Female Genital Mutilation Practices in Kenya: the Role of Alternative Rites of Passage a Case Study of Kisii and Kuria Districts

Female Genital Mutilation practices in Kenya: The role of Alternative Rites of Passage A case study of Kisii and Kuria districts

Habil Oloo Population Council Monica Wanjiru Population Council

Katy Newell-Jones Feed the Minds

Feed the Minds is a charity registered in England and Wales (291333) and in Scotland (SC041999).

To receive additional copies, email: [email protected] or visit www.feedtheminds.org PAG PAG R P P F A PAG A L PAG C PAG C PAG T PAG L PAG T PAG PAG PAG PAG Ba E Acknowled reflect theviews ofComicRelief. opinionsexpressedThe herein are thoseoftheauthors anddonotnecessarily reportThis was madepossiblethrough provided support by ComicRelief, UK. Abbrevi AG AG OCUS essons le imit xecutive summ he he pp pp e a a ck f se se study 1: FG endix endix A: erences E E E E E E E E E E E E E E R R 42 40 38 37 30 24 16 16 15 7 13 4 3 2 S g ese ese a tudy 2: FG G round to FG tions in ROU a a a tions rch Findin rch: Pur B a : rned P: T g RESE A ements DISCUSSION BLE the study a M M nd A a a

RCH ry a a O p nd recommend M mon mon ose F PA a cr g in

T s OOLS a RTICI onyms g g K nd G eny the the UIDE D

PA a esi K K

NTS isii community uri

g n a

a community tions

1. Contents 2. Abbreviations and acronyms FG FG G G FG SD N MYW M KDHS EC DHS A A UN TNI PA YWC WHO WH UNICE UN R W R DR G T E o TH A P A FPA M M D P Z A U O A A W A

YDO IDS A / O C F

Gesellschaft für Girl F F F Ad S R Program forAppropr M K (Ger E D Alternative T N M W U U Joint Y W eventh emale Genital emale Genital ocus Group oung ducation saru saru nited nited each en on-governmental emographic and orld orld aendeleo ya emorandum of ventist ya E man U mpowerment Programme mpowerment H H N W nited W H N N ealth ealth Assembly tomonok omen’ D ealth and omen and ations ations Population Fund T R ay Adventist C echnical elief Agency R N entre fortheAdvancement of D ite ofPassage O ations Programmeon W s iscussion C rganisation M M C ana T hildren’s Fund U I echnische Zusammenarbeit hristian Association hristian utilation / utilation D nitiative H Y nderstanding O ouths emographic C wake ealth iate rganisation ooperation) T S D echnology in urveys evelopment C utting H ealth HIV S O andAids H urveys urveys ealth rganisation W omen T through thedirect outthisresearch. experience ofcarrying We are gratefultoextend ourown fortheopportunity knowledge ofthecontext andKisii ofFGMinKuria Finally, thisresearch couldnothave ofComicRelief, UK. takenplacewithoutthepartnership support field work andKisii. inKuria to extend specialthankstoHelenDempsey ontheliterature forhersupport review which the informed through theofficialchannelsandIan Askew who provided technicaladvice. Feed theMinds would alsolike We are grateful tostaffatPopulation Councilincluding Osulah,Winnie who guided theresearch proposal ofpassageprogrammerites inKisiwithstaffandbeneficiaries. findings ofthis research are based. We also really todiscussthe valued theopportunity YWCAalternative as well inthefocus group asthosewho participated discussionsandin-depthinterviews, onwhich the We areandKisii discussionsinKuria inthe informal indebtedtoallofthosewho particularly tookpart and fororganising theprogramme offocusgroup discussionandinterviews. Kisii formobilisingthecommunities, introducing ustolocalagenciesinvolved inanti-FGMprogrammes We would liketoexpress oursincere thankstothestaffandvolunteers ofECAW andRWAYDO inKuria in Youths Development Organisation (RWAYDO), Kenya. UK, EducationCentre forthe Advancement of Women (ECAW), Kenya andReach Women and his research outby was carried Population Council, Kenya, inpartnership withFeed theMinds,

3. Acknowledgements 4. Executive Summary T FGM ascurrently practised by and theKuria researchThis tobetterunderstand was undertaken education andempowerment programmes. legal andhumanrights; andthepromotion ofgirls’ of passage; addressing FGMthrough religion; sources ofincometocircumcisers; alternative rites approaches; educatingandproviding alternative FGM include: practice healthrisk/harmful of success, toencourage communities toabandon In Kenya, approaches used, withvaryingdegree Luhya (lessthan1%). Turkana, andrarely practiced amongtheLuoand relatively low amongthe Kikuyu, Kambaand Kisii (96%), (96%)andtheMaasai(93%), Kuria has remained highestamongtheSomali(97%), prevalence isdecreasing. However, theprevalence FGM thanyounger women, indicatingthe further Older women are more likely tohave undergone a declinefrom 32%in2003and38%1998. In 2008/9, 27%ofwomen hadundergone FGM, of FGMhasbeendecreasing over thelastdecade. Surveys (KDHS)shows thattheoverall prevalence Evidence from theKenya Demographic andHealth fidelitywithin,and ensuring marriage. and women, thereby curbing sexual activity before, as ameansofreducing thesexual desire ofgirls family andsociety. Secondly, FGMisperpetuated mature, obedientandaware ofherrole inthe womanhood; acircumcised woman isconsidered are firstly,rite ofpassage from asa girlhoodto mainreasonsThe forthecontinuation ofFGM of whom live in28 countries.African currently live withtheconsequencesofFGM, most An estimated100–140milliongirlsandwomen the femalegenitalorgans fornon-medicalreasons’. female genitalia or other injury to female genitaliaorotherinjury or totalremoval oftheexternal ‘all procedures involving partial Mutilation (FGM)ascomprising he WHO defines Female Genital individual toinvestigate: interviews approach, involving focusgroup discussionsand Kisii communities. studyThe usedaqualitative preference inthisdirection. Kisii, although parents alsoexpressed inKuria a outtheprocedurecarry evident isparticularly in since 2001. changetousingmedicalstaff The to theillegalityofFGMunder ChildrenThe Act, before they mightrefuse andalsoinresponse appearsThis tobeinorder tocircumcise them younger, withmany girlsunder10years of age. marked trend towards girlsundergoing FGMmuch As reported inotherresearch, there hasbeena who are educated. is fargreater foruneducatedgirls thanforthose directed towards uncircumcised girlsandwomen andKisiithattheisolationstigma in bothKuria isolation andridicule. However, there isevidence and women frequently experience stigmatism, and more socially acceptable. Uncircumcised girls generally considered more suitableformarriage girls undergoing FGMare given giftsandare celebration, ofteninsecret. Inbothcommunities, is aprivate family affair, usually without public when circumcision shouldtakeplace. InKisii, FGM decrees from theCouncilofElders, which decides public event amongtheKuria, dictatedby the findings showThe thatFGMisstillacelebrated interviews.informant data through focusgroup discussionsandkey researchThe usedqualitative methods, collecting •• •• •• take decisionstoabandonFGM. factors which encourage individuals to Alternative RiteofPassage (ARP); awareness andattitudestowards the to FGMamongmenandwomen; current attitudesandpractices inrelation Kisii,group thissignificant ofpeople, who feel in reducing theprevalence and ofFGMinKuria socially acceptable. Ifreal progress istobemade send theirdaughters tobecut inorder tobe uncircumcised women issostrong that they will circumcised, but who feelthestigmatisationof FGM andwould prefer nottohave theirdaughters parents, who are of about thehealthrisks informed andKisii,in bothKuria mainly young peopleand studyThe identifiedasectionofthecommunities challenge themyths andassumptionsaround FGM. ofgirlsandwomen,violation oftherights andalso programmes which cover thehealthrisks, in community educationandgirlempowerment ARP needstobefully explained andembedded church, schoolandcommunity leaders. As such, including parents, theCouncilofElders (inKuria), accepted locally, by particularly decision-makers dependent ontheconceptbeingunderstood and an approach toabandoningFGMisstrongly studyThe suggeststhatthesuccessof ARP as recognises theseelementsonly tolimitedextent. ofgirlsandwomen,rights thelocalcommunity ofFGMandtheviolation the healthrisks ARP graduation ceremony, aswell astraining on season. Although thesecampsalsoincludean FGM, withcampsorganised theFGM during emphasis hasbeenplacedonrescuing girlsfrom the conceptof ARP islesswell articulated. The as analternative toFGM. Incontrast, inKuria, to recognise the ARP graduation ceremony activities, which encourage thelocalcommunity by intensivesupported community awareness programmes. Residential ARP campsare used inKisii, integrated withgirls’ empowerment researchThe foundthat ARP hasbeensuccessfully among theKisii. be more readily acceptedamongtheKuria, than celebration. wouldThis suggestthat ARP would time, replace thecutwhilst retaining thetraditional the intentionthat ARP graduation would, over where FGMinvolves apubliccelebration, with considered mostappropriate forcommunities religious andcommunity leaders. ARP isgenerally raising, working withschools, healthproviders, of aprogramme involving community awareness andKisiiinthelastdecade,in Kuria oftenaspart The ARP isoneoftheapproaches implemented to learn about FGM and the rights ofyoung aboutFGMandtherights to learn school are lesslikely tobeinvolved inactivities However, families whose children are notattending social inhibitionsanddiscussFGMwithpupils. the capacityofteachers tohelp themovercome work closely withschoolsandchurches, building address FGM. Itisrecommended thatpartners schools providing avaluable inwhich forum to abandonment ofFGMinKisiiandKuria, with factorinthe Education isseenasanimportant and Kisii,Kuria aselsewhere inthecountry. that law enforcement isseentobehappeningin awareness ofthelegislationisstrengthened and thiswork.undertaking thatpublic Itiscrucial little ornoactiontakenagainsthealthprofessionals parents canafford it. However, there appears tobe thereand inKuria isamove inthisdirection, where frequently by carried healthprofessionals inKisii prosecuting thosewho contravene thelaw. FGMis with theprocess ofreporting, investigating or framework atcommunity level andfew are familiar awareness oftheprecise nature ofthelegal as weak inrelation toFGM. There isalackof andKisii,In bothKuria thegovernment isseen professionals. as church leaders andschoolteachers andhealth community leaders, bothmenandwomen, aswell community awareness programme which reaches ARP shouldbeextended andcombinedwitha empowerment programmes which incorporate In Kisii, itisrecommended thatthemodelofgirl the CouncilofElders aspotentialchangeagents. community. Attempts shouldbemadetoengage moreconcept needstobearticulated clearly inthe throughout theyear. For ARP tobesuccessful, the education andgirlempowerment initiatives season andengageinlonger-term community shift theirfocusfrom rescue campsintheFGM In Kuria, itisrecommended thatlocalagencies whose girlsundergo FGM. understood andactionistakenagainstparents and privately, ofchildren therights are more fully and schoolteachers, opposeFGMbothpublicly respected people, forexample church leaders this ismore likely tohappeninaclimatewhere to break withtradition. researchThe suggeststhat pressurised toconform, needtofeelsafeenough

5. 6. the abandonmentofFGMinfuture. devise more effective interventions toencourage will enableagenciesworking andKisiito inKuria to theuseof ARP have identifiedfactors which to bebetterunderstood. findingsin The relation within which andKisii FGMtakesplaceinKuria researchThis hasenabledthecurrent context of FGM. interventions toencourage the abandonment working andKisiitodevise inKuria more effective It ishopedthatthesefindingswillenableagencies whom have limitedlevels ofliteracy. families outsidetheschoolnetworks, many of marginalised incommunities, those inparticular that agenciesalsotarget someofthemore girls andwomen. Itisrecommended, therefore, north-east Africa. north-east in 28 countries,African mainly inwest, eastand every year. Mostofthese girlsandwomen live women undergo oftheprocedure someform of FGM, andthatatleastthree milliongirlsand and women currently live withthe consequences The WHO estimatethat100–140milliongirls the more extreme procedure (typeIII). substantially higherforthosewho have undergone I. healthrisks, All typescarry althoughtheseare girls andwomen subjectedtoFGMundergo type (table) andestimatesthatapproximately 80%of The WHO hasclassifiedfourbroad typesofFGM deaths. andnewborn that canleadtomaternal later, childbirth potentialcomplicationsduring severe bleeding, infections, retention ofurine, and healthconsequencesofFGMinclude long-term the natural functioningofthebody. Immediateand to, healthy, genitaltissueinterferes normal with suffered cutting, during theremoval of, ordamage togirlsandwomen.harmful As well assevere pain health benefits. Onthecontrary, itisknown tobe 2 HO (2008) Eliminating Female Genital Mutilation: An 1 F

reasons to thefemalegenitalorgans fornon-medical

http://www WHO w p U i W nteragency statement OHCHR, UNAIDS, UNDP, UNECA, UNESCO, ublications/2008/9789241596442_eng.pdf NFPA, UNHCR, UNICEF, WHO http://whqlibdoc.who.int/ 2 ’. practiceThe ofFGMhasnoknown ebsite: .who.int/topics/female_genital_mutilation/en/ emale GenitalMutilation female genitalia or other injury female genitaliaorotherinjury or totalremoval oftheexternal ‘all procedures involving partial defined by the WHOascomprising 1 (FGM)is

Genit Ta 3 context andpasseddown thegenerations psychosexual andsocialreasons, specifictoeach culture, driven by acomplex combinationof their women are deeply rooted inthetraditional reasonsThe why somecommunities circumcise Ra

T T T T W ype ype ype ype An anal Muteshi JandSass(2005)F orld ble: tion of typesfemalegenital mutilation I IV III II ysis ofcurrent abandonment approaches. PATH H a ealth T l a y le M p O util es o scraping andcauterization. pricking, piercing, incising, purposes, forexample, genitalia fornonmedical procedures tothefemale (infibulation). without excision oftheclitoris and/or thelabiamajora, withor restitching thelabiaminora covering sealby cuttingand withcreationorifice ofa labia majora (excision). with orwithoutexcision ofthe andthelabiaminora,clitoris P (clitoridectomy). and/ortheprepuceclitoris P Unclassified –allotherhar Nar f rganisation’s classification artial ortotalremovalartial ofthe ortotalremovalartial ofthe or FG rowing ofthevaginal emale GenitalMutilationin Africa: f a Fem tion M a le 3 . mful

