An African Problem in the Heart of Europe

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Diaryatou Bah was just eight years old when she went through the most traumatic experience of her life. "A woman brought me into the bush with my grandmother and her sister-in-law," she recalls. "They took off the red loincloth I was wearing, placed leaves on my face and caught my hands and feet. Then the woman circumcised me with a knife that she had used to circumcise other girls."

Bah is now a 22-year-old living in France (previously she lived in the Netherlands and her native Guinea) but she still remembers the pain of that moment in the bush. "It was deep, so deep… but at the same time I felt proud, because I was like the other girls who went through this before me."

It is estimated that up to 130 million girls and women in the world have undergone what the United Nations refers to as female genital mutilation (FGM), which most often consists of the removal of part of the clitoris and labia - without the benefit of any anesthetic.

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According to a 2004 report from the French National Institute for Demographic Studies, more than 53,000 women living in France have undergone some form of the procedure. Many people assume that the women dealing with its aftermath were subject to the mutilation, as Bah was, in a distant native land. But the practice of female genital mutilation is being carried out secretly in many immigrant communities in France and other parts of the world.

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Western nations have their own troubled history with FGM. It was carried out in the 19th century in Great Britain and France, and then later in the United States, to prevent women from masturbating. It has since been officially banned in several African and Western countries. But it is still routinely performed in 28 African countries as well as in parts of Southeast Asia and the Near East. Justifications for the practice vary from social custom to religious mandate to social and political control of women's sexuality.

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In an attempt to draw attention to the issue, several African women living in France have written books in which they have shared the heavy, painful secret of FGM. Among the most prominent are the late Guinean top model Katoucha, who wrote Dans ma Chair (2007), Diaryatou Bah, with On m'a volé mon enfance (2006) and Senegalese activist Khady Koita, with Mutilée (2005).

The motivation for these revelations seems to be the desire to protect young girls from serious, sometimes lethal, consequences of the procedure, including fistula, complicated childbirth, high infant mortality and morbidity, AIDS and other sexually transmitted infections, and low sexual desire.

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France began paying attention to the issue of FGM in the late 70's. It became the first country in the world to sentence a FGM practitioner back in 1979. The practice was outlawed in the 1980s following the efforts of Linda Weil-Curiel, a lawyer for the Commission for the Abolition of Female Genital Mutilation (Commission pour l'Abolition des Mutilations Sexuelles - CAMS), which was founded in 1982 by Awa Thiam, a Senegalese academic who denounced FGM in her famous book La parole aux Négresses (1978). French law calls for prison sentences of up to 20 years for parents who subject their daughters to the practice, as well as for those who perform the procedure.

"I have participated in some forty cases in the Paris region" said, Weil-Curiel. "All cases have led to prison sentences, suspended or not, for around a hundred parents. Two excisors have been sent to jail."

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One of the two jailed practitioners Weil-Curiel refers to is Hawa Greou, a Malian woman who became one of France's most notorious excisors. After successfully prosecuting Greou, Weil-Curiel teamed with journalist Natacha Henry to help Greou tell her story in the book Exciseuse.

Greou spent almost five years in prison (1994 to 1999) and, says Weil-Curiel, she now speaks out against the practice. But many of those convicted of the crime in France receive suspended sentences, a fact many activists say sends a negative signal. "Suspended prison sentences make people think that they have been cleared of charges because they freely go back home," said Weil-Curiel.

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Several activists say that female genital mutilation is not as common as it was in the 80's, because of awareness campaigns, deterrent laws and a growing understanding of the many negative health implications of the practice.

Also important, some say, is the growing acceptance that the practice is not recommended or required by the Koran, as is commonly believed. "But since the practice is forbidden, it is secretly performed," says Sabreen AL'Rassace, of the Women's Commission of Amnesty International, France.

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Because of the secrecy surrounding the practice, organizations working to combat it have a difficult time documenting its prevalence. Many families, fearful of prosecution in France, send daughters to their native countries to have the procedure performed during the holidays.

Some extended families even act without the consent of a girl's parents. Fatou, a 24 year-old French woman who agreed to be interviewed for this article, but who declined to give her last name for fear of being criticized, said that her mother was able to protect her in France, but not from relatives in Senegal.

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"During the holidays in Senegal, when I was 11, members of my family discovered that I had not undergone it," recalled Fatou, a student. "They waited for my mother to leave and then they organized my mutilation."

To discourage such acts, French medical staff now often remind immigrant parents that their daughters will be checked for the procedure when they return to France from visits to their countries of origin. "France can sentence them even if FGM was performed abroad," explains Sophie Soumaré, a Malian who was herself subjected to the procedure and now works as a trainer and social, cultural mediator for the Marne (North) branch of Women's Group for the Abolition of Genital Mutilations (GAMS), which has been fighting FGM since 1982.

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Many of those for whom it is too late have wondered whether it is possible to repair the physical damage done by FGM. A French urologist, Pierre Foldes, taking inspiration from the more common penis-lengthening procedure, has been performing reconstructive surgery on FGM victims for more than a quarter century. So far, he said, he has done more than 2,500 operations.

"This operation is reversing a criminal act that was not desired by these women," said Dr. Foldes, who works at Saint-Germain-en-Laye hospital and Louis-XIV Clinic. He said he has been threatened several times because of his surgical reconstruction work, but he has devoted himself to training as many colleagues as possible to increase availability of the procedure.

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Among his students is Dr. Sébastien Madzou, who is now an advocate for the reconstructive surgery, which is reimbursed by the French health insurance system. "What the 16 women I operated on told me after the operation made me realize how important it was for them to get the surgery," says the Congo-born obstetrician, who has also performed the operation on some 50 women in Burkina Faso and trained about 20 new colleagues there to conduct the operation.

There are still some who argue that FGM has cultural significance and should be respected. Among them is the director of Paris Institute of Sexology, Dr. Jacques Waynberg, who said he thinks reconstructive surgery is "praiseworthy" but warns against a neocolonialist drift.

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"Female circumcision, like male circumcision, is part of an anthropological process that makes an individual belong to his/her community or group," he said. "So the West can be suspected of neocolonialism when it says female circumcision is a mutilation without explaining or respecting its anthropological roots and without replacing it with a new identity marking."

Diaryatou Bah knows that an operation to reverse the effects of that dramatic day in the bush would also mean discarding a part of who she is culturally, so she is carefully weighing the pros and cons before making up her mind. She said she knows the surgery is not magic. "The most important thing is to have female genital mutilation stopped, because what we will get after the operation may look like the original clitoris but it will never be exactly the same," she said. "And the trauma of FGM will stay with us forever, no matter what we do."

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Still struggling with the aftermath of her FGM, Fatou said she is also considering the reconstructive surgery. "It will enable me to take my revenge on those who did that to me," she said. "On those who wanted to take something from me."

Habibou Bangre is a writer lving in France.