Female Genital Mutilation: Discussion with World Vision Ireland.

Item No. 3 is female genital mutilation, FGM, eradication in Africa, a discussion with World Vision Ireland. I welcome a former colleague and Member of the Oireachtas, Ms Helen Keogh, chief executive of World Vision Ireland. She is accompanied by the following: Ms Tressan McCambridge, communications and advocacy manager, World Vision Ireland; Ms Eileen Morrow, senior programmes officer, World Vision Ireland; and Ms Juliet Lang, programmes officer, World Vision Ireland. I thank them for attending this meeting.

Since 2007 Irish Aid has provided more than €4.5 million to World Vision Ireland for humanitarian projects in a variety of countries. The funding has covered a number of different projects, including the response to the damage caused by Cyclone Nargis in Burma in 2008 and support for a disaster preparedness project in Sudan in 2007. In 2009, a total of €1.3 million has been allocated for humanitarian projects with World Vision Ireland, including a number in Somalia. Today, World Vision Ireland wishes to focus on a key aspect of its work, female genital mutilation, and the primary focus of today's discussion will be its work in that regard in Somalia.

Ms Zainab Bangura, Minister for Foreign Affairs and International Co-operation of Sierra Leone, appeared before the joint committee in May and FGM is among the many challenges facing Sierra Leone which were discussed that day. Indeed, I thank World Vision Ireland for submitting a briefing paper in advance of that meeting, which helped to inform our discussion. The joint committee is keen to hear from World Vision Ireland its views on how Ireland can best support work aimed at eradicating FGM. The Foreign Minister, Ms Bangura, was of the view that FGM is a consequence of illiteracy and lack of education opportunities for girls and women. The committee will be interested to hear the views of World Vision Ireland on that analysis and on the wider question of eradicating FGM.

Before we commence I advise witnesses that whereas Members of the Houses of the Oireachtas enjoy absolute privilege in respect of utterances made in committee, witnesses do not enjoy absolute privilege. Accordingly, caution should be exercised, particularly with regard to references of a personal nature. There is a vote in the Seanad so hopefully our Senators will be back fairly soon.

I now invite Ms Helen Keogh and her colleagues to address the committee. Following the presentations we will take questions from members.

Ms Helen Keogh

I thank the Chairman and other members of the committee for this opportunity to make a presentation on the eradication of female genital mutilation in Africa. It is an important part of our work, especially as we are a child-focused agency. I will not speak for long because I know the committee wants to get to the main business of questions.

World Vision Ireland is a humanitarian relief, development and advocacy organisation dedicated to working with children, families and communities in helping them to reach their full potential. It seeks to address the root causes of poverty and injustice. We are an autonomous Irish organisation, although we are part of the wider World Vision partnership, which is one of the largest humanitarian and overseas development agencies in the world.

Our focus in World Vision Ireland is mainly on Africa where we have long-term development programmes helping the poorest of the poor. More than 20,000 people in Ireland support our work either through child sponsorship or individual donations. As the Chairman mentioned, we also receive funding from Irish Aid and the EU for which we are very grateful.

Through our development programmes we help up to 500,000 people every year. In East Africa we work in Kenya, Uganda and Tanzania. In West Africa we work in Mauritania and Sierra Leone. We also support a long-term development programme in Swaziland. In addition — and this is where FGM comes in — we support important projects in Somaliland, Somalia, southern Sudan and Senegal.

As the Chairman said, my two colleagues will take the committee through the presentation. Some members of the committee may find what they hear to be a bit uncomfortable. It is an uncomfortable subject for people to listen to, but that discomfort is nothing compared to what the women and girls involved suffer. I will hand over to my colleague, Ms McCambridge, who will do the introductory piece.

Ms Tressan McCambridge

I will start off by giving a brief overview of female genital mutilation or FGM, to put it in some sort of context for the committee. Between 100 million and 140 million girls and women worldwide have undergone some form of FGM. It is mostly carried out between infancy and age 15, without anaesthetic and in extremely poor, unhygienic conditions. All forms of FGM violate human rights and can have serious social, health and psychological effects, about which the committee will hear more from Ms Morrow later.

There are different types of FGM and the way it is practised varies between different ethnic groups in different countries. For example, type 1 is considered the mildest form of FGM and involves partial or total removal of the clitoris. Type 3, which can be considered as the most severe form of FGM, not only involves the removal of part or all of the clitoris, but also the sealing of the vagina, leaving only a very small opening for urine or menstrual blood, typically the size of a matchstick. This type of FGM is called infibulation and is practised in Somalia where 98% of women and girls undergo it.

For the past three years, World Vision has been working in Somaliland, which is in the north west of Somalia, on an FGM eradication project funded by Irish Aid. There are considerable health risks associated with the practice of FGM. For the majority of girls who undergo it, the experience is one of excruciating pain followed by trauma and severe bleeding. Prolonged haemorrhaging can lead to death and there is also a strong risk of contracting HIV or tetanus through the use of unsterilised needles, blades, glass or other cutting instruments that are used.

