Managing and Preventing Female Genital Cutting (FGM/C) Among the Somali Community in Kenya

This 8-page report details results of a FRONTIERS project, conducted in collaboration with the Ministry of Health among the Somali community in Kenya. This project sought both to strengthen existing antenatal and delivery services in health facilities used by Somali women and to support the development, implementation, and evaluation of a community-based intervention to encourage the Somali community to abandon Female Genital Cutting (FGM/C), a traditional practice that not only contravenes girls' and women's human rights, but is also illegal in Kenya.

According to the report, studies confirmed that FGM/C is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice. First, it is a Somali tradition; and, second, it is believed that it is an Islamic requirement. The practice is also perceived to prevent immorality because it is seen as a way to reduce women’s sexual desires through using infibulation. It is also seen to enforce the cultural value of sexual purity in females by ensuring virginity before marriage and fidelity throughout a woman’s life. According to the report, health workers are increasingly being requested to perform infibulations and re-infibulations; many nurses are responding to these requests, with the justification that they can do it more safely than traditional practitioners, and because they can supplement their income, despite the fact that the practice is illegal and punishable.

Key findings of the report are categorised by the two components of the project: interventions to improve management of health and other complications associated with FGM/C; and community-based interventions to encourage abandonment of FGM/C.

Under the first component, the project identified weaknesses in providing reproductive-related care for women with FGM/C. This assessment was undertaken through a 5-day workshop with health professionals from all levels, who identified weaknesses in their facilities and came up with affordable and practical strategies for strengthening and delivering these services that could be included in District Action Plans. This included training needs and capacity building in FGM/C advocacy. According to the report, the next step involved developing a training curriculum and materials that could be used during pre-service training, or as a stand alone 7-day course. The third step of this component was to train health staff. According to the report, 145 health personnel from five districts were trained using the new materials.

Under the second component, the project held community interventions with religious leaders and community members in one district. The objective of meeting with religious leaders and scholars was to build a consensus that FGM/C is not a religious obligation. FRONTIERS held 6 symposia during which evidence from essential Islamic documents were used to question whether the practice is supported in Islam. Shariah guidelines that contradicted the practice were assembled to enable scholars to understand the correct position of Islam regarding FGM/C. According to the report, after the intervention a number of scholars had changed their minds about the practice, but were still unwilling to speak publicly against it. However, the intervention also linked participants with non-Somali Islamic scholars who oppose the practice, and who helped de-link FGM/C from Islam.

During this component, discussions were also held with over 1,200 people from the community, sensitising them about FGM/C and encouraging them to question the practice. These included: girls at Wajir Girls’ Secondary School; male leaders; female leaders; women from 6 women's groups; professional women (in collaboration with the United Nations Children's Fund (UNICEF)/Kenya Garissa office); education officers at the provincial level (in collaboration with UNICEF/Kenya); primary school teachers; traditional birth assistants (TBAs) and traditional FGM/C practitioners; and police officers. The training process sought to address reasons given for the practice using logical arguments to counter the held beliefs.

The report states that it is important to continue working with religious leaders to clarify the position of Islam on FGM/C and support them in speaking out against it. Health care providers also need further training, especially in the practical skills of managing women affected by FGM/C and their infants at the time of delivery. Further research also needs to be done better understand:

• The relationship between women’s decisions to stop or continue FGM/C, and their desire for sexual morality, acceptable sexual behaviour, and femininity.
  
• The association between FGM/C and women’s sexuality, especially whether and how FGM/C reduces sexual desires and/or alters sexual response.
  
• Men’s knowledge and perceptions of FGM/C and their potential role in efforts to encourage abandonment of the practice.
  
• Trends in the practice within different age and social groups and what led to changes.