A Study of Female Genital Mutilation

A Study of Female Genital Mutilation

If you are interested in reading about the issue of Female Genital Mutilation (FGM) from every angle, then you’ll definitely want to look at the Africa Journal of Urology. This entire issue is dedicated to FGM.

“In line with the objectives of the Pan African Urological Surgeons’ Association (PAUSA) to give special concern to health problems in Africa, the editorial board of the African Journal of Urology (AFJU) has decided to publish this special issue on female genital cutting/mutilation (FGM). Addressed to African health care providers, this issue emphasizes the myths behind the continuation of this tradition, types of FGM, their tragic effects on women’s health, and the measures that are being taken to eradicate the practice.

“In this issue, subject experts address a range of FGM-related topics that include epidemiology, public misconceptions, challenges ahead and religious perspectives of FGM of Islam, Christianity, and Judaism. The health implications of FGM, including reproductive issues, psychological repercussions and sexual complications are also addressed, as are the socio-cultural factors contributing to the continuation of this practice and the efforts to oppose it.

“According to the World Health Organization (WHO), about 140 million girls and women worldwide live with the health consequences of FGM, including 101 million living in Africa, mainly in the sub-Saharan areas.”

Female Genital Mutilation Los Angeles

Edna Adan, speaking in Los Angeles, describes Female Genital Mutilation after which the victim is stitched up using thorns.

  1. Female genital cutting/mutilation in Africa deserves special concern: An overview
  2. The Islamic view on female circumcision
  3. The Jewish and Christian view on female genital mutilation
  4. Female genital mutilation: A tragedy for women’s reproductive health
  5. Female genital mutilation: Tradition versus human rights
  6. The continuing challenge of female genital mutilation in Sudan
  7. Psychosocial and sexual aspects of female circumcision
  8. Debunking myths about female circumcision
  9. Medicalization of female genital mutilation/cutting
  10. International efforts on abandoning female genital mutilation
My Work is Not Done – by Wanda Chestnut

My Work is Not Done – by Wanda Chestnut

This article is by Wanda Chestnut, RN, DHSc, an HIV/AIDS Specialist from Glen Dale, Maryland. Even while working full time, and completing her advanced degrees, Wanda managed to participate in three medical missions to Ghana through her church in 2004, 2005 and 2006. In December 2012 she traveled to Hargeisa, Somaliland to volunteer and complete her Doctoral internship at the Edna Adan Maternity Hospital where she will return as a volunteer with Nurses for Edna, through the nonprofit organization, One Nurse At A Time in August.

“My Work is Not Done” – originally published @ The Huffington Post

In December 2012, I had the honor of voluntarily traveling to the Edna Adan University Hospital in Somaliland for two weeks to learn, understand, educate and care for women who had been subjected to Female Genital Mutilation (FGM). Additionally, my desire was to also use my skills as a nurse in any way that I could.

Prior to my trip to Somaliland, and even after my return to the U.S., my colleagues and friends would ask me why I chose to go there. My answer was that while I was doing research about FGM for my doctorate, I came across the hospital’s website. After reading the website in detail, and viewing all of the online video clips about Edna that I could find, I felt the pull at my heart to go there and help. I was so intrigued by Edna, her passion for the people of Somaliland and her desire to eradicate FGM, that I knew I had to meet her.

It took close to six months for us to make contact. After a few exchanges via telephone and by email, she graciously gave me the green light to come. Edna supplied me with the names and contact information of previous volunteers that I could speak with, about their experience and obtain answers to some questions that I had.

Although I had traveled to Africa three times previously, I had never traveled alone. Needless to say, I was a little nervous; however, I was not going to let my nerves stop me. I took the 15-hour flight to Somaliland on an early Sunday morning in December. Edna’s staff met me at the airport.

The ride from the airport to the hospital was a long two and a half-hours, but the scenery was absolutely amazing. The roads were unpaved and there was visual evidence of the war approximately 21 years ago. Despite the rubble remains of what were once homes, and possibly businesses, Nomads and other Somaliland people were seen along the countryside. These people in spite of their living conditions, appeared to be content in their situation.
When we arrived at the hospital, I was greeted by Maah, Edna’s assistant, who was so kind to me and made sure that I had everything I needed for my stay. That evening I met my mentor Dr. Kitto at dinner. She was a very jolly person, and before long, we became inseparable. She was passionate about her work, and turned out to be an awesome mentor who taught me a lot.

While in Somaliland, I had the unique experience of interviewing a local, traditional cutter in order to understand the cultural beliefs and traditions of FGM. I believed that the information from the cutter would be vital in devising my education plan.

A traditional cutter is a woman who performs FGM on girls between the ages of five-thirteen. The cutter confirmed that it is a tradition to “cut,” or surgically close the vaginas of young girls until marriage to prevent them from engaging in sexual intercourse with any other men besides their husbands. Although FGM is banned in Somaliland, the cutter stated that she performs the procedure on 15-20 girls per day. The cutter also reported that she charges $15-$20 per procedure.

When asked if she would ever consider discontinuing the practice of FGM, the cutter responded, “Not unless I am blind or dead.” Having performed the procedure on her own daughters and granddaughters, the cutter affirmed her belief in the continued practice of FGM. She went on to say that, there is no other line of work in her country that would allow her to make the amount of money that she currently makes.

While at the hospital I also assisted in the de-infibulation procedures of several women. De-infibulation is the surgical procedure used to open the “closed” vaginas of women who were subjected to FGM as children. While heart wrenching, I felt that it was important to participate in the procedures to fully understand how to educate the woman of Somaliland.

The women undergoing de-infibulation were terribly frightened as they were being prepped and cut open. Surrounded by a team of competent clinicians who now viewed the procedure as normal and routine, my role was to offer comfort to these women with a friendly touch and smile.

