WHAT do you remember from when you were five — your first day at school, playing or having stories read? For Amal Kowhah, memories are stained with pain. It was at the age of five that, like so many other girls raised in cultures where so-called “female circumcision” is practised, her body was scarred by cruel cuts.
“But when you’re not done, you can’t get married.”
Having this radical procedure, now known as Type 3 Female Genital Mutilation (FGM), was believed to keep girls pure, says North Sudanese-born Kowhah.
Sierra Leone-born Khadija Gbla has been campaigning loudly against Female Genital Mutilation since she was 13; she was harmed so badly she was told she could never have children and describes Female Genital Mutilation as a “life sentence”.
Kowhah and Gbla are part of a growing global push to have Female Genital Mutilation seen for what it is: a violation of girls’ human rights, child abuse and a crime.
For Kowhah, a mother of six, the memory of that awful experience is strong enough for her to be among a generation of mothers and fathers from cultures around the world to say “no more”. Kowhah and husband Haroun Kafi are among the first generation to spare their daughters. A resident of Shepparton’s large multicultural community, Kowhah and parents like her are speaking about Female Genital Mutilation to help stamp it out.
According to the United Nations Population Fund, 200 million girls and women worldwide live with Female Genital Mutilation, having had it performed in sub-Saharan Africa, some Islamic communities and Arab countries, Asia (some parts of Pakistan, India, Malaysia and Indonesia) and Latin America — and in diaspora communities in Europe, the US, Canada and Australia.
An estimated 83,000 girls and women in Australia have survived FGM, according to those working to prevent it here and to reduce the risk of girls being sent for it offshore.
The challenge for community members such as Amal Kowhah, her dynamic Shepparton Ethnic Council colleague Betul Tuna, Gbla and her No FGM Australia co-founder, Melbourne teacher Paula Ferrari, is to support women who have had FGM to say no to remnant cultural pressure.
Despite the criminalisation of Female Genital Mutilation across Australia, cases are being exposed. In November, a retired nurse and a mother of two young girls were found guilty of performing Female Genital Mutilation on the woman’s two daughters. And in 2014, a Sydney father was charged with organising for his infant daughter to be “circumcised” overseas. He was later charged with aiding, abetting, counselling or procuring female genital mutilation and handed a suspended jail term.
Gbla, 28, is still angry about what was done to her at her mother’s behest when they were living in Gambia. She attended the first National Summit on Female Genital Mutilation in Canberra in 2013, run by then health minister Tanya Plibersek, and floored listeners with her guts and passion. Gbla told how her mum held her down while an older woman cut her with a rusty knife.
“I was given a mic at the summit and asked to speak so I said, we shouldn’t just be having a talkfest; I want to put a face to something people talk about as a hypothetical thing; this is real, I was nine or 10 years old when a lady took a rusty knife and butchered me. Little girls who are at risk of this need support.”
Adelaide resident Gbla, a former Young South Australian of the Year, describes harrowing ongoing symptoms from FGM. Although she was lucky to defy predictions and have a baby (by caesarean) with her husband, she has monthly pain so strong it requires hospital admission for intravenous painkillers and suffers shooting abdominal pain so severe she needs to put her baby down before she drops to the floor.
Other common complications of FGM can be ongoing urinary and gynaecological problems, infections, psychological issues and sexual problems.
Gbla educates teachers, doctors, midwives and others about signs to look for in children who may be at risk of this “life sentence”. Of her decision to start the action group No FGM Australia with Ferrari, she says: “First and foremost I was angry something like that happened to me. I wanted to make sure it didn’t happen to anyone else. There is no reason for FGM; it’s brutal and has no health benefits.”
Gbla says as well as the physical and sexual damage of FGM, knowing your body has had pieces removed is hard. “My private place is a place of trauma; I can feel the scar and I know things are missing … You know you are weird and you know you are different.”
Gbla shares the vision of medical professionals such as The Children’s Hospital at Westmead’s paediatric professor Elizabeth Elliott, who heads the National Paediatric Surveillance Unit, that FGM is no longer considered something on the fringes to be managed quietly but is “everybody’s business”.
She wants questions about FGM included in antenatal appointments and wants FGM training to be standard for child protection workers. Gbla is also campaigning for FGM to be mentioned in the sexual health curriculum. She has called for the formation of a national strategy on FGM to mandate its handling by education, immigration, health and multicultural services and was consulted during the writing of Australia’s Third Action Plan to Reduce Violence Against Women and their Children, due this year.