Long-term health consequences include the following: chronic pain; urinary and menstrual problems; increased risk of infertility; childbirth complications and newborn deaths; an inability to feel sexual pleasure; and frigidity. In many areas where FGM is performed there is limited or no access to health facilities so these women suffer in silence.

It is really hard for us in the West to understand why FGM is practised. We might ask how a mother can do that to her daughter, because women are often the strongest defenders of the practice. It is important to note, however, that they do not do it with the intention of harming their daughters. They practice it with the intention of giving them the best opportunity in life. I will explain that. Although the reasons behind the practice of FGM vary across countries and ethnic groups, massive gender inequality is one underlying factor that we have found, certainly in the areas where World Vision works.

In nearly all of these places FGM is considered a prerequisite for marriage. A man will not marry a woman who has not been cut — in other words, who has not undergone FGM. In rural patriarchal Africa, life is very difficult for a woman who is not married and cannot find a husband. She is highly dependent on a man for her social and economic status. So if a mother decides not to circumcise or cut her daughter, she is condemning her to a life of extreme poverty and social exclusion. That is often the reason underlying the decision.

Other reasons given to justify FGM include the belief that it is necessary to make sure a girl is a virgin before marriage and remains faithful to her husband throughout her marriage. Some people also believe that it is a religious requirement, even though World Vision would maintain it is not. Others say it is part of their tradition and culture, and are proud of that fact. There are also a lot of myths and taboos around FGM, which are strongly believed. For example, in some cultures they believe that if the clitoris is not cut it will suffocate the man during intercourse, or even strangle or suffocate the baby during childbirth. We may laugh at that and dismiss it instantly, but it is believed in the areas where it is practised.

Any kind of FGM is recognised internationally as a gross violation of human rights. This has been contained in several international treaties, such as the Universal Declaration of Human Rights, the Convention on the Rights of the Child, and the Convention Against All Forms of Discrimination Against Women. All African countries, apart from Somalia, have signed these treaties.

Some African countries have also enacted domestic legislation against FGM, but many countries still lack feasible national action plans or dedicated strategies to address it. For example, in Sierra Leone and Somalia where World Vision works, there are no national laws against FGM and no commitment from national governments to introduce policies or educational measures to discourage or prohibit it.

Despite problems with enforcement, laws against FGM are useful in that they give local campaigners more legitimacy in their work. National laws can also help to protect uncircumcised girls against social pressure to undergo FGM. Such laws are useful therefore and they also show that the abandonment of FGM is a national objective and not an initiative of foreigners.

Closer to home, there is currently no specific legislation in Ireland criminalising FGM. Given that women and families from countries with a high prevalence of FGM, such as northern Sudan and Somalia — where the prevalence is over 90% — are coming to Ireland, World Vision would like to see specific legislation enacted here to outlaw FGM, similar to that introduced in the UK, Norway and Sweden. Legislation in these countries not only prohibits FGM but also protects girls from being taken out of the country to undergo FGM abroad. We would like to see such legislation introduced in Ireland. It would also greatly help doctors, midwives and nurses in Irish hospitals to have clear guidelines and procedures on how to deal with women who have undergone FGM when they arrive in hospital.

The abandonment of FGM requires communities to collectively change their behaviour and attitudes, so that a mother can decide not to have her girl cut or circumcised and still be confident that she will not be ostracised by her community and will still be able to get married. That is what we are working towards in our programmes, but this is not easy because FGM is often a much valued tradition and also the social norm. This requires a huge shift in attitudes therefore and needs action at community, national, regional and international level.

I will now hand over to Ms Morrow to share with the committee some of our experiences of working on the issue at community level.

Ms Eileen Morrow

As the committee has just heard from Ms McCambridge, FGM is a deeply ingrained practice which, unfortunately, makes it immensely difficult to eradicate. Going through the literature, I found cases of people trying to eradicate the practice since the 12th century but still today 6,000 women and girls undergo FGM.

What needs to be done to bring about a change in people's attitudes to FGM in the areas where it is practised? It takes more than just letting people know about the harmful effects of FGM on a woman's health or on her human rights. FGM is embedded in the society so for change to come about, there must be a critical mass of support for its abandonment. For a women or mother in Africa, this means she must know she can refuse FGM for herself or her daughter and be sure this will not affect her chances of marriage or her social status in the community.

We are talking about rural patriarchal Africa where generally a women's social status and livelihood are dependant on finding a husband and producing children. For these women, FGM is not just a health issue. The woman's whole future is at stake. For a woman to make the decision to refuse FGM, there must be firm family, social and political support for her decision — in other words, she must have what is commonly referred to as "an enabling environment" for her to make and maintain that decision to abandon FGM.

The good news is that according to social convention theory, the likelihood of a woman, who has not undergone FGM, getting married will gradually increase as the number of non-cut women increases. When a critical mass of women and men abandon the practice, very rapid change will take place with full FGM abandonment. This was seen in China with foot binding. This critical mass does not even need to be a majority and the more genuinely influential the individuals, the fewer needed. The tricky part is reaching this critical mass and World Vision has found it takes time and the co-operation of a wide range of people to achieve it.

