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Community-Based Approaches to Reforming Female Genital Operations in Africa: a Case Study from the Oromia Regional State of Ethiopia

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Community-Based Approaches to Reforming Female Genital Operations in Africa: a Case Study from the Oromia Regional State of Ethiopia Community-based Approaches to Reforming Female Genital Operations in Africa: A Case Study From the Oromia Regional State of Ethiopia Aneesa Kassam and Alemayehu Diro Lalise ABSTRACT: In the past, numerous attempts by colonial governments and international agencies to abolish the practice of female genital cutting in Africa failed to make any significant impact on behaviour. In this article, we describe how, since 1996, an indige- nous NGO has been attempting to reform the practice in the rural communities of Oromia (Ethiopia). We show that it has brought about enduring change by creating awareness about the health consequences of the practice, facilitating collective debate on the topic using participatory methods, and involving local elders in the decision to abandon it. We compare this approach to other successful African initiatives under- taken during the same period based on similar strategies. We argue that these pro- grammes have been able to amend the practice by empowering the communities to direct their own process of change, based on their own traditions. We caution, how- ever, that such interventions should not be made without a full understanding of the cultural meaning(s) of the practice, which should be seen in a holistic manner. KEYWORDS: Oromo (Ethiopia); circumcision; female genital cutting; community-based approaches The global campaign launched in the 1980s to to adopt an insider approach to resolving the reform the practice of female genital cutting problem. (FGC) led to experimentation with a number In this article, we discuss a similarly innova- of educational programmes in Africa to address tive experiment that was undertaken from the this culturally sensitive issue at the local level. beginning of 1996 by Hundee, an indigenous These innovative attempts include, amongst nongovernmental organization (NGO), in the others, the work of the Reproductive, Education regional state of Oromia in Ethiopia. We de- and Community Health programme of the scribe Hundee’s attempts to bring about posi- United Nations Population Fund in Uganda in tive behavioural change in respect to FGC and early 1996, the Alternative Coming of Age pro- compare and contrast its approach to those gramme initiated jointly by the Maendeleo Ya adopted by the aforementioned organizations. Wanawake Organization and the Program for Our analysis of these approaches is based on Appropriate Technology in Health in Kenya in the ‘convention shift’ theory of change proposed mid-1996, and the Tostan Basic Education Pro- by Mackie (2000). gramme in Senegal from 1997 (WHO 1999). This article forms the third in a series of ar- These local initiatives succeeded where global ticles about the work that is being carried out ones had failed, mainly because they were able by Hundee in the Oromo communities of Ethi- Anthropology in Action, 13, 3 (2006): 22–39 © Berghahn Books and the Association for Anthropology in Action doi:10.3167/aia.2006.130304 Community-based Approaches to Reforming Female Genital Operations in Africa | AiA opia. The first article provides historical back- which the problem is being tackled and describe ground to its formation in relation to the Oromo how both male and female forms of circumci- nationalist movement for self-determination, sion were conceptualized in the traditional which began in the 1970s (Kassam 2003). The Oromo culture as part of the gada social, polit- second, published earlier, analyses its ‘ethno- ical and religious institution. As Kratz (1994: development’ approach (Kassam 2002). The 346) notes, ‘[w]hat is called female circumci- present article examines an important aspect sion is part of numerous and diverse cultural of its work dedicated to eliminating the prob- practices and ceremonies, each differently em- lem of FGC, as a precursor to bringing about bedded in specific institutional and social struc- women’s development. Like the previous arti- tures’. It is important, therefore, to see male and cles, its shows that when the intransigent prob- female circumcision in relation to one another, lems of development are mediated from the as forming part of a cultural whole, rather than inside, by those who speak the language and to treat the latter in isolation, as has been the understand the culture, it is possible to bring trend in feminist literature.1 We then discuss about meaningful change. This approach in- Hundee’s Civic Education Programme and out- volves using indigenous knowledge, custom- line the participatory model that it employs in ary practices and traditional organizations as reforming FGC. We compare this approach to the basis