7. Background to FGM in Kenya 8. young woman iscircumcised ornot. appears nottomakeadifference towhether a however, forinstanceinEgypt, where education likely tobecircumcised. There are exceptions, the daughters ofwell-educated women beingless some evidence thateducationplays arole, with is higherinrural thanurbanareas. There isalso ties. Inmost, but notallcountries, FGMprevalence roring thehomelandsofspecificethniccommuni- prevalence ofFGMinmany countries, usually mir- is complex, withstrong regional differences inthe drive andrespecting cultural/traditional heritage. FGM isalsoconsidered ashelpingcurbsexual a woman, andchildbearing. includingmarriage woman, outtheroles abletocarry assignedto step inmarking thetransition ofagirlintomature beautiful by FGM. FGMisalsoseenasanessential are ugly, have abadodourandcanbemademore byoften underpinned beliefsthatfemalegenitalia are frequently quotedasfactors FGM, supporting used tojustifythepractice. Hygieneandaesthetics communities, religious interpretations have been sanctioned by any religious texts. Although insome across different religious groups. FGMisnot rather thanareligious practice, occurring be betterunderstood key factors influencingtheprevalence ofFGMto residence andeducationhasenabledsomeofthe tion characteristics suchasage, ethnicity, religion, Global Action bia’s report, Female GenitalMutilation: A callfor Surveys (DHS), prompted atleastby inpart Tou- through20 countries theDemographic andHealth collection onFGMhastakenplaceinmore than Since the1990s, nationalandsub-nationaldata Prev to thepractice have beenidentifiedasfeatures which contribute Although religion, aestheticsandsocialculture 5 4

Action. T date: Moham oubia N(1993)Female GenitalMutilation: A callforGlobal What works andwhat doesn’t work. Geneva: WHO/PATH a New York: Rainbo ud A Ali Nand N(1999)FGMprogrammesYinger to lence o 5 4 . collationofdatabyThe popula- , FGMremains primarilyacultural 3 . pictureThe which emerges f FG M

Eff health services. focusing onadvocacy, research andguidancefor education, finance, justiceand women’s affairs, generation through actionacross concerted health, an integrated approach toendingFGMwithinone Assembly resolution in2008(WHA61.16)calledfor the procedure results indeath. The World Health degrading treatment, tolifewhen andtheright person, tobefree the right from torture and to health, andphysical of the security integrity and dignityofwomenrights andgirls, therights for itspractice, andviolatesthe FGMisharmful FGM. Itstressed thatregardless ofthereasons approaches toencouraging theabandonmentof health consequences, andtheimpactofvarious professionals outFGMtoreduce incarrying the practice, theincreased involvement ofhealth years, focusingonthereasons forthecontinued on theresearch outintheintervening carried and policydimensions. statementwasThis based and astronger focusonthehumanrights, legal statement was released, withwiderUNsupport Nations Population Fund(UNFPA). In2008, anew Children’s Fund(UNICEF)andtheUnited Health Organization (WHO), theUnitedNations the practice ofFGMwas issuedby the World In 1997, statementagainst ajointinternational and policymakers. engagement ofcommunities, healthprofessionals to includelocally-led initiatives andthefull toencourageefforts abandonmentneeded issue.and humanrights Itwas acknowledged that Beijing, inwhich FGMwas portrayed asahealth Conference on Women (1995)tookplacein Development (1994)andtheFourth World Conferencethe International onPopulation and attitudes begantochangeinthemid-1990swhen outsiders withtheirown agenda. However, ofindigenousculturecritical andimposedby and 1970swere similarly regarded asbeing ofwestern feministsinthe1960s efforts The and were largely seenascolonialimperialism earlycolonial authorities inthetwentieth century, FGM were first recorded and by missionary Attempts topersuade communities toabandon I ntern orts onFG a tion a l M 3 . 7 ican Commission onHumanandPeople’s Rightswebsite: 6 Surveys According totheKenya Demographic andHealth Prev FG onHumanRightstheof Charter Women the 2003 UnionProtocolAfrican tothe Africa practice andwas specifically condemnedin FGM hasbeenwidely recognised asaharmful genital mutilation.....in order toeradicate them.’ medicalisation, andpara-medicalisation offemale offemalegenitalmutilation,forms scarification, to eliminatesuchpractices, including...... all legislativetake allnecessary andothermeasures recognised standards. international shall Parties ofwomenhuman rights andwhich are contrary to practiceall harmful which negatively affectthe states that shallprohibit‘Parties andcondemn Practices), 5EliminationofHarmful (article which ethnic groups andrelatively low amongtheKikuyu, (97%), Kisii(96%), (96%)andMasai(93%) Kuria prevalence rates remain highestamongtheSomali factors influencingthepractice ofFGMinKenya - in CoastProvince. Ethnicityisoneofthestrongest circumcised, compared to 14% in Nairobi, and 10% and Kisiidistricts),Kuria 34%ofthewomen were Province. InNyanza Province (which includes compared toonly 1%ofwomen in Western Province Eastern North hadbeencircumcised, in prevalence ofFGM-98%women in 2008/2009 KDHSfoundregionalThe variations of FGMisdecreasing. aged 45-49,indicatingthattheprevalence further being circumcised, asopposedto49%ofthose older women, with15%ofwomen aged15-19 proportion ofwomen circumcised ishigheramong decline from 32%in2003and38%1998. The of femalerespondents hadundergone FGM, a decreasing inKenya. In2008/9onaverage 27%

http://apps WHO Ken http://www Afr M a 7 (KDHS), theoverall prevalence ofFGMis lence ya Demographic andHealthSurvey 2008/2009 .achpr.org/english/_info/women_en.html .who.int/medicinedocs/en/m/abstract/Js17116e/ in K a nd ty eny p e a

a childtoFGMistwelve monthsimprisonment penalties underKenyan law foranyone subjecting illegal forgirlsundertheageof18. potential The adopted theChildren’s Act which madeFGM in collaboration withpartners. In2001, Kenya prospects’ (9%). marriage’ (16%); and ‘to have bettermarriage reasons citedinclude ‘to preserve virginity until reasonthe mostimportant forcircumcision; other were circumcised cited ‘social acceptance’ as In the2008/2009KDHS, 24%ofwomen who economic benefits, are associatedwithFGM. it. Deeply rooted customs, linkedtosocialand of socialandreligious reasons forcontinuing with nicked withnoflesh removed (typeIV). closed (typeIII). Only 2%percent saidthey were form, inwhich thelabiaare removed andsewn the clitoris. percent Thirteen hadthemostinvasive flesh removed, which usually includes removal of having beencircumcised saidthatthey hadsome In 2008/9, ofthewomen themajority who reported of women school. who attendedsecondary education beingcircumcised, asopposedto19% factor, with54%ofwomen withoutany formal in urbanareas. Educationisalsoasignificant that they were circumcised, compared tojust17% average 31%ofwomen intherural areas reporting FGM between rural andurbanareas, withon There are alsodifferences intheprevalence of Ra Luhya lessthan1%ofthewomen undergo FGM Kamba and Turkana, whilst among theLuoand 9 8 and indicators 2019), which setoutbroad goals, strategies, targets Plan of Action fortheEliminationofFGM(1999- In 1999, ofHealthissuedaNational theMinistry L Communities thatpractice FGMreport avariety

e per Ab www GTZ (2007)F ga tion usharuf RM(2007) Femaleusharuf Circumcision: multicultural spectives. Penn Press .gtz.de/en/dokumente/en-fgm-countries-kenya.pdf l st a emale GenitalMutilationinKenya. le 9 a . planwasThis tobeimplemented tus o f or FG f FG M M in in K K eny eny a 8 . a e

9. 10. reportedly resulting inanincrease inmale by UNAIDSand supported WHO, which is Currently, nationalcampaignsare takingplace, of AIDS andsexually transmitted diseases. programme asameansofreducing theprevalence Health launchedavoluntary malecircumcision Consequently, in2008theKenyan of Ministry result ofobservationalstudiesandclinicaltrials. a comprehensive HIVprevention package, asa male circumcision of shouldbeincludedaspart In 2007, UNAIDSand WHO recommended that male circumcision isdifferent from thatofFGM. taken by theKenyan government inrelation to Kenyan menwere circumcised. approachThe Kenya Male circumcision iswidely practiced across Ma to date. strong network have beenlargely unsuccessful action, whereas inKisiiattemptstoestablisha a thrivingnetwork which coordinates anti-FGM networks atregional level, forexample, has Kuria commission hashadmixed successinestablishing raise resources andcollaborate oninitiatives. The national andregional levels, toshare expertise, partners involved inthefightagainstFGMon practice hasbeensetup, together bringing coordinate activities fortheeliminationof for example, agovernment-led commissionto andencourageto try theabandonmentofFGM, of initiatives through theNationalPlanof Action KenyanThe government hasintroduced arange over 18years ofage. is nospecificlaw inKenya againstFGMfor women implemented, andhasfailedtocurbFGM. There that thelaw isnoteffectively protective, ispoorly FGM andthere have beenwidespread criticisms successful legalactionagainsttheperpetrators of review. However, there are few reported casesof (about US$600), althoughthisiscurrently under and/or afineofuptofiftythousandshillings Kenya. Programme: NationalGuidancefor Voluntary MaleCircumcision in 10

Ministr le circumcisionin 10 , withKDHS2003indicating84%of y ofHealth, Kenya (2008)National AIDS/STD Control K eny a that have beenimplementedinKenya, including: documented thedifferent typesofinterventions FGM. A situationanalysis in Kenya topersuade communities toabandon Different intervention approaches have beenused in a A male circumcision. like theLuo, who traditionally have notundergone circumcision, includingamongethnicgroups, in Kenya -a Situation Analysis. Population CouncilandUNFPA toabandonFemaleContributing efforts GenitalMutilation/Cutting 11 abandonment ofFGM. ARP is potentially a ontheuseof particularly ARP approaches tothe the cutting(medicalisation). reportThis focuses using medicalstaffandimplementstoperform including minimisingtheamountoffleshcut, and harm-reduction tendenciesinsomecommunities, is suspectedthatthisemphasismay have ledto traditional practice. notdocumented,Though it of FGM, andaddressing FGMasaharmful Early interventions focusedonthehealth risks

b pp Humphr a K • • • • • •

ro ndonment o eny traditional practice; Approaches addressing FGMasaharmful of FGM; and addressing healthcomplications Interventions approach usingahealthrisk marriage and FGM.marriage girlsescapingfromsupporting early empowerment toopposeFGM, and Promotion ofgirl’s educationand intergenerational dialogueapproach; approach,Legal andhumanrights the and religion; approach;Interventions addressing FGM alternativeThe ofpassage rite alternativeoffering incomegeneration; Educating traditional circumcisers and eys E, SheikhM, NjueC, and Askew I(2007) a ches a to the 11 conductedin2006 f FG M

based intheNarok Rift district, intheSouthern initiative. Itisacommunity-based organisation The NtomonokInitiativeTsaru (TNI)isonesuch been introduced ofthecountry. inotherparts developed their own modelsof ARP, which have non-governmental organisations (NGOs)have Since thefirst introduction of ARPinKenya, other to FGM. likely tobeadoptedasagenuine alternative ofpassage,linked totherite ARP would beless where FGMisamore private family affair, ornot would bemore likely tobesuccessful, whereas Where ofacommunity ritual, FGMispart ARP socio-cultural context inwhich FGMispractised. of thepractice inacommunity dependsonthe ARP intervention canmaketowards abandonment programme concludedthatthecontribution thatan 12 all communities consideration andthat ARP isnotappropriate in that thecultural context needstobetakeninto of FGM. However, evaluation reports suggest approach abandonment leadingtothelongterm as aninterventionaculturally offering sensitive the actofgenitalcutting. ARP isoftensuggested thus respecting theculture andtradition, without celebration ofthepassageagirltowomanhood, powerful alternative approach which maintainsthe community recognition of gifts, celebration, andapublicdeclaration for girls onfamily lifeandwomen’s roles, exchange female circumcision, suchaseducationforthe but maintainedtheessentialcomponentsof community,Meru which avoided genitalcutting and PATH, asan ‘alternative ritual’ amongthe (MYWO), alocalwomen’s development movement, introduced in1996by Maendeleoya Wanawake The Alternative RiteofPassage (ARP)was first Population Councilevaluation oftheMYWO ARP to womanhood, but cutting. withouttheharmful A to maintainthepubliccelebration ofthepassage rationale behind ARP was to persuade communities public event tocelebrate theirgraduation. The about theirroleto learn insociety, followed by a younger tocutting, girlsbeingsecludedprior ofalargepart community celebration withthe

P of F Alter Chege J opulation Council emale GenitalMutilationinKenya. FRONTIERS, native Rites Approach forEncouraging Abandonment , Askew IandLikuJ(2001) An assessmentofthe 12 . 12 . At thistimeFGMwas 11

been observed. abandonment inthetwo communities have Kisii are more recent, althoughsignsofincreased 2006. programmesThe amongtheMasaiand the programme hasbeenimplementedsince attitudes inrelation where toFGMamongtheMeru considerable progress hasbeenmadein changing fromAnecdotal information YWCA indicatesthat leaders inadditiontothe ARP andrescue camps. local schools, parents, religious andcommunity FGM. Inallthree areas, the YWCA works with non-circumcision, andraising awareness about also offertraining incombatingthestigmaof the YWCA hasestablishedrecue centres which leaders andparents are invited. Among theMasai, end withan ARP ceremony, towhich community and complicationsofFGM. week-longThe camps rights, career choicesandtheadverse effects the Kisii,events withshort focusingoneducation, approach and hasbeenadoptedamongtheMeru among theMasaiinKajiadodistrict. An ARP prevalence ofFGMishigh: Meru, and Kisiidistricts Programmes focusonthree regions where the the abandonmentofFGMinKenya since2006. has beenimplementingprogrammes encouraging The Young Women’s Christian Association (YWCA) other employment oreducationalopportunities. returning totheirfamily ormoving ontotakeup their training andbefore they leave thecentre, programme offered toyoung girlsattheendof or forced marriage. ARP isoneelementofthe own communities, but withoutthethreat ofFGM possible reintegration ofyoung women intotheir education andguidance, encouraging where provides ofrescue, aholisticservice counselling, from FGMandearly marriage. centreThe rescue centre foryoung Masaigirls, escaping Valley, establishedin2003andisaresidential Province alsohasthelowest medianageatfirst 2.8 inNairobi, and3.4inCentral Province. The ratestotal fertility inKenya, at 5.4, compared to general, Nyanza Province hassomeofthehighest Province, closetotheborder with Tanzania. In communities KisiiandKuria The live inNyanza K FG uri M

a a

mon p eo p g le the K isii a nd the

11. 12. in 2004 circumcised. A study by Population Council women from theKisiicommunity have been 2008/2009KDHSestablishedthat96%of The have someofthehighestlevels ofFGMinKenya. known asthe communitiesAbagusii) andKuria Despite thesepositive indicators, theKisii(also the sameprovince (85%). average forgirls(75%), but lower thanforboys in was 72%, favourably comparing tothenational school completionrate forgirlsin2008Nyanza increasing to98%in2008(MOE, 2009). Primary girls inNyanza were enrolled school, inprimary school; in2002,in primary 89%ofallschool-age past decadeingirlchildenrolment andretention region hasshown steady improvement over the women inNairobi (2009/2008KDHS). However, the at19years,birth nearly fouryears earlierthan 13 – 17years hadbeencutby atraditional circumciser, only 29%ofcircumcised girlsaged4 circumcised mothers hadbeencutby atraditional FGM. Population Council foundthatwhile 94%of medicalisation, usingmedicalstafftoperform the Kisii, athere hasbeenatrend towards observed andKisii. amongtheKuria Among Over time, changesinpractice have been 13 years, attheonsetofpuberty. Nyanza Province were undergoing FGMaged10- ofgirlsin 2008/2009 KDHSfoundthatthemajority communities who donotcircumcise women. The distinguishing theirdaughters from neighbouring a cultural identifieramongthe Abagusii, polygamous marriages. FGMisalsoconsidered perceived needtoensure fidelity, especially within be anotherreason forthepractice, aswell asthe sexual desire before was reported marriage to in thecommunity. needtocontrolThe awoman’s the society, characteristics thatare highly valued obedient andaware ofherrole inthefamily andin a circumcised woman isconsidered mature, of passagefrom girltoarespected woman; found thatFGMisconsidered rite animportant

