Africa: The Spectrum of FGM is NOT homogenous

“Many who before regarded legislation on the subject as chimerical, will now fancy that it is only dangerous, or perhaps not more than difficult. And so in time it will come to be looked on as among the things possible, then among the things probable;–and so at last it will be ranged in the list of those few measures which the country requires as being absolutely needed. That is the way in which public opinion is made.” Anthony Trollope, Phineas Finn

Screaming cakes losing the FGM message

At the beginning of the last week, we ran the gauntlet of a travesty masquerading as art; it was art that was tasteless, ignorant, stupid and worthy of excoriation.

Indeed, we need to bring to light the horrors of Female Genital Mutilation (FGM) or Female Circumcision but there is no excuse to treat this matter with levity and caricature if you have any inkling or knowledge of what it entails, who is affected, how entrenched it is and the obstacles in culture, traditions, norms and values that need to be overcome to consign these acts to oblivion.

Such was the display of utterly, utterly bad art when on a cake made almost to the form of Sarah Baartman [Wikipedia] who in the early 19^th Century was the unfortunate freak show in Europe.

The cake was cut into in Sweden by people who should know better of the suffering of women less fortunate than themselves to their entertainment and the artist with face painted like the cross between a golliwog [Wikipedia] and a piccaninny squealing and crying at each cut in the supposedly virginal area of the cake representing the act of circumcision.

It plumbed the depths of distaste and disgust but more importantly, it drew no attention to FGM or the plight of women who suffer from the debilitating effects of FGM, rather it became an odious platform for the artist, galvanised the global rebuke of the Swedish Culture Minister with a petition online asking for her to apologise for her cretinism to culminate in her resignation.

Mind Of Malaka does this matter the greatest justice with her blog titled Of Cakes and Clitorises.

FGM is NOT a Single Story

Now, I have been engaged in a rather robust discussion on Twitter on the matter of FGM where I have a rather pragmatic approach to the subject.

Having taken a stance on the event of the Swedish cake one should be careful not to be railroaded by what is turning out to be a single narrative of FGM thereby conflating the desired end of FGM with every societal, traditional, religious, economic and social strand as if the practitioners are a homogeneous entity – they are not.

Looking at the prevalence of FGM [Wikipedia] across Africa [Graphic from Wikipedia], the practice cuts across 30 countries from West Africa, through Central to East Africa and veering up to the North of Africa where in Egypt it affects 97% of females but you then wonder why the countries to the West of Egypt that have affinity with its peoples like Libya, Tunisia, Algeria and Morocco do not practice FGM.

However, this practice appears to date back to the Pharaonic times, in essence there is a mountain of entrenched traditions and customs behind this activity that might prove immovable even to those with the very best intentions.

Beyond this, each country and within these countries we have communities that implement any of the 4 types of FGM [Wikipedia] cutting with Ethiopia, Gambia and Guinea implementing the most intrusive Type IV mutilation that could affect 73%, 60-90% and 99% of females in those countries respectively.

Whilst Gambia and Guinea are close neighbours in West Africa, Ethiopia is as remote as you can get from West Africa as you wonder about the correlations between these countries.

Tough work ahead

Much as we would that FGM is outlawed, banned, proscribed, abrogated or even criminalised, we are nowhere near seeing that desire in reality, the practice is rife, the practitioners cover a broad spectrum of people from the enlightened to the oblivious and resistance to being sacrificed on the altars of traditions and customs is at best patchy and within relatively minor tribes.

Outlawing FGM in Africa requires political will and concerted efforts at education to persuade the core practitioners of alternatives if possible or ameliorating measures need to be implemented to monitor and regulate the practice.

Applying the political theory of the Overton Window [Wikipedia] to FGM, there are quite a number to whom the prospect of outlawing FGM is unthinkable whilst the cake eaters of Sweden and certain activists on this matter are on the other side of the spectrum where the idea is popular and they are ready to make it policy.

As for so many new ideas because the concept of the eradication of FGM is relatively new by reason of its extant prevalence, the unthinkable has to become radical, then acceptable before it is regarded as sensible from which point it might become popular and consequently it might become policy.

Developing approaches to eradication or regulation

The age-old value systems that aimed to deprive females of sexual expression for the fear that overarching patriarchy might lose complete control of their womenfolk needs to be visited with temperance because the diehards might well prefer to die out than to see needed change threaten their station.

There is no easy solution to this matter and it continues to this present day, girls sacrificed to long held belief systems many put at untenable risk to life, health and welfare – each of these need addressing as much as the aggressive push to make FGM history.

There are proactive and reactive approaches to consider much as some might deign to bludgeon and others might be indifferent. These customs being part of the societal framework of the affected communities has both men and women involved in the propagation of the acts as their norms and no greater purpose is served if any side is castigated as if to blackmail them into submission to the intended goal of the eradication of FGM.

Proactive alternative

On the proactive side, the Guardian newspaper Fighting Back [The Guardian UK] section filmed a documentary about changing attitudes to FGM amongst the Pokot people [Wikipedia] of Kenya where parents, daughters and activists worked towards adopting alternative womanhood initiation rites.