What is World Vision doing about FGM? Over the past three years, we have supported an FGM eradication project in Somaliland which is a relatively stable province in northern Somalia. We have also conducted research on FGM in Kenya and supported the Sierra Leone office to kick-start its programming response to FGM in a country where there is still marked distrust and sometimes even hostility towards anyone who speaks out against FGM. All three projects have been made possible with Irish Aid funding and all are in high prevalence areas.

FGM in Somaliland is virtually ubiquitous and the majority of girls undergo the most severe form — type 3 — mostly at around six to eight years of age. Our project there has been running in approximately 30 villages and we are trying to achieve the critical mass needed to bring about change by partnering with a wide range of stakeholders. These include religious leaders, women's groups, school children and teachers, men and boys, FGM practitioners, health workers and traditional birth attendants. We are also working with the government and community leaders as they can be very influential in encouraging abandonment.

It has been an uphill struggle but we are seeing changes. On beginning this project, our staff were struck by the total silence that surrounded FGM. No one spoke about it openly. They also noted that approximately 65% of people had heard of some kind of negative health consequence of FGM. They might have heard something on radio or seen a poster in the local health centre but most just thought this was a woman's burden.

Since the project started, we have reached hundreds of men, women and children with messages on FGM as well as information on child and women's rights. This has been achieved through large-scale community awareness meetings, training for community and religious leaders and business people and talks in schools.

The result is that people are beginning to speak about FGM which is helping to debunk some of the myths and mystery that surrounds the practice. As a result, we are beginning to see shifts in behaviour. People have moved from practising type 3 FGM, which is the most severe form, to type 1, which is less severe. While this is a good start, our aim is to ensure that every form of FGM is eradicated and we are delighted to report that some families have promised to completely abandon FGM and not cut any of their daughters, which is a major change. We are linking these families together to form groups, as it is not easy being the only family to say it will not cut its daughters, and to speak out about FGM. The aim is to bring about a critical mass of families who will come forward to publicly renounce FGM. Step by step we are getting there, although the families are still a little afraid their daughters might be raped or remain unmarried if they step forward too soon. However, the signs are positive and if we can continue to engage with these communities, we expect that within the next few years, we will have achieved the critical mass needed to abandon FGM.

Our project there is in its third and final funding year. In Somaliland and other areas where FGM is widespread, a sustained long-term engagement is needed for success and we would strongly recommend a minimum of a five-year engagement. Therefore, we request that the Government continue to support overseas development aid programmes working on FGM eradication and sustain and build on current funding levels. Already our Somaliland programme and FGM work in Sierra Leone and Kenya will be strongly affected by the funding cuts. Unfortunately, we are unable to continue our project in Kenya this year.

Another interesting development in our Somaliland project is that we found that many men were very shocked to discover what FGM actually involves as they had very little knowledge of the practice. One young man reported that his marriage to his young wife was severely strained because of his wife's type 3 FGM, which is also known as infibulation. Type 3 FGM involves the stitching of the genitalia to create a barrier and this makes intercourse and child birth immensely difficult. After several unsuccessful attempts to consummate their marriage, his wife went to hospital to be deinfibulated or opened up and she bled for 15 days afterwards. He said that even now, they do not enjoy their marriage because of the fright. He said before this experience, he did not know what FGM involved and is glad that the subject is now being talked about because many young couples are in the same position as they are.

Many women are afraid to come forward for medical treatment despite suffering needlessly from problems related to FGM. One example of reproductive problems linked to FGM is fistula. Fistula is a rupture in the birth canal caused by prolonged labour which, unless treated, leaves women permanently incontinent. The smell of leaking urine or faeces is uncontrollable and humiliating and often these women end up being divorced by their husbands and isolated by the community. Obstetric fistula occurs disproportionately among impoverished girls and women, especially those living far from medical services, and is compounded by FGM and early pregnancies. The World Vision project in Somaliland is working to promote awareness of the medical consequences of FGM and to encourage women to seek treatment for these problems. This has encouraged some fistula victims to come forward.

A girl called Nimco's story is a good example of the need for fistula repair. At just 15, she suffered from vaginal fistula due to complications during delivery. While her baby survived, she was deserted by her husband. She was isolated in a small room and ignored by her community. Only her mother visited her to help her and her baby. As one can imagine, it was absolutely devastating for her. When World Vision heard about her case, we brought her for surgery which, fortunately, was successful. Surgery has literally changed her life. She has now been accepted back into her family and is able to attend public meetings and meet her friends. She is now looking to the future and is interested in starting a small business so that she can support herself and her baby. Through this Irish Aid-funded project, World Vision has managed to treat Nimco and 50 other women who have suffered from fistula, which has helped to restore dignity to their lives and enabled them to begin again.

From this experience, World Vision strongly recommends that FGM eradication projects in areas with poor medical services incorporate a component of medical care, including the establishment of referral services for fistula repair. Projects should also include training for traditional birth attendants and medical practitioners on the identification and treatment of complications related to FGM and early pregnancy.

While the majority of women understand there are health risks associated with FGM, often they do not relate their own health problems to having undergone FGM themselves, usually because it has been performed on them when they were children. They may not remember how life was different before or even be aware that they have undergone it.

