Independent Appeal: Saved from the agony of female circumcision

Millions of women around the world are subjected to genital mutilation. But, in Ethiopia, the practice is slowly disappearing, writes Paul Vallely

This is Hanna Abera. She is seven. Her mother and grandmother wanted to slice off part of her genitals. But she was saved by an extraordinarily brave intervention from her aunt after a British charity launched a programme of education on the consequences of female circumcision – which is still widely practised throughout parts of Africa and the Middle East.

No one knows how many women are subjected to the procedure but it is thought that over two million procedures are performed every year. Amnesty International estimates that over 130 million women worldwide have been affected by some form of what it calls female genital mutilation.

In Ethiopia, which is where Hanna lives, 70 to 80 per cent of women are circumcised, as are almost all men. But this is not a bad news story. It is about change – for in the region around the town of Woliso in the central part of the country a remarkable project has brought a revolution in social attitudes.

And it has come about through the empowerment of a local community, thanks to a project run by the British development agency ActionAid, which is one of the three charities being supported in this year's Independent Christmas Appeal, which closes today – though staff will remain available to receive donations by post, telephone or via the internet until the end of next month.

Tijitu Obsu is a young woman who was, until quite recently, an enthusiast for the traditional practice. "I arranged the ceremony when my two elder nieces were circumcised, at the ages of seven and five," says the 22-year-old. "And I organised the party afterwards. But by the date that Hanna was due to be circumcised at the age of four, three years ago, my eyes had been opened. I knew that with the other two I had committed a terrible crime. So I saved Hanna from that fate."

Change began in Woliso in 1998 when ActionAid began a project to get local communities to focus on how traditional cultural practices were assisting the spread of HIV/Aids. But it took seven years before that work began to bear fruit and Hanna – and many young girls like her – began to be saved from the circumciser's blade.

The rate of HIV infection in Ethiopia is around 4.4 per cent – which is below the 6 per cent average for the continent or the astronomical rates in some southern African countries, where one in five of the entire population is infected. Still, 1.4 million Ethiopians carry the virus, and one of the key strategies in containing the spread has been to try to curb what became known as harmful traditional practices, including widow inheritance, wife sharing, abduction and circumcision.

Campaigners who had studied the eradication of the 1,000-year-long practice of foot-binding in China in the early 20th century knew that changing social attitudes, rather than passing laws against the practice, was key. ActionAid, which specialises in community-level development projects, sponsored training for 96 young people as facilitators of attitude change. To provide them with a living it also gave them training in crop farming or animal rearing.

The facilitators travelled through villages around Woliso calling community meetings asking local people to identify the taboos which might assist the spread of HIV. "We had to proceed slowly," says one of them, Negusse Beadada, 24, "because we knew that the village elders had the power to decide everything and that they didn't trust us or believe us. What we were raising was a challenge to the older community leaders. So the first move was to obtain their blessing for our discussions.

"We began by raising single issues, such as: how do you see the relationships between women and men in this village? Only after six weeks did we raise the issue of harmful traditional practices. Some villagers insisted female circumcision was essential as it stopped females from being rude," he says, employing the word which Ethiopians of all ages use to describe enthusiastic sexual activity, male but especially female. "Others were less strongly committed to it, but said 'It has been practised here for a long time and that can't be changed.' But we started the discussion."

The starting point for debate in these weekly Sunday community meetings was the spread of Aids, but the conversations broadened into wider sexual politics. Among the issues raised were early marriages and abductions as well as circumcision. Traditionally, girls in this part of Ethiopia were considered marriageable between the age of 12 and 14, though some were wed as early as the age of nine to men who were generally over the age of 30.

"Some of the girls are not physically compatible with their husbands," says Hawariat Petros, a young Ethiopian Masters graduate in her mid-twenties who works for ActionAid. "That means sex can be physically damaging. Fistula [a rupture of the vagina and urethra which leads to urinary incontinence in women] is a common problem. But around half of these girls stick with their husbands because they know that if they leave they'll never get another husband later in life unless they are from a rich family."

Even so, she says, thanks to girls' education a "real change" has begun. Hanna's aunt, Tijitu Obsu, is still unmarried at 22 "because I have not finished my studies". Among female graduates the average age for marrying is between 25 and 30. Weddings are expensive in Ethiopia, as anywhere. A dowry can cost 6,000 birr (£300) and a wedding feast 7,000 birr (£350) which together represent two years' wages. Men who are poor have got round this problem by lying in wait outside a different village and abducting a girl to be their bride.

"It's been a severe problem in our area," says Ms Beadada, "and it has been widely accepted in the culture and not seen as a bad thing. Sometimes the man will move far away so her family can't track her down. Or his elders come to the girl's family to apologise and see if they can agree a deal or compensation."

The community conversations have started a significant shift on that. There have been no abductions in the area for more than two years now. But circumcision has proved a more deep-rooted problem. "The assumption was widespread that an uncircumscised woman would be unfaithful and would look for other men," says Ms Petros. "She would be rude. But people are coming to see that it's not a question of being rude; it's about respecting your husband – and him respecting you."

