reproductive health > features > changing ways in uganda
Changing ways in UgandaPosted: 01 Sep 2000
by Charlotte Metcalf
Kapchorwa, a tiny town in the remote mountains of eastern Uganda, is the unlikely setting for a remarkable success story in the struggle to change traditional attitudes to the circumcision of young girls, writes Charlotte Metcalf.
The town is the home of the Sabiny people. Isolated by geography, poverty and lack of industry, they are fiercely protective of their culture. They are the only people in Uganda to circumcise the women.
Efforts in 1992 to shock the authorities into outlawing the practice through the production by a woman doctor of a gory film of mass circumcision of the girls, rebounded. The local people were outraged by the way their local culture was portrayed as being barbaric and backward. When the film was aired for a second time in 1994, twice as many girls as in 1992 opted for circumcision, a signal of their proud resistance to outside interference.
Now, just two years later, there is a radical change. Not only have the Sabiny girls chosen to reject the practice, but their right to choose has been sanctioned by the Clan Elders.
This astonishing turnaround has been brought about by a programme known as REACH (Reproductive and Community Health), the brainchild of the country representative of the UN Population Fund (UNFPA), Dr Francois Farah.
Importance of ritual
A charming and cosmopolitan Lebanese-born Canadian, he began by mastering the rudiments of the difficult language of the people. Then in a respectful and non-judgmental way he encouraged the Sabiny people to be proud of their culture while questioning the legitimacy of some of its practices. This approach accepts that a ritual which marks a girl's passage into womanhood is culturally valid and should be enhanced - with celebrating, dancing, singing and gifts to symbolise the coming of age. But it rejects circumcision itself, which serves no useful purpose.
The programme offers extensive education about the dangers of female circumcision - with a stress on 'offers'. It neither prescribes nor rebukes about genital mutilation. In fact, rather than use the that phrase with its implicit criticism, Farah prefers the plain and accurate 'genital cutting'.
He points out the many harmful effect of genital cutting. They include excessive bleeding, urine retention or incontinence, infections, the risk of HIV from dirty blades and the formation of scar tissue which can make birth difficult or even impossible. Girls have been known to bleed to death or die during births complicated by the operation. In addition there is the severe debilitating pain and psychological trauma.
However, even clinical arguments are hard to stand up in an environment in which people believe an uncircumcised woman is not fit to gather grain from a granary, let alone be married. It was against the backdrop of entrenched beliefs that REACH went to work.
Jackson Chekwoke is the REACH project manager. He watched his sister nearly bleed to death because she was circumcised when pregnant. His mother-in-law is paralysed in both legs as a result of circumcision 20 years ago.
Paralysed as a result of female circumcision
© Charlotte Metcalf
Jackson knows that men are the key to change in a male-dominated society, and he spends hours among fathers, brothers and decision makers, telling them of the dangers to their sisters, daughters and their wives - and how the practice can complicate and inhibit the healthy birth of potential sons.
REACH has also armed the teenage girls with significant facts and sends them into their schools to spread the message. I listened as two sisters aged 17 and 18, spoke out passionately about their views of adulthood. They both insisted they would only become women when their education was complete. In their eyes genital cutting had nothing to do with achieving maturity. They told me in whispers of two friends of theirs who had been forced by their parents: their legs were tied open and men sat on their chests to hold them down. Because they were struggling, the clitoris was cut savagely and messily. One of the girls is now incontinent.
Jackson Chekwoke, REACH Project Manger talks to
villagers about the pitfalls of female circumcision
� Charlotte Metcalf
Meanwhile Farah has worked tirelessly to sway the Elders. Mr Cheborion, Chairman of the Elders, admits he once supported the practice but now sees it as abhorrent. "It is essential we modernize and that our culture is not left behind," he says. "Education is the answer. The less ignorant we are, the more this practice will die out."
In fact, it was expected that virtually no girls in the community would choose to undergo the knife at last year's end. But as Farah points out, this is only a pilot project. The practice of genital cutting affects the lives and unborn babies of 90 million women. "This is only a start" he says. "Let's not forget the women all over the world who continue to suffer this futile and dangerous practice."
Charlotte Metcalf is an English film director, who recently visited Uganda to make a film about the REACH programme.