for modern development initiatives, those of other NGOs in Africa and analyse how in this case, through the intermediary of the and why these organizations have been suc- council of elders. In this respect, Hundee’s ap- cessful in changing behaviour. proach to tackling FGC can be compared those of a number of other local NGOs in Africa, which have also involved community elders in Definition and Types of FGC in Africa the decision-making process to reform it. In broader terms, our article contributes to There is no consensus among researchers and the study of local institutions in development feminist activists on the politically correct term (Korten 1980; Esman and Uphoff 1984; Uphoff to designate the practice of cutting the female 1986; 1992), and in particular, to the important genital organ. In the literature, it is commonly role that can be played by indigenous organi- referred to by the expression ‘female genital mu- zations (IOs) (Blunt and Warren 1996). Blunt tilation’ (FGM), but a number of scholars have and Warren (1996: xiv) define IOs as ‘local-level objected to this designation as being ethnocen- institutions with an organizational base that are tric and as carrying a negative value judge- endogenous as opposed to exogenous within ment. In this article, we follow Shell-Duncan the community’. Such IOs are ‘inclined to have and Herlund (2000) in designating the practice and to use local knowledge, to respond quickly as ‘female genital cutting’, but we also use ‘fe- to changes, to handle conflict and to create cli- male genital operation’ (Young 1965; Walley mates of opinion influencing behaviour (Blunt 1997) and ‘female genital surgery’ (Shweder and Warren 1996: xiv). In the institutional frame- 2002). Where we use the expression ‘female gen- work, national NGOs, which operate supralo- ital mutilation’, we put it in single inverted com- cally, often act as intermediaries between IOs mas to indicate that it is a controversial one. and international NGOs and/or government The World Health Organization (WHO) de- agencies to foster local capacity or to bring about fines female genital surgeries as ‘all those pro- change (see Uphoff 1986: 191–192). cedures, which involve partial or total removal We begin by defining FGC, discuss its prev- of the external female genitalia or other injury to alence in Ethiopia and its health consequences, the female genital organs, whether for cultural examine the national policy framework within or any other non-therapeutic reasons’ (WHO | 23 AiA | Aneesa Kassam and Alemayehu Diro Lalise 1995). The WHO distinguishes four types of pro- other related practices. There exist a number of cedures. Type I consists of the excision of the variations within these general categories. This prepuce with or without excision of a part or the classification is currently being revised (UNI- whole of the clitoris. In the medical literature, CEF 2004: 2). this type is generally termed ‘clitoridectomy’. Type II consists of the excision of the prepuce and of the clitoris, together with partial or total Prevalence of FGC in Ethiopia excision of the labia minora. This type is also more generally known as ‘excision’. Type III FGC is widely performed in Ethiopia. The most involves the excision of part or all of the exter- common forms of operation are Types I and II nal genitalia and the stitching together of the (clitoridectomy and excision). Type III (infibu- vaginal opening. It is the most extreme form, lation) is largely found in those regions inhab- which is referred to as ‘infibulation’. Type IV ited by Somali-speaking groups (WHO 1995). includes a number of procedures such as prick- The National Committee on Traditional Prac- ing, piercing or incision of the clitoris and/or tices in Ethiopia (NCTPE) carried out a base- labia; cauterization by burning of the clitoris line survey in 1998 and provides prevalence and surrounding tissue; scraping of the vagi- rates by region, updated in 2000 (see Figure 1).2 nal orifice or cutting of the vagina; introduction The extent of FGC varies according to ethnic of substances into the vagina to cause bleeding and religious background. or to cause the narrowing of the vagina, and Figure 1: FGC prevalance rates by region Source: Based on NCTPE 2003 24 | Community-based Approaches to Reforming Female Genital Operations in Africa | AiA Among the Orthodox Christian Amhara of ation (especially in cases of the early marriage highland Ethiopia, excision (girz) is based on of girls). Problems associated with childbirth the traditional code of the Law of Kings (Fetha include painful delivery due to the narrowing Nagast), a collection of ancient laws. It is not, of the vulva, necessitating episiotomy (surgical however, directly imposed by the Ethiopian cutting of the vagina to facilitate birth), which Church (Huber 1966: 87). Nevertheless, an un- may lead to rectovaginal fistula and/or fecal cut woman may not enter the holiest
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