Alice Behrendt Listening to African Voices Female Genital Mutilation/Cutting among Immigrants in Hamburg: Knowledge, Attitudes and Practice Alice Behrendt Listening to African Voices Female Genital Mutilation/Cutting among Immigrants in Hamburg: Knowledge, Attitudes and Practice Cover photo: Plan/Alf Berg – “Girls from a media and culture centre in Togo working against child rights violations.” Photos: Plan (p. 12), Suzanne Eichel (p. 6, 26, 86) Design: graphikzumgebrauch, Richard-Michael Diedrich www.g-z-g.de Plan International Deutschland e.V. Bramfelder Straße 70 D-22305 Hamburg Germany www.plan-deutschland.de Copyright: Plan February 2011 This publication is protected by copyright. It cannot be reproduced by any method prior to permission of the copyright owner. Forword Dear readers, According to the World Health Organization, every year an estimated number of three million girls and women are at risk for the harmful tradition of Female Genital Mutilation/ Cutting (FGM/C). Nearly 140 million girls and women suf- fer from its severe and long-lasting health consequences. FGM/C mainly is practiced in sub-Saharan Africa and Egypt, but also in some Arabian and Asian states as well as in some ethnic groups in Middle- and South America. The practice is one of the cruelest forms of violence and violates the basic human right of physical and mental integrity. It therefore is a strong matter in our victim protection to initiate and improve measures concerning the prevention and prosecution of FGM/C and to supply appropriate support. We know for sure that through migration and globalization, FGM/C also is a problem in Europe, but yet we do not know a lot about the occurrence, background and attitudes of African immigrants in Hamburg. Being the patron of this study, I am therefore particularly pleased that Plan Germany presents profound information about attitudes, motives and practices on FGM/C in Ham- burg. It is the fi rst study in Germany interviewing a large number of key Informants, African immigrants and con- cerned women and men. We will use these insights to refi ne victim protection measures and to provide affected women and girls with the support they need. I would like to thank everyone who contributed to the realisation of this study. Yours sincerely Dietrich Wersich Head of the Ministry for Social and Family Affairs, Health and Consumer Protection of the Free and Hanseatic City of Hamburg Acknowledgments Those who helped in conducting this research project were numerous. I would like to thank in particular: • The participants, the families and the institutions who received members of the research team. • The interviewers who showed outstanding commitment and patience in obtaining access to the different immigrant communities and encouraging them to talk about female genital mutilation/cutting: Traore Hawa Aissata, Andrea- Vicky Amankwaa-Birago, Armand Awo, Helena Bosompim, Coulibaly Brahima, Liethian Youssouph Coulibaly, Marie Lydie Dossou, Perpetual Ekeh, Noreen Khanali Ellrott, Nancy Falke, Lulit Mekonnen Gebeyehu, Mersha Alehegne Mengistie, Irena Mischke, Aboubacar N’Diaye, Zita B. Tsafack Ndongmo, Harouna Nebie, Manneh Nouhou, Maria Adam Nyangasa and Mohamed Toure. • The project coordinator of Plan Germany, Dr Anja Stuckert. • The communication team of Plan Germany, in particular Barbara Baden, May Evers, Christina Frickemeyer, Samia Kassid and the intern Jennifer Werner. As the author of this report, I am responsible for potential errors in the interpretations of answers given during the interviews and group activities. Alice Behrendt Dakar, 31st December 2010 Table of contents 1. Executive Summary 7 5.11. Meetings with institutions working with African immigrant communities in Hamburg 85 2. Introduction 9 2.1. Background 9 6. Synthesis of results and conclusion 87 2.2. Project objectives 9 6.1. What do immigrants from Sub-Saharan Africa 2.3. Research questions to be investigated 10 think about FGM/C? Are they in favour of it or against it? 87 3. Methods 13 6.2. What positive outcomes do people associate 3.1. Stages of study implementation 13 with FGM/C and how common are these 3.2. Preparation of the fi eld study 13 perceptions? 88 3.3. Implementation of the fi eld study 16 6.3. What do they know about the risks and 3.4. Data entry, analysis and report writing 17 harmful consequences of FGM/C? 88 3.5. Ethical considerations 17 6.4. Do they know that practices such as 3.6. Diffi culties and challenges during the project 18 FGM/C are illegal in Germany? 