Circumcision and health among rural women of southern Somalia as part of a family life survey

Health Care Women Int. May-Jun 1993;14(3):215-26. doi: 10.1080/07399339309516045.

Abstract

A study of 859 rural women in 16 semipastoralist and semiagricultural villages in Southern Somalia reaffirmed the special significance of female circumcision as a source of full womanhood and an instrument for the control of female sexuality in Somalia. Although condemned in the West, this strongly embedded tradition enjoys unrestrained privilege in one of Africa's predominantly Islamic pastoral societies. The author reviews and analyzes the age-old tradition of circumcision, paying attention to the accompanying health problems as part of the Family Life Center's program. The Family Life program aims at improving the health conditions of rural women in Somalia and increasing their access to educational and economic opportunities.

PIP: Girls and women are circumcised throughout much of Africa, especially where Islamic beliefs are strongest and poverty is extreme. Reasons cited for the existence and continuation of infibulation include protection and assurance of women's chastity, family honor and dignity, protection from rape, birth control, increased sexual attraction, and women's sanitation. Women remaining uncircumcised are mocked, tortured, and ineligible for marriage. The mainly Islamic societies of Somalia and other Horn of Africa countries practice the most complex version of female circumcision, infibulation or Pharaonic circumcision. This procedure entails clitoridectomy and excision of the labia minora and inner walls of the labia majora after which the edges are sewn together to block introitus, yet allow the passage of urine and menstrual fluids. A comprehensive Family Life Center survey on circumcision among 859 women in 16 semipastoralist and semiagricultural villages in southern Somalia was conducted to explore this practice, paying particular attention to the effect on women's health. Women aged 11 to more than 50 years, of mean age 34, were interviewed. Mean age at circumcision was 6.9 years with some being performed as late as 15 years. Though describing the procedure as a desirable painful experience, respondents reported a high incidence of vaginal disorders, childbirth complications, and difficult sexual encounters. Most favored continuing the practice, with concern focused upon pain before and after the procedure, ways to minimize keloid scars, and the potential for pain and complications during childbearing. While more educated women are likely to resist circumcision, strong support broadly remains in these societies for circumcisions for themselves and daughters. A finding that only 14% of medical students compared to 95% of nursing students concurred with the practice of circumcision supports the beneficial of higher education in changing these traditional norms. More education and women's strides toward positions of leadership and socioeconomic gain will therefore help realize international efforts to end the practice of female circumcision

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health / ethnology
  • Child
  • Circumcision, Male / statistics & numerical data*
  • Developing Countries*
  • Female
  • Health Surveys
  • Humans
  • Islam
  • Male
  • Rural Health*
  • Somalia
  • Women's Health*