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Fact Sheet No.23, Harmful Traditional Practices Affecting
the Health of Women and Children
States Parties shall take all appropriate
measures ...
to modify the social and cultural patterns of conduct
of men and women, with a view to achieving the elimination
ofprejudices and customary and all other
practices which are based on the idea of the inferiority or the
superiority of either of
the sexes or on stereotyped roles for men and women.
CONVENTION ON THE ELIMINATION OF ALL FORMS
OF DISCRIMINATION AGAINST WOMEN (art. 5 (a)),
adopted by General Assembly resolution 34/180 of 18 December 1979.
Contents:
- Introduction
- I.
An appraisal of
harmful traditional practices and their effects on women and the girld
child
- II.
Review of action
and activities by United Nations organs and agencies, Governments and NGOs
- Conclusions
- Annex:
- Plan of Action for the Elimination of Harmful Traditional Practices Affecting the Health of Women and Children
- Select Bibliography
The
Charter of the United Nations includes among its basic principles the
achievement of international cooperation in promoting and encouraging respect
for human rights and fundamental freedoms for all without distinction as to
race, sex, language or religion (Art. 1, para. 3).
In 1948,
three years after the adoption of the Charter, the General Assembly adopted the
Universal Declaration of Human Rights,(1) which has
served as guiding principles on human rights and fundamental freedoms in the
constitutions and laws of many of the Member States of the United Nations. The
Universal Declaration prohibits all forms of discrimination based on sex and
ensures the right to life, liberty and security of person; it recognizes
equality before the law and equal protection against any discrimination in
violation of the Declaration.
Many
international legal instruments on human rights further reinforce individual
rights, and also protect-and prohibit discrimination against-specific groups,
in particular women. The Convention on the Elimination of All Forms of
Discrimination against Women, for example, had been ratified by 136 States as
of January 1995. The Convention obliges States parties, in general, to
"pursue by all appropriate means and without delay a policy of eliminating
discrimination against women" (art. 2). It reaffirms the equality of human
rights for women and men in society and in the family; it obliges States
parties to take action against the social causes of women's inequality; and it
calls for the elimination of laws, stereotypes, practices and prejudices that
impair women's well-being.
Traditional
cultural practices reflect values and beliefs held by members of a community
for periods often spanning generations. Every social grouping in the world has
specific traditional cultural practices and beliefs, some of which are
beneficial to all members, while others are harmful to a specific group, such
as women. These harmful traditional practices include female genital mutilation
(FGM); forced feeding of women; early marriage; the various taboos or practices
which prevent women from controlling their own fertility; nutritional taboos
and traditional birth practices; son preference and its implications for the
status of the girl child; female infanticide; early pregnancy; and dowry price.
Despite their harmful nature and their violation of international human rights
laws, such practices persist because they are not questioned and take on an
aura of morality in the eyes of those practising them.
The
international community has become aware of the need to achieve equality
between the sexes and of the fact that an equitable society cannot be attained
if fundamental human rights of half of human society, i.e. women, continue to
be denied and violated. However, the bleak reality is that the harmful
traditional practices focused on in this Fact Sheet have been performed for
male benefit. Female sexual control by men, and the economic and political
subordination of women, perpetuate the inferior status of women and inhibit
structural and attitudinal changes necessary to eliminate gender inequality.
As early
as the 1950s, United Nations specialized agencies and human rights bodies began
considering the question of harmful traditional practices affecting the health
of women, in particular female genital mutilation. But these issues have not
received consistent broader consideration, and action to bring about any
substantial change has been slow or superficial.
A number
of reasons are given for the persistence of traditional practices detrimental
to the health and status of women, including the fact that, in the past,
neither the Governments concerned nor the international community challenged
the sinister implications of such practices, which violate the rights to
health, life, dignity and personal integrity. The international community
remained wary about treating these issues as a deserving subject for
international and national scrutiny and action. Harmful practices such as
female genital mutilation were considered sensitive cultural issues falling
within the spheres of women and the family. For a long time, Governments and
the international community had not expressed sympathy and understanding for
women who, due to ignorance or unawareness of their rights, endured pain,
suffering and even death inflicted on themselves and their female children.
Despite
the apparent slowness of action to challenge and eliminate harmful traditional
practices, the activities of human rights bodies in this field have, in recent
years, resulted in noticeable progress. Traditional practices have become a
recognized issue concerning the status and human rights of women and female
children. The slogan "Women's Rights are Human Rights", adopted at
the World Conference on Human Rights in Vienna in 1993, as well as the
Declaration on the Elimination of Violence against Women, adopted by the
General Assembly the same year, captured the reality of the status accorded to
women. These issues have been further emphasized in the reports of the Special
Rapporteur on harmful traditional practices, Mrs. Halima Embarek Warzazi,
appointed in 1988, and in the draft Platform for Action for the Fourth World
Conference on Women, to be held in September 1995.
The
Special Rapporteur on violence against women, its causes and consequences, Ms.
Radhika Coomaraswamy, appointed by the Commission on Human Rights in 1994, has
also examined all forms of traditional practices referred to in this Fact
Sheet, as well as other practices, including virginity tests, foot binding,
female infanticide and dowry deaths, all of which violate female dignity. In her
preliminary report, the Special Rapporteur pointed out that
blind
adherence to these practices and State inaction with regard to these customs
and traditions have made possible large-scale violence against women. States
are enacting new laws and regulations with regard to the development of a
modern economy and modern technology and to developing practices which suit a
modern democracy, yet it seems that in the area of women's rights change is
slow to be accepted. (E/CN.4/1995/42, para. 67.)
The
harmful traditional practices identified in this Fact Sheet are categorized as
separate issues; however, they are all consequences of the value placed on
women and the girl child by society. They persist in an environment where women
and the girl child have unequal access to education, wealth, health and
employment.
In part I, the Fact Sheet identifies and analyses the background to harmful traditional practices, their causes, and their consequences for the health of women and the girl child. Part II reviews the action taken by United Nations organs and agencies, Governments and organizations (NGOs). The Conclusions highlight the drawbacks in the implementation of the practical steps identified by the United Nations, NGOs and women's organizations.
I. An appraisal of harmful traditional practices and their effects on
women and the girl child
A.
Female genital mutilation(2)
Female
genital mutilation (FGM), or female circumcision as it is sometimes erroneously
referred to, involves surgical removal of parts or all of the most sensitive
female genital organs. It is an age-old practice which is perpetuated in many
communities around the world simply because it is customary. FGM forms an
important part of the rites of passage ceremony for some communities, marking
the coming of age of the female child. It is believed that, by mutilating the
female's genital organs, her sexuality will be controlled; but above all it is
to ensure a woman's virginity before marriage and chastity thereafter. In fact,
FGM imposes on women and the girl child a catalogue of health complications and
untold psychological problems. The practice of FGM violates, among other
international human rights laws, the right of the child to the "enjoyment
of the highest attainable standard of health", as laid down in article 24
(paras. 1 and 3) of the Convention on the Rights of the Child.
