By H'Rina DeTroy
Sudan has tried to eradicate female genital mutilation since 1946 to little avail. But now women's health groups have taken the crusade in their hands--or rather, their own painted hands--in an effort to subvert the practice.
NGOs are training midwives and henna artists to cooperate using a secret code communicated through henna tattoos. Called the henna technique, a special design dyed temporarily on the skin can indicate to a midwife that a mother wants to avoid genital mutilation on her daughter. The tattoos serve as a bridge to discuss what is traditionally taboo. In turn, a midwife can stage a fake circumcision.
"It's underground," said Mawahib Mohamed of the Sudan Council of Volunteer Agencies (SCOVA). "It's totally something that women would invent." She said that midwives from the eastern and mountainous Nuer region invented the technique.
Mohamed said that SCOVA supports organizations dedicated to social and health-centered initiatives, like educating midwives about hygiene, immunizations and the risks of FGM. In Sudan, midwives help deliver babies and circumcise the girls after they reach the age of 5.
Normally, NGOs train midwives on how to counsel mothers about the dangers of FGM. Now they are taking bolder steps, showing midwives how to make a bogus ceremony, without any cutting.
But training midwives wasn't enough. Organizations also started teaching henna artists how to talk to clients about FGM. Unlike a midwife, who is present only during birth and circumcision, the interaction with a local henna artist is frequent because henna is applied on the hands and feet for occasions like engagements, baby showers and weddings. Married women always wear a basic design.
If a mother confides that she's afraid or worried about circumcising her daughter, a henna painter can refer the mother to a list of anti-FGM midwives. If the mother feels shy about broaching the subject, she can rely on a henna tattoo to communicate what she can't in words.
In traditional Sudanese communities, women who speak out against circumcision can be criticized for condoning promiscuity and infidelity.
"It's the only thing that works," said Mohamed, who was born in Sudan and lives in Brooklyn. She wore henna on the tips of her fingers, with a heart just below her thumb.
Midwives and henna artists who undermine it gain popularity through referrals to others in the same dilemma. In this way, eradication is clandestine and in women-only spaces.
Generally, FGM happens to girls aged 5 to 14 because parents believe that it will preserve virginity, communicate status, and even protect them from rape. Circumcisions close to adolescence mark passage into womanhood, but are also performed as early as days or weeks after birth or as late as marriage or pregnancy.
In Sudan, the most common of 4 types of FGM is infibulation, considered the most invasive and harmful. The procedure involves removing the inner labia and clitoris, then sowing the outer labia together and leaving 2 openings for urination and menstruation. The skin fuses and intercourse or childbirth can cause breakage and subsequent re-sowing. Girls have died from loss of blood during the procedure, or from infections if the instruments weren't properly sanitized. For many, it's a life of chronic infections and pain.
The 2006 Sudan Household Survey, the most extensive population measurements to date, reflects circumcision in 75 to 80 percent of females in the northern parts of the country surrounding the capitol, Khartoum. In poorer regions, like Darfur, the survey shows that 40 to 60 percent are afflicted. The index illustrating the highest level of education and wealth translates into a higher prevalence of FGM, but also represents the group with the lowest intent to circumcise their daughters.
The procedure is not limited to a specific religion, but it is prevalent in Muslim communities in Sudan. In Kenya, FGM is common among Christians. Neither the Qu'ran nor the Bible endorses the practice.
Population surveys across the continent show three countries with a higher prevalence of FGM in Mali, Egypt and Guinea. Uganda recently launch a campaign to ban FGM.
Executive Director Taina Bien-Aime of Equality Now, a New York based group that works on FGM issues across Africa, said she had not learned of the henna technique-- but it seemed likely.
She commended any local effort to abandon the practice. She said large organizations like UNICEF have not been as effective in the past because they used one approach to fight female circumcision and applied it across Africa. She said a diverse response and customized, local approaches are key to eradication.
"If you ignore the work that's happening locally-- even though they don't produce glossy brochures, we will be trying to fight this for next 30 years," said Bien-Aime.
H'Rina DeTroy is a freelance writer and multimedia journalist studying international reporting at the City University of New York Graduate School of Journalism.