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Proud to be different
Published in Al-Ahram Weekly on 07 - 03 - 2002

NGOs are preaching deviance in the communities in which they are active. Mariz Tadros finds out why
"For the last three years not one girl has been circumcised in our village," boasted Warda, a young woman from Ezbet Guirgis, a village inhabited by 130 families in the Beni- Sueif governorate. Female circumcision or female genital mutilation (FGM) involves the complete or partial removal of the clitoris and labia minora. Warda was speaking to a gathering of NGO activists that recently took place in Beni-Sueif. The workshop was organised by the Coptic Organisation for Services and Training (COST), a local NGO, in association with the consultative committee on FGM and was funded by the Centre for Development and Population Activities (CEDPA), an international development organisation. Warda was one of the many women who spoke about efforts being made at changing community beliefs and attitudes towards the practice in their respective communities.
FGM is almost universally practised in Egypt. The latest figures in the Demographic Health Survey, published in 2000, confirm the results of the 1995 poll which indicated that 97 per cent of women of reproductive age had been circumcised. The survey was conducted on a nationally representative sample of 15,573 married and divorced women between the ages of 15 and 49. But the survey indicates that there is some ray of hope for next generation's young women. It suggests that there have been positive changes in peoples' attitudes towards the practice. There is some evidence that support for the practice is gradually changing. Just over eight in ten women with daughters (81 per cent) reported in 2000 that they had a daughter who is already circumcised or that they intended to circumcise in the future. This represented a decrease over the proportion of women with daughters who said in 1995 that they had or planned to have a daughter circumcised (87 per cent). Those who supported the continuation of the practice in 2000 dropped in 1995 from 82 per cent to 75 per cent.
FGM became a priority issue on the women's agenda at the 1994 International Conference on Population and Development which took place in Cairo. Since then, there have been concentrated grassroots efforts at experimenting with different approaches to eliminating the practice.
In 1997, the Court of Appeals ruled in favour of a ministerial decree banning the performance of the procedure under all circumstances -- irrespective of who performed the operation, whether inside hospitals or outside of them and whether by doctors or members of the community. The ruling stipulated that FGM violates the Criminal Law and those who perform it could face imprisonment. The decree helped legitimise the work of NGOs in the eyes of their constituency but, like all legislation, it offered little hope of engendering social change. Many NGOs themselves knew that an approach based on threatening to punish midwives and doctors who perform the practice could well backfire. Field workers point out that prosecuting the practitioners of FGM could well lead to antagonising entire communities, especially were the targeted doctor or midwife well-liked. It also raised the possibility that, should people not be convinced that the practice is harmful, scaring them with legal repercussions could potentially drive the phenomenon underground.
Another practical problem is that field workers complain that, even in instances when they did report on midwives and doctors who circumcise girls, no measures were taken against them. People wondered how NGOs can talk about FGM being illegal when doctors openly perform it on a regular basis.
The aim of the workshop at Beni-Sueif was to discuss one approach to fighting FGM in the community -- termed "positive deviance." Dr Shahira Hussein from CEDPA explained that the idea of "positive deviance" was initially applied to a malnutrition project in which children not suffering from malnutrition in villages where malnourishment is the norm were identified in a bid to understand why they are different, and what lessons can be learnt from their experience.
The theory has been applied to FGM by seeking members who have not been circumcised and are against the practice, or those that were circumcised but have taken a stand against it and are consequently considered by their community -- in which the practice is considered normal -- to be deviants in their social values. According to this system, NGOs working in local communities are encouraged to identify "positive deviants," understand why they think or act differently and, in so doing, discover culturally appropriate ways of addressing the issue. The approach was introduced by CEDPA through its work with four Egyptian NGOs: COST in Beni-Sueif; CARITAS; the Centre for Egyptian Women's Legal Assistance (CEWLA); and the Community Development Association in Manshiyet Nasser.
One of the young women with whom COST has been working, Warda, says, "I thought myself different in the village, I thought that there was something wrong with me because I wasn't circumcised." Warda was not circumcised because her sister was so traumatised by the experience that she managed to persuade her mother against circumcising her other daughters. COST discovered others such as Warda and helped them change from feeling inadequate and despised in the community to being confident and proud about not being circumcised. "The turning point is when they feel that they are being listened to, that they are not alone, that there are others like them from the village that are not circumcised, and that we will support them and back them up," said Tasoni Yoanna Salib, a Coptic nun and doctor who has led the COST project. Suggestions are then brought up about what could be done to change social traditions from women who are prepared to speak in the community against the issue. The next step is to provide these women with information on FGM and its implications and, through offering them training, enable them to communicate their message to others. "We tell them to start off with other members of their community and ask them simple questions such as, 'Did you hear about FGM before?' or 'Do you have girls and have they been circumcised?' If people turn out to be against the practice, we encourage them to talk about their personal experiences, ask them what message would be effective in the community, the kind of interventions that could be useful in disseminating this message and who needs it most," she explained.
"We took account of all the girls aged between 8 and 17 and started informing their mothers of the dangers of the practice and that, although not circumcised, we are well- adjusted and normal." said Warda.