The origin
of FGM has not yet been established, but records show that the practice
predates Christianity and Islam in practising communities of today. In ancient
Rome, metal rings were passed through the labia minora of slaves to prevent
procreation; in medieval England, metal chastity belts were worn by women to
prevent promiscuity during their husbands' absence; evidence from mummified
bodies reveals that, in ancient Egypt, both excision and infibulation were
performed, hence Pharaonic circumcision; in tsarist Russia, as well as
nineteenth-century England, France and America, records indicate the practice
of clitoridectomy. In England and America, FGM was performed on women as a
"cure" for numerous psychological ailments.
The age at
which mutilation is carried out varies from area to area. FGM is performed on
infants as young as a few days old, on children from 7 to 10 years old, and on
adolescents. Adult women also undergo the operation at the time of marriage.
Since FGM is performed on infants as well as adults, it can no longer be seen
as marking the rites of passage into adulthood, or as ensuring virginity.
Among the
types of surgical operation on the female genital organs listed below, there
are many variations, performed throughout Africa, Asia, the Middle East, the
Arabian Peninsula, Australia and Latin America.
Types
of surgical forms
(a)
Circumcision or Sunna ("traditional") circumcision: This involves the
removal of the prepuce and the tip of the clitoris. This is the only operation
which, medically, can be likened to male circumcision.
(b)
Excision or clitoridectomy: This involves the removal of the clitoris, and
often also the labia minora. It is the most common operation and is practised
throughout Africa, Asia, the Middle East and the Arabian Peninsula.
(c)
Infibulation or Pharaonic circumcision: This is the most severe operation,
involving excision plus the removal of the labia majora and the sealing of the
two sides, through stitching or natural fusion of scar tissue. What is left is
a very smooth surface, and a small opening to permit urination and the passing
of menstrual blood. This artificial opening is sometimes no larger than the
head of a match.
Another
form of mutilation which has been reported is introcision, practised
specifically by the Pitta-Patta aborigines of Australia. When a girl reaches
puberty, the whole tribe-both sexes-assembles. The operator, an elderly man,
enlarges the vaginal orifice by tearing it downward with three fingers bound
with opossum string. In other districts, the perineum is split with a stone
knife. This is usually followed by compulsory sexual intercourse with a number
of young men.
It is
reported that introcision has been practised in eastern Mexico and in Brazil.
In Peru, in particular among the Conibos, a division of the Pano Indians in the
north-east, an operation is performed in which, as soon as a girl reaches
maturity, she is intoxicated and subjected to mutilation in front of her
community. The operation is performed by an elderly woman, using a bamboo
knife. She cuts around the hymen from the vaginal entrance and severs the hymen
from the labia, at the same time exposing the clitoris. Medicinal herbs are
applied, followed by the insertion into the vagina of a slightly moistened
penis-shaped object made of clay.
Like all
other harmful traditional practices, FGM is performed by women, with a few
exceptions (in Egypt, men are known to perform the operation). In most rural
settings throughout Africa, the operation is accompanied with celebrations and
often takes place away from the community at a special hidden place. The
operation is carried out by women (excisors) who have acquired their
"skills" from their mothers or other female relatives; they are often
also the community's traditional birth attendants.
The type
of operation to be performed is decided by the girl's mother or grandmother beforehand
and payment is made to the excisor before, during and after the operation, to
ensure the best service. This payment, partly in kind and partly in cash, is a
vital source of livelihood for the excisors.
The
conditions under which these operations take place are often unhygienic and the
instruments used are crude and unsterilized. A kitchen knife, a razor-blade, a
piece of glass or even a sharp fingernail are the tools of the trade. These
instruments are used repeatedly on numerous girls, thus increasing the risk of
blood-transmitted diseases, including HIV/AIDS.
The
operation takes between 10 and 20 minutes, depending on its nature; in most
cases, anaesthetic is not administered. The child is held down by three or four
women while the operation is done. The wound is then treated by applying
mixtures of local herbs, earth, cow-dung, ash or butter, depending on the
skills of the excisor. If infibulation is performed, the child's legs are bound
together to impair mobility for up to 40 days. If the child dies from
complications, the excisor is not held responsible; rather, the death is
attributed to evil spirits or fate. Throughout South-East Asia and urban
African communities, FGM is becoming increasingly medicalized.
FGM is
known to be practised in at least 25 countries in Africa. Infibulation is
practised in Djibouti, Egypt, some parts of Ethiopia, Mali, Somalia and the
northern part of the Sudan. Excision and circumcision occur in parts of Benin,
Burkina Faso, Cameroon, the Central African Republic, Chad, Côte d'Ivoire, the
Gambia, the northern part of Ghana, Guinea, Guinea-Bissau, Kenya, Liberia,
Mauritania, Nigeria, Senegal, Sierra Leone, Togo, Uganda and parts of the
United Republic of Tanzania.
Outside
Africa, a certain form of female genital mutilation exists in Indonesia,
Malaysia and Yemen. Recent information has revealed that the practice also
exists in some European countries and Australia among immigrant communities.
FGM is a
custom or tradition synthesized over time from various values, especially
religious and cultural values. The reasons for maintaining the practice include
religion, custom, decreasing the sexual desire of women, hygiene, aesthetics,
facility of sexual relations, fertility, etc. In general, it can be said that
those who preserve the practice are largely women who live in traditional
societies in rural areas. Most of these women follow tradition passively.
In the
countries where the practice exists, most women believe that, as good Muslims,
for example, they have to undergo the operation. In order to be clean and
proper, fit for marriage, female circumcision is a precondition. Among the
Bambara in Mali, it is believed that, if the clitoris touches the head of a
baby being born, the child will die. The clitoris is seen as the male
characteristic of the woman; in order to enhance her femininity, this male part
of her has to be removed. Among women in Djibouti, Ethiopia, Somalia and the
Sudan, circumcision is performed to reduce sexual desire and also to maintain
virginity until marriage. A circumcised woman is considered to be clean.
Establishing
identity and belongingness is another reason advanced for the perpetuation of
the practice. For example, in Liberia and Sierra Leone, groups of girls of 12
and 13 of the indigenous population undergo an initiation rite, conducted by an
older woman "Sowie". This involves education on how to be a good wife
or co-wife, the use of herbal medicine and the "secrets" of female
society. It also involves the ritual of circumcision.
