CHAPTER ONE

INTRODUCTION

Female genital mutilation (FGM) commonly, but incorrectly known as female circumcision (FC),

according to the World Health Organization’s definition encompasses a number of traditional operations that involve cutting away parts of the female external genitalia or other injuries to the female genitals, whether for cultural or any other non-therapeutic reasons 1-6.

Female genital mutilation is practiced in one form or another in twenty-eight nations in the African Continent, in a few countries on the Arab peninsula (parts of Oman, United Arab Emirate and Yemen), among some minority communities in Asia including Malaysia and Indonesia and among immigrants from these areas who have settled in Europe, Australia and North  America 7-10.

There is evidence that this harmful traditional practice (HTP) existed before Christianity, Islam or Judaism began.  It is as old as the pyramids of ancient Egypt 11, 12.

There are four types of FGM operations as defined by WHO based on the extent of amputation of the tissues 13-16.  These are type I (Sunna) – excision of the clitoral hood (prepuce) with or without partial or total clitoral excision, type II – total clitoral excision with partial or total excision of the labia minora, type III – (infibulation, Pharaonic): partial or total excision of the external genital (clitoris, labia minora and labia majora) and stitching and /or narrowing of the vaginal opening, type IV – (unclassified):  all other operations on the female genitalia including introcision (e.g. Gishiri cuts), piercing or incising the clitoris and/or cutting of the vagina, introduction of corrosive substances and herbs into the vagina with the aim of tightening it.  Types I and II belong to a broad group called clitoridectomy (reduction operation) and type III to infibulation (covering operation).  The relative distribution of clitoridectomies and infibulation is not well documented.  A crude estimate of eighty to eighty-five percent clitoridectomies and fifteen to twenty percent infibulation or a ratio of 4:1 is made based on review of both statistical and non-statistical data 2,5,7,14-21.

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