I have spoken to several women who have undergone type 3 FGM and who were subsequently opened up in preparation for marriage. They told me that since being deinfibulated, urinating had turned from a ten minute ordeal into a one minute experience and said that their periods had dramatically shortened. They literally could not believe the difference.

Sadly, many women still fear being deinfibulated before giving birth and request that they are reinfibulated after giving birth in case they are perceived as loose or easy targets for rape. There are many advantages to being deinfibulated or opened up. It eases child birth, as well as more mundane functions like going to the bathroom. It is brilliant that there are guidelines on FGM for health care professionals working in Ireland stating that reinfibulation should not be performed. However, this is just a guideline. We request that the Government legislates against reinfibulation so that all doctors working in Ireland are left without doubt that this procedure is completely unacceptable.

One of the most interesting aspects of our projects was our work with FGM practitioners, in other words, the women who performed the cutting. These women often earn good money for performing FGM in poverty-stricken communities and hold positions of relative power and influence in the community. In our project in Somaliland we have involved these women in our abandonment work. We provided them with information about the negative consequences of FGM and we initially encouraged them to abandon the practice by providing them with an alternative source of income in the form of goat-keeping.

Ten FGM practitioners officially abandoned FGM in a ceremony, during which they handed over their blades and publicly declared that they would discontinue practising FGM. We employed this initiative as it was a best practice promoted by other NGOs. However, we found that this has not had a significant impact on reducing FGM prevalence in the area. This is because FGM is a demand-driven practice, in that women want their daughters to undergo FGM and are willing to pay high prices for the procedure and travel to where it can take place. We found that families were travelling from as far away as Europe to ensure their daughters underwent FGM in Somalia. Within Somaliland, families who could not avail of FGM in their local community would travel to a neighbouring community to ensure that there daughters would undergo FGM.

By focusing resources on the supply side or, in other words, on reducing the amount of female FGM practitioners in a community, one is not getting to the root of the problem. One female practitioner can easily be replaced by another, especially when large sums of money are offered for the service. We recommend that FGM practitioners are targeted in programmes with knowledge and awareness on FGM and its related issues, however providing them with income generating activities does not appear to be a suitable option for promoting FGM abandonment in a community.

We found that working with community leaders and politicians can have a significant influence on the discontinuation of FGM. By enacting legislation against FGM and developing political support to ensure its implementation, a government can help create the enabling environment needed to encourage families to abandon FGM.

In our projects, we try to bring politicians on board to discuss FGM, but it is often difficult to secure their co-operation. Many fear that speaking out against FGM will cost them votes. In Kenya, a former colleague of mine told me that when she worked on another FGM project with a different agency she brought a local MP to speak against FGM to his Maasai constituency. He first spoke in Swahili and told them all to abandon the practice. He was met with hostility and as a result switched to Maasai and told them all to ignore what he said and that they should continue with this great cultural practice. My poor staff member did not know what was being said because she did not speak Maasai.

It is clear that FGM is a prerequisite to obtaining power or influence in some communities, especially in rural areas. World Vision has been repeatedly trying to engage the Somaliland Government on completing its policy on FGM abandonment and participating in awareness raising, but it has been reluctant to commit.

World Vision sincerely thanks the committee for its recent questioning of the Foreign Affairs Minister from Sierra Leone. This scrutiny clearly shows African governments who have not yet enacted domestic legislation or action plans to eradicate FGM that the world is watching and is calling on them to fulfil their commitments. We ask the Irish Government to continue to raise the issue of FGM in international fora and during political talks with other countries, as it has planned in Ireland's national plan of action on FGM.

The committee must suspend for approximately 15 minutes due to a vote in the Dáil. Ms Morrow saw some of the other members having to leave earlier. That was due to another vote in the Seanad.

Sitting suspended at 4.30 p.m. and resumed at 4.50 p.m.

We shall resume with Deputy O'Hanlon.

I thank Ms Keogh, Ms McCambridge and Ms Morrow for their presentation. Female genital mutilation and the consequences thereof are abhorrent. In addition, the effects it can have, both physical and psychological, on a woman's health are extremely serious. Internationally, female genital mutilation is recognised as a serious violation of human rights and the Universal Declaration of Human Rights, the UN Convention on the Rights of the Child and Convention on the Elimination of All Forms of Discrimination against Women provide some assistance in preventing such violations.

What has been the level of success of programmes put in place during the past ten years in countries where female genital mutilation was part of the culture? Is there any evidence of an increase in female genital mutilation in Ireland, particularly in the context of the number of people coming here from states where it forms part of the culture? I would certainly support the introduction of legislation relating to this matter in Ireland. Have our guests consulted the Irish Medical Council, IMC, regarding the question of reinfibulation? If the IMC makes it illegal for doctors to carry out certain procedures, then there would be no way forward in this regard.

On the question of eradicating female genital mutilation and of the difficulty of imposing the will of the world on countries where it is part of the culture, it would appear that the first step we must take is to try to change that culture. How can our guests encourage increasing numbers of women to rebel against such mutilation? What work has been done to try to reduce the numbers of practitioners who facilitate female genital mutilation? If there were no such practitioners, then there would be no female genital mutilation.

