London, England; Zed Books: 1987.
The circumcision of women: a strategy for eradication
Female circumcision is a traditional practice in many parts of Africa that has significant medical consequences. The main arguments in its favor, including cleanliness, aesthetics, improved health and social benefits, are refuted in this monograph. This practice was studied in Sierra Leone, where it affects 90% of females, and is carried out by secret societies. Female initiates are usually in their early teens and must undergo training and participate in elaborate rituals. The health effects vary with the typ of circumcision and the conditions under which it is performed. Immediate consequences include pain, hemorrhage, urinary tract problems, and serious infections. Scar formation leads to late sequelae of dysmenorrhea, dyspareunia, pelvic infections and abscesses, hematocolpos, infertility, difficulty urinating, urinary tract infections and anal incontinence and fissures. Female circumcision is also a cause of later reproductive difficulty due to obstructed labor, resulting in several obstetrical complications. Psychological effects differ among women who have undergone it voluntarily, and those who have been forced to undergo this ritual, with the latter suffering much more psychologically. A pilot study of 135 people in Sierra Leone found that a significant number favor female circumcision and believe that it is essential to their culture. This attitude is related to illiteracy. In a survey of 300 women in Sierra Leone, tradition was the most common reason given for circumcision (85%), followed by social identity and religion. Circumcision was related to Muslim religion and inversely related to educational level. Statistical breakdown by tribe, method, complications, age, and attitude regarding circumcision is provided. A detailed strategy for the eradication of female circumcision is outlined.