Health
and psychological implications
The
effects of female genital mutilation have short-term and long-term
implications. Haemorrhage, infection and acute pain are the immediate
consequences. Keloid formation, infertility as a result of infection,
obstructed labour and psychological complications are identified as later
effects. In rural areas where untrained traditional birth attendants perform
the operations, complications resulting from deep cuts and infected instruments
can cause the death of the child.
Most
physical complications result from infibulation, although cataclysmic
haemorrhage can occur during circumcision with the removal of the clitoris;
accidental cuts to other organs can also lead to heavy loss of blood. Acute
infections are commonplace when operations are carried out in unhygienic
surroundings and with unsterilized instruments. The application of traditional
medicine can also lead to infection, resulting in tetanus and general
septicaemia. Chronic infection can also lead to infertility and anaemia.
Haematocolpos,
or the inability to pass menstrual blood (because the remaining opening is
often too small), can lead to infection of other organs and also infertility.
Obstetric complications
are the most frequent health problem, resulting from vicious scars in the
clitoral zone after excision. These scars open during childbirth and cause the
anterior perineum to tear, leading to haemorrhaging that is often difficult to
stop. Infibulated women have to be opened, or deinfibulated, on delivery of
their child and it is common for them to be reinfibulated after each delivery.
There has
been little research in the area of the psychological implications of FGM, but
evidence indicates that most children experience recurring nightmares.
In her
recent book, Cutting the Rose-Female Genital Mutilation: The Practice and
its Prevention,(3) Efua
Dorkenoo reports that some evidence of psychological effects is emerging among
the large immigrant communities now living in Europe, the Americas, Australia
and New Zealand. Teenagers, in particular, are having to live in two very
different cultures, where different values prevail. At school they move within
the very liberal setting of the Western culture; at home they have to conform
to values held by their parents. Some of these values often conflict. For some
teenagers this is proving to be problematic. Girls who have been genitally
mutilated have to come to terms with the fact that they are not like their
classmates. Mood swings and irritability, a constant state of depression, and
anxiety have all been noted among infibulated girls. A small number, upon
reaching the age of consent, are being deinfibulated without their parents'
knowledge and engaging in premarital relationships, thus validating the
reasoning behind their parents' wishes to have the operation performed.
There are
also reports of psychological and health problems suffered by women seeking
medical assistance in Western medical,,facilities due to lack of knowledge
regarding genital mutilation. Excised and infibulated women have special needs
which have been ignored or dealt with on a trial-and-error basis. In Western
countries, severe forms of FGM present challenges to midwives and obstetricians
in providing antenatal and post-natal care. For example, professionals need
training to know how to deliver infibulated women. The provision of health care
for women and girls who have been genitally mutilated should be appropriate and
sensitive to their needs. Health promotion work through women's health services
can develop appropriate information materials and actively contribute to
outreach work and awareness raising.
B.
Son preference and its implications for the status of the girl child
One of the
principal forms of discrimination and one which has far-reaching implications
for women is the preference accorded to the boy child over the girl child. This
practice denies the girl child good health, education, recreation, economic
opportunity and the right to choose her partner, violating her rights under
articles 2, 6, 12, 19, 24, 27 and 28 of the Convention on the Rights of the
Child.
Son
preference refers to a whole range of values and attitudes which are manifested
in many different practices, the common feature of which is a preference for
the male child, often with concomitant daughter neglect. It may mean that a
female child is disadvantaged from birth; it may determine the quality and
quantity of parental care and the extent of investment in her development; and
it may lead to acute discrimination, particularly in settings where resources
are scarce. Although neglect is the rule, in extreme cases son preference may
lead to selective abortion or female infanticide.
In many
societies, the family lineage is carried on by male children. The preservation
of the family name is guaranteed through the son(s). Except in a few countries
(e.g. Ethiopia), a girl takes her husband's family name, dropping that of her
own parents. The fear of losing a name prompts families to wish to have a son.
Some men marry a second or a third wife to be sure of having a male child.
Among many communities in Asia and Africa, sons perform burial rites for
parents. Parents with no male child do not expect to have an appropriate burial
to "secure their peace in the next world". In almost all religions,
ceremonies are performed by men. Priests, pastors, sheikhs and other religious
leaders are men of great status to whom society attaches great importance, and
this important role for men obliges parents to wish for a male child. Religious
leaders have a major involvement in the perpetuation of son preference.
Son
preference is universal and not unique to developing countries or rural areas.
It is a practice enshrined in the value systems of most societies. It thus
dictates the value judgements, expectations and behaviour of family members.
Son
preference is a transcultural phenomenon, more marked in Asian societies and
historically rooted in the patriarchal system. In certain countries in the
Asian region, the phenomenon is less prevalent than in others. Son preference
is stronger in countries where patriarchy and patriliny are more firmly rooted.
Tribal societies, which are matrilineal societies, tended to be more gender
egalitarian until the advent of settled agriculture.
In almost
all regions, the practice is rooted in culture and the economics of son
preference, these factors playing a major role in the low valuation and neglect
of female children. The practice of son preference emerged with the shift from
subsistence agriculture, which was primarily controlled by women, to settled
agriculture, which is primarily controlled by men. In the patrilineal
landowning communities with settled agriculture which are prevalent in the
Asian region, the economic obligations of sons towards parents are greater. The
son is considered to be the family pillar, who ensures continuity and protection
of the family property. Sons provide the workforce and have to bring in a
bride-"an extra pair of hands". Sons are the source of family income
and have to provide for parents in their old age. They are also the
interpreters of religious teachings and the performers of rituals, especially
on the death of parents, which include feeding a large number of people,
sometimes several villages. As soldiers, sons protect the community and hold
political power.
Son
preference in the Asian region manifests itself either covertly or overtly. The
birth of a son is welcomed with celebration as an asset, whereas that of a girl
is seen as a liability, an impending economic drain. According to an Asian
proverb, "bringing up girls is like watering the neighbour's garden".
Psychological
and health consequences
The
psychological effect of son preference on women and the girl child is the
internalization of the low value accorded them by society. Scientific evidence
of the deleterious effect of son preference on the health of female children is
scarce, but abnormal sex ratios in infant and young child mortality rates, in
nutritional status indicators and even in population figures show that
discriminatory practices are widespread and have serious repercussions.
Geographically, there is often a close correspondence between the areas of
strong son preference and of health disadvantage for females.
The areas
most affected by the problem seem to be South Asia (Bangladesh, India, Nepal,
Pakistan), the Middle East (Algeria, Egypt, Jordan, the Libyan Arab Jamahiriya,
Morocco, the Syrian Arab Republic, Tunisia, Turkey) and parts of Africa
(Cameroon, Liberia, Madagascar, Senegal). In Latin America, there is evidence
of abnormal sex ratios in mortality figures in Ecuador, Mexico, Peru and
Uruguay.