After interviewing the traditional cutter and actually witnessing the de-infibulation procedures, I shifted my focus to educating and raising awareness among both professional and lay providers of the potential physical and emotional repercussions of FGM. I had the opportunity to spend a great deal of time with over 50 Somaliland nursing students.
One Nurse at a Time

In my lectures and discussions, I reviewed how endemic the practices of FGM still are in Somaliland and emphasized the significant, negative reproductive, urological and mental health sequelae of FGM. Students were grateful to learn more about the cultural practice that, although banned, still negatively affect many women and girls.

During my time at the hospital 27 babies born, all with good outcomes. I assisted in the delivery of approximately one third of those births. I also assisted with postpartum assessments, taught mothers how to breast feed their newborn babies, and educated many Somaliland women and men on FGM.

While working on the hospital’s maternity ward, I also shared information with practicing locals physicians and nurses on FGM. In addition, I carefully presented facts about the practice, including the long-term sequelae of the traditions of FGM. Maintaining the delicate balance of respecting cultural traditions and raising awareness about the ill effects of a practice rooted in the history of that culture was instrumental in my success in connecting with the people I encountered.

It was a privilege and an honor to volunteer my knowledge of western nursing practice, and medicine, to educate nurses, health care professionals and patients on the taboo subject of FGM. While valuing the culture and beliefs of the people of Somaliland, I believe that I was still able to make an impact by educating the current and future health care professionals on the effects of FGM.

I cannot thank Edna enough for affording me this opportunity. While my visit to Somaliland is over, my work around FGM is not over. I am committed to educating my colleagues in the U.S., increasing awareness about Somaliland and the wonderful people there, encouraging others to volunteer their time and talents, and providing financial resources to deserving nurses to help them further their education. And, I will be back in Hargeisa in August to volunteer!

Visit Nurses for Edna
International Day of Zero Tolerance to Female Genital Mutilation

International Day of Zero Tolerance to Female Genital Mutilation

Today is International Day of Zero Tolerance to Female Genital Mutilation, which is a condition suffered by approximately 140 million women worldwide.

Edna Adan has always used her hospital and her notoriety to educate the people of Somaliland to reject this practice, which has extraordinarily deep roots in the culture throughout the Horn of Africa.

On this day, Edna has provided the following statement.

As a midwife, I have been delivering babies for 50 years, many of whom were being born to women who had undergone FGM. Witnessing the FGM-associated complications that many were suffering caused me to speak out against it in public in 1976 which at that time shocked my family and my people.

37 years later, and after so many resolutions have been passed to eradicate the practice, we sadly found that 97% of our women still suffered FGM as shown in the survey carried out on 4000 women at the Edna Adan Hospital between 2002 to 2006.

We are still looking for resources to study the prevalence of FGM and hope that the next survey/audit will reveal a reduction of FGM in our women, particularly after all the campaigns that we have held over the years.


For much more detailed information about FGM as practiced in Somaliland see this link:

FGM as practiced in Somaliland

This map indicates the prevalance of Female Genital Mutilation, also known as Female Circumcision, in Africa.
FGM has no place in Islam
FGM Prevalence in Africa

And here is an article by Kate Grant, from our partner organization, The Fistula Foundation, writing about. Fistula and FGM


Edna Adan Ismail: a Somali Inspiration

Edna Adan Ismail: a Somali Inspiration

The following profile was written by Joanne Butcher, BA Politics, University of Sheffield, and published here: Edna Adan Ismail: a Somali Inspiration

Born in Hargeisa in 1937, Edna Adan Ismail is one of Somaliland’s most prominent public figures. From 1954 to 1961, she studied in Britain – the first Somali woman to do so – to become a nurse and midwife. After working as a civil servant, she held the position of Minister for Family Welfare and Social Development and most notably held the title of Somaliland’s Foreign Minister from 2003 until 2006. Throughout the 1980s, she served as advisor to a range of councils at the World Health Organisation before retiring in 1997 when she dedicated her life to her most recent project: the Edna Adan University Hospital.

Alas the gravity and magnitude of Ismail’s career is lost in simply detailing her achievements. It’s important to remember that Edna Adan, as a young girl growing up in Somaliland, was not expected to go to school or acquire any qualifications. “Britain used to select boys from secondary schools to study in England and in 1952 or 53. The very first school for girls was opened in Somaliland and I was a pupil-teacher at the time,” she remembers.

It was a year of waiting before she and another girl were finally sent off to study nursing. “We were the only two [Somali] girls in London at the time. It was very challenging; it was a great opportunity to study something that I certainly felt very passionate about. I loved learning, I loved studying and to be given this opportunity was a great gift, and I loved every minute of it.”

However, on returning to her homeland, she found her dreams of making a Florence Nightingale debut were squashed by the newly independent Somaliland government. “I was the only woman, the only qualified female nurse running all the female section of the hospital,” she explains. “So that was challenging, and of course there were very few doctors and many of the emergencies and the medical care that was needed was beyond the training of a nurse. Very often I just had to substitute for what a doctor would have done, because there would be no doctors. So, very often you just had to do what you had to do.”

It took the government nearly two years to finally concede defeat. “I refused to quit,” she declares. “I just worked for 22 months without a salary. I just stuck to my guns and eventually, they had to give in. I was appointed to the civil service. So, to me, that was a victory because that opened the door to women to be appointed to the senior civil service.”

While working for both the World Health Organisation and the United Nations, Edna Adan had made several attempts to set up a hospital of her own. However, efforts were often thwarted by the political climate. The civil war with Somalia had left Somaliland completely ravaged. Medical professionals had either fled the country during the conflict or been killed by enemy forces. Hospitals had been destroyed in the fighting, leaving the country with one of the highest maternal and infancy mortality rates in the world. “I just recycled my whole life,” she explains. “I just turned everything I could dispose of into cold cash and started to build a hospital.”

Edna Adan’s credentials as a nurse, a midwife and a health advisor, made her one of the most qualified people to set up a medical centre. But, according to Ismail herself, it was the memories of her father that truly stirred her to establish the Edna Adan University Hospital.