The main thrust of this exercise had to address a number of underlying issues –

• The reassessment of the value of females in those communities.
• The need for the education of females with the promise that they can be of greater significance to their communities than the immediate value of a dowry mostly comprised of cows and beer
• Addressing the apparent sense of loss of a girl is not circumcised and married off
• Addressing the communal stigmatisation that accompanies girls who have refused to be initiated through FGM
• Persuading the elders, men and the community to accommodate new thinking that makes FGM insignificant and unnecessary as a precursor to marriage
• Removing FGM from the process of initiation into womanhood.

One striking thing that came out of the documentary was the recognition that girls who have decided not to follow tradition might harm themselves though it was also encouraging that honour killings prevalent in other societies where the price placed on female chastity is astronomically high did not present itself in the Pokot narrative.

Reactive for safety

On the reactive side, this came as a result of a botched FGM activity [AkinBlog.NL] in Nigeria in 2012 that led to the loss of life by exsanguination – the poor girl bled to death in hospital, the perpetrators being her grandmother and other womenfolk relations having run out of options after crudely mutilating the girl.

It goes without saying that FGM entails radical intrusive surgery outside of professional supervision with crude implements in possibly non-sterile conditions.

What is interesting is the news [The Guardian UK] that as many as 100,000 women in Britain have undergone the FGM procedure. Much as it is illegal in the UK, ethnic minorities who one would expect are enlightened, emancipated, educated and well aware of the complications that do result from FGM procedures are adhering to the practice and are not persuaded of the need to change.

The news story highlights a more interesting development. There is a part of these ethnic minority communities that are concerned about surgical procedures carried out by the unschooled that they have procured the services of medical practitioners to perform the FGM procedure.

In my blog written in February, the death of the girl was preventable if the FGM procedure was not carried out and where I ran the gauntlet of serious opposition and the amazingly implacable was when I suggested that as long as FGM continues to exist in whatever community until it is eradicated, the girls made to suffer such procedures must have at the minimum a safe environment under medical supervision where the procedure is carried out.

Bridging the contrary and the compromise

In my view, this is not to find a workaround that will give FGM a new lease of life halting the drive to have it eradicated but it is to bring the activity under regulation, supervision and safe environments to deal with the immediate complications of administering FGM.

This is by no means comfortable, but the practitioners who have not been persuaded of the need to stop FGM will procure the services wherever they can – it is only sensible and it will be utterly curmudgeonly to refuse girls safe environments for FGM when the battle and the war to abolish FGM is far from won.

I extended that thinking yesterday with the suggestion that FGM education be aggregated into primary healthcare delivery systems and having brought FGM under medical supervision, it offers the opportunity to address this matter as elective surgery with outcomes and consequences all of which must be preceded with levels of counselling, consultation, possible success factors and the repercussions for maternal welfare which can be debilitating on quality of life for the person, her offspring and her community.

In effect, if we are cajoled into adopting a single story on FGM so as to treat it as a homogenous procedure practiced by a non-diverse people of Africa with apparently similar traditions and customs such that activism simply presents an unyielding single solution without working out different compromises for the varied communities that will help those immediately affected, we would be no further than what we saw in Sweden and we might well go up there and eat some cake.

Editorial: Taking Medicine and Talking Miracles

It is an outrage!

There are very few occasions that I am so utterly incensed about some situation and those are usually with reference to child sex abuse, injustice to women, homophobia and religious abuse.

To varying degrees, I could either submit a whole range of opinions on Twitter or in the heat of the moment craft a blog on the matter.

This morning I overheard on SkyNews that some churches had been advising people with apparently incurable and sometimes terminal illnesses especially those infected with HIV to come off their pills because they had been healed.

I believe in miracles

In the interest of full disclosure, I was brought up a High-Church Anglican but converted to Evangelical Pentecostalism almost 3 decades ago. Within this setting we have a whole range of belief systems that allow for supernatural intervention in natural circumstances in matters of prayer, confidence and miracles.

However, I subscribe to that leaning that engages the intellect fully, demands deep religious scholarship and mixes all the vicissitudes of faith with an abundance of reason.

I am wont to using a very basic analogy on the matter of the interaction of medicine and miracles. If you need A wheelchair and after prayer you cannot verifiably discard of THE wheelchair, you still need THAT wheelchair. In essence, you cannot pretend you can walk if you cannot walk.

When it comes to the miraculous healing by reason of faith and all the ceremony that could include the laying on of hands and other obscure activities beyond the understanding of outsiders, some things are self-evident.

The use of medical opinions

Before the person seeks healing, that person would probably have obtained a medical opinion, will most likely have a confirmed diagnosis and usually have begun a treatment regime.

The desire for healing is not an alien thing to human-beings; people need succour, respite, palliation and possibly cures for their illnesses – some of these can be achieved through medicine over a period of time, if medical science offers that prospect or the good grace of a miracle may offer either accelerated improvements in welfare or a sudden change for the better.

The most important thing to know is that a medical opinion remains the certified opinion until a new medical opinion is sought signifying a change for either the better or the worse accompanied with the particular instructions of the medical expert, the condition is technical still the condition before the "miracle".