Discrimination
in the feeding and care of female infants and/or higher rates of morbidity and
malnutrition have been reported in most of the countries already listed and
also in Bolivia, Colombia, the Islamic Republic of Iran, Nigeria, the
Philippines and Saudi Arabia. More than two thirds of the world's population
live in countries where registration of death does not occur and many more live
in countries where death rates are not published by sex. Moreover, discrimination
against girls has to be extreme to emerge in mortality rates. For every growing
girls who dies, there are many whose health and potential for growth and
development are permanently impaired. Countless reports the world over have
demonstrated that, in societies where son preference is practised, the health
of the female child is adversely affected.
In some
communities in the Asian region where son preference is highly marked, efforts
to differentiate a female child from a male child through various socio-economic
norms and practices start as early as the foetal stage and continue throughout
the entire life cycle. In these communities, amniocentesis tests and sonography
for sex determination have resulted in the abortion of female foetuses. The
introduction and expansion of scientific methods of sex detection have led to a
revival of female foeticide and infanticide.
Education
Access to
education by itself is not enough to eliminate values held by society, for such
values are in most countries transmitted into educational curricula and
textbooks. Women are thus still depicted as passive and domestically oriented,
while men are depicted as dominant and as breadwinners.
Education
does, however, offer the female child an improved opportunity to be less
dependent on men in later life. It increases her prospects of obtaining work
outside the home. As laid down in articles 28 and 29 of the Convention on the
Rights of the Child, all children have the right to education, and the content
of such education should be directed to the development of the child's
personality, talents and mental and physical abilities to their fullest
potential.
According
to the United Nations Children's Fund (UNICEF), the expansion of educational
opportunities over the past several decades has clearly affected girls,
although this has not been a result of deliberate policy to reduce gender
disparities in educational access. Girls' education, measured by gross primary
school enrolment ratios, has improved substantially in the Middle East and
North Africa region, for example. Nevertheless, in 1990, the region still had
44 million illiterate mothers, a large and increasing backlog left over from
times of lower enrolment levels. Differences in primary school enrolment levels
for boys and girls and competition between them are still very significant in a
number of countries. In countries where overall enrolment is much lower than
desired, girls are particularly disadvantaged.
Although
in many countries school drop-out rates are steadily falling, they continue to
be higher among girls than among boys. The reasons for the high drop-out rate
among girls are poverty, early marriage, helping parents with housework and
agricultural work, the distance of schools from homes, the high costs of
schooling, parents' illiteracy and indifference, and the lack of a positive
educational climate. Girls begin school very late and withdraw with the onset
of puberty. Parents do not see the benefits of girls' education because girls
are given away in marriage to serve the husband's family. Sons are given
priority. In certain countries, enrolment rates for girls have actually
declined despite attempts to increase them.
Recreation
and work opportunities
According
to article 31, paragraph 1, of the Convention on the Rights of the Child,
States parties "recognize the right of the child to rest and leisure, to
engage in play and recreational activities". However, from an early age,
girls from rural and poor urban homes are burdened with domestic tasks and
child care, which leaves them no time to play. Studies have shown that
recreation plays a vital part in a child's emotional and mental development.
When time for play is found by girls, it often takes place near the home. Young
boys, however, have fewer demands made of them and are allowed to engage in
activities outside the home. The status of girls is linked to that of women and
their exploitation. A woman's work never ends, especially in rural areas and in
poor urban households.
The
Convention on the Elimination of All Forms of Discrimination against Women
calls for the elimination of discrimination against women in the field of
employment, "in order to ensure, on a basis of equality of men and women,
the same rights" (art. 11, para. 1). It also calls upon States to ensure
that women in rural areas have access to agricultural credit and loans,
marketing facilities, appropriate technology and equal treatment in land and
agrarian reform (art. 14, para. 2 (g)). Evidence indicates,
however, that as girls grow older they face discriminatory treatment in gaining
access to economic opportunities. Major inequalities persist in employment,
access to credit, inheritance rights, marriage laws and other socio-economic
dispensations. Compared with men, women have fewer opportunities for paid
employment and less access to skill training that would make such employment
possible. Women are usually restricted to low-paid and casual jobs, or to
informal activities.
Landlessness
has increased among women, and the number of women cultivators has declined in
some regions, partly due to increased mechanization of agriculture. An
increasing number of women in most developing countries are occupied in the
informal, invisible sectors where national social and labour legislation on
maternity benefits, equal wages and crèche facilities does not apply.
C.
Female infanticide
Sex bias
or son preference places the female child in a disadvantageous position from
birth. In some communities, however, particularly in Asia, the practice of
infanticide ensures that some female children have no life at all, violating
the basic right to life laid down in article 6 of the Convention on the Rights
of the Child. Selective abortion, foeticide and infanticide all occur because
the female child is not valued by her culture, or because certain economic and
legislative acts have ruled her life worthless.
In India,
for example, infanticide was formally legislated against during British rule,
after centuries of practice in some communities. However, recent reports have
shown that there is a revival.
In certain
parts of India and Pakistan, women are still considered unnecessary evils. In
the past, when victorious armies took their revenge on defeated communities,
women were raped as part of the spoils of war. Subsequently, these communities
resorted to killing their daughters at birth or when the enemy was advancing,
to spare the female population and community from shame.
Modern
techniques such as amniocentesis and ultrasound tests have given women greater
power to detect the sex of their babies in time to abort. Illegal abortion,
particularly of female foetuses, either self-inflicted or performed by
unskilled birth attendants, under poor sanitary conditions has led to increased
maternal mortality, particularly in South and South-East Asia.
Female
foeticide is an emerging problem in some parts of India, and the Government has
introduced a bill in Parliament to ban the use of amniocentesis for
sex-determination purposes. Such misuse of amniocentesis is also prohibited in
the States of Maharashtra, Punjab, Rajasthan and Haryana, where the problem is
more prevalent.
D.
Early marriage and dowry
Early
marriage is another serious problem which some girls, as opposed to boys, must
face. The practice of giving away girls for marriage at the age of 11, 12 or
13, after which they must start producing children, is prevalent among certain
ethnic groups in Asia and Africa. The principal reasons for this practice are
the girls' virginity and the bride-price. Young girls are less likely to have
had sexual contact and thus are believed to be virgins upon marriage; this
condition raises the family status as well as the dowry to be paid by the
husband. In some cases, virginity is verified by female relatives before the
marriage.
Child
marriage robs a girl of her childhood-time necessary to develop physically,
emotionally and psychologically. In fact, early marriage inflicts great
emotional stress as the young woman is removed from her parents' home to that
of her husband and in-laws. Her husband, who will invariably be many years her
senior, will have little in common with a young teenager. It is with this
strange man that she has to develop an intimate emotional and physical
relationship. She is obliged to have intercourse, although physically she might
not be fully developed.