Uncircumcised women in the community who dared speak out against the practice were important in dissipating fears and myths about what happens when women are not circumcised, such as that they grow a male organ or develop an insatiable sexual appetite. However, Marie Assaad, coordinator of the FGM committee, suggests that often the best spokespersons are those women who have gone through difficult experiences themselves.
Iman Mohamed, from Beni-Sueif's Gezirit Al-Mosada, talked at the workshop about her daughter bleeding intensely for a long time after she was circumcised. That was what convinced her not to let her other daughter go through with the operation. She resisted pressure from her mother and neighbours and fought back against their warnings that her uncircumcised daughter would develop loose morals.
Fola Shehata, from Minya, also decided not to circumcise her daughters after having a traumatic FGM experience. However, she kept it a secret as she was too embarrassed to tell people about it. After discovering that it was a harmful practice and that she had nothing to be ashamed of she started speaking out. Being a literacy teacher, she visited those of her pupils at home who she knew were approaching the age of circumcision in a bid to talk the family out of circumcising them. There were times, she recounted, when they virtually threw her out.
Hanan Mohamed Ragab, from Maghagha, vowed not to allow her sisters to undergo what she went through at the age of 11, when her circumcision was followed by 15 days of haemorrhaging. "My parents wouldn't take me to the doctor because they did not want to cause problems for the midwife who circumcised me so my mother kept on applying oven-ashes to try and stop the bleeding. My mother was deeply moved by my pain and decided not to circumcise my other sisters. My father objected and so did my uncles but I made sure that four of my other sisters did not get circumcised. In 25 out of 30 cases where I tried to prevent others from being circumcised I succeeded."
Tasoni Yoanna recounts that several approaches were tried and rejected before fixing on the strategy of seeking to identify and empower women who are against the practice in order that they might disseminate the message in their community. For example, the first years of campaigning focused on organising lectures that targeted women: "We would speak to women and they would tell us to speak to the men as they are the decision-makers. We would speak to the men, and they would say that this is a women's' issue and they have nothing to do with it." Then, there were the conventional lectures that they would have to put up with from the priest, sheikh and doctor who would talk about the practice's religious and medical aspects. On its own, that, too, was not a very effective tactic. People would listen, express their commitment not to circumcise and then go ahead and do it anyway.
The FGM committee has arrived at the conclusion that, essentially, people stick with the practice because it is a custom. "After trying out different approaches for the past five years, we have realised that there was a need to concentrate on the socio-cultural understanding of the practice and that this is not a religious or health issue but one to do with our heritage," emphasised Marie Assaad. "Whether you call it 'positive deviance' or a 'socio-cultural approach' or whatever, it is really about the same thing -- namely, about finding a way to reach the women who are victims and letting them talk about their experiences," she added.
However, warned Tasoni Yoanna, it would be pointless for an NGO to go into a community and confrontationally seek to identify "positive deviants." It is only after having worked for a long time in the community on wider development issues, that efforts should be made to break the silence on this issue. Positive deviance is only one of several approaches that can then be applied.
CEDPA, the organisation which introduced the concept to Egyptian NGOs, does caution that "positive deviance" is merely an approach, rather than a solution in itself. There are still questions as to the potential for a strategy that is highly individualistic. There are the obvious limitations, chief of which is that some individuals may have trouble in communicating the message well, to the point of having a reverse effect, as Tasoni Yoanna admits. Also, there is the danger that their efforts would amount to nothing should the community leaders -- such as the mayor, sheikh or priest -- be in favour of the practice.
There is also something somewhat disturbing about an approach that encourages people to talk about themselves as deviants, positive or not. Almost all the young women and girls at the workshop introduced themselves to the audience by saying, "I am a positive deviant" -- in Arabic it is namouzag igabi, a 'positive model' -- and the front cover of CEDPA's pamphlet on the issue has a cartoon of a woman stating, "I am a positive deviant." But, assuming that they are positive, then it is hard to escape the logical conclusion that the others who still practice FGM are seen as being negative, an unnecessarily confrontational stance that is sure to yield few constructive results. This issue was indirectly raised by one of the workshop participants who pointed out that, while being sympathetic to these girls' rejection of the practice, he was disturbed by the tendency in their accounts to represent circumcised women in a negative manner, as if they are all frigid and incomplete women.
For Tasoni Yoanna, real success does not come when girls are spared circumcision but after they have successively got married. This is because there is always a danger lurking that the uncircumcised woman will marry someone who continues to believe in the practice and insist that his wife undergoes the operation prior to or immediately after the marriage. Therefore, COST has also directed its efforts at the current generation of young men in Ezbet Guirgis, in the hope that they will take a stand against the practice. "For the message to be of local relevance, those who are considering not circumcising their daughters want to feel that there are people like them who bucked the trend without paying a heavy social price. When pressed, some fundamental issues were raised, like the possibility of guaranteeing that an uncircumcised girl would get married and escape being stigmatised or even rejected by her community for deviating from the norm," reflects Yoanna.
The current generation of girls at Ezbet Guirgis who have been spared circumcision is 15 years old. "The first time that a man marries an uncircumcised woman and be publicly proud of it, then our task will have been achieved," Yoanna adds. One will have to wait for a few more years before the results start showing.
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