Medical science must validate miracles

The faith healer, no matter how sensational, amazing, wondrous or even magical the performance that suggests a person has been healed is NOT a medical expert and as such because the same cannot offer certified confirmation of changes to the physiology and state of health of the person supposed healed – the faith healer MUST NEVER assume the role of medical expert and offer medical advice like stopping the usage of medication.

The faith healer can trust that a person is healed, the person may feel in themselves some change either real or imagined but this all must be verified (to fulfil all righteousness) inconvertibly by the medical profession even with the option of a second and third opinion for the certainty and assuredness of the supposed miraculous healing work.

Unconscionable religious irresponsibility

In terms of the news story - Church Tells HIV Patients To Stop Treatment [1], the church after having engaged in their esoteric activities assumed the role of a medical expert service advising those infected with HIV that they had been healed and urging them to stop using their medication.

The story suggests that six such persons who presumably had received healing had needlessly in my view died because the church in a callous, irresponsible, outrageous and reprehensible egregious extension of influence overstepped its remit as an unregulated religious organisation to become an illegal laboratory for guinea-pigs of snake-oil miracle healings.

The law must act

The church failed woefully in its duty of care to its flock and the health of those concerned to ensure that those who they considered healed should first sign-off with medical advice that allows for such people to then come off their medication.

In an ideal world, such an organisation should be proscribed forthwith and the cop-out that they do not heal but God heals cannot hold water if they as intermediaries between God and man portend to speak in God’s name when projecting themselves as a faith healing organisation and then shirk from responsibility when faced with scrutiny for practices that are at best fraudulent and plain deceptive or murderous at worst by reason of the fact that people had placed their lives in the trust of leaders of those churches.

Miracle happen, medicine works

Now, there are records of people who have obtained amazing miracles in this modern age but they all have medical proof of the changes and the medical advice that allows them to discontinue medication because the need for such had been miraculously removed.

On the matter of medicine and miracles, medicine is NOT evil, it is NOT witchcraft and it serves a purpose in the management of illness. Many people of faith have combined their beliefs and medicine to have accelerated results from the use of medical science.

There are amazing advances in medical science that allow for people with HIV to live productive lives with the virus in the blood diminished to undetectable levels, there is no particular reason not to use medical science and religious beliefs in the finding solutions to illness.

Bunkum!

Reading the detail of the news story, the said pastor suggested persistence of diarrhoea and vomiting show the virus is leaving the body – Bunkum! That is probably evidence that the condition of the person is rapidly deteriorating and such a one is in need of immediate medical attention.

I will to God there was a law of the land to bring those people to book and punish them severely for being quacks, charlatans and dishonestly assuming roles of a qualified medical practice.

These people give Christianity a bad name, pervert the gospel for the spectacular and they are sepulchres for the macabre masquerading as churches – their cultist activities must for all that is good, safe and tolerable in modern society be shutdown with immediate effect.

Sources

[1] HIV Deaths: Church Tells Patients To Give Up HIV Drugs After Claiming They Were 'Healed' | UK News | Sky News

Healing on a jet plane

Running for president

This is beginning to look like some sort of amusement, a comedy mating with a farce to produce the utterly laughable.

Only last week, the obituary was written of the rather sprightly and seriously healthy presidential candidate of the PDP when he was carted off (flown) to Germany for a checkup related to "breathlessness", which he fully recovered from, he would shortly be back on the campaign trail.

Now, it seems the Vice President was over-doing his daily workout on his treadmill and has in the process acquired a torn tendon - Go figure! Those things have emergency STOP controls. He was then flown out to the UK to his "local" hospital on the presidential jet - was that the magnanimity of Jekyll Obasanjo or Hyde Obasanjo at play? - For surgery. He was literally running for president, one chuckles.

My frustration at the fact that there are no health services capable of handling breathlessness or surgery in Nigeria is really disheartening.

Another opportunity for excellence

The Vice President for instance has established a seemingly reputable university in his home state of Yola which from all appearances would be a centre of excellence. - [Late edition - I stand corrected by Chippla, the home state of the Vice President is Adamawa, whatever happened to the good old North Eastern State? Thanks Chippla]

One wonders why one or two teaching hospitals cannot be selected to be groomed as centres of medical excellence where resources are not spared in bringing the best medical brains, equipment and means to serve as the incubators for raising health and healthcare expertise in Nigeria.

The people who have then built these institutions can from there become ambassadors or evangelists of administrative prowess and development for other hospitals such that we do not have to run off to Europe for anything as mundane as a sneeze.

One can only wish these men well, but if in the 47^th year of our independence we cannot fulfil basic health needs beyond primary health care and international NGO-sponsored immunisation programmes; Nigerians now need to demand of their leaders better stewardship of health along with other infrastructure needs as electricity, transport and communications.

For anyone who aims to lead Nigeria, these should be no-brainers, Obasanjo failed to see the sense of duty to handle these issues, maybe of the crop of the crippled (Abubakar), breathless (Yar'Adua), smart-arse (Utomi) or non-charismatic (Buhari) choices we have to make, a surprise might arise before we suffer the fate of Goodluck as president - and that would a fate equal to Armageddon.