Girls from
communities where early marriages occur are also victims of son preferential
treatment and will probably be malnourished, and consequently have stunted
physical growth.
Neglect of
and discrimination against daughters, particularly in societies with strong son
preference, also contribute to early marriage of girls. It has been generally
recognized at United Nations seminars on traditional practices affecting women
and children, and on the basis of research, that early marriage devalues women
in some societies and that the practice continues as a result of son preference.
In some countries, girls as young as a few months old are promised to male
suitors for marriage. Girls are fattened up, groomed, adorned with jewels and
kept in seclusion to make them attractive so that they can be married off to
the highest bidder.
Health
complications that result from early marriage in the Middle East and North
Africa, for example, include the risk of operative delivery, low weight and
malnutrition resulting from frequent pregnancies and lactation in the period of
life when the young mothers are themselves still growing.
Another
economic reason which perpetuates the practice of female genital mutilation is
related to dowries.
The dowry
price of a woman is her exchange value in cash, kind or any other agreed form,
such as a period of employment. This value is determined by the family of the
bride-to-be and her future in-laws. Both families must gain from the exchange.
The woman's in-laws want an extra pair of hands and children; her family desire
payment which will provide greater security for other relatives. The dowry
price will be higher if the woman's virginity has been preserved, notably
through genital mutilation.
In certain
communities in South Asia, the low status of girls has to be compensated for by
the payment of a dowry by the parents of the girl to the husband at the time of
marriage. This has resulted in a number of dowry crimes, including mental and
physical torture, starvation, rape, and even the burning alive of women by
their husbands and/or in-laws in cases where dowry payments are not met.
It should
be noted that the Committee on the Rights of the Child, in a number of
recommendations in the light of article 2 of the Convention on the Rights of
the Child, has called upon States to recognize the principle of equality before
the law and forbid gender discrimination, including the adoption of legislation
prohibiting harmful traditional practices such as genital mutilation, forced
and early marriage of girl children, early pregnancy and related prejudicial
health practices.
The work
of the Committee has also permitted the identification of certain areas where
law reform should be undertaken, in both civil and penal areas, such as the
minimum age for marriage and establishment of the age of criminal responsibility
as being the attainment of puberty. Some States have argued that girls attain
their physical maturity earlier, but it is the view of the Committee that
maturity cannot simply be identified with physical development when social and
mental development are lacking and that, on the basis of such criteria, girls
are considered adults before the law upon marriage, thus being deprived of the
comprehensive protection ensured by the Convention on the Rights of the Child.
The International Conference on Population and Development, held at Cairo in
September 1994 (see p. 36 below), encouraged Governments to raise the minimum
age for marriage. In her preliminary report to the Commission on Human Rights,
the Special Rapporteur on violence against women, its causes and consequences,
Ms. Radhika Coomaraswamy, also recognized that the age of marriage was a factor
contributing to the violation of women's rights (E/CN.4/1995/42, para. 165).
E.
Early pregnancy, nutritional taboos and practices related to child delivery
Early
pregnancy can have harmful consequences for both young mothers and their
babies. According to UNICEF, no girl should become pregnant before the age of
18 because she is not yet physically ready to bear children. Babies of mothers
younger than 18 tend to be born premature and have low body weight; such babies
are more likely to die in the first year of life. The risk to the young
mother's own health is also greater. Poor health is common among indigent
pregnant and lactating women.
In many
parts of the developing world, especially in rural areas, girls marry shortly
after puberty and are expected to start having children immediately. Although
the situation has improved since the early 1980s, in many areas the majority of
girls under 20 years of age are already married and having children. Although
many countries have raised the legal age for marriage, this has had little
impact on traditional societies where marriage and child-bearing confer
"status" on a woman.
Those who
start having children early generally have more children, at shorter intervals,
than those who embark on parenthood later. Fertility rates have been falling
over the past decade, but they remain very high in Africa, parts of Latin
America and Asia. Once again, the link between delayed child-bearing and
education is crucial.
An
additional health risk to young mothers is obstructed labour, which occurs when
the baby's head is too big for the orifice of the mother. This provokes
vesicovaginal fistulas, especially when an untrained traditional birth
attendant forces the baby's head out unduly.
Generally
throughout the developing world, the average food intake of pregnant and
lactating mothers is far below that of the average male. Cultural practices,
including nutritional taboos, ensure that pregnant women are deprived of
essential nutriments, and as a result they tend to suffer from iron and protein
deficiencies.
Poor
health can be improved by a more balanced diet. The choice of food consumed is
determined by a number of factors, including availability of natural resources,
economics, religious beliefs, social status and traditional taboos. Because
these factors place limits in one way or another on the intake of food,
communities and individuals are deprived of essential nutriments and, as a
result, physical and mental development is impaired. This is generally the case
in most developing countries, but especially throughout Africa.
Although
poor distribution of resources-whether due to harsh geographical or climatic
conditions in a region, or to poverty resulting from a lack of purchasing
power-contributes greatly to the severe imbalance of diets throughout Africa,
taboos placed on food for religious or cultural reasons are an unnecessary
practice which exacerbates the situation.
The
reasons for such taboos are many, but all are steeped in superstition. Many
taboos are upheld because it is believed that the consumption of a particular
animal or plant will bring harm to the individual.
Permanent
taboos are also placed on female members of most communities throughout Africa.
From infancy, the female child is given a low-nutrition diet. She is weaned at
a much earlier age than the male infant, and throughout her life she will be
deprived of high-protein food such as animal meat, eggs, fish and milk. As a
result, the intake of nutriments by the female population is lower than that of
the male population.
Temporary
taboos which are applicable only at certain times in the life of an individual
also affect women disproportionately. Most communities throughout Africa have
food taboos specially for pregnant women. Often these taboos exclude the
consumption of nutriments essential for the expectant mother and foetus.
These
nutritional taboos are unnecessary impositions made on women, who are already
malnourished. It is perhaps not surprising that maternal and infant mortality
rates are so high and life expectancy low in the countries concerned. But
nutritional taboos also have far-reaching implications for women in the field
of work, where their levels of productivity can be affected.
Lack of
basic knowledge of human bodily functions can lead to illogical conclusions
when illness sets in, or especially when a mother or her infant dies.
Surrounded by myths and superstition, what may be a simple mishap can be
explained in much more sinister terms as the product of evil spirits or bad
omens.
Most rural
areas throughout the developing world have disproportionately fewer health
centres and clinics, trained midwives, nurses and doctors than urban areas. For
most rural dwellers, health treatment must be obtained from traditional birth
attendants (TBAs). Most TBAs have no formal training in health practices but
acquire their skills via apprenticeship. These are skills passed down through
generations of women. By observing a given situation, the TBA learns which
remedy to use for which illness, or how to perform different kinds of delivery.