“My father was someone who was known as the father of healthcare in Somaliland,” she recalls. “As a teenager I would be home for the holidays, from school in Djibouti, and I would be hanging around the hospital, giving him a hand. And I would often hear him complaining about a piece of equipment, and I just made a kind of mental, subconscious promise that one day I would build the kind of hospital my father would have liked to work in.”

The Edna Adan University Hospital started life as a maternity hospital. After four years building on what used to be a garbage dump, the hospital was opened in 2002. For over a decade, the hospital has taken in literally thousands of patients and, to this day, continues to expand. Despite her position as both the founder and director of this monumental institution, Ismail remains humble about her contribution. “I’m doing less and less legwork,” she notes.

But Ismail is kept busy by the cascade of political issues that still flood the hospital. Gender politics still lie at the heart of what she does in Somaliland. The hospital, along with educating women to become nurses and midwifes, is using its influence to try and stop female genital mutilation – a tradition still practised in parts of Somaliland. “The more we do, the more we see that more needs to be done,” she admits. “What we’ve done now is a drop in the ocean.”

However it’s not just within the walls of the hospital that women are treated unequally. Ismail remains as passionate about gender equality as she was as a little girl. It’s important to note that when she was young, only boys were educated in Somaliland. “At that time, education was considered undesirable for a girl,” she explains. “Friends and relatives would come and say ‘God has given you one daughter and you are teaching her to read and write? What good will come of it? She will disgrace you!’ I grew up with that and I was always trying to prove to them that education was good.”

When she sat in Cabinet in the new millennia, she was the only female minister around the table. Even now there are only two women elected to Parliament and just one female in the Senate. “This is what I’ve had to fight all my life and we continue to fight because it needs to be fought. Somebody’s got to speak for these voiceless women. Somebody’s got to stand their grounds. If I had that opportunity to do that then I must do it. It’s a responsibility that I must accept.”

There’s no doubt that progress has been made. Once upon a time women were not even allowed to drive cars, and Ismail agrees that the changes that have occurred have made her optimistic about the future for women in Somaliland. “I would like the change to be bigger and I would like more women to keep that pressure going,” she says. “The world needs both men and women. Because it’s not a question of men or women, it’s a question of both men and women doing a job together to make the world a better place for humankind. That’s all.”

Throughout her life, education has been at the core of everything she’s accomplished. Her thirst for learning has fuelled her career and now she intends to impart her wisdom onto others in hopes that they will continue her mission. “My real gift that I wish to leave for my people is the gift of knowledge; for them to love knowledge – to encourage them to seek more knowledge.”

As always Ismail practices what she preaches and has dedicated her later life to encouraging young women to join the profession. She notes that it is still hard to persuade Somali families to let their daughters study but over time Ismail has persuaded masses of girls to take the opportunity to become a nurse or midwife. “These are exciting years,” she exclaims. “I am proud that the first lady of Somaliland today was one of those young students, young women who we talked into taking up nursing in those days.

There’s still a mountain ahead for Edna Adan Ismail, but she’s still enthused by the belief that people need change and its these young women who are able to deliver it them. “I want to be a role model, to show them that anyone can do it and so can you,” she explains.

Her love for what she does and her ability to convey such a wealth of knowledge onto others is what has made Edna Adan such an influential and compelling teacher. “I feel blessed at 74 that I can still do that. An old woman following her lifelong passion. And loving every minute of it.”

The preceding profile was written by Joanne Butcher, BA Politics, University of Sheffield.

Ask Edna

Ask Edna

United States Senator Kirsten Gillibrand (NY) has published to her web site, Off The Sidelines, a page of Questions and Answers, questions from her Book Club members addressed to Edna Adan.

The goal of Sen. Gillibrand’s group is to make more women aware of the need to be involved in the decisions that affect their lives every day and to let women know that their voice matters, to give them the resources to start to get more involved and tell the inspiring stories of women who already are. She says, “I’m so proud that today, for International Women’s Day, Edna Adan has agreed to answer some of our book club members’ questions, which we’ve posted at Off The Sidelines here.”

Edna discusses how she decided, at the age of 11 or 12, to study nursing and how she broke a taboo by speaking out against Female Genital Mutilation. Describing what has contributed to making her successful in her endeavors, Edna cites her “rebellious character and the courage to speak out against what I find to be unjust.”

She also discusses in some considerable detail what the hospital is looking for in the way of Volunteers and the process that leads to their being accepted.

Thankfully, we do not have in Somaliland all of the atrocities mentioned in “Half The Sky” but whatever atrocities exist in a community should be stamped out. The one that exists and persists in my community is female genital mutilation or female circumcision. I rebelled against it first because it has affected me personally, and secondly because I am a midwife and in my profession, I see on a daily basis how women’s bodies are damaged by this practice. I guess I just reached a point in my life when I couldn’t take it anymore and I just kind of exploded. I have been fighting against the practice ever since. [more]

Off the Sidelines

Edna in Washington

Edna in Washington

Edna was invited to Capitol Hill to participate in the 4th Annual International Women’s Day Breakfast, sponsored by Women Thrive Worldwide, on March 1. Edna spoke about the issue of Female Genital Mutilation (FGM).

Following some members of Congress, and others, Edna’s presentation about FGM begins soon past the 38-minute mark.

See below for a complete video of this event.

“When it comes to female genital mutilation, I am not going to put every mother and every grandmother in jail, because FGM is done out of a sense of duty. They think they’re doing the right thing! We were trying to convince illiterate women, mothers and grandmothers, about FGM which is contrary to the teaching of Islam, but they thought it was a religious obligation, so you need to inform them about this. They thought they were doing the right thing, that it’s hygienic, which it is not; that it would improve their marriageability, which it does not because it interferes with their potential to reproduce and have children.

