US: Alum Asks Mother to Rethink Dangerous Custom

Nawal Nour '88 treats the repercussions of a practice not often seen here - female circumcision. An obstetrician and gynecologist at the Harvard-affiliated Brigham and Women's Hospital, she helps women who have been circumcised and tries in a culturally sensitive manner to dissuade them from doing the same to their daughters.

Nour lived in the Sudan, Egypt and England before moving to the United States at the age of 14. She knew many women and girls who faced the challenges of female genital cutting. After graduating from Brown with an undergraduate degree in development studies and international relations, she studied at Harvard Medical School. There, Nour did her own research on female genital cutting, since it was not a part of the Harvard curriculum in gynecology.

Nour usually counsels pregnant women, many of whom are African immigrants, struggling with the complications that can result from genital cutting. For women who have been subjected to the most serious form of genital cutting, Nour sometimes performs reconstructive surgery.

Nour asks circumcised women in the first trimester of their pregnancies if they would circumcise a daughter. Though it is illegal to perform female circumcision in the U.S., Nour said she knows of mothers who have taken their daughters back to their native countries to be circumcised.

Professor of Obstetrics and Gynecology John Buster said this aspect of the practice in particular was shocking. "What amazes me is that women do it to other women," he said.

Nour said she does her best to convince women not to have their daughters circumcised. "The biggest question is: Why do they continue?" Nour said. She said she listens to each of their reasons for having their daughters undergo the custom and then questions them. "I can go through step by step challenging them." For example, when a mother says that female genital cutting is a necessary Islamic ritual, Nour uses her knowledge of the Koran and the Hadith, a collection of holy texts in Islam, to counter the idea.

Engin Akarli, a professor of history and a practicing Muslim, confirmed Nour's evaluation. "It is certainly not Islamic," Akarli said. Instead, he said, genital cutting is a regional practice, pervasive in countries such as Egypt, Sudan, Ethiopia and Somalia. In these places, women of all religious backgrounds may be circumcised, including Christians and Jews, he said.

Nour said the primary reason parents decide to continue the practice with their children is that "they actually care for their daughters," since parents may think a circumcised girl will more easily find a husband. Nour cannot definitively refute this claim, though she informs them about the health risks of female circumcision. "I can't guarantee that they are going to get married" if they forgo the custom, Nour said. "I can only quote studies that show that men now prefer uncircumcised girls."

When she can convince women not to have their daughters circumcised, Nour said she still worries that they may reconsider the practice following their pregnancy, since circumcision usually does not occur until six to 12 years after birth.

Nour said it's important to understand female genital cutting as a cultural tradition, but also to realize that it can cause severe medical problems. Between 100 million and 140 million females across the globe have undergone genital cutting, according to the World Health Organization. The immediate problems associated with female genital cutting include infection and death; in the long term women can suffer from chronic pain, infection, scarring and infertility.

Buster said the complications are not only physical. "There are some terribly huge psycho-social issues involved with this," he said. But, he added, "it's not done as punishment. It's done routinely."

"Most of the women I work with don't consider themselves mutilated," Nour said. The use of terms like "genital mutilation," she said, are counterproductive to the ultimate goal of ending the practice because they disregard the values of the cultures that practice the custom. She prefers the terms "genital cutting" or "circumcision."

Nour wants the practice to end but understands that it is rooted in certain cultures' traditions. "If everyone has done it - your mother, your aunt, your grandmother - it's hard to tell them to stop 'just because,' " Nour said. Nevertheless, she said it's crucial that the practice be abolished, even if "it's something that's going to take a long time and the whole community is going to need to agree."

SOURCE: The Brown Daily Herald

AUTHOR: Devin Gould

URL: Click here

DATE: 06/03/2008

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