FR Cutting amongthe Njue C ONTIERS, Population Council 13 , and Askew I(2004)MedicalizationofFemale Genital amongtheKisiiinNyanza Province Abagusii inNyanza Province, Kenya.

of FGMinKisiiandKuria. type approaches cancontribute toabandonment study was toexplore theways, ifany, inwhich ARP- reported success. ofthisreport and purpose The been involved ARP events insupporting with years. BothRWAYDO andECAW have recently activities tocombatFGMforseveralundertaking Women (ECAW) inKuria, thathave been Kisii, andEducationCentre forthe Advancementof Youths Development Organization (RWAYDO), in two community-based NGOs, Reach Women and Feed theMinds(FTM), UK, hasbeensupporting prevalence remains amongthehighestinKenya. andKisii,the abandonmentofFGMinKuria the the widerange ofinterventions toencourage on suchprogrammes currently. However, despite sensitization activities, although neitherisleading the early 1990s, alongsidepubliceducationand first toincorporate ARPintotheirprogrammes in community leaders. MYWO andPATH were the with schools, healthproviders, religious and involving community awareness raising, working which ofaprogramme hasusually beenpart and government agencies, including ARP, implemented byNGOs localandinternational interventions todiscourage FGMhave been In thelastdecade, arange inKisiiandKuria of undergoing FGM. a decrease foundintheageatwhich girlswere to bechanginglesserforms. There was also appearednoted thatthetypeofFGMinKuria than cutting. by GTZin2005 Reports towards todraw theclitoris pricking blood, rather is decreasing severity ofthecutting, withamove home. Another changethathasbeenreported while therest were cutattheirown oranother practitioner, abouthalfwere cutatahealthfacility a nurse ordoctor. Among thosecutby amedical circumciser, hadbeencutby andthatthemajority TZ (2005) Female Genital Mutilation in Kuria District: findingsbase of line a survey. GTZ / Kenya Ministry14 of Health

G 14 and2007 8

a widerange ofcontexts. debate abouttherole of ARP-type interventions in is hopedthatitwillalsocontribute totheongoing andKisii.for theabandonmentofFGMinKuria It involved intheimplementationofprogrammes relation tofuture work by FTMandagencies researchThis decision-makingin willinform ARP-type approaches intheabandonmentofFGM. factors forthesuccessfulinuseof necessary have beenused, itwas hopedtoidentifythekey analysing theway inwhich ARP-type approaches factors which contribute toitsabandonment. By the pressures tocontinue thepractice andthe social context withinFGMtakesplace, including andKisiiwerefor Kuria developed exploring the communities. Consequently, separate casestudies of FGMdependsonthecultural context ofthe of interventions toencourage theabandonment literatureThe review indicatedthatthesuccess the abandonmentofFGMinthesedistricts. Alternative RitesofPassage (ARP)approaches for need tobetakenintoaccountwhen selecting provide anassessmentofthefactors which would tocombatFGMand out inKisiiandKuria investigate thecontext withinwhich FGMiscarried to abandonFGM. studyThis was conductedto recent years toencourage thetwo communities allocated by agenciesandthegovernment over S A tudy ob •

practices inrelation toFGMamong men To investigate current attitudesand j considerable resources being the highestinKenya, despite remainKisii andKuria someof the prevalence ofFGMinboth s indicatedintheprevious section, ectives practice ofFGM. individuals totakedecisionsabandonthe To analyse thefactors which encourage orenable S following groups: FGDs wereconductedwiththe involved inFGMthetwo communities. represent mostofthekey stakeholdergroups two districts. respondentsThe were chosen to conducted withselectedrespondents inthe (KIIs) usingsemi-structured questionswere discussions (FGDs)andkey interviews informant decision-making inrelation toFGM. Focus group order tounderstand thefactors which influence exploring attitudesandsocialpractices in studyThe usedaqualitative approach, tudy desi • • • • •

Kisii andKuria. encouraging theabandonmentofFGMin attitudes towards, ARP approaches to To investigate theawareness of, and levels inKisiiandKuria; and women atfamily andcommunity not undergone FGM; undergone FGM; and(b)thosewho have separate FGDsfor: (a)thosewho have Young women over theageof18, with School teachers; Community leaders (menandwomen); have attendedarescue camp(inKuria) through an ARP ceremony (inKisii)orwho have notbeencut; and(c)have been whose daughters: (a)have beencut; (b) Mothers, withseparate groups formothers g n

13. The Research: Purpose and Design 14. o

of thereasons drivingthepractice. respectability are andabilitytoget married some the abandonmentofFGM, especially associal as well aswomen ininterventions toencourage have ofincludingmen highlightedtheimportance on thetimingofFGMseason. Previous studies regions theCouncilofelders andinKuria decides influential inupholdingcultural traditions inboth for theceremony. their daughter’s opinion, andare likely toarrange the decisionthemselves, parents ofteninfluence undergoes FGM. Even incaseswhere girlsmake the key decisionmakers aboutwhether agirl camps. the ARP ceremonies andteachingattherescue traditional circumcisers have beeninvolved in encouraging itsabandonment. andKisii, InKuria FGM, but they canalsobepowerful agentsfor because oftheirdirect involvement inperpetuating Parents Ra • • Traditional circumcisers potentially influential peopleinthelives of young selected individuals: wereIn-depth interviews heldwithtwo groups of f tion res • • who usedtocircumcise. traditional circumciser andaretired nurse agencies implementingFGMactivities, a administrators, managers from local police andparalegal officers, local Key individualsandKisii, inKuria including involved incombatingFGM(appendix A); Key organisations nationalandinternational •

School teachers married andunmarried; married separate FGDsforthosewho were Young menover theageof18, with this group was only interviewed inKisii; have in ARP ceremonies participated – Young women over theageof18who Older menandwomen. were includedasthey are among p a ondents le Community leaders f or the selection have beenincludedas were interviewed are of thesepractices were alsoincludedinthestudy. in ARP andthosewho have notundergone either have undergone FGM, those who have participated the law onFGMandinchildprotection. included asthey have arole toplay inupholding Sa Health professionals FGM andtheimpactof ARP ceremonies. essential tounderstanding thefactors driving viewsThe ofyoung women themselves are issues likeearlyandFGM. marriage establish studentclubstodiscussandquestion people. ECAW hasbeenworking withschoolsto subsequently undertaken in Kuria andKisii to inKuria subsequently undertaken Community mobilisation meetingswere FGDs andinterviews. and therelevance ofthevarious target groups for local agenciestodiscusstheaimsofsurvey meetingswiththestafffromorientation thetwo and alocalconsultantvisitedthesitesheld the target groups inlateNovember. FTMstaff organisations identifyingandmobilising started local community andstakeholders. twoThe to ensure thatthey were representative ofthe about theresearch, andhelpingsetupthe FGDs, were responsible forraising community awareness RWAYDO (inKisiidistrict). ECAW andRWAYDO NGOs,local partner ECAW and district) (inKuria Respondents were recruited by staff from the 55 women). and 70women) and101inKisii(46men interviewed (appendix A), (45men 155inKuria 45 and90minutes. were A totalof216participants between 75and90minutes. KIIslastedbetween andlasted had amaximum of12participants of4weeksperiod andKisii. inKuria EachFGD werein-depth interviews conductedover a Twenty focus-group discussions(FGDs)and10 Children andGenderofficers women (over 18years) risks associatedwithFGM.risks fromarising increased awareness ofthehealth Kisii area, driven by demandfrom thecommunity of theirdocumentedinvolvement inthepractice in m p le si z e were included because Police officersand , includingthosewho have been Young A dataverification.further (ECAW andRWAYDO inKuria inKisii)toallow for organisation theresearchthe partner supporting mini-cases. casestudieswereThese shared with separately forKisiiand Kuria, drawing onthe more comprehensive casestudieswere produced Once themini-caseswere completed, larger, respondents atthisearly stage. the researcher, therecorders andattimesthe enabled dataverification totakeplacebetween researchers were stillinthecommunities. This drafted withinafew days oftheFGDs, whilst the template (seeappendixB). mini-caseswereThe the frameworks provided by thequestionsasa of theFGDsandindividual interviews, using mini-casesinnarrativebrief from form each collated usingacasestudy approach, constructing interpretive, rather thanstatistical. Datawas As aqualitative study, dataanalysis was in appendixB). consentforms (seeinformed consent toparticipate research andobtainedtheir toalltheparticipants FGD orinterview, theresearcher explained the and thenotestranslated intoEnglish. Before each facilitation. All FGDswere conductedinKiswahili inqualitativeexpertise research, includingFGD experienced researcher aboutFGMand informed accessible totheparticipants, facilitatedby an FGDs were atvenues conductedinKisiiandKuria D and Nyamira. inKisiiCentral,FGDs andinterviews Mosocho across thedistrict; inKisii, RWAYDO organised In Kuria, ECAW organized FGDsandinterviews intheFDGs.invited toparticipate from whom across-section ofindividuals were skills. groupsThese hadupto40participants, from organisations thepartner todevelop their questions tobeusedandenabletherecorders raise awareness abouttheresearch, topilotthe ND A T A A COLLECTION N A LYSIS

the rescue campsasanalternative ofpassage. rite term ARP, localpeopledidnotappeartorecognise age. Although theorganisers ofthecampsused always apublicevent tocelebrate theircomingof graduation. of certificate However, there isnot the circumcision period, receive training anda rescuerun camps, towhich girlsescapeduring happening; inKuria, thelocalagenciesinstead community mobilisationthatonly inKisiiwas this certificates. However, it the was foundduring graduate inapublicceremony, completewith girls receive sexuality andlife-skillstraining and typical ARP programmes,supporting where that FTM’s partners, ECAW andRAYDO, were study was designed, ithadbeenanticipated ‘Alternative RiteofPassage’:‘Alternative Understanding anduseoftheterm, Delayed start: L invasive procedures. not involve under18s, anddidnotincludeany clearance was notrequired forthestudy, asit did Council, alongwiththerequired fees. Ethical wereinstruments submittedforreview by the clearance, thestudy proposal anddatacollection Permit NumberNCST/5/002/R/683/20. To obtain Council forScienceand Technology, through studyThis was approved by theKenya National R Mobilisation: against FGM. two agencieswork closely, who are already have beenbiasedtoinclude peoplewithwhom the may a possibilitythattheselectionofparticipants intheFGDsandinterviews.participants There is implementing agenciestomobilisethe and Technology. through theKenya NationalCouncilforScience approval process tookover amonthtoclear to delays inobtainingaresearch permit. The imit ese a a rch A tions in This studyThis usedthe Fieldwork was delayed due pp rov the study a l When the

15. 16. The Research: Findings ages 8-15years. reported Participants thatinsome girls are circumcised when they are between the girl was considered ready formarriage. Today, circumcised attheageof17-18years –when a to adulthood. Inthepast, girlswere Kuria is observedofpassagefrom asarite childhood established thatcircumcision amongst theKuria ARP intotheirgraduation ceremonies. rescue camps, which incorporate of theprinciple working tocombatFGM. They offer anumber of active. coordinating ofallagencies theefforts In Kuria, theanti-FGMnetwork hasbeenextremely go againsttheirdecisions. and cancastspellscurses onindividuals who beliefs thattheelders have supernatural powers hold onthecommunity, which isreinforced by local settlement ofdisputes. CouncilhasastrongThe till thelandornot. CouncilisalsoinvolvedThe in harvesting, andwhether thecommunity should thecommunity planting,instructs when tostart be held, andends. when itstarts Councilalso The circumcision: they dictatewhen theceremony can culturalimportant events takeplace, including Council roles inthecommunity istodecree when revered body which isentirely male. Oneofthe its own CouncilofElders, amuch respected and Nyabasi, BugumbeandtheBukira. Eachclanhas Tanzania. fourclansinKenyaThe are theBwirege, ofKenyacorner western tipof andthenorth 13clansspreadcomprises over thesouthwestern especially amongthegirls. ethnicgroup Kuria The haslow district The schoolcompletionrates, traits withtheKisiitribe, includinglanguage. number 260,401individuals. They share cultural In 2009, populationwas theKuria estimatedto resident inNyanza Province insouthwest Kenya. are Kuria The anethnicandlinguisticgroup K FGM amongthe C Rite ofpassage: continues R e ur a ase study 1: sons why the community ia community to researchThis study p r a ctise FG M the cutbecauseofpeerpressure: although insomecasesgirlscandecidetogofor decisiontocutisusuallyThe madeby theparents, of thegirltodecidewhether sheisofageornot. cases, theparents consideronly thephysical size (participant, FGD, Council ofElders). higher casesofHIVand AIDs amongstthem” are free withtheirbodies andthat’s why they have community] are notcircumcised that’s why they other communities. the community -shewould onlyby bemarried outcast andwould in notbeeligibleformarriage before circumcision would beconsidered an womansaid thataKuria who becamepregnant inanFGDwiththeCouncilofEldersA participant young men). cut herwhile (participant,FDG, sheisdelivering” will ensure that shedelivers at homesothat they labour: can arrange forhertobecircumcised during beforemarried circumcision, herhusband’s family that asaresult ofthispressure, ifawoman gets before circumcision. inthisstudy Participants said that awoman would orhave getmarried achild child-bearing; itisunthinkableformosttoimagine FGMisapre-requisiteIn Kuria and formarriage teachers). the cuteven at anearly age” (participant,FGD, the girlssuccumbtopressure andopttogo for can prove tobeimpossible tobearandmostof Preserving sexualmorality: Preserving good morals: become promiscuous, andtomaintain reduce thesexual urge ofgirlssothey donot desire. tocurtail necessary Today, itisdone to a prolonged period. Circumcision was therefore or raid from communities theneighbouring for if theirhusbandswent outtograze theanimals stay oftimewithouthaving forlongperiods sex traditionally, women were expected tobeable in women. Respondentsinterviewed saidthat circumcision sexual urge isalsodonetocurtail The womenThe [from aneighbouring If thegirl isuncircumcised, thein-laws and insultsfrom the ridicule theirpeers Female seen ascritical: medical andsocialeffectsofthepractice were not culture,the Kuria aboutnegative andconcerns the community considered in FGMasimportant culture.of theKuria Even younger members of to eradicate femalecircumcision, anintegral part government andotherplayers were attempting with theCouncilofElders; they wondered why the culture.Kuria was raised concern This inanFGD practice were perceived asdilutingor “killing” the heritage; asaresult, todiscourage efforts the that femalecircumcision oftheircultural ispart communityalso foundthattheKuria believes woman” (participant,FGD, young men). toanuncircumcised circumcised orare married position inthiscommunity ifthey are not community fully. foranelective Onecannotrun Kuria, soyou getlicensetoparticipate inthe Social pressure: Upholding cultural tradition: around FGM: following sanctionsheldby thecommunity abandoning thepractice. FGDsrevealedThe the name-calling, stoppedmany familiesfrom Fear andsocialstigma, ofridicule aswell as discourage women’s refusal tobecircumcised. communitythat theKuria hasstrong sanctionsto interviews, including: expressed widely expressed inthe There were also myths andmisconceptions • • • ••