“We need this to be a national conversation like the UK is having that says FGM is happening in Australia, this is what it looks like — not targeting any community, just saying all children should be protected under Australian child protection laws. This is about human rights; we can use language that is inclusive.”
Data about FGM in Australia are almost non-existent, to the great frustration of those trying to support women and protect children.
A survey of paediatricians by Elliott’s surveillance unit, released last year, found 10 per cent had seen at least one case of a girl aged 18 or younger who had FGM. Sixteen doctors had seen it in the past five years. They observed 59 child cases.
The study revealed widespread ignorance about FGM among doctors, many of whom had no idea it occurred in Asia as well as Africa and parts of the Middle East. Elliott wants paediatricians to report monthly on new cases.
“Some thought it was a religious rather than a cultural practice. For example, they were not aware it might be practised by Christians (including in South Sudan),” says Elliott, a key speaker, along with Human Rights Commission president Gillian Triggs, at the Female Genital Mutilation is Everybody’s Business conference in Sydney in April, co-convened by her unit and No Female Genital Mutilation Australia.
“Many didn’t know who were the at-risk groups … were not aware of WHO diagnostic and very few of them asked about or ever looked for it. A significant proportion didn’t even know what the classification was even if they found it and didn’t know what to do or where to refer people for services.
“These data aren’t published yet, but will confirm Female Genital Mutilation is being seen by paediatricians in Australia and the children they see have a range of complications including infection, menstrual and urinary problems.
“A significant proportion of cases we had reported had infibulation (stitching of the area); Type 2 (cutting off of external genitalia), and Type 3 (cutting and infibulation) constituted 50 to 60 per cent of the cases — it’s not that they’re having a more trivial procedure.”
Paediatricians had been asked where Female Genital Mutilation could be obtained and if they would do it.
Betul Tuna is a grassroots worker striving to support more women to resist pressure from countries of origin to continue Female Genital Mutilation. As well as educating newly arrived communities about child protection laws and support for their own health needs, she takes a no-exceptions line on Female Genital Mutilation.
“Female Genital Mutilation is a gender-based crime. It’s violence against little girls for being born girls,” Tuna says.
Her South Sudanese colleague Thon Thon says more needs to be done to help identify girls at risk and to link people with networks to support their choice to discontinue it. He engages men in the campaign to eradicate FGM on child protection grounds and keep a watchful eye on girls.
“Most of the men say, ‘No, I will not let that (what happened to their wives) happen to my daughter’; let’s keep saying that,” Thon says.
After Foreign Minister Julie Bishop made a powerful statement condemning FGM last year and urging people to speak up about at-risk girls, Thon says, “I thought there might be a big campaign.”
He was disappointed.
Ferrari wants communities to feel empowered to “activate child protection laws”. She wants to bring discussion into the open and have Female Genital Mutilation addressed as something akin to all other forms of family violence. She was pleased the Victorian Royal Commission into Family Violence included strong statements against Female Genital Mutilation. Ferrari and a group of medical and legal specialists are working to reframe Female Genital Mutilation as child abuse and want to “educate the mainstream” about how they can help end it. According to research by Melbourne University, the Multicultural Centre for Women’s Health and the Royal Women’s Hospital, progress is being made and Female Genital Mutilation is said to be declining, particularly in urban Australia.
Anti-Female Genital Mutilation advocates face secrecy and taboos. They navigate the conversation respectfully to avoid stigmatising survivors or driving FGM further underground. It still has such a hold there are reports a regional Victorian hospital has been asked to restitch women, as is traditional after they give birth.
Elliott says FGM is “alive and well” and the size of the problem is “likely underestimated, considering paediatricians don’t know who to ask and who to look at”.
Identifying children who have had Female Genital Mutilation early increases their chances of receiving good treatment and preventing later health and psychological issues.
“If they are a young child, you may also be able to intervene and prevent a sibling from having it done.”
Elliott says communities need to know professional groups are on their side.
“We all know FGM is reportable to child protection authorities, but as far as prevention is concerned it’s really the community that has to take a major lead. But they should be open to support from professional groups,” she says. “We all have the best interests of the children at heart; we’ve got to take it from the point of view that we’re all here to have the best outcomes for the kids who are our future.”
As a tireless campaigner and survivor Gbla says, intervening to protect girls from this lifelong harm should concern us all — “and you only get one chance”.
Article and images courtesy Herald Sun News