“And when we went back to the drawing board, we found that we had overlooked the major role that men should and must play in this because this little girl, who is being cut up, is the daughter of a father. And parents, both mothers and fathers, must join hands. And it cannot remain a feminist issue. It’s a human issue. It’s a family issue. So we began to incorporate men into this. And how I would go about it is, “You are the father. It is your daughter who is being subjected to this. And as the leader of this family, you must have a say in this family. And you must put your foot down and say, ‘My daughter will not go through this!’ Show your strength. Show your heroism. Show me how brave you are. It shouldn’t be left to – I often use this – to little old women like me. It should be the responsibility of wise men with big turbans and big beards, wise and knowledgeable men should be telling me to do something about it.

“This is how we about it. And it works better. It’s not something that we campaign against because of the particular damage that it does to the female reproduction. But it damages the human value of this girl. She must have a say and be consulted in this.”

Edna then goes on to congratulate the USA for posting a public notice on the topic of FGM at the US Consulate in Djibouti, where she had recently gone to renew her visa. People traveling from countries where FGM are endemic are now being warned that if they do this to girls while in the USA then it will be treated as a violent crime.

A little past the 57-minute mark, Edna speaks passionately about her goal to train 1000 midwives and dispatch them to isolated areas to help reduce the extremely high rate of maternal and infant mortality. “It costs us less than a cup of coffee a day to train a midwife. We train them for two years. These women go back to their communities competent, vocal and help us to fight many of the problems of women…. They can influence many of the social problems that women have. They become competent.”

Women Thrive Worldwide works to create a world in which women and men work together as equals so that they, their families and their communities can thrive.

Women Thrive Worldwide advocates for change at the U.S. and global levels so that women and men can share equally in the enjoyment of opportunities, economic prosperity, voice, and freedom from fear and violence.

We ground our work in the realities of women living in poverty, partner with locally based organizations, and create powerful coalitions to advance the interests of the women and girls we serve.

Here is the follow-up letter from Women Thrive Worldwide:

Women Thrive Worldwide Letter

Video streaming by Ustream

Meet Edna in Los Angeles

Meet Edna in Los Angeles

We’ve bumped this message back to the top of the page. It’s coming up soon, the weekend before Thanksgiving.

Edna Adan plans to visit the Women Hold Up Half The Sky exhibit at the Skirball Cultural Center in Los Angeles on Nov. 19, beginning at noon. If you can be in the vicinity, then you are invited to join her as she views the exhibit for the first time.

Edna’s work in Somaliland is featured prominently in this exhibit (as in the book). The full dates are October 27, 2011 – March 11, 2012, and we encourage you to visit the exhibit at some point. But, how much better if you can visit it with one of the women whose work is being spotlighted?

Visit the Exhibit Home Page

Experience a groundbreaking new exhibition inspired by the critically acclaimed book Half the Sky: Turning Oppression into Opportunity for Women Worldwide, by Nicholas D. Kristof and Sheryl WuDunn.

Featuring documentary photographs, visual art, innovative sound installations, and interactive opportunities for visitors to get involved, Women Hold Up Half the Sky addresses gender equality as the human rights cause of our time. Confronting the malign persistence of sex trafficking, gender-based violence, and maternal mortality, the exhibition tells stories of women from around the globe who have changed their lives through education, economics, and self-determination. Among them is Saima Muhammad, who lived in fear of her abusive husband and whose community ignored her suffering until she received a $65 microloan and built an embroidery business that now supports thirty families in her Pakistani village. The exhibition also spotlights visionaries like Edna Adan Ismail, the former first lady of Somalia, who used her life savings to build a maternity hospital in war-torn Somaliland, prompting donations and support from all over the world.

Experience these tales of perseverance, courage, and hope – and celebrate how individuals can be part of workable solutions.

Half the Sky Los Angeles

Into Africa: A Somaliland Experience

Into Africa: A Somaliland Experience

Elayne Clift is a writer from Vermont who recently volunteered two weeks of service at the Edna Hospital.

A writer! You know what that means?

It means there’s now a perceptive and beautifully-written journal entry which can help you better to understand the life of the Hospital and the culture of Somaliland.

She is not real happy about the treatment of women in Somaliland….

I am beginning to see the dark side of this country and culture, where voiceless, disempowered women must have their husbands’ permission to have a C-section or an induction for medical reasons. (If they need a hysterectomy their father must agree – her body belongs to him.) I watch as husbands come to sign (or not), ignoring their laboring wives who walk the halls. Imperious and authoritarian, they swagger in and out self-importantly. The doctor says he has seen them deny their wife her life, even when she is crying to be rescued.

On the other hand…

The longer I’m here the more I like the Somali women I meet; they have a good sense of humor, are generally warm and appear to welcome our help. At lunch we are joined by an American missionary surgeon and his wife; the doctor can hardly control himself as he whispers to me, “Can you imagine going to Wyoming and telling people to change their ways?”

Another excerpt, describing her experience teaching a class of first-year nursing students…

They seem rapt when I am speaking, mesmerized perhaps by this elderly white lady who talks of strange things, but when I ask them questions or want to know what their questions or thoughts are, they are silent. I say, “Allah gave you a voice! Women’s voices are beautiful! You must not be afraid to use your voice!” but this falls on deaf ears – they have been long socialized into silence.

Please follow this link, and read the full journal entry:
Into Africa: A Somaliland Experience

Female Genital Mutilation

Female Genital Mutilation

Famous blogger, Andrew Sullivan, nowadays blogging at The Daily Beast, has helped to put a spotlight onto the issue of Female Genital Mutilation (FGM).

