Slowly, Africa rethinks a tradition

Villagers here are confused. "We are waiting to figure this out," admits Momina Hassan, a traditional circumciser who has spent her life performing ritual cuttings of the community's young girls. "We were very sure of some things that now confound us."

In Doho and surrounding villages, where Ms. Hassan lives and works, no one imagined there was any alternative to female genital mutilation (FGM), a millenniums-old practice in some 28 African and several Middle Eastern and Asian nations. The practice, they explain, is "tradition." Not the kind they understand, they admit, nor know the true origins of - but one they simply had to follow. Until now.

Three years ago, the nongovernmental organization (NGO) Care International launched a pilot program in this region, as well as in Kenya and Sudan. The aim was to research the best ways of convincing different communities to stop FGM - a practice that affects some 130 million women and girls worldwide.

Care moved slowly, beginning with informal workshops and moving on to training sessions on health issues. "We would sit around the cow hides for days, chatting with the traditional circumcisers and religious leaders about pros and cons of various traditions," says Seid Lemma, one of the local facilitators. "In time, we touched on many taboo things."

"We could not come in and say - 'Wait! No! This is wrong and let's stop,'" says Asmelash Woldemariam, Care's Ethiopia reproductive-health project coordinator. "It does not work that way.... But we could begin a conversation."

Today, the entire district seems to be debating FGM. Several villages have postponed female-circumcision ceremonies to allow leaders to rule on the issue. In others cases, circumcisers are making "symbolic," less-invasive cuts.

Care estimates it has reached some 15,000 people with its Ethiopia project. Next month, the NGO will begin rolling out the programs in the next district.

The success of Care's project here stands in contrast to many earlier, more aggressive interventions on FGM. In the past, propelled by a deep sense that the practice was a flagrant human-rights abuse and a moral wrong, many interventions turned to the legal and criminal systems for help. The United Nations repeatedly called for an end to the practice, and nine African countries declared it illegal and punishable by jail terms.

But these approaches were often ineffective and even counterproductive, pushing the practice underground, charge observers. In Kenya, for example, when FGM was outlawed two years ago, mothers began circumcising daughters upon birth - so as to less easily be detected - putting them at further risk.

"What many of us are realizing is that the only way to make and maintain change is to use a participatory, educational approach," says Mr. Woldemariam. As such, his teams spent time with religious leaders, both Christian and Muslim, trying to trace the origins of the practice in either the Koran or the Bible, where none were found. Facilitators listened as women here admitted the problems with the practice, and prodded them to discuss the implications of all this information. "The last thing we want to do," says Woldemariam, "is condescend."

This participatory approach is increasingly prevalent, says Clare Short, Britain's secretary of state for international development, on a visit to Ethiopia last month. "Our paradigm of development is to ... help a community decide what is best for itself," she told African development specialists. "No more specialists and advisers jetting in from the West - only to set up projects which are totally unsustainable."

When it comes to FGM, there are a growing indications this new approach is working. In Senegal and Guinea, for example, women's groups are helping to create alternative rites of passage that emphasize positive cultural rituals without FGM. In Uganda, education projects by local NGOs have managed to completely stop the practice in some regions.

And in Ethiopia, "uncircumcised weddings" may be catching on. This past summer, Bogaletch Gebre, who directs Ethiopia's Kembatta Women's Center, participated in the first such event in her home district of Kembatta. The bride wore a sign reading: "I am proud to be uncircumcised." The groom wore one saying: "I am proud to be marrying an uncircumcised girl." The guests wore T-shirts supporting the occasion. National TV filmed it.

For Ms. Gebre, who was six years old when she was circumcised, it was the fulfillment of a lifelong dream. "That wedding day was not only about one couple," says Gebre. "It was about our whole world changing.... I have no doubt that this country can and will change."

But change comes slowly. Two years ago, Nasro Ali's mother watched as Doho women held their hands over her 11-year-old daughter's mouth and circumcised her with a rusty knife. Then Ali's legs were tied together and she was carried off, whimpering and faint, to lie, bound, for three weeks, until the blood coagulated. Milk was poured over her to "facilitate adhesion." She was now ready for marriage.

The practice, by any account, brings untold suffering: women have trouble urinating, get infections during menstruation, experience no sexual pleasure, and need to be cut open - and sewed together afterward- on their wedding nights and when they bear children. Maternal and childbirth mortality rates here, as well as infertility rates, are among the highest in the world.

Ali's face muscles contract when asked about her circumcision. "I cried so very much," she says. "I would not want my own daughter to go through this." She looks at the girls and women sitting outside. "But that is not possible," she adds, slowly. "Because of my grandmother. Because of my mother. Because of tradition. I would have her cut."

"I can't say for sure anymore," admits Hassan, the traditional circumciser, musing that maybe her own great-granddaughter will only be symbolically cut, or not at all. The women giggle nervously. And Ali bends her head and pulls a colorful scarf around her sunken young face, hiding a smile.