2 Registered Charity: No. 1150379 Limited Company: No: 08122211 E-mail: [email protected] © 28 Too Many 2019 Contents Preface .................................................................................................... 3 Foreword ................................................................................................ 4 Information on Country Profiles ............................................................. 5 Background ....................................................................................... 5 Purpose ............................................................................................. 5 Use of This Country Profile ............................................................... 6 Acknowledgements .......................................................................... 6 The Team .......................................................................................... 6 List of Abbreviations ......................................................................... 7 A Note on Data ................................................................................. 9 Executive Summary ............................................................................... 11 Introduction .......................................................................................... 18 General National Statistics .................................................................... 22 Political Background.............................................................................. 24 Laws Relating to Women and Girls ....................................................... 30 Anthropological Background ................................................................. 36 The Role of Women in Society .............................................................. 39 FGM: National and Regional Statistics and Trends ................................ 46 The Saleema Initiative ........................................................................... 58 Understanding and Attitudes ................................................................ 61 The Sustainable Development Goals..................................................... 70 Education .............................................................................................. 72 Healthcare ............................................................................................ 79 Religion ................................................................................................. 91 Media .................................................................................................... 93 Work to End FGM in Sudan ................................................................... 99 Ending FGM: Challenges ..................................................................... 104 Conclusions and Strategies for Moving Forward ................................. 108 2 Preface ‘The seeds of success in every nation on Earth are best planted in women and children.’ ~ Former President of Malawi Joyce Banda One distinguishing characteristic of the most recent revolution in Sudan is that it was led predominantly by youth and women. In keeping with the spirit of this revolution, it must be recognised that women, particularly young women, hold in their powerful hands the keys to success in achieving social change. The roles of men and youth are also priceless to the success of anti-FGM programmes. Paving the road to changes in social norms, including the abandonment of FGM, requires quality research and evidence. Actors working to combat FGM in Sudan have realised the importance of evidence in understanding factors influencing the continuation of the practice and ensuring the success of any interventions in Sudan. The few recent published studies have confirmed that Sudan is undergoing several shifts, including increased medicalisation, driven by social, religious, professional and legal norms, economic benefits and increasing awareness of FGM’s health impacts. Despite national, local and community efforts made to date, Sudan still has a very high prevalence of FGM. Unfortunately, the medicalisation of FGM, especially by trained midwives, is predicted to support the continuation and normalisation of FGM in the country. I strongly believe that healthcare providers, regardless of their title, can play a critical role in combating FGM, particularly in communities, where they are highly respected and have great influence. They can promote the abandonment of all types of FGM, leading to zero tolerance for it. The practice of reinfibulation demands intensive and focused awareness programmes for all medical personnel, especially trained midwives, who have direct contact with women of reproductive age. The time is now opportune in Sudan to harvest the fruits of decades’ worth of advocacy and activism and endorse a national law criminalising FGM. This requires sensitisation of and dialogue with policy makers, legislators, religious leaders and the media, using data from Sudan and lessons from other countries that have succeeded in criminalising FGM. The series of country reports by 28 Too Many provides exactly the resources needed for such an effort. Moreover, the efforts and reports by 28 Too Many offer pertinent support and direction for all actors on the ground and provide them with the necessary evidence and best practices to bring about changes in policy, legislations and interventions that can make our countries and continents free from all forms of FGM. Nafisa Mohamed Bedri Professor in Women and Reproductive Health Ahfad University for Women 3 Foreword In 2003 in West Darfur, I met a 10 year old girl, displaced from her home, orphaned by war and heavily pregnant as a result of rape by the militia. She suffered complications in labour as a result of FGM and needed to have a caesarean section, and shortly afterwards she was relocated to relatives far from her home. As an aid worker, I felt an overwhelming burden to help her and other girls and women affected by FGM. 28 Too Many was born out of that encounter. As the world watched the political protests unfold in Sudan this year, the young activist Alaa Salah addressed the crowds adorned in white and spoke about the strength of women. This iconic moment in history is significant because it demonstrates that the continuing challenges faced by the Sudanese people, and especially women and youth, are complex and go far beyond the political platform. One such challenge continues to be the very high prevalence of FGM. 86.6% of women aged 15–49 have undergone FGM, and it is most commonly Type III (infibulation). That shows that the practice is still deeply entrenched in communities across the country and impacts the lives of millions of women and girls. In this new Country Profile, 28 Too Many brings together the available data and knowledge to demonstrate where Sudan stands in 2019 in efforts to end FGM and what impact recent events have had. We consider the opportunities the change in the political environment offers moving forward and highlight the real hope and optimism among those working tirelessly on anti-FGM programmes. During this research we have been honoured, once again, to connect with key organisations and activists who are working to end FGM. The network in Sudan is a good example of cooperation, and we call upon the new administration to work closely with it to develop and accelerate activities that are making a real difference. These activities include the Saleema awareness campaign, which is now recognised by the African Union as a key tool in ending FGM, and the community dialogue programmes across Sudan that are leading to FGM abandonment. There also now appears to be a very real opportunity to pass national legislation banning all forms of FGM, and we support all partners and activists who are working so hard to bring the law back to the table. As well as winning protection for women and girls through the law, there are still many challenges to overcome in Sudan, including medicalisation and the continued support for the sunna cut from some stakeholders. Additionally, there is a need to empower midwives to maintain their important role in communities while advocating for an end to FGM and tackling the continued practice of reinfibulation, which is so devastating to mothers’ health. There is still a pressing need for more up-to-date and accurate data to inform programmes. All these challenges are being tackled in Sudan, and, 16 years on from my first visit, it is pleasing to see the positive progress being made and the appetite for change. We look forward to reporting on continued progress as the country, and particularly women and young people, are empowered to say no to FGM. Dr Ann-Marie Wilson 28 Too Many Executive Director 4 Information on Country Profiles Background 28 Too Many is an international research organisation created to end FGM in the 28 African countries where it is mainly practised and in other countries across the world where members of those communities have migrated. Founded in 2010 and registered as a charity in 2012, 28 Too Many aims to provide a strategic framework where knowledge and tools enable influencers and in-country anti- FGM campaigners and organisations to make sustainable change to end FGM. We are building a global information base, which includes detailed country profiles for each country practising FGM. Our objective is to encourage all those working in the anti-FGM sector to share knowledge, skills and resources. We also campaign and advocate