Yesterday, he wrote about an Egyptian woman who participated in the uprising in Cairo early this year and who had, herself, suffered FGM:

In 2006, when she was 24, Ziada had a long debate with an uncle about her seven-year-old cousin Shaimaa, the family’s youngest female child. “We talked most of the night. He was shocked at the blunt discussion,” she recalled. “I told him that he had no right to circumcise her. I said I’d cut off Shaimaa’s finger if he went through with it. He looked at me with surprise and said that would ruin her life – and I said, ‘Now you get it.’ I thought I’d lost. But he called me the next day and said I’d convinced him. …

Ziada soon became a leading activist among the pink hijab generation, young women committed to their faith, firm in their femininity, and resolute about their rights. With three college classmates, she launched a campaign to educate women about genital mutilation and domestic violence. Then she moved on to human rights. And she ended up at Liberation Square. http://archive.wilsonquarterly.com/essays/pink-hijab

Today, in a follow-up, The Pink Hijab Generation, Ctd, Andrew references the work of Edna Adan with this grim story:

Thank you for helping to bring attention to the issue of Female Genital Mutilation (FGM). My hero, Edna Adan, has made it among her life missions to help to eradicate this evil. In Somaliland, she has built a maternity hospital that educates local women about FGM in the hope that their daughters will be spared. In this region, as elsewhere, it is the women who enforce and carry out this practice.

I was present when Edna spoke last year to several hundred students at the University of California in Santa Barbara. Edna shocked the audience when she told of an 11-year-old girl brought to Edna’s hospital. The child, born with Down Syndrome, was near death.

She had been bleeding for several hours following a botched FGM procedure. Through the heroic efforts of the staff, her life was saved. But so much was cut away, Edna said, that the girl would never be able even to control her bladder. “Cut to the bone.”

After a week, she was released back into the care of her mother, but first Edna took her aside. “Your daughter already had Down Syndrome. Didn’t she have enough problems? How could you do this to her?” But the mother was adamant, maintaining she had done what was necessary.

In Somaliland, in the Horn of Africa, at least 98% of girls are mutilated. And, of these, 99% are mutilated in the worst way, Type 3 FGM. “Excision of part or all of the external genitalia and stitching together of the exposed walls of the labia majora, leaving only a small hole (typically less than 5cm) to permit the passage of urine and vaginal secretions.”

Andrew Sullivan

Thank you, Andrew Sullivan!

FGM: Torturing Girls

FGM: Torturing Girls

In the third article in a series from Somaliland, New York Times columnist Nicholas Kristof writes about the persistence of Female Genital Mutilation (FGM) despite concentrated efforts to eliminate the practice.

“This is one of the most pervasive human rights abuses worldwide, with three million girls mutilated each year in Africa alone, according to United Nations estimates. A hospital here in Somaliland found that 96 percent of women it surveyed had undergone infibulation. The challenge is that this is a form of oppression that women themselves embrace and perpetuate.”

A Rite of Torture for Girls

People usually torture those whom they fear or despise. But one of the most common forms of torture in the modern world, incomparably more widespread than waterboarding or electric shocks, is inflicted by mothers on daughters they love.

It’s female genital mutilation — sometimes called female circumcision — and it is prevalent across a broad swath of Africa and chunks of Asia as well. Mothers take their daughters at about age 10 to cutters like Maryan Hirsi Ibrahim, a middle-aged Somali woman who says she wields her razor blade on up to a dozen girls a day.

Edna Adan with Nicholas Kristof

Video: Hospital's Ever-Expanding Mission

Video: Hospital's Ever-Expanding Mission

“Originally intended to be a small, normal maternity facility…”

In this video, Edna Adan relates how the mission of the hospital expanded from the original goal of serving expectant mothers. More than 10,000 babies have now been born at the Edna Hospital. In addition, the hospital treats everything from snake bite to war wounds.

Turned out, there were not enough trained nurses, so the hospital took upon itself the task of training more.

Many women had extreme difficulty giving birth because of Female Genital Mutilation (FGM) and so the hospital educates the society to turn away from this traditional practice.

Above all, “Knowledge is the biggest gift.” Edna’s primary mission is to educate.

African Communities Abandon FGM

African Communities Abandon FGM

All across Africa, thousands of communities are abandoning the practice of Female Genital Mutilation, establishing a new social norm.

Julia Lalla-Maharajh reports for The Daily Beast from The Gambia:

For me, the most incredible sight was the former cutters dressed in long red shifts, swaying briskly into the center of the square to the rapid beat of a drum, carrying leafy branches. They danced, then stood in front of the crowd and explained that they now were aware of the implications of female genital cutting, that it brings health problems, that there are many difficulties. The woman who was the spokesperson held out a calabash, a hollowed out gourd traditionally used to hold the cutters’ instruments. Now, ceremonially she put it down in front of them, on the ground. Bringing her foot down with a stamp, it shattered and she held her hands out to the crowd:

“We are no longer going to practice this. We are no longer going to practice this.”

Female Genital Cutting: How the Gambia is Fighting It – The Daily Beast

Full Article The full article is very well worth reading as it shows a path to success in changing ages-old practices in these communities.

Knowledge really is power. What is so powerful is that communities themselves identify what no longer serves them. In this way, the changes made are sustainable and owned.

Orchid Project Julia Lalla-Maharajh was a volunteer working in Ethiopia when she learned the scale and impact of female genital mutilation. She won a YouTube competition to participate in the World Economic Forum in Davos, Switzerland, to talk about this issue with world leaders. Later, she created the Orchid Project which seeks to see a world free from female genital mutilation by 2025.

FGM Outlawed in Switzerland

What follows is a message to Edna from Switzerland bringing news that her recent 3 week tour there has helped to bring about a new law against Female Genital Mutilation in that country. Adults may not give legal consent for their young daughters to undergo the procedure and may be held criminally liable in the event the procedure does take place.

Dear Edna Adan,

Once again I want to thank you very much for your great presentation during your roundtrip in Switzerland. Hereby you can find news about the FGM problematic in Switzerland:

Mutilations génitales : le Conseil national durcit le ton (Swiss Parliament Chamber)


La Suisse devrait durcir le ton contre les mutilations génitales féminines. Le National a adopté le 16 décembre 2010 par 162 voix contre 2 une nouvelle norme pénale spécifique. Le Conseil des Etats doit encore se prononcer.

[Rz 1] Ce fléau frappe quelque 140 millions de personnes dans le monde, selon l’OMS. Les cas les plus fréquents sont l’excision et l’infibulation. Ces mutilations sont le plus souvent pratiquées sur des mineures de moins de 14 ans, a relevé Paul-André Roux (PDC/VS) au nom de la commission.