[Circumcision] identifies you asatrue come visiting. elders orherhusband’s peers ifthey She isnotallowed tocookandserve livestock enclosure; She isnotallowed toopenthegate would up; dry water willbecontaminatedandthewell communal water source becausethe She cannotdraw water from the neighbour’s garden upanddie; willdry because ifshedoes, thevegetables inthe vegetables from herneighbour’s garden An uncircumcised woman cannotpick researchThe findingsshow theresearch for thepubliccelebration. when thecommunity hasplentyoffoodnecessary observed inDecembereachyear, atharvest time circumcisionThe hastraditionally period been are referring toboththemaleandfemalerites. talkofacircumcisionthe Kuria ceremony, they circumcision alsotakesplace. Indeed, when by thecommunity elders, which during male celebration pronounced aspecifiedperiod during a communal andpublicevent, heldwithmuch circumcision istraditionally amongtheKuria Communal andpublic event: a H Age atcircumcision: Timing ofFGM: coaching from femalerelatives. families doorganise forthegirl initiatestoreceive as was thecaseinpast, althoughindividual have sex. initiatesnolongergointoseclusion The encourage theinitiates(bothgirls andboy) to the songscontainmessagesthatseemto observedtheceremonies, thatduring participants field withtheelders present. Some research circumcisionThe ceremony isheldinanopen marked withpublicdancing, andfeasting. drinking cutting ceremoniesThe are colourfulevents, girl was circumcised inthatyear. circumcision ceremony, andasaresult, noboy or 2007, theCouncildecreed thatthere would beno badluck,that thenumber 7portends intheyear informants, peoplebelieve becausetheKuria community values. For instance, according to by theCouncilofElders, inconsideration ofthe own circumcision ceremony atadatespecified much lower agethanpreviously. Inthepast, girls research reported that girlsare circumcised ata mon ow FG • •

woman gave birth,hewould die. astheuncircumcisedwith theclitoris If ababy boy’s body cameintocontact that spotwould die; somewhere, any children walking over If anuncircumcised woman urinates g the M isconducted K Eachclanorganizes its uri Participants inthis Participants a

Female

17. 18. (or herfamily) did ornotdo. For instancea attributed tocurses duetosomethingtheinitiate negative results associatedwith FGMcouldbe feltthatany complications or Other participants of Elders). the Luowomen” (participant,FDG, Council complete (real women) andthey donotendupas can marry them off and get the bride price. themoffandgetthebride can marry have theirdaughters circumcised early sothatthey alsothoughtthatsomeparentsSome participants FGD, parents). pregnant before circumcision” (participant, they are cutearliertoavoid thetabooofgetting become sexually active when they are young, so become promiscuous. effects, thatthewomen includingensuring donot feltthatFGMhasonly positivesome participants instance, intheFGDwithCouncilofElders, circumcision orrefused toacknowledge them. For were unaware ofthenegative effectsoffemale However, there were who alsoparticipants faster” (participant,FDG, teachers). recovery process afterthecircumcision willbe to engage insex claimingthat by doingsothe ceremonies actually encourage theinitiates including having sex: believe thatthey coulddoanything they liked, promiscuity, asthecircumcised girlstendedto feltthatcircumcisionparticipants oftenledto of negative socialeffectsofthepractice –some of hard scars. Someofthemwere equally aware difficulty indelivery ofbabiesanddevelopment such asexcessive bleeding, trauma andshock, medical effectsofFGMandeasily citedproblems inthisstudy wereMost participants aware ofthe Aw this hascomedown to8-9years. would becircumcised atabout18years ofage, but a reness o The cutensures thatThe our women become Parents that are concerned girlsmight the songs sang during circumcision the songs sang during f e ff ects o f FG M (Interview, Coordinator LocalNGO, Kuria). responsibility. They donothing”. speaking justforthesakeof fulfillingtheir especially when they drop outofschool. child-bearing, earlygirls togetmarried andstart were alsoseenasmore likely thanuncircumcised and tocompletetheireducation. Circumcised girls hand, were considered more likely tostay inschool among these girls. Uncircumcised girls, on the other cause ofpoorgrades, anddropping out ofschool thoughtthisattitudewasParticipants theleading (participant, FGD, teachers). you canteachthemletalonepunishingthem” meaning you are andhencethere peers isn’t much themselves asgrown women justlikeyourself, participant remarked:participant has notdoneenoughtofightFGM. One FGD most oftherespondents feltthat thegovernment government withrespect tofemalecircumcision, When askedabouttheplaceandrole ofthe er Attitudes tow punishment from them: hence they or shouldnotbetakinginstructions themselves equaltothefemaleteachers, and especially inschoolswhere thegirlsconsider FGDs saidthatthisattitudecreates majorproblems, themselves fully grown women. in Participants anddifficultbecausetheyto berude considered Circumcised girlswere considered mostlikely in theirgeneral attitudeandpersonal bearing. community, mostthoughtthatthegirlsdiffered the circumcised anduncircumcised girlsintheir there was notmuch significantdifference between seemedtoagreeWhile mostoftheparticipants that circumcision andhealingperiod. the come intocontactwiththeinitiatesduring sex” imposedonthepeoplewho rule might attending totheinitiatesfailsobserve the “no circumcisionduring happensifoneofthepeople traditional circumciser saidthatexcessive bleeding a dic The local administratorsThe are double once they are circumcised they consider a te FG M a rds e ff orts to

circumstances thathedidnotunderstand: circumcised, but they were laterreleased in had beenarrested forhaving theirdaughters recalled acasewhere parents ofgirlsunder18yrs practice. Inanin-depthinterview, apoliceofficer goodwill amongtheleaders toeradicate the However, itwas feltthatthere was notenough against FGMinpublicmeetings. local chiefsandtheirassistantoftenspokeout to outlaw thepractice. Itwas reported thatsome discourages FGM, andthatalaw hadbeenpassed wereparticipants aware thatthegovernment Kuria, were ofthepractice. intacitsupport Some (chiefs andtheirassistants)who are themselves It was feltthatsomeofthelocaladministrators initiate (bothmaleandfemale). of thetotalfeescharged forcircumcision ofeach saidthattheeldersParticipants receive uptoathird because they benefitedfinancially from it. encouraged thecontinuation ofthepractice Some respondents feltthatthe CouncilofElders get circumcised. do iftheirdaughters madethe decisionto feltthatthereparticipants isvery littlethey can approach. In thedifferent FGDsandinterviews, explains theapparent contradiction intheCouncil’s a girl’s request forcircumcision which perhaps Among theKuria, itisconsidered tabootorefuse for marriage, but didnotpledgetoabolishFGM. stop parents pullingtheirdaughters outofschool circumcision ofgirlsyounger than18years, andto believe thatthey only pledgedtostoptheforced Council ofElders representatives indicatethatthey public ceremony. However, withthe interviews practice. MoUwasThis signedinJune2010, ina under which theelders pledgedtostopthe Government andtheCouncilofElders ofKuria, of Understanding (MoU)signedbetween the wasabandonment ofFGMinKuria aMemorandum by thegovernmentAmong theefforts toencourage (Interview, Police Officer, Kuria). the entire community present at theceremony?” with what –isitthecircumciser, theparents or I donotknow what orwho exactly tocharge and a complaintwas brought tomebut theproblem is As apolice officer, someoneif Icanarrest choose tohave theirdaughters circumcised earlier: community. To avoid thispossibility, parents now before circumcision, which would betaboointhe active atanearly gettingpregnant ageandrisking to parents’ ofgirlsbecomingsexually concerns attributed thelowering ofageatcircumcision due now comedown toaslow as8-9years. Participants were older(atleast17years andover), but thishas performed. Traditionally, girlswere cutwhen they change intheageatwhich thecircumcision is isthe bychange described theparticipants (participant, FGD, mothers ofcircumcised girls). asitused to happeninthepast”feast slaughter abull andinvite everybody tocomeand as they usedtointhepasthenceit’s noteasyto marry themoffsothat theymarry cangetcows to either price: themoffand getthebride can marry have theirdaughters circumcised early sothatthey with decliningresources, someparents chooseto contributed totheearly ageofcircumcision; faced Increasing poverty was alsothoughttohave married” (participant,FGD, CouncilofElders). would when even price shegot askforbride andnobody offtooutsiders fit only tobemarried circumcised shewould beconsidered anoutcast declared illegalinKenya: repercussions given thatthepractice hasbeen economic challengesandthefearoflegal public ceremonies. wasThis attributed tocurrent for theinitiatesandlesspeopleattending in thepast–there islessfeasting, fewer gifts ceremonies have lesspompthanthey usedto practised, research saidthatthe participants Although thepubliccelebration ofFGMisstill in theway femalecircumcision out. iscarried significant changes over the years amongtheKuria studyThis establishedthatthere have been with re C Age atcircumcision: h a n people no longer have asmany cattle Parents want to circumcise theirgirlsand if agirlgot pregnant before they were g es in the community ga rd to FG Another significant M

19. 20. Kenya’s official stance onFGM. infection, which iscontrary totheGovernment of surgical bladesandgloves toreduce cases of government agenciesprovide the community with thecircumcisionthat during period, some sometimes preferred; alleged someparticipants staff have alsobeeninvolved andthatthey are reportedKuria, thatmedical someparticipants done by thetraditional circumcisers amongthe friends” tomorrow sheisjumpingaround, playing withher circumcised girls). to cutjustalittle” (participant,FGD, mothers of – more oftenthannotthey tellthecircumciser tothe circumciserprescribe how much tocut Seclusion: ofcut: Type to joinin. sisters goingforcircumcision, they toomay decide insulted orwhen they orolder seetheir friends contributed tothelowering ofage–when girlsare feltthatpeerpressureOther participants hasalso FGD, Paralegals). for theboys withinthefamily” (participant, take theboys toschooloreven pay price bride Medicalisation: no needforseclusion: the cuthasresulted healingperiod, thus inshorter heal. Itwas alsofeltthatreduction intheseverity of toeducate thegirlsandtoallownecessary themto up makesitdifficulttohave thelongseclusions pointedoutthatthecurrentparticipants socialset for theirdaughters from otherfemalerelatives. The parents may privately choosetoorganise coaching education oncommunity values. Insomeinstances, longer gointoseclusiontoreceive coachingand preserved, inadditiontospeedinguphealing: ofthefemaleanatomy werethe essentialparts of developing hardened scars, andtoensure that the desire toreduce trauma andthelikelihood This, pointed, outof theparticipants hadarisen severity ofthecuthasdeclinedamongKuria. had beenobserved inotherresearch –thatthe These daysThese agirl iscircumcised today and daysThese the mother oftheinitiate will (participant,FGD, parents). Unlikethepast, initiatesnowadays no Participants also confirmed alsoconfirmed what Participants Although FGMisstilllargely the br the initiates: dropout, earlyandpromiscuity marriage among social effectsoffemalecircumcision suchasschool istherealizationamong theKuria ofthenegative might have ledtosomefamiliesabandoningFGM conviction: beginning toopposethepractice outofreligious were reported instancesofindividual families campaigning againstFGMintheregion. There which have contributed tochangeisthechurches’ Kisii), where thepractice isequally widespread. in southNyanza region (which and includesKuria vocal inthecampaignagainstfemalecircumcision Adventist Church (SDA) hasbeenparticularly reportedParticipants thattheSeventh Day opposes” (participant,FGD, teachers). circumcision andothertraditions that thechurch but areChristians secretly practicing female FGM, notthechurch goers who claimtobe On theotherhand, said someparticipants been circumcised. togirlswho havesocial support not which have contributed significantly ingiving ofanti-FGMclubsinschools,include theformation some familiestoabandonthepractice. These practice were alsoconsidered tohave influenced Activities by localorganisations todiscourage the FGD, teachers). more interested inmen” (participant, concentrating ontheirstudiesthey and are rude circumcised girlswho are promiscuous; insteadof Religious influence: FGM amongtheKuria. may have brought aboutchangesinthepractice of researchThe toidentifyspecificfactors tried that ors th F consequences ofFGM: Awareness oftheundesirable a ct ou p It is real Christians whoIt isreal Christians have abandoned contrary tothecommon belief–itisthe g r a ht ch ctice a a t m n g Oneofthefactors a e to y h Another factorwhich a ve existing laws: community ofthechild, abouttherights andthe Children tosensitizeAct feltitwas the important whoThose didunderstand thesignificanceof The individuals who goagainstthem. powers andabilitytocastspellscurses on Elders are widely believed tohave supernatural them ifthey went againsttheCouncilofElders. The practice becauseoffearwhat would happento was illegalmany communities continued withthe Although many recognised thattechnically FGM than seenasprotecting children from thepractice. including whether ornottobecircumcised, rather children tomaketheirown theright decisions, often poorly understood andinterpreted asgiving hadheardparticipants of ChildrenThe Act itwas especially regarding thelaws againstFGM. Where was needfor ‘proper education’ inthecommunity, (participant, FGD, young men). women inthecommunity delivering everyday” circumcised andthey mothers seecircumcised difficulty indelivery: that FGMleadstohealthcomplicationssuchas for thecommunity tounderstand andappreciate In someFGDsitwas claimedthatitwas difficult (participant, FGD, young men). have allowed togo theirdaughters through?” thing they themselveshave gone through and circumcised. How canthey talkillofthevery they are circumcised, are theirdaughters also themselves notgood role modelsbecause participants feltthatalthoughthegovernmentparticipants community are notfamiliarwiththesystem. Other to lodgeacomplaintincases ofFGM, asthe There alsoexists aperception thatitisdifficult FGD, teachers). thatrights needtoberespected” (participant, Illegal statusofFGM: the community: that there hasbeenresistance tochangein They themselves wereby born campaigning againstThose FGMare In thiscommunity, children donothave Participants saidthere Participants been circumcised. teachers, theirpeers andgirlswho have not todiscussthiswithNGOworkers,opportunity aboutabandoningFGMandthe to information those inattendanceare more likely tohave access heavily onlinkswithschools. meansthat This of theyoung girlsfortherescue campsrelied awareness raising, forexample, therecruitment a meansofmakingcontactwithyoung girlsand Many anti-FGMinitiatives work withschoolsas FGD, young men). herbecauseshehasmoney”marry (participant, and thismightattract somemenwho mightjust becausesheislikely tohave anincome married education thenshestandsachanceofbeing in thecommunity: and increases thechancesofthembeingaccepted education thiscompensatesforthemnotbeingcut who avoid circumcision managetogetagood According toFGDparticipants, ifthefew girls FGD, teachers). opposed tothecircumcised girls” (participant, more obedientandrespectful as totheteachers betterinschoolbecausetheytend toperform are in learning: difficult toteachandmore easily loseinterest women andnolongergirls, hencethey are more be duetothegirlsseeingthemselves asmature who have undergone FGM. isconsideredThis to among girlsisreported tobehigheramongthose and uncircumcised girlsatschool. Schooldropout differences inbehaviour andfocusofcircumcised ofFGM,of educationaboutthehealthrisks the a commontheme, oftheimportance interms Education: practice, itwas notplaying amajorrole. could significantly influenceabandonmentofthe views onthesuccess ofthealternative of rite researchThis alsoexplored community’s theKuria (A Altern R P) in The girls whoThe have notbeencircumcised If agirlis notcut but hasagood a K The importance ofeducationwas importance The tive riteo uri a f

