A loose talk with my patient turned friend Dr Anagha, is the reason behind me writing this blog. News about INFIBULATION being practised in some part of our little Kerala was too shocking and from there started the journey of reading more about this savage practice. I am trying to write this article about ‘Infibulation’ for the last few weeks. But I am unable to write it due to the stress I go through while trying to put it in words. The information fills me with disgust. Let me warn, this is not going to be a pleasant read at all. But I am writing this just to make people aware of this barbaric culture. Though the inquiry started on infibulation, it took me to a whole new world of FEMALE GENITAL MUTILATION or FGM. According to WHO, infibulation is Type III FGM.

Type 3? So this implicates there are other types of this brutal procedure. Unfortunately, the World Health Organization has identified four types of FGM:

  1. Type I, CLITORIDECTOMY: partial or total removal of the clitoris

  2. Type II, EXCISION: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. The amount of tissue that is removed varies widely from community to community.

  3. Type III, INFIBULATION: This is the ritual cutting or the removal of some or all of the external female genitalia. Though the procedure differs with the country or the ethnic group, in Infibulation the inner and outer labia are removed and the Vulva is sutured. By inserting a twig or similar object before the wound heals, a small opening is provided for the passage of urine and menstrual blood. The weirdest part is, the infibulated vagina is usually penetrated at the time of a woman’s marriage by her husband’s penis or by cutting the tissue with a knife. This practice of cutting open a woman who has been infibulated to allow intercourse or to facilitate childbirth is called DEINFIBULATION. The practice of sewing the external labia back together after Deinfibulation is termed as REINFIBULATION.

  4. Type IV: all other non-medical, harmful female genitalia procedures like pricking, piercing, incising, scraping or cauterization.

Though the age for FGM performed varies with different regions/community, mostly it is carried out on girls between newborn - 15 years of age. Almost 29 countries in Africa, Certain Asian communities including India, Pakistan, Malaysia, SriLanka, Indonesia and in some part of the Middle East, certain communities in Georgia and Russian Federation which belongs to Eastern Europe, certain communities in Columbia, Ecuador, Panama and Peru of South America and in many advanced countries including Australia, Canada, US, Uk and various EU countries supposedly perform FGM.

According to WHO, more than 200 million girls and women alive today have undergone FGM and 3 million girls are at risk of undergoing FGM every year. The procedures are normally done without anaesthesia, by the designated elders in the community using special knives, scissors, blades and scalpels. If the procedure of Infibulation is done, the legs of the girls are often bound together to immobilize them for around 2 weeks, to heal the wound. Due to the damage to the female sexual organs, sexual intercourse can result in the laceration of tissue, which increases the risk of HIV transmission and STD s. The risk of death during childbirth due to loss of blood is also high.

FGM is the symbol of deeply etched Gender Inequality that prevails in many communities. It is an odd way to control the sexuality of a woman and to ensure virginity before marriage and fidelity afterwards. In someplace it is done just to increase the sexual pleasure of the male partner. In many communities, FGM is the prerequisite for marriage and there are girls who have done multiple infibulations just because the elders are not satisfied by the previous procedure. Due to religious and socio-economic factors, it is difficult for the families to abandon this practice without the support of the society they belong to.

It is always and forever unethical to harm a female in the name of ethnicity, beliefs or religion. Many movements have tried to put an end to the practice of FGM. Several countries have even legally banned FGM. Though a decline is seen in the numbers, it may take a few more decades of protest and hand-holding from all over the world to stop this ruthless and sickening practice.

The Somalian Poem “ The Three Feminine Sorrows” says:

It is what my grandmother called

the three feminine sorrows:

the day of infibulation,

the wedding night and

the birth of a baby.”

We are supposed to be the modern generation, fully equipped, educated, cultured and whatnot. Reports like this make us think, are we really advancing forward or are we rushing backwards?

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