More than 60% of Kurdish Iraqi Women Subjected to Female Genital Mutilation

Set on an arid plain southeast of Kirkuk, Hasira looks like a place forsaken by time. Sheep amble past mud-brick houses and the odd sickly palm tree shades children?s games. There is no electricity.

Yet along with 39 other villages in this region that Iraq?s Kurds have named Germian (meaning hot place), Hasira and its people have become noted for presenting the first statistical evidence in Iraq of the existence of female circumcision, or female genital mutilation (FGM), as critics call it.

?We knew Germian was one of the areas most affected by the practice,? says Thomas von der Osten-Sacken, director of a German nongovernmental organization called WADI, which has been based in Iraq for more than a decade.

Of 1,554 women and girls over 10 years old interviewed by WADI?s local medical team, 907, or more than 60 percent, said they had had the operation. The practice is known to exist throughout the Middle East, particularly in northern Saudi Arabia, southern Jordan, and Iraq. There is also circumstantial evidence to suggest it is present in Syria, western Iran, and southern Turkey.

But while this practice was suspected in the region, there was never solid proof that the procedure was so prevalent.

The effects of genital mutilation can lead to death. At the time the mutilation is carried out, pain, shock, haemorrhage and damage to the organs surrounding the clitoris and labia can occur. Afterwards urine may be retained and serious infection develop. Use of the same instrument on several girls without sterilization can cause the spread of HIV.

More commonly, the chronic infections, intermittent bleeding, abscesses and small benign tumours of the nerve which can result from clitoridectomy and excision cause discomfort and extreme pain.

Infibulation can have even more serious long-term effects: chronic urinary tract infections, stones in the bladder and urethra, kidney damage, reproductive tract infections resulting from obstructed menstrual flow, pelvic infections, infertility, excessive scar tissue, keloids (raised, irregularly shaped, progressively enlarging scars) and dermoid cysts.

First sexual intercourse can only take place after gradual and painful dilation of the opening left after mutilation. In some cases, cutting is necessary before intercourse can take place. In one study carried out in Sudan, 15% of women interviewed reported that cutting was necessary before penetration could be achieved. Some new wives are seriously damaged by unskilful cutting carried out by their husbands. A possible additional problem resulting from all types of female genital mutilation is that lasting damage to the genital area can increase the risk of HIV transmission during intercourse.

During childbirth, existing scar tissue on excised women may tear. Infibulated women, whose genitals have been tightly closed, have to be cut to allow the baby to emerge. If no attendant is present to do this, perineal tears or obstructed labour can occur. After giving birth, women are often reinfibulated to make them "tight" for their husbands. The constant cutting and restitching of a women's genitals with each birth can result in tough scar tissue in the genital area. . . .

Genital mutilation can make first intercourse an ordeal for women. It can be extremely painful, and even dangerous, if the woman has to be cut open; for some women, intercourse remains painful. . . .

Despite the lack of scientific evidence, personal accounts of mutilation reveal feelings of anxiety, terror, humiliation and betrayal, all of which would be likely to have long-term negative effects. Some experts suggest that the shock and trauma of the operation may contribute to the behaviour described as "calmer" and "docile", considered positive in societies that practise female genital mutilation.