The detail of what was done varied from one area to another. In towns the operation – often performed with unsterilised blades – was often done when the baby girl was about six weeks old but in rural areas it was left until the girl was between four and seven. "The degree of cutting in the Christian areas of central Ethiopia was less severe than in the Muslim areas," says Ms Petros, "but there are only three or four regions in Ethiopia that don't do it. Some men, if they marry a women who hasn't been circumcised, will send her away as an adult to have it done."

The procedure involves the slicing away of the clitoris and the removal of the inner and sometimes the outer lips of her vagina. The genitals are then held together using thorns or stitches with the girl's legs tied together for six weeks to allow the healing of the two sides of the vulva.

The procedure can result in a wide range of problems from infections to sterility and even death from shock or unstemmed bleeding. It can make sex painful – husbands sometimes have to cut the women after marriage to allow penetration. Severe complications in childbirth include the tearing of the vagina to such a degree that death of both mother and child can follow. The chances of the transmission of HIV from mother to child are also significantly increased.

It was after hearing all this that seven-year-old Hanna's aunt, Ms Obsu, was overcome with guilt at the operations she had organised for her two nieces. "I knew I had committed a crime and went to see my brother and sister-in-law and I started discussing it," she says, a confidence and assurance kicking in as she switches from speaking a hesitant Amharic – Ethiopia's national language – to Woliso's local tongue.

She planted the seeds of doubt in her brother's mind, but when he went to see his mother she told him that the circumcisions must go ahead. But in the teeth of her mother's opposition Ms Obsu managed to talk her brother out of the operation.

Changing attitudes is a long process and involves a number of strategies. "You have to deal with myths, like it doesn't hurt the child very much, and wounds heal," says a local man, Tariku Adinuya, 29, who is one of those whose mind has been changed. "I said to the chief elder: 'If you cut your hand with a knife, does it hurt? Well, then it will hurt a child to be circumcised.' It is also self-evident that there can more easily be physical damage during delivery if the vagina does not expand sufficiently. The child may suffer and the mother may die."

He managed to convince his wife with such arguments. But with the village elders he had to deploy a religious approach. "I asked them: 'Do you think that men and women are different in the sight of God?' And when they said no, I said: 'If we are all equal in front of God if you do something bad to a female you do something bad to God'."

Much of the resistance to change resides not with the male elders but with the older women in the community. "Many illiterate women assume that their circumcision has in some way helped them," says Hawariat Petros. "They assume that it makes it easier to give birth. And the women who perform the operation resisted; because it was their livelihood."

"Hanna's grandmother was very annoyed when her parents decided against the procedure," says Ms Obsu. "But since then something has happened to change her mind. My elder sister was pregnant and there were complications so she had to go to hospital. She was given a Caesarean. The doctors told my mother that if my sister had tried to give birth at home she would have died because she had been circumcised so badly. That altered her attitude entirely."

Other attitudes have been changed through the storytelling techniques which have been taught to the facilitators. "We tell the story of a merchant in a village not far from here who had a wife in the country and a mistress in town. When he finds he is HIV-positive he has to decide what to do," says Negusse Beadada. "We ask the villagers what they would do. Some say they wouldn't tell anyone. Others say they would use holy water. Others that they would kill themselves, because they were so evil. Others that they would tell their wife so she could go to hospital. Then we explore the pros and cons of the various options. And in the process of all this discussion you start to change minds."

It works. There have been no female circumcisions now in the area for three years. Many girls of Hanna's age have escaped mutilation. "My friends Getae and Kumisha are not circumcised either," the seven-year-old says. "They are very happy about that. And so am I. When I grow up I'd like to be a doctor to help people like I have been helped."

Change is rippling through the community. Most people now agree to having an HIV test before marriage. Under a local law those who abduct or practise early marriage are fined and jailed for three months. Sixteen girls have been saved from circumcision in one village of 17 households alone. ActionAid now would like to spread the project into other areas.

"I am not afraid that my daughters will not get husbands when they grow up, " says Tariku Adinuya. His children are aged nine and five. With the money he has saved from the operation and the parties that would have followed he has bought an ox.

"There has been such a change in the community that I'm not worried that my daughters will be left without husbands when the time comes," he adds. "Change has begun here and the change must continue."

£93,000 and counting Total raised so far

*This is the final day of the Independent Christmas Appeal. The total raised so far is £93,571. This includes £38,836 raised through the paper's annual auction of services offered by its staff and contributors.

*This is some way short of the £117,904 raised last year, though the three charities for which we are raising funds – ActionAid, Peace Direct and Computer Aid International – are hoping that delays in postal donations caused by the snowy weather will mean there are more in the pipeline.

*"Our readers are always very generous, and on average give the highest individual donations of any newspaper Christmas appeal," said The Independent's Associate Editor Paul Vallely, who organises the appeal each year. "We hope that, despite the tough economic conditions this year, readers will make one final push to boost the funds which will go to our three charities. The stories we have run every day over the past month show what extraordinary work they each do."

*Though today's is the final appeal for our Christmas charities, staff will remain available to receive donations by post, telephone or via the internet until the end of next month.

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