pa ss ag e

21. 22. do notrecruit initiatesfrom areas inthe districts with young men, there were claimsthatthecamps and thefacilitators oftherescue camps. InaFGD However, somehadnegative views ofthegirls to FGM. are effective inempowering thegirlstosay no and theirparents feltthattherescue programmes women who hadpreviously attendedthecamps FGM, hygiene, career choicesetc. Several young girls receive training onlifeskills, sex andsexuality, away from thecommunity. While inthecamps, the for theentire ofthecircumcision period inacamp from allover andgiven thedistrict accommodation girls seekingtoescapecircumcision are mobilised precedingIn theperiod thecircumcision season, introduced externally. theseeventssponsoring but view themasbeing place andthatthecommunity didseeitsrole as would always fundsinorder needexternal totake widespread agreement thattherescue camps untilthefirststart day ofthenew term.There was women, usually from thedateschoolholidays tothegirlsandyoungthe whole ofrisk period FGM season. Where fundspermit, thecampscover Council ofElders ofthetimingandduration ofthe in direct response totheannouncementby the of theirexistence. timingofthecampsis The resources them, tosupport andraising awareness local agenciescoordinate thecamps, pooling promotes collaboration between agencies. The from thelocalanti-FGMnetwork which actively RescueCampsareThe by run acommitteedrawn period. timed tocoincidewiththeendofcircumcision ceremony forthegirlsatendofcamp, which is Rescue/ARP Camps, andholdan ARP graduation the organisers interviewed considertheseas rather thananalternative ofpassage. rite However, community considered theseasrescue camps the circumcision period. Therefore, thelocal awayCamps forgirlsrunning from FGMduring community,Kuria localagenciesorganised Rescue circumcision. However, thestudy foundthatinthe passage asanalternative totraditional female on andendupbeingcut. coming from therescue campsfindtheseasonstill circumcision seasonwas extended andgirls reported thatinsomecasesthetraditional homes andgetcircumcised. Another participant camps, somegirlsattendthen gobacktotheir afterthe andsupport Due tolackofmonitoring given thattheiragesvaryfrom 8/9to20yrs. separated according totheiragesatthecamps, also feltthatthegirlsincampsshouldbe and toavoid thembeinglured away. Participants ceremonies, toshieldthegirlsfrom theactivities, from where communities holdtheircircumcision also becarefully selected–they shouldbeaway exploitation. sitesfortherescueThe campsshould and notmensoastoreduce ofsexual therisk felt thatfacilitators shouldbemostly women daughters becircumcised. Further, participants themselves notcircumcised andhadnotlettheir together withgoodrole modelswho were by havingserve asfacilitators, peopleofintegrity men, thoughtthatthecampscouldbeimproved FGD participants,The theyoung particularly officials andcollaborating church leaders. including thedaughters ofNGOstaff, government seen tobemore likely tobeinvited toattend, associated withtheorganisers ofthecampswere Camps. daughtersThe andrelatives ofthose in which thegirlswere recruited fortheRescue There was considerable abouttheway concern mischief” (participant,FGD, young men, FGD). where meettohave friends anicetimeandsome such anumber –itendsupbeingafuncamp andit’sparticipants impossible toclosely monitor them adequatementoring: not possibletoclosely monitorallthegirlsorgive were too big, inadequately managed, soitwas offered. alsofeltthatthecamps Someparticipants number from ofnew girlsabletolearn thetraining attend thecampseachyear, thereby limitingthe poor selectioncriteria, somegirlscontinued to where thepractice ismostprevalent. Duetothe the camps sometimes have upto200 ears was abandoned. eventually cometoanendjustlikethecuttingof remarkedAnother participant thatFGMwill girl, Kuria). (Participant, FGD, motherofcircumcised education they stillare going togetmarried” girls are notcircumcised andthey getagood uncircumcised girls. Oneofthemsaid: most ofthemothers saidthey willnotcuttheir younger uncircumcised daughters inthefuture, When askedifthey would circumcise their FGM has nobenefit whatsoever -Ifthe rights ofwomenrights atothertimesoftheyear. about thehealthrisks, illegalityofFGMandthe FGM season, withinadequateawareness raising that theevents tookplaceonly atthetimeof own, even ifwell resourced. There was criticism that they would notbethesolutiontoFGMontheir parents andprevious -recognised participants All involved intheRescue/ARPCamps-organisers,

23. 24. culture: considered and oftheirheritage anessentialpart that istheway ithasalways been, andbecauseitis out, Kisiicommunity circumcises girlsbecause found outininterviews. pointed As oneparticipant Kisii peoples’ way oflifeandculture, asthisstudy circumcision isconsidered anintegralofthe part continue withit. However, itwas alsoreported and theoneswho put pressure onparents to are themainsupporters offemalecircumcision, generation (bothmaleandfemale grandparents) saidthattheolder intheinterviews Participants Nyamira). circumcised” (participant,FGD, men, married the land, it’s almostimpossible toavoid getting not thegirlshouldbecut–thisislikelaw of circumcised girls, Kisii). found inplace” (participant,FGD, mothers of practicing it; sowe justfollow theculture we Upholding cultural tradition: p R high literacy levels andwidespread Christianity. abandonment amongothercommunities, including of factors thathave beenknown tohave ledto practice hascontinued despite theexistence seem tohave limitedimpact. Inaddition, the persuade thecommunity toabandonthepractice by NGOs, churches andthegovernment to and healthsurvey hadbeencircumcised. Efforts community the2008/2009demographic during Kisii -96%ofthewomen interviewed from this census. FGMisnearly universal amongthe individuals, according tothe2009Kenya national KisiiethnicgroupThe numbers justover 1million K FGM amongthe C community continues r e isii community a a ase ctise FG sons why the We wereandfoundourpeople born There areThere nodiscussions astowhether or S M tudy 2: K isii Female to still only marry onewhostill only is circumcised. marry young meninanFGDNyamira saidthey would uncircumcised girl/woman, mostoftheunmarried partners, when askedifthey wouldan marry uncircumcised women were bettersexual thoughtthat Although someparticipants circumcised girls). childish behaviour” (participant,FGD, mothers of adhere. obligation towhich familiesfeelcompelledto ofpassageintoadulthood,a rite but asacultural however thepractice continues, notnecessarily as in-laws etc, toprepare themformarriage. Today, elders, how tobeagoodwife, relations withthe training inthevalues ofthecommunity, respect for and would thengothrough of aseclusionperiod the past, girlswere circumcised aged15-18yrs, girl towoman. MuchlikeamongtheKuria, in essential transition from childhoodtoadulthood, was considered ofpassage, arite marking the In thepast, femalecircumcision amongtheKisii FGD, Nyamira). in thisarea have beencircumcised” (participant, (participant, FGD, mothers ofcircumcised girls). who behaves [wildly] untilshe’s withaman” were circumcised: in Nyamira, itwas reported thatallgirlsinthearea areas. For instance, inanFGDaremote village and thatthepractice was more prevalent inrural that thecultural pressure was lessinurbanareas Preserving sexualmorality: Preserving urges: considered incapableofcontrolling theirsexual promiscuous. Uncircumcised women were widely widespread beliefthatuncircumcised girlsare children andachieve respectability. There was a circumcised sothatthey cangetmarried, have women donotbecomepromiscuous. girlsareThe with thepractice, theKisiiseektoensure thattheir reduces sexual urge inwomen –incontinuing show thatitiswidely believed thatcircumcision They [uncircumcised women] have by theage of14 and15years, allthegirls I have an uncircumcised neighbour Interviews Interviews Private familyPrivate affair: a H andsocialintegrationmaking learning achallenge. out withthoseoftheirown circumcision status, and tensiondeveloped asthegirlstendedtohang Teachers interviewed saidthatinschools, factions this oftenledthemtodemandcircumcision too. treatment thecircumcised girlsreceived, and uncircumcised girlsenvied thegiftsandgood saidthatinsomecases,Some participants the as contributing togirlsgettingcircumcised. Peer pressure amongthegirlswas alsoseen (participant, FGD, young men). unmarried and they are notwelcome at ourceremonies” Social pressure: their peers: girls are mockedby thecommunity and mature. reported Participants thatuncircumcised her. Circumcision was seenasmakingthegirls husband becausenomanwillbewillingtomarry will nothave any andshewillnothave friends a she cannever berespected inthecommunity, she saidthat with contemptandmany participants the Kisii. A girlwho isnotcircumcised istreated individual girlstosubmitcircumcision among this study foundthatthere isalotofpressure on where thepractice iscelebrated publicly. However, there are regions ofthecommunity given specialtreatment andfedonaspecialdiet. this time; amongwell-off families, thegirlsare bought new clothes, shoes andothergiftsduring their daughters circumcised together. girlsareThe sometimes, agroup offamiliesmay planandhave centre. practiceThe ishighly secretive, although cases, girlsare circumcised inthehospital/health a traditional attendantornurses; birth insome privately by families, outathomeby andcarried in FGDsreported thatcuttingisorganised and celebrations organised tomark it. Participants public cuttingceremony norare publicfestivities a private event; formostfamilies, there isneithera among theKisiidiffers from inthatitislargely Kuria mon ow FG We have names forthemlike ‘Egesagana’ g the M isconducted K JustlikeamongtheKuria, isii practiceThe ofFGM families usethetraditional circumcisers, who are Nyamira, which is a remote rural area, more [school] holidays” (Headteacher, interview, Kisii). by thewomen andmen are rarely involved: ceremonyThe ismainly organized andmanaged circumcised girls). by thewomen” (participant,FGD, mothers of are circumcised ornotifthey were notinformed wouldcircumcised never bride tellwhether they what tocut. Eventhemenwho insistonhaving a affair –it’s thewomen who decidewhen and Age atcircumcision: Timing ofFGM: staff: Traditional circumcisersvs. medical prevailing beliefsaround thenecessityofFGM. she wants thistohappenornot, becauseofthe the midwife ortraditional attendant, birth whether uncircumcised woman labourby tobecutduring In somevillages, itisacommon occurrence foran (participant, FGD, men). married daughter hasbeencut’ andwe celebrate” to becircumcised: been known toremove theirdaughters from school any theyear timeduring and someparents have pointedout,participants circumcision canhappen and have adequatetimetoheal. However, assome December, when thegirlsare homeonvacation, their daughters circumcised themonthof during daughters getcircumcised. do organise apubliccelebration when their awayvillages further from urbancentres, families According interviewed, totheparticipants insome perform thecutting: perform decision onwhen tocircumcise andaboutwho will was 15-18years. Parents, mostly mothers, makethe 13years, unlikeearliertimeswhen theaverage age low as5-7years, withmostgirlscircumcised by circumcised amongtheKisiihasdropped toas reported thattheageatwhich girlsare In someareas inthedistrict, especially We are just told by thewomen that ‘your It is no longer done only during the It isnolonger done only during (female) circumcision(female) istotally awomen’s Most familieswillhave Several participants

25. 26. (participant, FGD, menFGD). married blade foreachgirltoavoid spreading infections” through our culture. Now the nurses can use a new diseases thegirlswere protected from these new diseases, there was noproblem withcatching young men). unmarried of thetraditional circumciser” (participant,FGD, thecutinstead doctor (medicalstaff)perform money, ifthey can, soastobeable tohave a the nurses usedifferent bladesforeachgirl: no longeraproblem forthecommunity because practice argued thatthemedicalcomplicationsare the inthestudyParticipants who supported this isthoughttoleadexcessive bleeding. initiates hadengagedinsex tothecutting, prior requirements. For example iftheattendantsto to curses orlackofobservationcultural some interviewees associatedthesecomplications reproductive organs. orurino-genital However, deliveryduring damagetonerves, orpermanent bleeding which may leadtodeath, problems ofinfectiontothewound,mentioned includedrisk practice offemalecircumcision. effects The identify themedicaleffectsassociatedwith intheresearchAlmost alltheparticipants could e Aw Financial exchange: cutting by ahealthstaffisconsidered safer: who cansave foritprefer touseanurse because there were reports thatwell-off familiesandthose considered cheaperandeasily accessible. But e.g. chickens. and sometimesare items paidwithnon-monetary circumcisers charge comparatively less 2000, dependingon “market rates”. Traditional from thehospitalscharge between KShs500- According toresearch participants, medicalstaff initiate pays forthecostofcircumcision. ff a ects o reness o In thepast people didnotcontract these Even the poorfamilies willsave some f FG f the M The familyThe ofthe the practice, reported thatthey participants were government inpromoting abandonmentofthe When askedabouttheirviews ontherole ofthe ones lackedtheconfidence. publicly duetotheirupbringing, while theyounger were oftentooembarrassed totalkaboutthetopic circumcision withtheirstudents; theolderones that teachers founditdifficult to discussfemale consider abandoningit. For instance, itwas felt FGM inthecommunity, andtogetlocalpeople feltthatitwas stilldifficulttoaddressparticipants However, despitetheseefforts, research geographic coverage have notbeensuccessful. interventions, avoid duplicationsandensure better regional network toencourage sharing, harmonise Secretariat Coordinator, attemptstoestablisha work inisolation; according totheNationalFGM/C noted that, unlikeinKuria, theorganisations inKisii re-evaluate theirbeliefsaround FGM. studyThe to urge thepeoplechangetheirattitudesand through publiccommunication, suchasvideos, community through workshops, seminars andalso Mosocho andRWAYDO. organizationsThe train the (the Adventist Reliefagency), ActionAid, Fulda the YWCA, Maendeleoya Wanawake, ADRA been active inthearea intherecent past, including in thisstudy identifiedkey agenciesthathave agencies todiscourage thepractice. Participants activities implementedby churches, andlocal KisiiregionThe hashadmany programmes and to er Attitudes tow often togetmarried. sometimes loseinterest inschoolanddrop out, social effectmentionedwas thatcircumcised girls satisfied intheirmarriages. Anothernegative or keepmistresses becausethey are notsexually womento marry from assecondwives othertribes in theunion. Insomecases, theirhusbandschoose poorly sexual during relations, leadingtoproblems of love because thewomen inmarriage respond On thesocialeffects, reported lack theparticipants K isii a dic a te FG a rds e M

a mon ff orts g

practicing femalecircumcision: not donemuch todiscourage thecommunity from Other respondents feltthatthegovernment had circumcised girls). ceremonies” Even thecelebrations are disguisedasbirthday the government canknow what ishappening. secretly andmainly at night–there’s noway knowledgeable enoughtoprotest orrefuse. the girlsatanearlieragewhen they are not by becomingsecretive, resorting tocircumcising arrest andprosecution, thepublichave reacted that becausethegovernment hasbeenthreatening practice underground. administratorThe thought the current laws had, inhisopinion, driven the prosecution ofoffenders, andthe existence of He feltthatthelaws were notadequatetosecure who toprosecute inacaseoffemalecircumcision. laws donotgive aclear prescription onhow and A localadministrator complainedthattheexisting (participant, FGD, young men). unmarried but they are notdoingmuch, itisjustwords” the government coulddomore: circumcising theirgirls. feltthat Otherparticipants much in explaining why the community should stop They alsofeltthatthegovernment hadnotdone (participant, FGD, men). married government campaigningagainst FGM” Preference for medicalstaff: C the community doesnotcomply withtheban: aware thatthegovernment hadbannedFGM, but with re health stafftodothecutting, insteadof years hasbeentheincreasing preference forusing the way theceremonies are over performed the acknowledgedparticipants thatamajorchangein h a n this thing (circumcision) isdone the government isagainst thepractice we have never heard aboutthe g es in the community ga (participant,FGD, mothers of rd to FG M