[Rz 2] Aucune religion ne prescrit de telles pratiques, qui visent souvent à atténuer le plaisir féminin ou à préserver la virginité de la femme. Elles n’en restent pas moins des atteintes violentes à l’intégrité corporelle et psychique de la victime, dont la vie est en outre mise en danger, ont souligné de nombreux orateurs.

Punir systématiquement

[Rz 3] Les mutilations génitales féminines sont déjà punissables en Suisse. Mais la nouvelle norme en fait désormais un délit à part entière, ce qui facilitera les démarches de la victime en lui évitant des examens astreignants. Ces lésions corporelles seront sanctionnées qu’elles soient graves ou légères.

[Rz 4] La révision du code pénal permettra de réprimer ces actes quelle que soit la nationalité de l’auteur et de la personne mutilée. Ainsi, les mutilations seront sanctionnées en Suisse même si elles ont été commises à l’étranger et qu’elles ne sont pas pénalement répréhensibles dans l’Etat en question.

[Rz 5] Il suffira que l’auteur se trouve sur territoire helvétique. La Suisse n’est pas épargnée, ont rappelé plusieurs orateurs. On y compterait quelque 7’000 femmes et jeunes filles mutilées ou menacées de l’âtre. Et ces excisions ne sont plus seulement pratiquées à l’étranger.

Peines et prescription

[Rz 6] Le projet prévoit de punir celui qui aura mutilé des organes génitaux féminins, aura compromis leur fonction naturelle ou leur aura porté toute autre atteinte.

[Rz 7] L’auteur risquera une peine privative de liberté d’au maximum dix ans ou une peine pécuniaire d’au moins 180 jours-amende. L’UDC a proposé en vain de placer le seuil à un an de privation de liberté.

[Rz 8] La victime pourra quant à elle poser plainte jusqu’à quinze ans après les faits. Et tout cas jusqu’à ses 25 ans révolus, si a elle a été mutilée avant l’âge de 16 ans.

[Rz 9] Les adultes ne pourront pas consentir à une mutilation. Des exceptions restent toutefois envisageables pour des interventions légères telles que les tatouages, les piercings ou certaines opérations esthétiques.

It was a real pleasure meeting you. I wish you all the best in all your projects (we are waiting for 1000 midwives) and a happy new year in advance!

Kind regards

Richard Greiner
Protection, juriste

www.osar.ch Organisation suisse d’aide aux réfugiés OSAR, Berne
Protéger les réfugiés – Préserver la dignité humaine.

Der Bund news article (in German)

Der Bund news article (in German)

Here is a newspaper article published in the Swiss newspaper, Der Bund. Edna is gathering much support among the Swiss.


Edna Adan, ehemalige Aussenministerin von Somaliland, Gründerin eines Frauenspitals in Hargeisa

«Wir fordern die Frauen auf: Lasst eure Töchter nicht verstümmeln!»

Edna Adan kämpft gegen die Beschneidung der Frauen. «Mein Vater war dagegen», sagt sie, «das gab mir Mut.»

Edna Adan in Der Bund

And, here is another article, also in German.

Safe Motherhood in Somaliland
Year End Newsletter 2010

Year End Newsletter 2010

2010 has been an exciting year for my country Somaliland as Presidential elections were held in June and a new President elected. We have also been very busy at the Edna Adan Hospital.

While there have been many things to celebrate in 2010, there remain many challenges which we will continue to fight in the coming year. With your support we will remain dedicated to improving health for the people of Somaliland for many years to come.

Operating Theatre interior

Operating Theatre interior

More Space for Life-Saving Surgery

After being decorated by President Sarkozy with the French Legion d’Honneur, our greatest joy has been the construction and completion of our new operating theatres that were partly funded by the Fistula Foundation with supplies provided by Direct Relief International. This newly-built complex consists of a small theatre for minor operations and two theatres that are much larger and brighter. This has enabled us to dedicate our older theatre to be used exclusively by the maternity department for Caesarian sections.

The new theatres will enable us to do more repairs of obstetrical fistulae, cleft lips, and general surgery including orthopedic surgery; and will also help us to train nurses and medical students in theatre protocols and procedures.

Happy Post-Basic Midwives

Happy Post-Basic Midwives

Our Midwives to Receive BS Degrees

We have also been fortunate to find support for some of our best Midwives to study for a Bachelor of Science Degree in Midwifery. I feel that this will not only give the graduates from this course a chance to grow in their profession but will also help to develop their leadership potential. This has been made possible by Tropical Health and Education Trust (THET) who helped with the development of the curriculum and also obtained the necessary funding from DFID. The Degree will be implemented as a joint program between the University of Hargeisa, our hospital, THET and the Somaliland Nursing and Midwifery Association.

I feel very excited about this long-awaited course which I have wanted to start as far back as 1977 when I was Director of Training in the Ministry of Health. Some things just take that long to become realized.

Newly-graduated Pharmacist

Newly-graduated Pharmacist

Giving the Gift of Knowledge

Human Resources development have always been very big for me as I truly believe that the best gift I can leave for my people is the gift of knowledge. In this spirit – and in addition to our usual training of nurses, midwives and laboratory technicians; we have graduated 63 men and women who received a one-year training course to become the very first pharmacy assistants trained in Somaliland. 30 of them have opted to continue training for six more months to obtain a Diploma in Pharmacy.

The training of Laboratory Technicians continues and now have our fourth group of men and women in training.

Nurses Final Exam

Nurses Final Exam

Congratulations to our Graduate Nurses

Following the graduation of our third group of General Registered Nurses, 33 proceeded to do a further training of one year to become Post-Basic Midwives, the remaining 19 took a one-year course in Critical Care nursing and became the very first nurses to take this course in Somaliland.