From what our guests stated, I understand that all the countries in Africa with the exception of Somalia have accepted the international legislation. What is the position with regard to the implementation of such legislation in the countries to which I refer? Where countries accept legislation, then the international community is in a better position to press for its implementation.

Our guests indicated that they hope to issue a comprehensive report, with recommendations attached, in September and that this will be based on the deliberations which took place at the workshop they held last October. Perhaps they might forward copies of the report to members of the joint committee. What can the committee or the Government do over and above what is being done at present in respect of this matter?

Deputy O'Hanlon referred to a couple of the matters I intended to raise, namely, the incidence rate in Ireland, our guests' success rate and the barometers their organisation uses. Ms Morrow referred to an incident involving a gentleman from the Maasai tribe. When we visited Tanzania last year, we had a similar experience. We visited projects at which female genital mutilation is dealt with and we raised it, as forcefully as possible, with the highest officials, including the Prime Minister. There was an element of sheer vagueness and ambiguity among the politicians to whom we spoke.

Our guests referred to female genital mutilation being a social norm that is embedded within society and stated that there must be a shift in behaviour. When I approached a gentleman from the Maasai tribe in Tanzania, it was with some resistance that he conversed with me on the subject. He eventually stated that the Maasai women want matters to remain as they are at present. I was surprised by that statement.

I understand how difficult it is to change the type of norms and customs we are discussing. We may provide funding in respect of this issue but there can be no expectation that we will achieve instant success. Funding must be provided on a continual basis and people must understand the problems that arise in the context of encouraging others to change their attitudes and customs. As Deputy O'Hanlon stated, it is sometimes extraordinarily difficult to bring about such change.

What is the position with regard to our guests' application for multi-annual programme funding? I am aware that an assessment has been carried out. How have the major budget cuts that have taken place affected the application?

We support the introduction of legislation relating to this matter in Ireland. Will our guests indicate the status of such legislation and the discussions in which they have engaged in respect of it? Deputy O'Hanlon referred to the Irish Medical Council. What is the position regarding the matter to which he referred?

Deputies Deasy and O'Hanlon have already covered some of the points I wished to raise. As Deputy Deasy indicated, we raised this issue at the most senior level, both with senior representatives of the Prime Minister of Tanzania and the chairpersons of the various parliamentary committees in that country. The response was evasive. It was suggested that people's attitude should be changed first and they would then be willing to represent the change. The specific question was put by a number of us as to whether they would spearhead the changes, but there were no takers. We saw practical examples of the cutters — three or four elderly women who were at a ceremony at which they had ceased activity and they were in a small group around them. By my recollection it was one of the poorest groups we met when visiting two countries. They were pathetically poor in the sense of the way the people were dressed, the venue and the resources available to them. I am strongly supportive of additional multi-annual resources being made available.

The Labour Party has published a Bill outlawing female genital mutilation, FGM, in this country. It was published by Deputy Jan O'Sullivan and it is on the Order Paper and is available from Deputy O'Sullivan who is the party spokesperson on health.

I wish to raise a fundamental issue. In a way I wish some of our African visitors were here as my point affects them. I refer to the discourse on rights. This entire issue has arisen again in the human rights discourse. It is usually framed in terms that the Universal Declaration on Human Rights is just that and it should gradually be making its way across all the different systems of the world and be applied. The view from some anthropologists in particular is that this view was established out of western values and western philosophy and has to take account of difference and does not do so. One then finds the idea of culture rather like the ones that were used, these myths and taboos, with derivations based on religion and culture that must be taken into account. I have spent decades at this concept of culture defence and I do not accept it. Where one has to be very careful is that the integrity of the body as a right has to come out of African experience or Asian experience itself. Moving towards the vindication of the body out of the universal declaration in a western formulation is already being attacked.

The situation has become much worse. A book just published in the past two months by a very distinguished American anthropologist, changes the argument again. The suggestion is that those who have argued radically for the extension of protections on the basis of rights that are derived from the Universal Declaration on Human Rights, neglect Articles 3 and 5, articles on violence against women. What is set up against this now is the notion of communal rights and family rights. I am declaring this argument but I reject it. It is a very important part of the discourse.

If for example a mother decides she does not want her daughter to have to go through FGM, it is pointed out to her that not just that particular family unit but the extended family will suffer ostracisation, lack of access within the village community such as participation in power and so forth. Is the vindication of the young child's rights, which is what we are talking about, at the cost of the communal or family rights? This is the new argument that is being advanced by very many scholars who really should know better. It is coming out of that part of the previous argument. The way the culture was most abused in the human rights discourse was to say that everything was relative, that one was only fumbling one's way towards a kind of a universal declaration and that really a very small number of countries participated in drawing up the universal declaration to which western scholars make reference.