If the situation changes, they try to adapt their knowledge and remedies and
hope that that works. If things go wrong, however, supernatural explanations
are given; blame is never attributed to the TBA.
According
to the World Health Organization (WHO), more than half the births in developing
nations are attended by TBAs and relatives. Although these women have every
good intention to assist their patients, mortality rates are higher in the
rural areas where they operate.
The use of
herbal mixtures and magic is common during delivery throughout Africa. The
chemical components of some of these mixtures are beneficial, but others are
quite lethal, especially when taken in large dosage.
In the
case of obstructed labour, the abdomen is at times massaged or pressed to force
the baby out. Some TBAs perform surgical operations to extract the foetus,
using a knife or razor-blade to cut the labia minora and vaginal opening. A
similar operation, known as the "Gishiri cut", is performed in some
parts of Africa, and the likely complications are known to be haemorrhaging and
infection.
Among the
most bizarre treatments for obstructed labour are the psychological ones. In
many societies, difficulty in labour or delay in delivery is believed to be punishment
for marital infidelity. The woman is pressured to confess her misdeed so that
labour may continue without complications. This practice, which inflicts great
mental cruelty on a woman already in agony due to obstructed labour, is
prevalent in several African countries. In addition to the psychological trauma
suffered by the woman, the practice further delays her being taken to hospital.
Treatment
of obstructed labour by ineffective and harmful traditional methods can also
cause uterine rupture. Rupture of the uterus still constitutes one of the major
causes of maternal death in obstetric practice in developing countries. Death
rates as high as 37 per cent have been reported in studies of hospitalized
women with ruptured uterus. Foetal mortality is also very high: it was 100 per
cent in a study of 144 cases of uterine rupture in one African country and 96
per cent in an Indian review of 181 cases.
Even when
obstructed labour does not result in maternal death, it leads to prolonged or
even permanent ill health in the majority of cases. For example, vesicovaginal
fistula is a condition that has traumatic physical as well as social
consequences. Due to prolonged pressure on the bladder during obstructed
labour, the lower genital tract is severely damaged, causing a false passage
between the bladder and the vagina. The woman suffers from incontinence of
urine and sometimes of faeces as well, since 10 to 15 per cent of all
vesicovaginal fistula cases have associated rectovaginal fistula.
In two African
countries, a practice known as "Zur Zur" is performed on women
between the 34th and 35th weeks of their first pregnancy. A deep cut is made in
the anterior wall of the vagina, sometimes on the posterior wall. The wound is
allowed to bleed, then the woman rests for a while before being sent home to
nurse her wound. The purpose of this operation is to prepare the woman for an
easy delivery. However, the consequences can be death through excessive
bleeding, shock, infection of the birth canal, and vesicovaginal or vaginal
fistula.
Misdiagnoses
have been made by midwives and doctors who receive these women once
complications set in. The bleeding is often mistaken for an ante-partum
haemorrhage, and Caesarean sections have been performed; but invariably the
bleeding continues. Midwives are fighting to get the practice stopped in the
countries concerned.
Various
forms of contraception and methods of tightening the vagina are practised
throughout the world. Many involve inserting herbal mixtures and foreign
objects-for example, aluminium hydroxide, cloth, stone, soap and lime-into the
vagina. Many of these inserts have an irritating or erosive effect on the
vaginal mucosa, which is a natural defence against infections and disease, such
as HIV.
F.
Violence against women
Most of
the practices reviewed so far constitute acts of violence against women or the
girl child by the family and the community, and are often condoned by the
State. In its resolution 1994/45 of 4 March 1994, the Commission on Human
Rights recognized other forms of non-traditional practices, such as rape and
domestic violence, as violence against women. In that resolution (paras. 6 and
8), the Commission decided to appoint, for a three-year period, a special
rapporteur on violence against women, including its causes and consequences.
Ms. Radhika Coomaraswamy of Sri Lanka was subsequently appointed Special
Rapporteur on violence against women.
This
appointment came after more than two decades of tireless campaigning by women
worldwide. An important step marked by resolution 1994/45 was that, for the
first time, Governments were held accountable for acts of violence against
women committed by the private individual.
In the
same resolution (para. 7), the Commission invited the Special Rapporteur, in
carrying out her mandate, and within the framework of the Universal Declaration
of Human Rights and all other international human rights instruments, including
the Convention on the Elimination of All Forms of Discrimination against Women
and the Declaration on the Elimination of Violence against Women, inter alia,
to recommend measures, at the national, regional and international levels, to
eliminate violence against women and its causes, and to remedy its
consequences.
The Special
Rapporteur's mandate includes carrying out field missions, either separately or
jointly with other special rapporteurs and working groups, and consulting
periodically with the Committee on the Elimination of Discrimination against
Women. In addition, the Commission requested the Secretary-General to ensure
that the reports of the Special Rapporteur are brought to the attention of the
Commission on the Status of Women.
The Special Rapporteur submitted a preliminary report to the Commission on Human Rights at its fifty-first session, in 1995 (E/CN.4/1995/42).
II. Review of action and activities by United Nations organs and
agencies, Governments and NGOs
A.
United Nations organs and agencies
Action on
traditional practices affecting the health of women and children, in particular
female genital mutilation (FGM), was first taken in 1958 when the Economic and
Social Council (ECOSOC) invited the World Health Organization WHO to undertake
a study of the persistence of customs subjecting girls to ritual operations and
to communicate the results of the study to the Commission on the Status of
Women.
In
1960, the issue of FGM was debated at the Seminar on the Participation of Women
in Public Life, held at Addis Ababa for the African region. Concluding remarks
included a call to WHO to make a statement condemning all forms of
medicalization of FGM. In its resolution 821 II (XXXII), adopted in July 1961,
ECOSOC again invited WHO to study the medical aspects of operations based on
customs. A seminar convened in 1979 by the WHO Regional Office for the Eastern
Mediterranean in Khartoum marked a milestone in the campaign against harmful
traditional practices, setting the pace and direction for international and
national plans of action. Additional forms of harmful traditional practices
were identified and a recommendation was made for the formation of the
Inter-African Committee on Traditional Practices Affecting the Health of Women
and Children. In addition, the seminar reiterated the concluding remarks made
at the 1960 seminar and urged Governments to collaborate with international
bodies in a concerted effort to eliminate these practices.
Commission
on Human Rights and Sub-Commission on Prevention of Discrimination and
Protection of Minorities
For a
number of years, many voices, both national and international, have been
echoing the United Nations call for an end to the suffering of girls and women
caused by harmful traditional practices. In the 1980s, the campaign against
such practices became so widespread that, in 1983, the issue was taken up by
the Sub-Commission on Prevention of Discrimination and Protection of Minorities.