My Ambition: to Train 1000 Midwives

The training of the Community Midwives from the different regions of Somaliland continues with 42 women due to graduate in March, 2011. They are the best motivated group of women we have and I am confident they will have a strong impact on the high maternal mortality rate of our women. My ambition is to train 1000 community midwives to cover the needs of our people. Even if I don’t make it in my lifetime, I hope some of my former graduates will accomplish that goal.

Trainee Secretaries

Trainee Secretaries

Small Steps Alleviate Poverty

Lastly, another new training that we started this year is the training of office assistants or secretaries. This training, which is quite different from our usual health-related training programs, is one which will provide 24 women with office skills that will help them find jobs and provide their employers with much-needed secretarial support. Hopefully, it will be a small step towards poverty alleviation among our women.

Success Stories: A Baby at Last

When it comes to patients, babies continue to be born and the sick get looked after as best we can. One patient we are all very excited about is a woman who had miscarried six times in a row, then had a full-term pregnancy which she informed us she lost during childbirth. She came to us with pregnancy number eight and a premature rupture of membranes. We treated her for 24 hours and then performed Caesarian section. A healthy 2.7 kilo baby boy was delivered. At last, this family has one living child, and we have the assurance that she will come back for prenatal care when/if she gets pregnant again in a couple of years. Naturally, the operation for this woman was free of charge as this was a special occasion for us, too, as we feel blessed to have been here for this woman.

Success Stories: Results for FGM Survey

We are greatly relieved to have printed the results of the Female Genital Mutilation Survey which we carried out at the hospital. The printing of the booklet was made possible by a generous Norwegian benefactor who wishes to remain anonymous but to whom we are very grateful.

Donated water tanker

Donated water tanker

Two Essentials: Water and Electricity

Water and Electricity (or lack thereof) continue to represent our biggest source of worry, causing delays and emergencies. We are grateful for the gift, by a generous benefactor, of a water tanker which has helped us greatly. What would help us even more would be a borehole, for a well. With our new operating theatres in place, we also have need of a more reliable electric supply. We need solar panels for the roof. These are paramount on our wish list and a tall order to ask of our supporters. But it would save so many more lives.

Our Wish List

While we have had a large number of much-appreciated volunteers, our greatest needs continue to be ‘doctors’ as well as nurse and midwife trainers. And, we need a new ambulance to replace our old one which has been our life-line for the past ten years and which is now ready to give up the ghost.

How YOU Can Help Edna Adan

1. Tell your friends about us

Forward this email and ‘Like’ us on Facebook. This will greatly help us to get the word out about our important work.

2. Support the work of the Edna Adan Hospital

Our supporters have used PayPal to help provide us with operating funds. These donations have ranged from $5 well into the thousands.

None of whatever we have done or achieved would have happened without your generosity and encouragements. Thank you all for your continued support and blessings and special thanks to the Friends of Edna Adan Hospital in the USA.

Remember to visit our newly-redesigned web site www.EdnaHospital.org which was donated by Chuck of UPDmedia, who has linked us up to the world beyond the borders of my country.

Edna in Snowy Switzerland

Edna in Snowy Switzerland

We are finishing up work on the Edna Hospital’s year-end newsletter. That should be going out in a few days.

Meanwhile, Edna is visiting Switzerland for three weeks, participating in a series of events relating to Female Genital Mutilation (FGM). She is the honored guest of Voix des Femmes (Voices of Women) and they appear to be taking very good care of her.

Edna’s note follows:

“Am going through lots of PR activities here and have had a full week and still have another two weeks to go of the same. First heavy snow started yesterday and everything looks so white and clean. They are getting paranoid about me freezing to death that they keep lending me scarves, gloves and door-to-door car so that I will not slip on snow.

“On Saturday 27th November, there was a two-page article about the work I do on FGM and the hospital. I don’t know the exact link but it’s in Der Bund Newspaper: www.derbund.ch.

“Although in German, here is the link to last year’s magazine article which started it all.”

Der Mädchen-Effekt

Afrika braucht mehr Frauen wie Edna Adan. Mit ihrem Spital in Somaliland zeigt sie, wie man Extremismus und Armut bekämpfen kann.

«Tausend Hebammen», sagt Edna Adan, «tausend Hebammen will ich ausbilden. Vorher sterbe ich nicht.» Die Direktorin sitzt hinter ihrem schweren Schreibtisch im Büro der Maternité in Hargeisa, der Hauptstadt von Somaliland, und blickt auf die Landkarte an der Wand gegenüber. Manche Orte sind mit Bleistift eingekreist. Xudun. Kalabaydh. Garadag. Wie ein Kriegsstratege, der Schlachtpläne ausheckt, um ein Land zu erobern, stellt sich Edna Adan vor die Karte, wandert mit dem Zeigefinger von Name zu Name, verbindet sie zu einem unsichtbaren Netz.

Edna with Mayor of Zurich

Edna with Mayor of Zurich

After the folks at Voix des Femmes read the article above, that’s when they invited Edna to come visit Switzerland.

When we find the links to this new newspaper article, and any others, we will update this page. There was also a Swiss radio interview conducted in French.

Edna in Switzerland for FGM

Edna Adan will participate in a conference later this month, Voix de Femmes (Voices of Women), in Bern, Switzerland. The topic will involve female genital mutilation as practiced in Somaliland.

“TERRE DES FEMMES Suisse s’engage pour les droits des femmes et des filles en Suisse. Pour sensibiliser la population aux différentes formes de violences et de discriminations envers les femmes, nous faisons du travail d’explication et de prévention.”

Sorry, we don’t have the English translation available.

Here is more information, at the official web site: Terre des Femmes.

Voix dex Femmes – view brochure
Male Genital Mutilation?

Male Genital Mutilation?

This site’s web site administrator has been reading Andrew Sullivan’s Blog for years, and happened to notice a reference today to “male genital mutilation.” Having seen Edna Adan just last week speak convincingly to dismiss the notion that the cutting of males and females are remotely comparable, an emailed protest was pretty much inevitable.

