The
Guardian
April 1, 2015
In Thailand’s Muslim south, authorities turn a blind
eye to FGM
Female genital mutilation, banned by the WHO,
seems to be common in the
three Muslim-majority southern provinces, but officials are taking no
action
by Gabrielle Paluch
Eight-week-old
baby Amiyah grimaces when sunlight falls on her face as though she
isn’t used to the idea of having been born yet. On a Saturday
afternoon, in Thailand’s southern Pattani province, her Muslim mother
has brought her to a small clinic so midwife Dah can slice her clitoris
for
sunat. The practice, a
form of female genital mutilation (FGM), has been banned by the World
Health
Organisation.
In majority Buddhist Thailand,
the public health department says FGM does not happen. But in the three
southernmost provinces of Yala, Narathiwat and Pattani, ethnic Malay
Muslims are a majority. Some are locked in an intractable conflict with
the Thai government, which labels them insurgents. Here, midwife Dah
says she has cut almost all female births she has attended.
“Her clitoris is so small,” says Dah, 64, who seems a
little flustered as she swabs the crying baby’s vulva with alcohol with
her gloved hands. Despite her experience, she is having difficulty
finding the clitoris as the baby squirms on the operating table. She
holds a sterile surgical blade, for which she has fashioned a handle
out of tin foil.
After five long minutes, during which the baby cries
relentlessly and the mother tries to comfort her, the incision is
finally made. The midwife mops up a drop of blood with a cotton swab,
recites the name of God, and declares the baby “circumcised”.
“I feel relieved that I have done my duty,” the mother
says.
The conflict in the southern Thailand can make it hard
for women to access healthcare, according to Dr Sudarat Teeraworn, a
public health supervisor for maternal health in neighbouring Yala
province. Sudarat says FGM isn’t on the health ministry’s agenda –
though according to her, almost every Muslim baby girl in the south is
cut.
“There are no laws about it because there are not many
health consequences, and it’s a cultural practice,” she says.
Thai health authorities have taken a pragmatic approach,
apparently turning a blind eye.
FGM as practised in Thailand falls under type IV in the
WHO’s classification, which
involves pricking, piercing, incising, scraping and cauterisation.
Types I and II involve excision of either clitoris or labia or both,
and type III includes a procedure where the vulva is sutured together
after removal of the clitoris and labia. The WHO says the procedure has
no known health benefits, arises from a deep-seated gender-bias, and
amounts to a violation of both children’s and women’s rights.
Just across the border in Malaysia, a study conducted in
2011 showed 93% of Muslim women have been cut, including in Kelantan
state on Thailand’s border, which is culturally and religiously similar
to Pattani. Though the practice dates back centuries for Muslims living
across the Malay peninsula, Malaysia’s highest religious authority did
not
issue a fatwa until
2009
requiring the
cutting of all Muslim women.
Malaysia’s fatwa has put health workers in an awkward
position. As women increasingly give birth in hospitals, mothers
looking for a safe way to cut their female babies are essentially
asking doctors to break WHO guidelines.
To reduce the prevalence of FGM in Malaysia , Saira
Shameem, who works for the UN Population Fund (UNFPA) in Kuala Lumpur,
is working with health authorities to make the practice symbolic, with
a routine alcohol swab performed by obstetricians at birth. “What the
fatwa does not do, is it does not specify what the procedure should
be,” she says, “that allows us an avenue to define the procedure in a
non-invasive, non-harmful manner and shift the practice accordingly.”
In southern Thailand women are also increasingly giving
birth in hospitals. Traditional midwives who pass their trade on from
generation to generation are disappearing, and mothers are increasingly
having their babies cut by doctors.
Many women in southern Thailand don’t even know they’ve
been cut until adulthood, when they read about it. The practice is not
talked about.
Dr Patimoh Umasa is one of the only female doctors in
Yala, where she runs a small clinic on the edge of the city’s Muslim
quarter. She knows the WHO guidelines, and doesn’t believe what she
does directly contravenes them. “If it is done by a doctor and they are
using the right technique, then never mind,” she says. “It’s just a
little. Just an incision, no excision.”
But doctors such as Nawal Nour, director of the Global
Women’s Health Centre at Harvard Medical School, believes a “right
technique” does not exist. “There are girls who suffer short and
long-term consequences, even from type IV,” she says. “The clitoris on
a baby girl is tiny, and in error, cutters can remove it completely.
Also botched jobs can lead to haemorrhage, infection, sepsis and death.”
Back in Pattani, Peung, 33, has gathered her family
together to watch her eight-month-old daughter, Mia, being cut by her
mother-in-law, who is sterilising a pair of nail scissors with alcohol.
Some of Mia’s cousins are playing on the floor in the living room.
Peung’s two older daughters are curious. “What are they
doing? Will it hurt?” they ask. “Sunat, we all must do it,” Peung
responds. “The children are so eager, but it is not good for them to
watch this. It will become a phobia for ever.” She caresses her
youngest infant, about to be cut. “At least she doesn’t know what’s
going on here.”
The baby’s grandmother draws blood from the clitoris
with the curved tip of the nail scissors, a technique she says she
developed herself to be safer. Mia cries loudly.
Peung is pleased her daughter is now “complete”, but she
isn’t sure why. “I don’t know what the benefit is behind it, but I
believe there must be one. I know the prophet said it is desirable for
the husband when women are cut. Actually in Islam we believe that women
have more desire than men, so there must be something to control the
women, give them humility and modesty – and this could be one way to do
it. Maybe in the future the scientists will find out and then we will
know the benefit. All the girls here in the south do it.”
Some names have been changed
