinned people have self-esteem issues.”

Both Ali and Abdi say that they’ve seen Somali women obfuscate their use of skin lightening products by describing the practice as cleaning their skin or helping it to glow.

“I’ve had my aunts come up to me telling me, ‘Salma you’re not ugly, it’s just that your skin is just a little dirty. You need to clean it up. I got some products from China. I’mma hook you up.’ I’m like, ‘How is my skin dirty? I’m taking care of myself.’ But because of the fact that I have darker skin, I’m seen as ugly. And that’s just part of the way we’ve all been socialized.”

Changing attitudes

Adawe wants to disrupt that socialization, but changing ingrained behaviors and perceptions takes time. She sees medical providers as key partners in actualizing systemic change. Over the past six and a half years, Adawe says she and her colleagues have trained more than 100 clinic systems, with a focus on pediatric care.

She advises doctors and nurses not to ask patients about skin bleaching directly, but instead to probe slowly and with sensitivity about the different lotions women use. Nurses who conduct home visits with pregnant women can play an especially important role since they build a relationship with mothers over time and can see if skin lightening products are being kept in the home.

On a Thursday afternoon in mid-February, Sharif, the outreach worker, stands in front of a class of Somali, Hmong, Nepalese and Karen adult students and their translators. The students are all new arrivals to the United States. The class hums with a staccato melody of different languages.

“The No. 1 thing you can do is to stop using these products,” Sharif tells the students in English and Somali. “The biggest takeaway from this presentation is that every shade is beautiful,” she says.

A Somali man in the class says it’s been ingrained in him to gravitate toward lighter-skinned women.

Sharif laughs and says, “The change needs to start with you. It really does.”

She asks him if he has dark-skinned daughters, and the man says he does.

“What does that say to your daughter?” Sharif says when reflecting on the exchange after class. “Do you want a guy to treat your daughter that way where he tells her she’s not beautiful because she’s dark?”

“You have dark skin and you are beautiful”

Salma Ali says she had low self-esteem when she was younger. It’s something she thinks a lot of darker-skinned young women experience. Things shifted in high school when she started reading books by black women writers and found inspiration in seeing black women actors play strong leading roles on television.

Social media helped Ali and Abdi to find affirming messages about black beauty as well. Both of them are fans of black women beauty vloggers like Jackie Aina and Alyssa Forever whose YouTube channels attract millions of views. They credit Rihanna for leading the way with releasing a makeup line with many different shades for darker-skinned women.

“It can really change the way you think about yourself and the way you see the world,” says Ali about social media. “I really do have hope for this next generation of darker-skinned women who want to be represented. Who want to be uplifted and celebrated for our skin. You have dark skin and you are beautiful. I really want that to be a cultural norm,” she says.

Adawe says that after working on this issue for nearly seven years, she’s starting to see hints of change. More people are talking, disagreeing and questioning colorism out in the open. “All of that didn’t exist before,” she says. “All of that helps.”

Adawe is now writing a curriculum for teachers. Her next step is to take the conversation into the schools.

“This is going to need systemic change,” says Ali, who is studying sociology with a focus in health care and a minor in public health and neuroscience at the University of Minnesota. “I feel like it’s something that’s so within us that it’s going to take a while. It’s going to take some work.”

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Crime

Somalia’s first forensic lab targets rape impunity

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AFP — Garowe – The new freezers at Somalia’s only forensic laboratory can store thousands of DNA samples, although for now there are just five.

The big hope is that they could be the start of a revolution in how the troubled Horn of Africa country tackles its widespread sexual violence – provided some daunting hurdles are overcome.

The first sample arrived at the start of the year taken on a cotton swab from the underwear of a woman, a rape victim from the village of Galdogob.

It was wrapped in paper and driven 250km to the Puntland Forensic Centre in Garowe, capital of semi-autonomous Puntland, slipped into a protective glass tube and placed in one of the three ultra-low temperature fridges.

If DNA ID can be teased from the sample, this would be a crucial step in convicting the woman’s rapist.

No longer would it be a case of he-said-she-said, in which the survivor is less often believed than the accused. Two decades of conflict and turmoil have made Somalia a place where lawlessness and sexual violence are rampant.

“Now, people who have been raped hide because they don’t have evidence,” said Abdifatah Abdikadir Ahmed, who heads the Garowe police investigations department.

But with the lab, he said, “it’s a scientific investigation. There are biological acts you can zero in on.”

Challenges

Not yet, however.

Abdirashid Mohamed Shire, who runs the lab, has a team of four technicians ready but is awaiting the arrival of the final pieces of equipment.

Their work to provide the evidence that might convict or exonerate is yet to begin.

And the pressure is on. The freezers mean the DNA samples can be safely stored for years but Somali law allows a rape suspect to be held for a maximum of 60 days. Shire needs the analysis and identification machines urgently so that, as he put it, “justice will be timely served”.

The laboratory, partly funded by Sweden, was launched last year after the Puntland state government enacted a Sexual Offences Act in 2016, which criminalised sexual offences and imposed tough penalties.

But technology alone will not solve Somalia’s many judicial weaknesses.

The DNA sample from Galdogob, for example, was stored in unclear and unrefrigerated conditions for five days before being sent to the lab, meaning a defence counsel could potentially argue the DNA evidence had been tampered with.

Human rights lawyers worry the new lab might backfire for this reason.

“A lot of thought needs to be given to how the chain of custody can be preserved in these kinds of cases,” said Antonia Mulvey of Legal Action Worldwide, a Kenya-based non-profit organisation.

More fundamental still is the failure of Somalia’s police to take sexual assault cases – and their jobs – seriously.

Corruption is rife, with a legal advisor to Puntland’s justice ministry saying officers “meddle” in cases, undermining them for personal gain.

“My concern is that the corrupted system could not make a sure success of the lab,” the advisor said, requesting anonymity to speak candidly. “Investing in the lab is good, but we need to think about the preconditions.”

The UN Population Fund (UNFPA) which helped pay for the lab is trying to address this by running training programmes for dozens of the Garowe police on sample collection, gender violence investigations and documentation.

But, the legal advisor cautioned that donors can only do so much.

“The issue is more complicated than training police. It relates to the political commitment of the government. UNFPA can train police but who will pay those you train? Are they given power to do the work?”

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