The Sub-Commission's recommendation that a working group be established to
conduct a study of all aspects of the problem was endorsed by the Commission on
Human Rights and the Economic and Social Council.
The
Working Group on Traditional Practices Affecting the Health of Women and
Children, composed of experts designated by the Sub-Commission on Prevention of
Discrimination and Protection of Minorities, UNICEF, UNESCO and WHO, and
representatives of concerned NGOS, held three sessions in Geneva during 1985
and 1986. The report of the Working Group (E/CN.4/1986/42) was submitted to the
Commission on Human Rights at its forty-second session, in 1986.
By its
resolution 1988/57 of 9 March 1988, the Commission on Human Rights requested
the Sub-Commission to consider measures to be taken at the national and
international levels to eliminate the practices in question, and to report to
the Commission on the subject. Pursuant to that request, the Sub-Commission
appointed one of its members, Mrs. Halima Embarek Warzazi, as Special
Rapporteur to study, on the basis of information to be gathered from
Governments, specialized agencies, other intergovernmental organizations and
concerned NGOS, recent developments relating to traditional practices affecting
the health of women and children (Sub-Commission resolution 1988/34 of 1
September 1988).
The
Special Rapporteur submitted a preliminary report (E/CN.4/Sub.2/1989/42 and
Add.1) and a final report (E/CN.4/Sub.2/1991/6), containing information
received from the above-mentioned sources, as well as information gathered
during field missions to the Sudan and Djibouti. These field missions, together
with two regional seminars on the subject organized by the Centre for Human
Rights in Africa and Asia (Burkina Faso, 1991; Sri Lanka, 1994), have
contributed to a better understanding of the phenomenon of harmful traditional
practices which violate the rights of women and children.
Finally,
in its resolution 1994/30 of 26 August 1994, the Sub-Commission adopted the Plan
of Action for the Elimination of Harmful Traditional Practices Affecting the
Health of Women and Children, which was prepared by the Sri Lanka regional
seminar (see annex).
In the same resolution, the Sub-Commission recommended the extension of the
Special Rapporteur's mandate for an additional two years, to enable her to
carry out an in-depth analysis of the issue, taking into consideration the
conclusions and recommendations of the two regional seminars and the effects of
the implementation of the Plan of Action.
The
resolution also called upon the Secretary-General to transmit the Plan of
Action to the International Conference on Population and Development, held at
Cairo in September 1994, and to the Fourth World Conference on Women, to be
held at Beijing in September 1995. The Special Rapporteur was requested to
submit reports at the forty-seventh and forty-eighth sessions of the
Sub-Commission, in 1995 and 1996, respectively. The Sub-Commission's
recommendations were endorsed by the Commission on Human Rights in its decision
1995/112 of 3 March 1995.
Committee
on the Elimination of Discrimination against Women
At its
ninth session, in 1990, the Committee on the Elimination of Discrimination
against Women addressed the issue of harmful traditional practices, in
particular FGM. In general recommendation No. 14 adopted at that session, it
indicated its recognition of work carried out by women's organizations in
identifying and combating harmful traditional practices. The Committee
recommended that Governments support those efforts and encourage politicians,
professionals, and religious and community leaders at all levels, including the
media and the arts, to cooperate in influencing attitudes towards the
eradication of FGM. The Committee also called for the introduction of
appropriate educational and training programmes and seminars based on research
findings about the problems arising from FGM.
The same general recommendation urged Governments to:
. . .
(b)
Include in their national health policies appropriate strategies aimed at
eradicating [FGM] in public health care ... [including] the special
responsibility of . . . traditional birth attendants . . . ;
(c)
Invite assistance, information and advice from the appropriate organizations of
the United Nations system to support and assist efforts being deployed to
eliminate harmful traditional practices;
(d)
Include in their reports to the Committee under articles 10 and 12 of the
Convention on the Elimination of All Forms of Discrimination against Women
information about measures taken to eliminate [FGM].
United
Nations Children's Fund
The United
Nations Children's Fund (UNICEF) has supported a wide range of programme
activities for the advancement of women and girls through advocacy,
policy-oriented research and technical cooperation. There are many examples in
the sectors of health, education, income generation and water supply and
sanitation of projects successfully addressing the needs of women and girls and
promoting their participation in community development.
Special
attention is given to the girl child and to the need to reduce disparities in
the treatment of boys and girls. The Convention on the Rights of the Child and
related policy efforts have stimulated regional and country-level action for
advocacy and mobilization in favour of girls and for the elimination of
discriminatory social and cultural practices. Social mobilization has focused
on changing attitudes, particularly those related to the preference for sons in
most countries in Africa, Asia, the Caribbean and Latin America. UNICEF's
national, regional and international advocacy of appropriate policies and its
efforts to bring about attitudinal and behavioural change, especially in such
critical areas as early marriage, female genital mutilation, teenage pregnancy
and female infanticide, will be intensified through support to local and national
groups and organizations concerned with these issues.
In May
1994, UNICEF's Executive Board requested the Executive Director to give high
priority to a number of efforts to promote gender equality and gender-sensitive
development programmes, taking into account the special needs of individual
countries and, inter alia, the provisions of the Convention on the
Rights of the Child and the Convention on the Elimination of All Forms of
Discrimination against Women. The priorities for action include:
(a)
strengthening the integration of gender concerns in country programmes by
eliminating the disparities which exist at each stage of the life cycle of
girls and women;
(b)
promotion of ratification and implementation of the Convention on the
Elimination of All Forms of Discrimination against Women, as well as the
Convention on the Rights of the Child;
(c)
support for specific action and strategies which promote gender equality within
the family, including the sharing of parental responsibilities.
UNICEF
country offices are working closely with NGO partners and Governments, as well
as with other groups, including women's organizations, religious leaders,
health workers and teachers.
World
Health Organization
The World
Health Organization (WHO) has been concerned with the issue of harmful
traditional practices since 1958, when ECOSOC requested a study of the health
implications of FGM. At a seminar in 1979, organized by the WHO Regional Office
for the Eastern Mediterranean in Khartoum (see p. 24 above), WHO condemned FGM
as a serious health risk which should be abolished, and called upon medical
personnel to refrain from performing FGM.
WHO
promotes and supports traditional practices which enhance health-for example,
breast-feeding-and discourages those which are harmful, particularly to the
health of women and girls. Among the latter, female genital mutilation presents
the most dramatic risk of ill health, affecting some 75 million women and girls
in Africa alone. The organization also discourages nutritional taboos which
prevent pregnant and lactating women from eating essential foods. WHO works
closely with all concerned national authorities, and particularly with
non-governmental organizations, on these issues.