Almost all

re-evaluate theirbeliefsandvalues: hasledcommunityThis members tobegin associatedwithFGM.the illegalityandhealthrisks exposure toothercultures andeducationabout influence ofthechurch, andtoparents gaining attributed thisshifttothegrowingand interviews bow tosocialpressure. intheFGDs Participants families rejecting thepractice andrefusing to haveparticipants observed changes, withsome remains nearly universal amongtheKisii, to theauthorities. they are enoughtoreport notinformed theparents parents circumcising theirgirlsatanagewhen to thegovernment banonthepractice leadingto enough toberebellious. Ithasalsobeenattributed the girlscutatatenderagebefore they are old combination ofreasons includingtheneedtoget of theageatcircumcision to5-7years isfora recognised ascomplying withtradition. scratch soasjusttogetalittlebloodandbe the motherasksnurse/cutter tomakeasmall Kuria. Respondentsreported thatinsomecases, changes inthetypeofcutting, asobserved in cared forby theirmothers. There have alsobeen month. Nowadays, girlsremain athomeandare cared forby theirgrandmothers andauntsfora longer putintoseclusionasinthepast, tobe is thefactthatnewly circumcised girlsare no notable changepointedoutby participants cultural things” (participant, ARP initiatesFGD). tomakeuptheir ownauthority mindsandresist who are educated have theknowledge andthe Lower age atcircumcision: No moreseclusion ofinitiates: Families resistingFGM: the girlsathome. parents arrange foradoctor/nurse tocomeandcut now takesplaceinhospitals/healthcentres, orthe initiates. As pointedoutearlier, mostofthecutting or scissors, which was oftenshared amongst razors (scalpels)rather thanthetraditional knife, traditional circumcisers. Healthstaffuseindividual Education makes adifference -those Although FGM The loweringThe Another

27. 28. the contrib difficult tostopthepractice ifonly thegirlsand resistance tochange. They pointedoutthatitis coverage ofthearea by NGOsfor thecontinued throughout thecommunity. They blamedthepoor abandonment ofFGMneedtoinvolve peoplefrom feltthatactivitiesParticipants toencourage the school clubsonFGM. FGM andanumber ofschoolsare after running teachers talkedofpupilsaskingforadvice about being facilitators atthe ARP camps. Elsewhere, schools, usingtheirfacilitiesandwithteachers YWCA works inclosecollaboration withlocal empowering girlstosay notobeingcircumcised. andillegalityofFGM on thehealthrisks of accessingyoung girls, providing information of FGMhave worked through schoolsasameans ofprogrammes majority The ontheabandonment some KisiistochangetheirstandonFGM. been mostnoticeableinurbanareas andhasled andillegalstatusofFGM.the healthrisks has This is education, andexposure tonew on information Education: Religious influence: reference toFGM. or resistance tochangeinthecommunity with following factors thathave contributed tochange identifiedthe participants FGD andinterview ors th F and awiderange ofstakeholders: Involvement oflocalauthority, police Exposure toothercultures: social pressure andnotcircumcise theirdaughters. from other communities have managed to resist the community who have wives married orhusbands pointed outthatsomemembers oftheKisii female circumcision. malecircumcisionquoted assupporting but not members abandoningthepractice. Bibleis The rejected femalecircumcision, resulting insome was thestandtakenby thechurches, which have attributed totheabandonmentofpractice a ct p r a ctice Another factor repeatedly mentioned uted to ch a t m A key factorthatis a y h a a Participants Participants n ve g e in

are invited toattend. Both initiatesandparents are initiates of ARP are given and parents certificates between 6-12yrs. At theendoftraining the other localpartners. girlsrecruitedThe are aged YWCA members, Maendeleo Ya Wanawake and the schools, churches, Provincial Administration, girlsattendingthe The ARPs are recruited through circumcisers, localofficialand YWCAtrainers. the community andincludeteachers, reformed and December. Facilitators are drawn from across although FGMtakesplaceprimarilyin August three timesayear in April, August andDecember, programmes, uptooneweek long, are offered was introduced intotheprogramme in2008. ARP The YWCA programme beganin2006and ARP the activity. ensured andendorsement theirsupport of Commissioner, Officer, District andChiefs, government officers, suchastheDistrict involvementThe oflocaladministrators and circumcisers andthelocaladministration. officials, schoolauthorities, church leaders, guardians, boys, opinionleaders, government working withgirlsandyoung women, parents and YWCA istakinga ‘whole community’ approach communities inwhich theevents takeplace. their graduation ceremonies tobeinthespecific to repeat thisasbothorganisations would prefer graduation ceremony; however, there are noplans programme. In2009 YWCA and ADRA shared a which hasmuch incommonwiththe YWCA aGirlsEmpowermentruns Programme (GEP), districts: IgongaandGuchadistricts. ADRA also organised by the YWCA intwo administrative In Kisiithisstudy focusedonthe ARP events (A Altern of FGM. adequately aboutthenegative informed effects feelingthatthecommunitymany isnot participants demand formore widespread sensitization, with ofthepractice.to theperpetuation There isa out menandgrandmothers who alsocontribute mothers are targeted, asisoftenthecase, leaving R P) in a K tive riteo isii f

pa ss ag e the girlsgobackandgetcircumcised. Asked if successful –according torespondents, very few of It alsoappears thatthe ARP training hasbeen andfollowbetter monitoring upaftergraduation. involved asmallnumber ofgirls(50), toensure were well managedandeffective becausethey According tothestudy participants, the ARP events engage theyoung girls. Games, drama, songsandrole play are usedto misconception andtheillegalstatusofFGM. about thenegative effectsofFGM, myths and organised by YWCA they were alsotaught theoneweekmentioned thatduring training the challengesofadolescence. participants The they changefrom childhoodtoadulthoodand their body, theirreproductive healthandhow the ARP helpstheinitiatestounderstand about reported thatthetrainingFGD participants at the ceremony. but alsoreceived attheendof certificates attending the ARP hadalready beencircumcised to theresearch participants, someofthegirls invited tobecomemembers of YWCA. According week forthegirls. providing goodfoodandaccommodationfora support, duetothehighcost, which includes adopt andsustainthe ARP courses withoutexternal felt thatitwould bedifficultforthecommunity to other communities. However, FGDrespondents before moving ontoreplicate thisapproach in each target community forapproximately 2years adequate resources. YWCA intendstosupport in recruitment, monitoring, follow upandsecuring will bereduced to25. isbecauseofdifficulties This number ofgirlsattendingeach YWCA ARP in2011 considerable organisation andresources. The However, ARP events are intensive, requiring FGD, ARP initiates). my are daughters notcircumcised” (participant, ARP saidthey would not: who hadthemselvesparticipants undergone the they would circumcise theirdaughters, mostofthe I would do allin my abilitytoensure that

29. 30. Lessons learned and recommendations communities. two the each of in activities future for recommendations key with concludes section The • • • • T include: ARP involves acombinationofactivities that would increase itseffectiveness. communities, and toidentifythefactors which andKisii abandonment ofFGMamongtheKuria the role ofthealternative ofpassageinthe rite A key objective ofthisstudy was toexplore A This section discusses section This limited. been has attitudes R P in women. women. uncircumcised of acceptability social FGM; to relation in making decision FGM; and education between links pose; approaches these challenges the and Kisii and Kuria in used being is ARP ways the •

K rights ofgirlsandwomen;rights of FGM, its illegalityandviolationofthe programmes alsocover the healthrisks the transition towomanhood. Some ARP women aboutgrowing upandmaking providing educationtoyoung girlsand ur ia and of FGM, success in changing changing in success FGM, of abandonment encourage to agencies national and local of efforts the despite Kisii, and Kuria in that, indicates study his K isii A addition, the pressure toofferasmany placesas recognise itasanalternative ofpassage. rite In the girls, theirparents northe localcommunity at which thegirlsreceive acertificate, neither graduation ceremony attheendofeachcamp and women. However, althoughthere isan ARP ofgirls its illegalityandviolationoftherights education which ofFGM, includesthehealthrisks intensive. campsdoprovideThe aprogramme of the circumcision season, makingthemresource by providing arefuge throughout thewhole of ofpassage.rite campsaimtoprotectThese girls for young girlsthanonproviding analternative onprovidinga higherpriority arescue centre Network forthe Abandonment ofFGMhave placed However, organisations working undertheKuria encourage abandonmentofFGM. cutting, would beanappropriate approach to ARP, mirroring localculture inallbut theactof social pressure. Itwould seemtherefore, thatan parents andyoung girlssubjectedtoconsiderable decide when theceremonies willtakeplace, with widely withceremony. CouncilofEldersThe remained acommunity ceremony, observed In Kuria, circumcision (maleandfemale)has the future. and sponsorthemfrom theirown resources in orKisiiwouldin eitherKuria adoptthe ARP events of FGM. Itwas feltunlikely thatlocalcommunities holistic programme encouraging theabandonment ofa in combinationwithotheractivities aspart districts, ARP isseenasanapproach tobeused Kisii, withvaryingdegrees ofsuccess. Inboth ARP isbeingusedindifferent ways and inKuria R P in •

girlhood towomanhood. ceremony ofpassagefrom fortherite a publicly recognised alternative K uri a nor abletomakedecisionsabout theirfuture in knowledge andunderstanding oftheir own culture, Neither are they seenashaving acquired made thetransition from girlhoodtowomanhood. are notseenby the widercommunity ashaving Consequently, young girlswho attend thecamps • • were unaware, including ofwhichthe modelusedinKuria theorganisers however, key weaknesses have beenidentifiedin effectiveness oftheRescue/ARPCampapproach; researchThis didnotattemptafullreview ofthe adequate fundingandresources. that mostoftheseissuescouldbeovercome with avoid undergoing FGM. However, theNetwork felt the RescueCampsonseveral occasionsinorder to cut afterthecampsandthatsomegirlsattended and follow upwiththegirls, thatsomegirlswere in recruitment, thelackofadequatepreparation camporganisersThe were aware ofthedifficulties ‘rescued’ from FGM). number ofattendees(i.e. number ofyoung girls FGM andsuccesstendstobemeasured asthe as ameansofencouraging theabandonmentof appropriateness oftheRescue/ARPCampmodel date there hasbeennoin-depthreview ofthe of Elders, ideally ineachoftheclanareas. To season whenever announcedby theCouncil Rescue/ARP Campswhich lastforthewhole FGM Abandonment ofFGMcurrently are tooffermore Network plansoftheKuria The forthe and insomecasespoorrecruitment. under-resourced, withvery limitedfollow-up with relatively limitedlocalconsultation, possible hasresulted inlarge camps, planned about their rights andtheimpactofFGM. about theirrights camps, notplaceswhere young girlslearn towards thecamps, seeing themasholiday communities, have strong negative feelings many localpeople, especially meninthe adulthood; analternativeoffering ofpassageto rite to avoid thecuttingseason, rather thanas camps seethemprimarilyasrescue camps parents andeven young girlsattendingthe from earlyandFGM. marriage intensiveThe is aresidential rescue centre, refuge offering NtomonokInitiativeTsaru (TNI)inNarok, which are by theexperience ofvisitingthe supported findingsofthe The research andKisii inKuria to maturity, withoutundergoing thecut. girls andtheirparents totake a proactive approach is ongirlsempowerment, which requires young under the YWCA and ADRA modelstheemphasis cut, which isapassive concept, whereas inKisii, the emphasisisplacedonrescueKuria from the andtheKisiiisthatin ARP isbeingusedinKuria difference crucial The between theway inwhich circumcised. parents andgirlschoosingforthenottobe effective inchangingattitudestowards FGM, with few locations, however, they appeartobebeing ARP programmes are takingplaceinrelatively community leaders andlocalauthority. These taking anholisticapproach, working withparents, coursesshort are offered throughout theyear, illegality ofFGM, withan ARP ceremony. These hygiene, ofgirls andwomen, therights the programmes courses offering onhealthand ADRA have combinedgirls’ empowerment However, someagencies, including YWCA and local practice inrelation toFGMinKisii. to womanhood, mirror doesnotparticularly the alternative ofpassageceremony rite from girlhood the circumcision isdoneinsecret. ARP, asapublic withinthefamily,will beaparty andsometimes whole community celebration, sometimesthere girls beingcircumcised by 13years. There isno arrange fortheirdaughters tobecut, withmost traditional cutlure. Parents, usually themothers, womanhood andmore withupholding concerned ofpassageagirlto less associatedwiththerite In Kisii, FGMisprimarilyafamily event, which is A been marginalised andremains unrecognised. the ARP elementofthecamps, thisaspecthas In conclusionby alackofsufficientemphasison or employment. oftheirownterms bodies, theirfuture education R P in K isii

