[afro-nets] JHPIEGO & WHO Male Circumcision Clinical Training Course in Africa (2)

General afro-nets
1

Dear Colleagues:

I was quite pleased to see this posting dealing with training opportunities for provision of safe medical practice for male circumcision. I would like to gain some ideas, opinions and feedback from this group about how the WHO and others like ourselves might help to develop the same kind of approach to female circumcision in Africa.

First let me state that I personally do not believe that female circumcision is a good thing-- however I have no way of knowing for two reasons. One is that I am male ( circumcised as a baby by the way), and the other is that active, emotion-driven discrimination against provision of medical support for female circumcision makes it impossible to judge.

I take serious issue with the current oppressive approach to female circumcision that the world seems to tolerate without regard for the fact that millions of intelligent black African women believe that it is a good thing. In case you have not already seen it I would like you to consider the full scope of human rights implications of this recent action by the Metroplitan Police of London, UK:

In which is reported that GBP 20,000 ($47,000) is being offered as a reward for anyone revealing another person practicing female circumcision.

I wonder what would have been the implications of such a reward for say, illegal abortions, breast implantations, or plastic surgeries when they were considered "unacceptable" not so long ago?

From a more pragmatic viewpoint , this amount of money could be much better spent on defining international guidelines for safe medical practice of female circumcision, providing public healthcare for those desiring it, and creating a controlled, participatory platform for its eventually demise (or wider adoption!) depending on what women/girls choose for themselves or their children. Since many concepts of womanhood and beauty are associated with femaile circumcision, there is no a priori reason to assume that a thriving female circumcision industry could not emerge in the same way it has for plastic surgery. Our current attitudes in the West could in effect be blocking a global development opportunity for black African women.

Medical attitudes towards male circumcision have recently been radically altered as a result of the discovery that it has an impact on transmissibility of HIV for example, so the jury is still out on whether female circumcision has a place in 21st century public health interventions or not.

Whatever one's personal opinion, or emotional response to the consequences of unregulated female circumcision practices, I believe that we need to stand up for the rights of black African women to receive the same 21st century scientific, legal, and medical interventions in support of circumcision that we give to all ethnicities of men.

Eluemun Blyden, PhD
mailto:eluem_blyden@yahoo.com

2

Dear colleagues,

I was shocked and dismayed to read the remarks of Eluemeno Blyden, who tries to equate male circumcision with female circumcision (also known as female genital mutilation (FGM) or female genital cutting (FGC)). It is precisely this kind of misinformation that can harm campaigns to encourage male circumcision in Africa, which three recent randomized-controlled trials have shown to be very protective of HIV (as high as 60%). Female circumcision, in stark contrast, has no health value whatsoever and can even cause death or morbidity.

Despite this important new evidence that male circumcision is beneficial to men, Blyden argues that money for male circumcision clinical training "could be much better spent on defining international guidelines for safe medical practice of female circumcision, providing public healthcare for those esiring it, and creating a controlled, participatory platform for its eventually demise (or wider adoption!) depending on what women/girls choose for themselves or their children."

Blyen is clearly out of step with the international community which has strongly condemned the practice. As UNFPA notes: "FGM/FGC is harmful to the health of women and girls and violates their basic human rights and medicalization of the procedure does not eliminate this harm. On the contrary, it reinforces the continuation of the practice by seeming to legitimize it. Health practitioners should provide all necessary care and counseling for complications that may arise as a result of FGM/FGC."

We do not need international medical guidelines for a procedure that is detrimental to the health, sexuality and life of girls and women, not only in Africa but also on other continents.

Blyden further argues that women in Africa have the "right" to be mutilated. But many African governments have banned the practice by law because of its harmful effects. These include: Benin, Burkina Faso, Central African Republic, Chad, Cote d’Ivoire, Djibouti, Egypt (Ministerial decree), Ghana, Guinea, Kenya, Niger, Nigeria (multiple states), Senegal, Tanzania, and Togo. (In Sudan only the most severe form of FGM/FGC is forbidden by law.) Clearly, they do not think that female circumcision is a "right"--and neither should we.

Blyden also maintains that "millions of intelligent black African women believe that it [FGM/FGC] is a good thing." Just because an activity persists, it does not mean that women think it is "good." Rather, studies indicate that communities continue to practice FGM/FGC if they believe that their tradition or religion requires it, if they think that girls would be unmarriageable and unruly if it were not done, and if they are not aware of the health effects across a woman's life course.

Hence, with greater awareness of the health consequences, more exposure to uncircumcised women, and increased education/empowerment of women, many communities are abandoning the practice.

I hope these comments will help others in this forum to combat efforts like Blyden's to conflate male circumcision with female circumcison. Unfortunately, these efforts may increase now that more international funding is becoming available for male circumcision activities.

Sincerely,

Paula Tavrow, PhD
Director
Bixby Program in Population and Reproductive Health
UCLA School of Public Health
Los Angeles, California USA
mailto:ptavrow@yahoo.com