As I look at the literature in 2009, I see a new kind of scholarship that is sweeping much of the ground away with regard to the rights discourse. It is not necessarily all progressive. On the question of finding the way out of this, in a way one is on much better ground with regard to the World Health Organisation, to which reference was made in the presentation. This organisation is more solidly grounded in some respects, in so far as countries find it very difficult to breach WHO guidelines overtly or refute its evidence. On the issues of control over the body and how the body is viewed, sexuality, reproduction and the functions and purposes of marriage, we have to try and find within the different communities — I have been in Somalia, Ethiopia and other countries — the grounds for a discourse in which the body in a personal sense is valued and protected and is not reduced to an objective status which is the case in the myths and taboos and the notion of it as a means of passing on property and so forth. Western countries are not immune from such thinking so I am not making an anti-African statement. These are just facts. The reason I say this is because the area I probably know best is the human rights discourse. I am simply saying it has not been all one way. In fact, there has been quite a regression in the discourse. Making it plain, the argument is that if the family is ostracised it suffers economically and so forth. The next twist on that argument is that it is westerners who want to protect the integrity of the child's body at the cost of the family's economic welfare and that it is westerners who are imposing this external idea of the right to bodily integrity at the cost of the community. That is only one step away from saying this is all coming out of a colonising model. The lesson is that the development area cannot introduce human rights into the development discourse having sourced it and dragged it from the western conception. It has in fact defined the human rights justification on the ground. The issue I described — I apologise for being abstract about it — is being currently debated in places like the American Anthropological Association. I worry that people are relying on the wrong arguments sometimes to carry the emancipation and liberation that is involved. I support the work of the delegation.

I thank the witnesses for their presentations. It is rather harrowing to know there is so much female genital mutilation being carried out. It is estimated that in Somalia, 98% of the female population undergo FGM. I wonder why it is not done in a cleaner and healthier environment such as in a hospital with all the medical equipment available and not in a way where the majority of the girls are going to suffer excruciating pain and with the chance there may be prolonged haemorrhaging or infections such as tetanus and HIV-AIDS. Unsterilised shared knives and razor blades are used. If 98% of the female population have female genital mutilation performed on them, at least if it is going to be done, why is it not done in a clean medically safe way?

In order to try to get rid of the traditional cultural bogeys there should be plain diagrams showing exactly what is done, the effect it has and what happens to the libido and the sexual enjoyment. We need to let men know up-front as well as everybody else that there is a better way. While people want and are prepared to go through FGM, why is it not done in a sterilised hospital-type environment so that people do not need to suffer to excess?

Ms Helen Keogh

I thank members for their interesting questions. I take on board the remarks Deputy Higgins has made on human rights. It is a matter of which we are aware, but often in our day-to-day work we do not stand back to really appreciate the changes that are occurring regarding the rights element. We are very respectful of the environments in which we work. It is about education and partnership with people, particularly women, in the field where we can drive that. We will deal with the questions in the order in which they were asked. I will ask Ms Morrow to deal with the more technical aspects. Ms McCambridge will also come in and I will address some of the more general questions.

Ms Eileen Morrow

I thank the members for their very interesting questions. As Ms Keogh said, we work very respectfully with the local communities. Our focus is on empowerment. FGM is caused by gender inequality as much as anything else. Why is it still so prevalent in Maasai communities and why are they so resistant to stopping it? In these communities women are from a very tender age socialised to be very respectful of men. They have low levels of literacy and education. Much of their day-to-day lives involve looking after animals and fetching water. There is no exposure to information. There is no radio or television. They live very much within their community and what their community says is law. The culture is what forms their comfort and security blanket. When somebody comes from outside and suggests that what they are doing is wrong, it is an automatic challenge. This is not the way we approach it. We approach it in a very respectful way.

Normally we would have already been engaging with the community on another issue like their water or food needs, which is very relevant to them. Then we begin to talk to them about health, education and rights. We frame it in a way that human rights are meaningful to them in their context. We take these international treaties and work through how to apply them. We ask questions such as what the right to bodily integrity means at their level. We help them understand that.

As women get to understand more they link their health problems with, for example, childbirth. Many of them really struggle to go through childbirth because they have been through type 2 FGM. When they go to the health centres and see other women who have not undergone FGM have an easy birth, they begin to link it and begin to understand that all the problems they are experiencing are linked to FGM. Gradually this has an impact and they begin to discuss it among themselves and the silence is broken. They really understand what is happening to them and they decide that they do not need to do that anymore. They will then collectively abandon it. This process takes time. In Somalia we are just at the point where we have broken the silence and people are talking about it. People are beginning to relate what is happening within their lives to the health messages and human rights messages. They understand that they have low numbers of girls in school because of FGM. This is becoming relevant to them. After three years we have already probably got approximately 20% abandonment. We are aiming for total abandonment in Somalia.

Regarding prevalence in Ireland, of approximately 10,000 women living here, an estimated 2,500 have undergone FGM. It is their daughters who will be vulnerable to FGM. I have not heard of any cases in Ireland so far. Usually families bring their children to third countries like Somalia or Mali to undergo FGM. While we have not heard of this so far, Ireland is a changing nation and it is possible that this will happen in the future. From being in Somaliland and having talked to the practitioners I know their most lucrative season is in the summer. Girls from Norway, Sweden and Denmark are going to Somaliland to undergo FGM. It is more than possible that this could be happening in Ireland also.