31. 32. a against FGM, but many oftheseusecomplex Posters are used extensively incampaigning associatedwithFGM.of rights provide andviolation onthehealthrisk information clubs tostrengthen thepeersupport, aswell as making. Someschoolsare now anti-FGM offering Peer influences support young girls’ decision be targeted ifthey choosenottobecircumcised. be stigmatisedandherchildren are lesslikely to teacher oracommunity leader, sheislesslikely to and holdsapositionofresponsibility, suchasa to choose. Inparticular, ifawoman iseducated perceiving ‘educated families’ asbeingmore able uneducated girls. There were reports ofpeople uncircumcised girlsandwomen isfargreater for the isolationandstigmadirected towards There isevidence andKisiithat inbothKuria ofyoungrights girlsandwomen. aboutFGMandthe activities aimedatlearning attending schoolare lesslikely tobeinvolved in it doesmeanthatfamilieswhose children are not efficient way ofagenciesaccessingbeneficiaries, empowerment programmes. Whilst thisisan out-of-school clubs, rescue camps, ARP and raising activities, through theactionsofteachers, young peopleandtheirparents inawareness programmes work closely withschoolstorecruit FGM programmes. Inaddition, mostanti-FGM and discussionswithagenciesimplementinganti- communities, mentionedinallFGDs, interviews the abandonmentofFGMinbothKisiiandKuria Education isperceived factorin asanimportant educ L relationships, educationandemployment. decisions forthemselves ontheirfuture of interms enabled totakecontrol oftheirlives andmake Through thisprogramme theyoung women are education andemployment, where appropriate. of theirschooleducationandaccesstohigher rights, theacquisitionofbasicskills, continuation programme which includeseducationontheir programme offered at TNI isagirlsempowerment inks between b a ndonment o a tion a nd the f FG M the role oftheall-maleCouncilElders cannotbe to encourage theabandonmentofFGM. InKuria, in mindwhen itcomes todevising interventions differenceThis ingenderroles shouldbeborne and driven by theolderwomen. whole process issomething which iscontrolled the menclaimingthey play littlerole andthatthe older women play a significant role, withsomeof making islocatedwithinthefamily. Usually the In Kisii, there are nofixed datesandthedecision- has beentakenby theCouncilofelders. once thedecisiontohave acircumcision season outbycarried theolderwomen ofthecommunity, preparations ofthegirlsforceremony are FGM willoftencomefrom thegrandparents. The the family, the pressure foryoung girlstoundergo few would goingagainsttheirwishes. risk Within Council ofElders have supernatural powers and agricultural andsocial. Itiswidely heldthatthe and continuation ofthecultural practices, both respected menwithresponsibility fortheretention clan. CouncilofEldersThe are agroup ofhighly season are setby theCouncilofElders foreach In Kuria, thedatesandlocationforFGM culture by theelders ofthecommunity. seen asafundamentalchallengetothetraditional in bothcommunities theabandonmentofFGMwas relation toFGMbetween andKisii, Kuria however, There were differences inthedecision-making D encouraging theabandonmentofFGM. school networks, are unabletoaccessactivities those who are non-literate, orwho are outsidethe to read leafletsandposters, it would appearthat attending families. Inadditiontonotbeingable activities toincludenon-literate ornon-school which explicitly extended theirawareness raising There were very few examples ofprogrammes confidence toaskforhelp. those withlimitedliteracy skillsandwithoutthe posters are inaccessibletonon-literate peopleor language requiring ahighlevel literacy. These rel ecision-m a tion to FG a kin M g in against parents whose girlsundergo FGM. are more fully understood andactionistaken both publicly andprivately, ofchildren therights church leaders andschoolteachers, opposeFGM a climatewhere respected people, forexample FGDs suggestthatthisismore likely tohappenin to feelsafeenoughbreak with tradition. The avoid FGMbut feel pressurised toconform, need groupsignificant ofpeople, who would prefer to the prevalence andKisii, ofFGMinKuria this If real progress istobemadeinreducing todrawprick blood. community, although askthecircumciser toonly that theirdaughters are notostracised by the they willreluctantly have theirdaughters cut, so public andanotherinprivate. Several were saying being hypercritical about FGM, saying onethingin to enforce thelaw, localleaders andcriticise for frustration thatthegovernment was notdoingmore understanding of ChildrenThe Act, express socially acceptable. They tendedtohave limited societal pressure andtherefore toconform be harmful, andontheotherhand, theconsiderable not appeartohave any healthbenefitsandcanbe on theonehand, knowing thatFGMisillegal, does obligation. They withthetensionbetween, struggle of socialacceptabilityandseeFGMasacultural but they fearthesocialconsequences, interms prefer theirdaughters orfuture wives nottobecut young menincludedmany unmarried who would andKisiitheFGDswithparentsIn bothKuria and are struggling. tensionswithwhich participants internal indicate opposingviews, whilst others reflect offered by FGDparticipants. Somecontradictions number ofcontradictions in theviews andopinions There are, inevitably inqualitative research, a uncircumcised women S its abandonmentintheirfamilies. women speakingoutagainstFGMandmodelling In Kisii,tohave itwillbeimportant highprofile forwidespreadis crucial changesinthepractice. ignored ofchangesinpractice andtheirsupport oci a l a cce p t a bility o f

• • andKisiiitisrecommendedIn bothKuria that R • • ecommend and healthprofessionals; church leaders, andtraditional circumcisers staff, teachers,authority community and whole community, includingboys, men, local include therole of ARP andengagethe women. Itisrecommended thatprogrammes ofchildrenits illegalityandtherights and the negative healthandsocialeffectsofFGM, Increased community educationisneededon their cultural background; for adultlifeintheircommunities andrespects undergoing aceremony which prepares them recognise thatthegirlsattendingcampsare is recommended sothatthecommunity undergo FGM.community awareness Further parents tomakeactive decisionsnotto approach andempowers girlsandtheir programme which takesarights-based of FGM, but always ofaholistic aspart interventions toencourage the abandonment ARP canenhancetheeffectiveness of mutual support; together toshare experiences andoffer provide people tobring opportunities Schools andchurches are well placedto those wanting tomakesimilardecisions. ceased thepractice groups andsupport for made ofrole modelsoffamilies who have the practice ofFGM. Greater usecouldbe social pressure thatforces themtosubmit parents andgirlscopewiththe tremendous More interventions are developed tohelp residential programmes; range from clubsinschoolsandchurches to or community pressure. initiativesThese could and FGMandskillstoresistmarriage family and lifeskills, aswell ofearly astherisks these programmes includehealth, nutrition range ofcommunities. Itisrecommended that in theircommunities isextended toawider the range andresponsibilities ofrights ofgirls empowerment programmes which address provisionThe oflocal, accessiblegirl a tions

33. 34. • • • • successful prosecutions; Kisii couldbenefitfrom widerpublicityabout consequences ofbreaking thelaw. and Kuria to cultural traditions outweigh any fearofthe of FGM, but thesocialpressures toconform are generally aware ofthetechnicalillegality the research shows andKisii thattheKuria the existing laws inrelation toFGM. As itis, need tostrengthen publicawareness around Government urgently andthelocal authorities pupil hasundergone FGM; and what thereporting procedures are ifa activities, how todiscussFGMwithparents FGM intoclassroom andnon-classroom based benefit from given training inhow tointegrate with bothgirlsandboys. Teachers would social inhibitionsandaddress FGMinclass capacity ofteachers tohelpthemovercome more closely withschoolsandbuilding the recommended thatpartners considerworking the issueduetosocialperceptions. Itis that teachers feelincapableofaddressing people toreject it. However, thefindingsshow address FGMandencourage theyoung Schools provide anexcellent avenue to knowledge andskillstoenforce thelaw; law enforcers, who currently lacktheauthority, contravention. There needstobetraining for taking stronger actionininstancesof professional bodiesandthegovernment the role ofhealthprofessionals inFGM, with Specific consideration needstobegiven to need tobeimplementedandmonitored. investigate andprosecute offenders, which to bedeveloped toreport contraventions, isneeded.rights Explicitprocesses need prohibiting FGMandpromoting children’s Stronger enforcement oftheexisting laws empowerment and ARP programmes. enable themtoplay astronger role ingirl the abandonmentofFGMwhich would basedapproachin adoptingarights to Churches leaders couldbenefitfrom training sustainability ofabandonmentprogrammes. churches, they couldimprove thereach and if agenciescanwork more closely withthe to reducing thepractice ofFGM; therefore, Churches have significantinfluencein relation • • • girls’ empowerment programmes; might betoinvolve theCouncilofElders inthe taken outofschoolforthepurpose, later steps women beingcircumcised againsttheirwillor Kuria. First stepsmightbetoprevent girlsor wise approach totheabandonmentofFGMin a positive role fortheCounciltoplay inastep new MoUwould bebeneficial which includes Memorandum ofUnderstanding. A realistic and theCouncilofElders inrelation tothe recommended between theLocal Authorities the practice ofFGM.consultationis Further is oneofthesocialpressures maintaining of goingagainstthewishesCouncil of theKuria. Currently, fearofrepercussions because ofthekey role they play inthelives sensitised as change agents in relation to FGM, CouncilofElders Kuria The needstobe community awareness raising programme; season andwere combinedwithanintensive throughout theyear, theFGM notjustduring would bemore effective ifthey tookplace a strong ARP element. programmesThese a broader programme rights-based including circumcisioncamps during seasonstowards they considerchangingfrom hostingrescue and are unsustainable. Itisrecommended that and are therefore limitedintheireffectiveness not succeededingaininglocalacceptance, from theresearch thattherescue campshave Rescue/ARP Campapproach asitappears of FGMwould benefitfrom reviewing the Network Kuria The forthe Abandonment marriage, FGM). young women (forexample of early interms livelihoods, as andtodemandtheirrights ability tomakedecisionsabouttheirlives and see theirsuccessatschoolaslinkedwith recommended thatgirlsare encouraged to experienced ifagirlisuncircumcised. Itis the stigmaanddegree ofdiscrimination progression educationreduces intosecondary with theireducationforlonger. Successful from actively encouraging girlstocontinue Anti-FGM programmes would benefit research that; itisrecommendedIn Kuria onthebasisofthis • • • • • research that: In Kisiiitisrecommended onthebasisofthis intervention. literacy andare beingmissedcurrently by existing networks many ofwhom have limitedlevels of their resources onfamiliesoutsidetheschool of themostmarginalised, by focusingsomeof Local agenciesandpartners couldreach some networks many ofwhom have limitedlevels Kisii, however, familiesoutsidetheschool School attendancebeingrelatively highin effectively, sanctions; withstricter this issue, andenforce theprohibition more in changingbehaviour. torevisit Itisimportant practice, but itappears nottohave succeeded has inthepastissuedprohibitions againstthe out the procedure.carry of Health Ministry The increased reliance onhealthprofessionals to government more strictly, especially withthe FGMmustperpetuating beaddressed by the involvementThe ofmedicalstaffin them aswell; for theceremony, toinclude soitisimportant households providing theresources needed However, menhave arole toplay asheadsof personally andprofessionally against FGM. women leaders who have takenastand affair, hencetheneedtohave prominent practiceThe isseenaslargely awomen’s out oninitiatives toabandonFGM. awareness raising andalsousethemtospeak makers, bothmaleandfemaleingreater Local agenciescouldengagedecision- and building collaboration between agencies; taking astrategic role ofreducing competition effectiveness ofanti-FGMinterventions by Kisii. networkThis couldstrengthen the experiences ofanti-FGMinitiatives across the Abandonment ofFGMwhich shares anactiveand support KisiiNetwork for Local agenciesare encouraged toestablish extended tocommunities across theregion; community engagementprogramme is courses incorporating ARP andanintensive currentThe programme ofgirlsempowerment encouraging abandonmentinrural communities approachThis hasclearly beeneffective in integrated intoagirlsempowerment programme. was combinedwithapublic ARP ceremony fully community sensitisationprogramme aboutFGM of thecamp. However, inKisii, anintensive girls from FGM, but only theperiod during ARP ceremony, hashadsomesuccessin saving Rescue Campswithtraining onFGM andan Kisii. focusinKuria,The onproviding primarily ARP ispracticed very differently and inKuria brave stepnottohave theirdaughters circumcised. continue thepractice would helpthemtomakethe with appropriate actiontakenagainstthosewho FGM intheirpublicandprivate lives, combined figures inthecommunity consistently opposing suggests thatacombinationofhaving respected andillegalityofFGM,the healthrisks thisstudy could bedonetoincrease awareness about andKisii.abandonment inKuria Although more elementinfuturea crucial strategies toencourage stigma againstuncircumcised women istherefore in order tobesocially acceptable. Reducingthe strong thatthey willsendtheirdaughters tobecut the stigmatisationofuncircumcised women isso have theirdaughters circumcised, but who feel ofFGMandwouldthe healthrisks prefer notto andKisii,in bothKuria who are about informed studyThe identifiedasectionofthecommunities those which encourage itsabandonment. which contribute tothecontinuation ofFGMand some insightsintothefactors, andKisii, inKuria incremental programmes. studyThis provides of FGMcanbeachieved through well-focused, social resistance, progress towards abandonment findingsofthisstudyThe show that, despitestrong C onclusion illegality. associatedwithFGMandits the healthrisks in relation ofgirlsandwomen, totherights and engagethemintheawareness raising can accessthismarginalised group ofpeople agencies andpartners considerhow they interventions. Itisrecommended thatlocal of literacy are notbeingtargeted by current

35. 36. abandonment ofFGM. developed andKisiitoencourage inKuria the will enablemore effective interventions tobe It ishopedthatthefindingsfrom thisstudy and knowledge fortheiradultrole intheirsociety. programme ofeducationandhave acquired skills undergone athoughtfulandculturally appropriate presenting themasyoung women who have the stigmaagainstuncircumcised women, by FGM. Inthisway ARP canplay arole inreducing recognised asanalternative toundergoing involves acommunity ceremony, andisexplicitly a structured girlsempowerment programme and is mosteffective when ittakesplaceattheendof in Kuria. studyThe concludes, therefore, that ARP universal, andcouldalsobeavaluable approach in Kisii, where FGMwas previously virtually 8. 7. 6. 5. 4. 3. 2. 1. kenya.pdf (accessed 30.01.2011) www.gtz.de/en/dokumente/en-fgm-countries- GTZ (2007) Female Genital Mutilation in Kenya. en/m/abstract/Js17116e/ (accessed 30.01.2011) 2008/2009 http://apps.who.int/medicinedocs/ WHO Kenya Demographic and Health Survey women_en.html (accessed 30.01.2011) Rights website: www.achpr.org/english/_info/ African Commission on Human and People’s for Global Action Toubia N (1993) doesn’t work programmes to date: What works and what Mohamud A, Ali N and Yinger N (1999) abandonment approaches. PATH Mutilation in Africa: Muteshi J and Sass J (2005) genital_mutilation/en/ (accessed 30.01.2011) WHO website: http://www.who.int/topics/female_ (accessed 22.02.11) int/publications/2008/9789241596442_eng.pdf UNHCR, UNICEF, WHO http://whqlibdoc.who.UNAIDS, UNDP, UNECA, UNESCO, UNFPA,Mutilation: An interagency statement WHO (2008) . Geneva: WHO/PATH Eliminating Female Genital . New York: Rainbo Female Genital Mutilation: A call An analysis of current Female Genital OHCHR, FGM 14. 13. 12. 11. 10. 9. Ministry of Health District: findings of a base line survey. GTZ (2005) Council Nyanza Province, Kenya Female Genital Cutting among the Abagusii in Njue C, and Askew I (2004) Kenya Abandonment of Female Genital Mutilation in of the Alternative Rites Approach for Encouraging Chege J, Askew I and Liku J (2001) (2007) Humphreys E, Sheikh M, Njue C, and Askew I Voluntary Male Circumcision in Kenya. STD Control Programme: National Guidance for Ministry of Health, Kenya (2008) multicultural perspectives Abusharuf R M (2007) Situation Analysis. Female Genital Mutilation/Cutting in Kenya- a . FRONTIERS, Population Council. Contributing towards efforts to abandon Female Genital Mutilation in Kuria Population Council and UNFPA Female Circumcision: . FRONTIERS, Population . Penn Press Medicalization of National AIDS/ An assessment GTZ / Kenya