89 3.7. Limits of the study 20 6.5. How many girls and women have undergone FGM/C? 89 4. Literature review 21 6.6. Summary of the situation of the immigrant 4.1. FGM/C and its different forms 21 populations (per country of origin) 90 4.2. Prevalence and geographic spread of the practice of FGM/C 21 7. Recommendations 95 4.3. Circumstances of FGM/C 22 7.1. Recommendations regarding the context 4.4. Motives for practicing FGM/C 22 of the action plan 95 4.5. Sources for further reading 23 7.2. Recommendations regarding the 4.6. FGM/C in Europe 23 preparatory stage 96 4.7. FGM/C in Germany 24 7.3. Recommendations regarding the implementation of the action plan 97 5. Results 27 7.4. Recommendations regarding the previewed 5.1. Overview of immigrant populations from outputs, outcomes and impact 97 practicing countries in Hamburg 27 5.2. Theoretical estimation of the number of 8. Annex 99 women and girls concerned in Hamburg 29 8.1. References 99 5.3. Samples of the qualitative and quantitative 8.2. Question list for key informants: survey and their characteristics 29 African community members 101 5.4. Knowledge, attitudes and practices of immigrants 8.3. Question list for key informants: from Sub-Saharan Africa: an overview 33 medical staff 102 5.5. Knowledge, attitudes and practices of 8.4. Question list for key informants: communities (with > 100 immigrants) 36 researchers, activists, social workers etc. 103 5.6. Knowledge, attitudes and practices of 8.5. Questionnaire for quantitative interviews communities (with < 100 immigrants) 75 – Men 104 5.7. Girls at risk in Hamburg 76 8.6. Questionnaire for quantitative interviews 5.8. Suggestions from participants on how the – Women 108 abolition of the practice could be promoted 8.7. Map of the geographical spread and prevalence among immigrant communities in Hamburg 81 rates of FGM/C in Ghana 112 5.9. Perceptions and practices regarding health 8.8. Map of the geographical spread and prevalence care practices of African women immigrants 83 rates of FGM/C in Togo 113 5.10. Media preferences and information networks 8.9. Map of the geographical spread and prevalence of immigrant communities from Sub-Saharan rates of FGM/C in Nigeria 114 Africa in Hamburg 84 1Executive Summary Background and objectives sex and by country of origin. Parents of daughters who were assessed to be at risk of being subjected to FGM/C in the Female Genital Mutilation/Cutting (FGM/C) is a harmful tra- future (n = 13) were identifi ed so that they could participate ditional practice. It is estimated that between 100 and 140 in a follow-up project implemented by two of the women million girls and women have been subjected to the practice researchers. worldwide. Most of them live in Africa, but there is also a considerable number of women concerned among immigrant Results populations in Europe. According to offi cial records, about 11,200 immigrants from Little attention has been given so far to the perceptions of Sub-Saharan Africa reside in Hamburg. The fi ndings of the African immigrants in relation to FGM/C. Campaigns and current study indicate that about 40% of these immigrants activities are mostly based on anecdotal evidence and are have roots in families where FGM/C is practiced. There are often carried out without the implication of main stakehold- more men from practicing families than women due to the ers of the African immigrant communities. The purpose of considerably higher proportion of men immigrants from cer- the current project was to listen to the opinions, perceptions tain countries in West Africa (Guinea, Burkina Faso, Gambia, and propositions of immigrants from Sub-Saharan Africa Cote d’Ivoire) in which there is a moderate to high prevalence regarding the practice of FGM/C. It was implemented in col- of FGM/C. The majority of immigrants from practicing groups laboration with the Hamburger Behörde für Soziales, Familie, ( ≈ 70%) associates FGM/C with one or more advantages, Gesundheit und Verbraucherschutz (BSG) (Department of notably the social acceptance of their community, better mar- Social and Family Affairs, Health and Consumer Protection) riage prospects as well as the reduction of the sexual desire and under the patronage of Senator Dietrich Wersich. in women. Furthermore, about 18% of the participants from practicing groups perceive FGM/C as a religious requirement. Method There are both Christians and Muslims in this group, although the Muslims represent the greater proportion. The evaluation activities included a literature review and a three-month fi eld study targeting immigrants from Sub- About two-thirds of the participants reported some aware- Saharan Africa residing in Hamburg. The principle research ness of the risks and harm arising from the practice of activities took place from July to November 2010. The FGM/C. The proportion was signifi cantly smaller among research was led by a consultant who worked jointly with a immigrants from practicing families. The lowest degree of team of 20 students and researchers with African migration awareness was found among members of the Guinean and background. After a one-week preparatory workshop, the re- Gambian communities. search team started with a qualitative research component: they carried out key informant interviews with African com- It can be estimated that at least 30% of women immigrants munity members as well as with activists, researchers, health from Sub-Saharan Africa underwent FGM/C before migrat- personnel and social workers from institutions that provide ing to Europe.