It is not really fair to describe male circumcision as genital mutilation. That would seem to put it on a similar level with the horror that is Female Genital Mutilation (FGM). I was privileged to hear Edna Adan speak last week to an audience at the University of California Santa Barbara. The topic was Human Rights and Women’s Health.

Edna shocked the audience when she told of an 11-year-old girl brought to Edna’s hospital in Somaliland. The child, born with Down Syndrome, was near death. She had been bleeding for several hours following a botched FGM procedure. By the heroic efforts of the staff, her life was saved, but so much was cut away, Edna said, that the girl would never be able even to control her bladder. “Cut to the bone.” After a week, she was released back into the care of her mother but, first, Edna took her aside. “Your daughter already had Down Syndrome. Didn’t she have enough problems? How could you do this to her?” But the mother was adamant, maintaining she had done what was necessary.

In Somaliland, in the Horn of Africa, at least 98% of girls are mutilated. And, of these, 99% are mutilated in the worst way, Type 3 FGM. “Excision of part or all of the external genitalia and stitching together of the exposed walls of the labia majora, leaving only a small hole (typically less than 5cm) to permit the passage of urine and vaginal secretions.”

Male circumcision is the removal of some skin. FGM is a whole other ball game.

Read a Study about FGM in Somaliland

Reader comments are welcome, as always.

Ayaan Hirsi Ali on FGM Compromise

Ayaan Hirsi Ali on FGM Compromise

The author, and former member of The Netherlands parliament, Ayaan Hirsi Ali, has weighed in on the proposed compromise on Female Genital Mutilation (FGM).

Ayaan Hirsi Ali on FGM While the American Academy of Pediatrics agrees that FGM serves no medical purpose, it argues that the current federal law has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation. The pediatricians say that “it might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm.”

But is this plausible? I fear not.

I am familiar with this debate in two ways. First, I come from a culture where virtually every woman has undergone genital cutting. I was 5 years old when mine were cut and sewn. Second, while serving as a member of parliament in the Netherlands, I was assigned the portfolio for the emancipation and integration of immigrant women. One of my missions was to combat practices such as FGM.

Read the full article by Ayaan Hirsi Ali at The Daily Beast:

Why Are American Doctors Mutilating Girls? Read a Study about FGM in Somaliland

FGM Compromise?

Africa Rising: The Grassroots Movement to End Female Genital Mutilation is a short film about the grassroots movement in Africa working to end the practice of Female Genital Mutilation (FGM):

Meanwhile, blogger Andrew Sullivan, among others, is horrified to learn that the American Academy of Pediatrics (AAP) has endorsed a ‘kinder gentler’ form of FGM:

NEW YORK, May 5 /PRNewswire-USNewswire/ — International human rights organization Equality Now is stunned by a new policy statement issued by the American Academy of Pediatrics (AAP), which essentially promotes female genital mutilation (FGM) and advocates for “federal and state laws [to] enable pediatricians to reach out to families by offering a ‘ritual nick’,” such as pricking or minor incisions of girls’ clitorises. The Policy Statement “Ritual Genital Cutting of Female Minors”, issued by the AAP on April 26, 2010, is a significant set-back to the Academy’s own prior statements on the issue of FGM and is antithetical to decades of noteworthy advancement across Africa and around the world in combating this human rights violation against women and girls. It is ironic that the AAP issued its statement the very same day that Congressman Joseph Crowley (D-NY) and Congresswoman Mary Bono Mack (R-CA) announced the introduction of new bipartisan legislation, The Girls Protection Act (H.R. 5137), to close the loophole in the federal law prohibiting FGM by making it illegal to transport a minor girl living in the U.S. out of the country for the purpose of FGM.


The Debate Continues Female Genital Mutilation in East Africa
Hillary Clinton photo

Hillary Clinton photo

The Daily Beast has kindly provided Edna with a photo of herself with Hillary Clinton at the conference in NYC.

Hillary Clinton with Edna Adan in NYC

Edna missed getting a photo of the encounter, herself, but happily somebody else did.

The two go way back.

Says Edna:

“I had a longish chat about FGM [Female Genital Mutilation] with Hilary Clinton and reminded her of our first meeting in Beijing in 1995 during the Women’s Conference there when I was the first person on that occasion to raise the question of FGM.”

Daily Beast Womens Summit: Photos

Daily Beast Womens Summit: Photos

Edna Adan has shared some photos from the recent Women in the World Summit in New York City.

Here are some of the best of what was taken.

There are many (many!) more photos in the Edna Hospital Photo Galleries.

New Profile of Edna

New Profile of Edna

Lynn Sherr has published a new article profiling Edna Adan at the Daily Beast.

Read Full Article at The Daily Beast

Edna Adan Nursing School Graduates

Edna Adan with Graduating Nurses

“The biggest gift I want to leave behind is not a building, but the skills I leave with the women. I want to train 1,000 midwives.”

Her progress so far is astounding. Since the hospital opened, they have delivered more than 9,500 women and lost only 39. “That’s 39 too many,” she laments, nonetheless delighted that they have reduced the maternal mortality rate by one-fourth. In 1988, the last time a study was done, there were 160 deaths per 10,000 births in Somaliland, making it the third worst in the world. “Women are dying of complications nobody is picking up,” she explains. “Because nobody is there to support them, care for them, or deliver them. They are getting infected, torn apart. No woman should die of childbirth, because modern obstetrics has ways to save them.” The challenge: “ignorance, poverty, and harmful traditions.”

Those are also the culprits in her other lifelong cause: ending the practice now called Female Genital Mutilation. When she started speaking out–to the embarrassment of her husband-it was simply Female Circumcision. “No one would talk about it then. I was the first Somali woman to pick up a microphone.” And despite all the publicity in recent years she says, “We have not cracked the surface of it. I am giving out a document at the conference showing a new survey of 4.000 women. Of them, 97 percent, shamefully, had been cut. After 34 years of campaigning. We’re nowhere near winning that battle.”

But Edna Adan Ismail takes comfort that now, “we have the whole world talking about it, it’s out of the closet.”

Read Full Article at The Daily Beast