37. References 38. Appendix A: Table of Participants M K M C C N N M M C C N wn/village T ria K K K K Across o e e e e h h h h t t t a a a a imaru imaru imaru u hancha hancha hancha hancha inato inato inato inato bera bera bera bera (b) Younger man was secretary,(a) not Female a formal participant member of not the a Councilmember ofof theElders Council of Elders K u ria (Chair) Committee Kuria, Anti-FGM he eetd 1Female 1 Chief (elected) circumciser Traditional Officer Children’s Local Authority Police officer 35 – 55 6 male, 3 female 35 - 65 2 male,ECAW) 10 female 9 (working with Paralegals 12 School teachers Parents (mixed) daughters uncircumcised Parents with daughters circumcised Parents with (married) Older men unmarried) (mainly Young men Elders Council of rescue camp attended a daughters had Parents whose (uncircumcised) Young women (circumcised) Young women C a tegory participants N u mber of 010 female 35 - 65 10 2 male, 10 female 12 12 male 12 12 male 12 2 12 female 12 Male 1 Female 1 Male Male 1 1 8 female 8 8 - over 70 8 male, 1 female (a) 9 6 female 6 8 female 8 Gender 40 - 50 35 - 45 65 55 - 60 35 - 40 27 - 62 35 - 55 45 + 18 - 32 1 - 60 – 70 (b) 28 - 45 18 - 25 18 - 27 g et)% literate (est.) Age (est.) 100% 100% 100% 80% 75% 90% 50% 75% 30% 66% 50% Yes Yes Yes Yes No K K K K K K K M S N K M M N N wn/village T sii K u o i i i i i i i i y y y o o o sii sii sii sii sii sii sii sii neka i amira amira amira socho socho socho are e 212 male 12 (circumcised) Young women Married men unmarried men Young oieOfcr1 Male circumciser Traditional nurse Ex-circumciser Female Police Officer 1 Director Programme YWCA Headteacher director Programme ADRA Older men daughters circumcised Mothers with aet mxd 28ml,4fml 35 - 55 8 male, 4 female 12 Parents (mixed) Teachers daughters uncircumcised Mothers with ARP initiates) (uncircumcised, Young women C a tegory participants N u mber of 111 female 11 12 male 12 21 eae 30 - 40 12 female 12 212 female 12 Female Female 1 1 Female 1 Male 8 male 1 8 ae eae 25 - 45 4 male, 4 female 8 8 female 8 Gender 21 - 32 18 - 30 35 - 65 70 - 80 30 - 40 40 - 50 45 - 55 55 - 80 30 - 40 45 - 55 32 - 45 19 - 25 g et)% literate (est.) Age (est.) 100% 100% 100% 100% 100% 75% 50% 75% 75% Yes Yes Yes Yes Yes No

39. Appendix A: Table of Participants 40. Appendix B: Reseach Tools YES /NO Date Date Office inNairobi. If you have any questionsafterthediscussion, you may Evelia contactHumphries atthePopulation Council Do you have inthediscussiongroup? any questionsaboutparticipating the group discussion. We willprovide you withasmallgifttocompensateyou forthetimespenttravelling in toandparticipating identify any individual person. afterwards. Any report from thisdiscussiongroup willnotuseany namesorany thatmay otherinformation be considered private andconfidential. Itwillbeusedforthisstudy only andthenoteswillbedestroyed be treated asconfidential.The noteswillbekeptsafely atthe Population Council’s officeinNairobi andwill We willbetakingnotesofthediscussion. Nonameswillbe usedinthenotesandsoanything you say will any oftheissues, you donothave toandyou canleave thediscussiongroup atany time. groupThe discussionwilltakeabout60minutes. Ifyou indiscussingsomeor donotwant toparticipate opinions amongthegroup participants. wrong answers tothequestionswe willaskaswe expect thatthere willbedifferent experiences and group’s ideas, attitudesandopinions onvarious aspectsoffemalecircumcision. There are or noright community attitudesandpractices. Ifyou agree inthediscussion, totakepart we willbediscussingthe I would liketoinvite you tojoinagroup discussionaboutfemalecircumcision, more tolearn about willbeusedby information This localorganisations toimprove theirprogram implementation. PopulationThe from Counciliscollectinginformation peopleliving inthisarea aboutfemalecircumcision. taking notes. ismyThis colleague______who isassistingmeinthediscussiongroup by of communities. an organisation research thatundertakes intosocialandhealthissuestoimprove thewellbeing Hello. Mynameis______Iwork forthePopulation Council, formed I S S D (Tel. No. (02)713480/1/2/3/4). ignature ofinterviewer ignature (ormark)ofgroupparticipant n o you agree to participate inthediscussiongroup? o you agreetoparticipate

C o nsent Form

Focus Group Discussions

Date S Date S YES/NO D YES/NO D (Tel. No. (02)713480/1/2/3/4). Council OfficeinNairobi If you have any questionsafterthediscussion, you may Evelia, contactHumphries atthePopulation Do you have inthediscussiongroup? any questionsaboutparticipating thatmayinformation identifyany individual person. will bedestroyed afterwards. Any report from thisdiscussiongroup willnotuseany namesorany other safely andwillbeconsidered private andconfidential. They willbeusedforthisstudy only andthe notes I would liketotakenotesofthediscussion. Your namewillNOT beusedinthenotes. noteswillbekept The you atany canstoptheinterview time. willtakeabout30minutes. interview The Ifyou donotwant toanswer any question, you donothave toand us andsowe want you inanswering tobehonestandtruthful ourquestions. orwrongno right answers tothequestionsIwill askyou. Your opinionsandexperiences are to important asking you aboutyour ideas, attitudesandopinionsonvarious aspectsoffemalecircumcision. There are I would liketoaskyou somequestionsaboutfemalecircumcision. Ifyou agree tobeinterviewed, Iwillbe willbeusedby information This localorganisations toimprove theirprogram implementation. PopulationThe from Counciliscollectinginformation peopleliving inthisarea aboutfemalecircumcision. of communities. an organisation research thatundertakes intosocialandhealthissuestoimprove thewellbeing Hello. Mynameis______Iwork forthePopulation Council, I ignature (ormark)ofinterviewee ignature ofinterviewer nformed nformed o you agreetobeinterviewed? o you agreethatnotescanbetaken oftheinterview?

C onsent Form Individual Interview

41. Focus Group Discussion Guide 42. Focus Group Discussion Guide this community. I would likeustobeginby focusingonthemeaningandsignificanceattachedtofemalecircumcision in S 4. 3. 2. 1. ection 1.

Probe for: uncircumcised girls? isattachedtothepractice?value andimportance In your view, In your view, Probe for: What aretheproceduresandpractices What Probe for: Generally ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

Awareness ofprosecutions nationally, locally Knowledge oflegality Rights, dutiesandsocialexpectations oftheinitiate Gifts provided toinitiate ofseclusion Length ofperiod Persons responsible forpassingonthiseducation/information Kind ofeducation, &skillsinitiatesreceive information Who thepractitioners are Implications foragirlfailingtocomply Level ofsecrecy /knowledge tocircumcision ofgirlsprior Decision-making power (thegirl, mother, father, otherrelatives orclan) Time (orseason)when ittakesplaceandnumber ofgirlsinvolved Age ofcircumcision and what kindofpeoplediscourage ordon’t practice femalecircumcision? From your general observation, andencourage what kindofpeoplesupport thepractice not tobecircumcised? In your understanding, why dosomeGIRLSchoosetobecircumcised andothers decide others decidenottocircumcise them? In your understanding, why dosomeFAMILIES choosetocircumcise theirgirlswhile How prevalent isthepractice? how doesthecommunityhereview female circumcision, how doesthegovernment view FGM? what arethemaindifferences betweencircumcisedand General overview associated withfemalecircumcision? what meaning, 5. 6. 7. related tofemalecircumcision? medical complications. NOTE: The focus oftheprobingshouldbeonsocialimpact; avoid detailon Now let’s talkaboutthe Probe for: In your view, Probe for:. Probe for: factors What

♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

Perceived disadvantages ornegative effectsoffemalecircumcision tothecommunity and Perceived benefits/advantages offemalecircumcision tothecommunity, thefamily andto the girlinitiatetoday the girlinitiatetoday which andwhat rights effectmightthishave? In your view doesfemalecircumcision contravene children’s andwomen’s Ifyes, rights? problem(s), consequences, what hasbeendonetoaddress them) Awareness ofany problems associatedwithfemalecircumcision (nature ofthe Illegal statusofFGM Women’s empowerment withgroupsIntermarriage who donotpractice femalecircumcision Media campaignsandcoverage administration Campaigns by key personalities inthecommunity e.g. women leaders, local Specific anti-FGMprograms implemented by government /NGOs Education –schoolliteracy infamily /churchChristianity Or any changesinthe ‘ceremony’? Or any changesintheageofgirls? Are there any changesinthetypeofcircumcision beingundertaken? Are there fewer ormore girlsbeingcircumcised now thanpreviously? has therebeenchange inthiscommunity have brought aboutchangesorencouraged resistance tochange? effects offemale circumcision regarding attitudesandpractices

43. Focus Group Discussion Guide 44. Focus Group Discussion Guide I would liketonow talkaboutprogrammes toeliminatefemalecircumcision inyour community Rite ofPassage (ARP)events S 4. 3. 2. 1. ection 2. circumcision inyour community? What doyou know about Probe for: Are you aware ofany Probe for: Are you aware ofany Probe for: Are you aware programmes inyour district? Probe for: ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

What they knew aboutthealternative ofpassage rite Who madethedecision Age when went through therite What experience, ifany, doyou have of ARP? When didthealternative intervention ritual begininthiscommunity? Have any insuchaprogramme/activity? girlsinthiscommunity participated What issuesdoesthe ARP address? How effective were they? Who attended? How longwere they? Who hasorganised them? Can peopleread themeasily? What kindofmessages dothey give? areWhat kindsofIECmaterials beingusedincombatingFGM? Are they useful? How are theseorganisations perceived inthecommunity? What are theiractivities? Who are they? How longthe ARP process took form written provided kindofinformation The before andafter therite, by whom andwhether in numberThe ofothergirlsinvolved intheceremony of organisations orgroupsofpeople alternative rite ofpassage (ARP) rite alternative Rescue Camps

how girlsareprepared for ARP? Rescue Campsand Alternative forgirlsinyour district? working toeliminatefemale (circumcision through words) 9. 8. 7. 6. 5.

be circumcised? Probe for: Do you think ARP willever becomean Probe for: If you have adaughternow orifyou have adaughterinfuture, would you Do you know ofgirlswho have beenthrough ARP but who were What are the What are the Probe for: community? Probe for: ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦

rationale behindthisandthecircumstances ofthiscase(orcases). Did they personally decide, orwere they forcibly circumcised? Pleaseexplain the Would you bewillingtosponsoryour daughtertogothrough an ARP ceremony? community? What isthecosttofamily fortraditional ofpassageceremonies rites inyour traditional circumcision? Are peoplewillingtogive thesamekindsofgiftsatan ARP ceremony asthey dofor What expenses are incurred by thefamily inpreparation fortheceremonies? Who pays for ARP ceremonies? Do girlsortheirparents needtobeableread in ARP processes? totakepart andwrite Are there any limitationsto ARP? Are there any advantages of ARP? circumcision? Do you thinkthisapproach hasbeeneffective ingettingfamiliestoabandonfemale Does the ARP inany way disadvantage girlsinthiscommunity? Do you thinkthealternative femalecircumcision benefitsgirls? rite If yes, what would needtohappen for thistotakeplace? If not, why not? Has your opinionchanged, ifsowhy? If notwould you consider ARP, ifsowhy /why not? What factors would beinvolved inthedecision-making? Why? financialarrangements associatedwithARP? most positiveandnegative ARP? aspectsabout

established part oflocalcustom established part later circumcised? want herto in this

45. Focus Group Discussion Guide 46. Focus Group Discussion Guide I would liketohearmore aboutthis. I understand thatyou have takendecisionsandactionsagainstfemalecircumcision and (with S ection 3. For example Young women who have refused toundergo FGM(over 18years old) 3. Probe for: 2. Probe for: 1. 4. p eo ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ oppose femalecircumcision? have your daughters circumcised, toopposeFGM) Probe for: Who knows aboutyour decision? Why didyou make thedecision What isthe How hasARPplayed arole Probe for:

p NGOs opposingFGM Health professionals who have stoppedpracticing FGM Traditional circumcisers who have stoppedpracticing Health professionals who publicly opposeFGM Community leaders who have opposedFGM Relatives who have ‘hosted’ runaways Parents who have decidednottocircumcise oneormore daughters Men who have uncircumcised married women ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ ♦ le who h

your life, thelives ofothers inthefuture? If public– Why? What impacthasthishad?How has/willyour decisioninfluence Is itsecret orpublic?Ifsecret - Why? What fears doyou have? Has anyone opposedyou? Were you by otherpeople? aloneorsupported you?Who supported Who didyou talkto? Was itonmedicalgrounds, orrights-based, orotherreasons? Is there more orlesspressure nowadays? Where doesthepressure come from? How easyisitforgirlsorfamiliestodecidenotgocircumcision? What, ifany, pressures are there inyour community inrelation toFGM? Willingness tocampaign Willingness Attitude toown children inthefuture Social impact? Acceptability incommunity Health impacts, prospects? marriage /longterm Immediate impact/mediumterm general attitudetowards female circumcision Taking actionagainst FGM a ve t a ken inyour decisionnottogothrough with circumcision /to a st that you did?(nottoundergo circumcision /notto a nce aga inst FG inyour community? M ) e

47. Notes 48. Notes

March 2011

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