Ms Morrow has stated that 2,500 immigrants have undergone FGM.

Ms Eileen Morrow

That is the estimate.

Have no cases involving children been reported?

Ms Eileen Morrow

I have not seen that mentioned in the guidelines. There is a document on guidelines for health practitioners and that is where I am getting that information. I have not seen any cases reported.

While I am glad to hear that, why does Ms Morrow believe that is so?

Ms Eileen Morrow

It is quite possible that it is either happening to girls when they are very young and do not know or that they have not had the chance to travel abroad yet. I doubt it is because it has been happening in Ireland. Usually it would require a practitioner — a doctor — who is prepared to do it in Ireland. I do not believe that is so. It is either because it is happening to girls when they are still below the age at which they can talk about it or else they have not returned to Somalia or Nigeria to have it performed.

We were asked about medicalisation and why these families are not going to hospital. In Somalia the medical facilities are absolutely appalling. There are no health centres available locally. Even if a woman is giving birth there are issues of trying to get her to a medical practitioner. If she is having any problems in labour her chances of being seen are very slim. We have noticed a trend of the traditional FGM practitioners using out-of-date anaesthesia and equipment for which they have not been trained. It is still often a botched job.

In terms of medicalising the procedure and getting women to a hospital, in a sense it is very worrying for us. We are noticing a trend whereby women are moving from doing it in their homes with rough tools to going to the hospital. This concerns us also because going to a doctor actually lends authority to the practice. If the medical institutions are doing it, it gives the appearance it is sanctioned by that country's ministry of health. We would be concerned about the trend even though it saves lives and reduces the pain. In a sense it reinforces the practice because the medical institutions are practising it. We would like to discourage that. That would be our call.

We are very thankful that the committee questioned the Minister for Foreign Affairs of Sierra Leone on this issue. It is met with resistance by politicians. Even politicians are practising it themselves. I encourage the committee to continue to question them about it and encourage them to develop domestic legislation and, particularly, national action plans which are uncontroversial so that they can educate their population on it. Even if they are not prepared to speak out publicly about it, at least they should ensure that national plans are in place so that, for example, the school curriculum includes information on female genital mutilation. Doctors also need to learn about it. Many doctors have never received training on FGM. They do not understand the major health risks it incurs and do not know exactly how to treat it. These are really important steps. I urge the committee to continue to push African governments to enact legislation and have national action plans that set up education and health programmes on FGM.

I would like to comment on the interesting point about the difference between the rights-based arguments usually made by women of different ages. Young females often argue that they have a right not to undergo FGM. Their mothers and friends of middle age often argue that they are entitled to their economic, social and cultural rights, just as their daughters are entitled to their personal rights. That is an illustration of why this matter is not being resolved.

I have debated this matter with African politicians. I wish they were here to discuss this matter again. The point I usually make is that, ultimately, we need to decide whether the state has the final say when it comes to bodily integrity. Does one's personal right to bodily integrity take precedence over the other rights I have mentioned? Having listened to what Ms Morrow has said, it strikes me that it would be enormously helpful if assumptions in relation to marriage were to change. The evidence from Somalia is that, in many cases, marriage is the gateway to the status of the extended family, both within the clan and between clans. There is a notion that this practice is essential for marriage, or for one's notion of marriage. I was interested to learn that many women of a particular age support this practice because they are concerned about their passage to a certain status. I suggest that there are alternative means of achieving that status. I suspect we are very far from a point at which these women, as a body, might decide not to allow their daughters to have this experience.

Ms Helen Keogh

I agree. As Ms Morrow said earlier, we are endeavouring to focus on the empowerment of women in our FGM programmes and throughout our development work. Deputy Higgins is right to suggest that the empowerment of women is essential to the success of all our development projects, including that aimed at the eradication of female genital mutilation.

Different projects might be more appropriate to people of different ages.

Ms Helen Keogh

Exactly. When we had the privilege of attending a meeting of the Oireachtas Sub-Committee on Overseas Development, we discussed the importance of education in dealing with HIV-AIDS. That is another example of the need to change attitudes. Deputy Higgins mentioned his experience of trying to change attitudes in Tanzania and other parts of Africa. We know how difficult it is to change attitudes in Ireland. It is much more difficult to change attitudes in a society that does not have access to the privileges we enjoy. It is a very difficult and slow process. It was good of the members of the committee to ask what they can do. It is very useful for the committee to have asked us to contribute to this discussion. It would be useful for the Government to increase its moral power by introducing legislation.

Deputy Deasy asked about our application for funding under the multi-annual programme. It is obvious that we need to issue a cry for help in this regard. World Vision Ireland, ActionAid Ireland and Oxfam Ireland have applied for funding under the programme. The process has been delayed for a year, unfortunately. I am delighted to say that our assessment went extraordinarily well. There also needs to be a field assessment, naturally. I hope that will take place towards the end of this year. We had expected to be within the process at this stage, but that has been a victim of the current economic situation to some extent. We have had to impose cutbacks on some of our projects, obviously. The FGM eradication programme in Kenya is to be cut completely, unfortunately, as a result of our cutbacks. Like all other agencies, the funding we receive from the Government has been reduced by approximately 20%.