In 1993,
the Forty-sixth World Health Assembly adopted resolution WHA46.18 on maternal
and child health and family planning for health. The resolution expressed
concern, inter alia, about the continuing inequities affecting
women in general and the persistence of harmful traditional practices such as
child marriages, dietary limitations during pregnancy, and FGM. It urged member
States to continue to monitor and evaluate the effectiveness of their efforts
to achieve the goal of health for all, in particular in eliminating traditional
practices affecting the health of women, children and adolescents.
In 1994,
the Forty-seventh World Health Assembly adopted resolution WHA47.10, dealing
specifically with harmful traditional practices, in which it urged all member States
(para. 2):
(1) to
assess the extent to which harmful traditional practices affecting the health
of women and children constitute a social and public health problem in any
local community or subgroup;
(2) to
establish national policies and programmes that will effectively, and with
legal instruments, abolish female genital mutilation, child-bearing before
biological and social maturity, and other harmful practices affecting the
health of women and children;
(3) to
collaborate with national non-governmental groups active in this field, draw
upon their experience and expertise and, where such groups do not exist,
encourage their establishment;
In the
same resolution, the Assembly requested the Director-General of WHO to
strengthen technical support to member States in implementing the above
measures; and to continue global and regional collaboration with
non-governemental organizations, United Nations bodies, and other agencies and
organizations concerned in order to establish national, regional and global
strategies for the abolition of harmful traditional practices.
B.
Governments
The
preliminary report (E/CN.4/Sub.2/1989/42 and Add.1) and final report
(E/CN.4/Sub.2/1991/6) of the Special Rapporteur on traditional practices affecting
the health of women and children contain summaries of information on the topic
received, in response to requests by the Secretary-General, from 28
Governments. However, many of these Governments stated that harmful traditional
practices were unknown in their countries. Others recognized the existence of
some such practices, namely female genital mutilation (FGM), son preference and
inferior social status of women, and practices related to marriage, pregnancy
and nutrition.
A number
of countries throughout the world have either taken or supported action to
prevent traditional practices affecting the health of women and children, in
particular FGM.
Bangladesh
clearly
upholds the principle of equality of men and women and prohibits discrimination
against women. To protect the legal rights of women and to stop violence and
repression against them, the Government has adopted the following legislation:
(a)
Dowry Prohibition Act, 1980, which provides for punishment for giving,
taking or abetting the giving or taking of dowry;
(b)
Cruelty to Women (Deterrent Punishment) Ordinance, 1983, which provides for
punishment for abduction of women for unlawful purposes, trafficking in women, or
causing or attempting to cause death or grievous harm to a wife for dowry;
(c)
Child Marriage Restraint Act Amendment Ordinance, 1984, which raises the
marriageable age for women from 16 to 18 years, and for men from 18 to 21
years. It also provides for punishment for marrying or giving in marriage of a
child;
(d)
Muslim Family Laws Ordinance, 1961 (as amended in 1982), which provides for
increased punishment in cases of polygamy and divorce in violation of the
statutory provisions.
In the Sudan,
a law was passed in 1946, under the British Colonial Administration, to
prohibit the practice of infibulation.
In Sweden,
the Act on Prohibition of Female Circumcision was passed in 1982. It
not only seeks to bring to justice those breaking Swedish laws, but also any
person living in Sweden who assists in carrying out FGM in another country
which also has prohibitive laws.
In the United
Kingdom, the Prohibition of Female CircumcisionAct was adopted in
1985. Measures against FGM have also been included in the child protection
procedures at local authority levels.
In the United
States of America, the Federal Prohibition of Female Genital Mutilation
Act was under consideration by the House of Representatives in early 1995.
A number
of countries which have not yet passed specific laws use existing national
legislation to prohibit the practice of female genital mutilation.
In
France, no specific law exists, but article 312-3 of the Penal Code is
applied to prosecute persons exercising violence against or seriously
assaulting a child under 15, "if the result has been mutilation,
amputation or . . . loss of an eye or other permanent disabilities, or death
not intentionally caused by the perpetrator". The Criminal Division of the
Cour de cessation decided, by a judgement of 20 August 1983, that ablation of
the clitoris resulting from wilful violence constituted a mutilation under
article 312-3 of the Penal Code. While the term "female genital
mutilation" is not used in the Penal Code, this decision makes it quite
clear that such practices fall within the purview of the enactment.
In
Norway, all hospitals were alerted in 1985 to the practice of female
genital mutilation.
All the
above Governments have also acknowledged the importance of education and
awareness raising among both the practising communities and service providers.
Practical steps are being taken in Australia, Belgium, Canada, Djibouti, Egypt,
Finland, France, Germany, Italy, the Netherlands, Norway, Somalia, the Sudan,
Sweden and the United Kingdom to ensure that relevant information is
disseminated. Lack of information from Africa and Asia makes it difficult to
ascertain what recent action has been taken at national and grass-roots levels.
Some
African countries are in the process of formulating national legislation
against FGM, including Burkina Faso, Djibouti, Egypt, Ghana and Nigeria. In
Burkina Faso, Kenya and Senegal, statements have been made by heads of State expressing
the need to eliminate FGM.
As regards
Asia, the following countries reported on ongoing and planned action to
eradicate harmful traditional practices at the second United Nations regional
seminar on the subject, held in Sri Lanka in July 1994: China, India, Islamic
Republic of Iran, Iraq, Malaysia, Nepal, Pakistan, Republic of Korea,
Singapore, Sri Lanka and Thailand (E/CN.4/Sub.2/1994/10, paras. 75 ff.).
C.
Non-governmental organizations
Available
information indicates that increasingly more grass-roots activities in the area
of harmful traditional practices are taking place in Africa and Asia, as well
as in Western countries. In Australia, Canada, Europe, New Zealand and the
United States of America, the work of dedicated women is raising awareness and
providing training and advice to service providers such as midwives, health
visitors, nurses, doctors, teachers and social workers.
Of the 29
countries in Africa identified as having communities practising female genital
mutilation, 24 have branches of the Inter-African Committee on Traditional
Practices Affecting the Health of Women and Children, in addition to many
women's NGOs. Many established national women's organizations have carried out
research and surveys, and others have ventured into communities where FGM and
other harmful traditional practices prevail, setting up training programmes for
excisors, traditional birth attendants and community members.
Work at
this level is vital, for it is through the activities of NGOs that positive
changes are being realized. Although early results of work in these communities
are encouraging, to change a community's attitude totally will take at least a
generation. The NGOs in question thus urgently need continuing financial
support to ensure that their programmes are fully implemented.
Prominent
non-governmental organizations
(a) Inter-African Committee on Traditional Practices Affecting the Health of Women and Children