Can Ms Keogh give us details of the operation in Kenya? What did it consist of?

Ms Eileen Morrow

We had just started the operation. We had conducted research into the specific nature and context of FGM in Kenya. We had initiated dialogue with some of the stakeholders in the community there. We had planned to undertake a massive programme of awareness-raising. FGM in Kenya, which tends to involve girls between the ages of 14 and 16, takes place during a ceremony as a rite of passage. We were hoping to help local communities to modify their rites of passage. We did not intend to alter the extent to which the ceremony is owned by the community. We planned to maintain the economic and cultural benefits of that ceremony. However, we wanted to remove the cut from it. That was the big plan. We hoped to find a way to convince girls that they can be seen as adults without undergoing FGM. Many women in Kenya undergo FGM because they are not seen as fully-fledged women without it. We planned to change that.

I would like to make a final point in this context. I refer to the concept of "churching" as part of the Roman Catholic tradition in the West. The notion that "unclean" status had to be removed from women after conception and childbirth evolved over a period of time. One of the papers I have read raised the possibility of emptying FGM rituals and ceremonies of anything but symbolic value. The suggestion I have heard — that gatherings would continue to take place, but they would be entirely symbolic — is useful. The value of such a system would be that it would remove the needs for covert operations that significantly maximise the risks for the girls involved.

The practice mentioned by the Deputy has long since been discontinued in this country. I appreciate the point the Deputy makes about the way it was turned into——

I am glad it is gone. That is a different issue.

It has been gone since I was a child, which is a long time ago.

Ms Helen Keogh

I thank the Chairman and the members of the committee. We appreciate the opportunity we have been given to discuss this important aspect of our work. As Ms Morrow is based in Nairobi, it was fortuitous that she was available to attend this meeting. I thank the members for organising this discussion during her return to Ireland.

We have all spoken about the need for legislation.

We will come back to that.

It has been mentioned that the UK and other countries have introduced legislation. It has been suggested that as far as we are aware, FGM is not prevalent in Ireland. What has the experience been in other countries? Did the UK and the other countries introduce legislation because the practice was taking place, or was it a preventive measure? If Fianna Fáil, the Labour Party and Fine Gael are in favour of legislation, what is holding it up?

A Bill has been published.

I know, but what is the status of it?

The Irish Medical Council might have a role to play in this regard.

Ms Eileen Morrow

I understand that the Irish Medical Council has issued guidelines on FGM for health practitioners. As far as I am aware, the council has not moved beyond guidelines. I will get in touch with the council to find out more. I do not know of any developments with the legislation mentioned by Deputy Deasy, other than that it has been held up. Nothing is going through at the moment. The UK and Norway, which have large communities from countries in which FGM is practised, introduced legislation after it became apparent that incidents of FGM had taken place in their jurisdictions. They struggled to implement their legislation and faced difficulties when they tried to secure prosecutions. While they have encountered issues, the legislation has definitely given them the legal authority to initiate prosecutions. If we were to follow suit, it would give us a strong moral and legal authority, particularly in our dealings with other Governments, to speak about FGM and encourage other countries to produce national action plans and domestic legislation.

The three countries that were mentioned earlier were the UK, Norway and Sweden. I thank the representatives of World Vision Ireland for making a presentation to the joint committee. World Vision Ireland does vital work which is appreciated and supported by the joint committee. Members are conscious that Somalia is a dangerous country and we commend the organisation on the courage and vision it shows in working there.

Female genital mutilation is an emotive issue and members agree that its existence in developing countries such as Somalia is not a function of cultural difference and tradition but an extreme form of gender based violence. Inequality is at the root of all such systemic violence. I commend the work done by World Vision Ireland and wider work supported by Irish Aid in challenging inequality and human rights issues, the root causes of female genital mutilation.

Following today's discussion, the joint committee will communicate with the Minister for Foreign Affairs requesting that Irish Aid continue to support World Vision's work on female genital mutilation. We will also write to the Minister for Justice, Equality and Law Reform about domestic legislation. I note the Opposition has produced a Bill on this issue, although I understand it has not yet come before the House.

That is correct, although the Bill has been published.

In any event, Government legislation will probably be required and the joint committee will pursue the issue with Government. I look forward to receiving a copy of the recommendations World Vision Ireland plans to publish in September.

The joint committee will request information from the Medical Council on its regulation of medical personnel in Ireland. We will also press governments to put an end to the practice of female genital mutilation every time the opportunity arises. As our guests will have noted, members frequently meet delegations and officials from other countries.

I thank the delegation for spending so much time with the joint committee. Its contribution has helped members gain a clear understanding of the practice of female genital mutilation and the work being done on the issue by World Vision Ireland. As there is no other business, I propose to adjourn the meeting.

The joint committee adjourned at 5.35 p.m. until 3 p.m. on Wednesday, 1 July 2009.