Fmeale genital mutilation-Towards an end to the Cloak and Dagger ?

The Female Genital Mutilation (FGM) education campaign progressed remarkably smoothly in Laikipia North this year, now in its third year the 28 established NHP Health Workers and their support team , led by NHP Nurse Rose, are now proving to be a self motivated and highly efficient team –Rose’s smile and calmness have maintained a positive effect on the whole community, deflecting the fiery exchanges seen in our first year.

The new Bill outlawing FGM, passed on September 7th, has helped this campaign dramatically. The Bill, proposed by Mt Elgon MP Fred Kapondi back in 2010, provides that a person convicted of carrying out FGM will face seven years in jail or a half million shilling fine; causing death via FGM can result in life imprisonment. Aiding and abetting FGM also carries heavy penalties. Three years ago it was difficult to get local politicians to support the campaign to, at the least, delay female circumcision, since they were not sure on which side votes lay; but the new law has made things clear for all. We have been fortunate that the local Chiefs have taken a very positive and forward thinking stand, ensuring that progress over the last three years has been fast. Traditionally, as soon as a girl has been circumcised she is pronounced ‘ready’ for marriage, leading to the end of her education. But in many cases the Chiefs have actively insisted that girls not be taken out of Primary school and have also assisted them in registering themselves in school, where local teachers have identified girls being kept at home.

Our campaign in Isiolo is in its first year, with a brand new team of highly enthusiastic Health Workers. Here many lessons have to be learned concerning logistics- particularly as we are currently drowning under a sea of mud, wiping out roads on a daily basis.And never underestimate the infinite time required for Kenyan politics ! No one can focus on education until the all important decisions of how many ‘lunch’ goats to be assigned to each village has been settled. Perhaps such precise allocation decisions have more priority in the Samburu community than in the Masai community where NHP was formerly based. We still have the biggest Baraza (meeting) tomorrow, and rains permitting, we will meet our last year total of over 2,000 attendees.

The team are promoting an alternative public ‘Blessing’ for the girls as their Coming of Age ceremony- rather than the Cloak and Dagger (..literally) ceremony that has been taking place behind closed doors for so many years. Since the average age for circumcision is puberty this has meant few girls accessing secondary education.

The health problems begin with the infections and heavy bleeding caused by the non-sterile and unprofessional operation, proceed via the hazards of early pregnancies, for girls who often have several more years of growing and are already poorly nourished ; through to large areas of scar tissue causing horrific and often life threatening tears and haemorrhaging during birth. In addition mothers will starve themselves during pregnancy, even when food is plentiful, in order to limit the size of their baby to limit the danger and pain of a healthy birth weight baby.

I cannot say that I am taken in by the argument given against the cut by many men and women, at every baraza that the lack of sexual satisfaction obtained by the women causes more female 'promiscuity' or as generally translated from the Maasai 'prostitution', but I guess I am not one to be able judge this question.

Whilst meetings can be highly charged, and to some it is still seen as a controversial and emotive topic; if each year another cohort of young girls is given the choice to delay the cut until after secondary schooling that has got be a good thing for Kenyan development.. and Kenyan politics.

Girl's Education.. Family Planning Choices.. and Fertility Rates...

On Tuesday,leaders from around the world meet in Senegal for the International Conference on Family Planning. As the population in Kenya has soared in the past 30 years by two and a half times, with an average growth of 3 percent per annum, this topic needs to be top of kenya’s development agenda.

The current Kenyan population level is 41 million, up from 21 million in 1989. There is no greater challenge to development, as over-population tends to nullify economic progress. With the advent of Free Primary Schooling in 2003, kenya did a great job of getting Bottoms On Seats. Access to education has improved enormously, but as population levels rise the GOK and donor governments have been unable to meet the required funding, particularly in the poorest rural areas where fertility rates remain highest. In schools we work with, if we removed our teaching support, class sizes would rise in some cases to 120 pupils to one teacher. Education for sure: but based on Quantity not Quality.

There is a clear correlation between levels of female education and female fertility rates. Education leads to delay of marriage, to increased knowledge about contraceptive choices, to greater economic choices for women, to increased autonomy in women’s decision making and to greater communication within marriage: all of these assisting in access to Family Planning and increased exercise of choice. As effective FP choices increase so greater education is required. With the advent of three year Implants, choices increase in both number and complexity.

It is inevitably the economic cost of education, versus its perceived benefits that will be the prime determinants of parents sending kids to school in the poorer rural areas. When the drought of 2009 in the Ol Lentille Community killed over three quarters of domestic livestock, not only did the schools see a large increase in enrollment of younger children, but also many Morans, who would formally have been out herding, entered primary school for the first time.

Seven or more years in school cuts fertility rates in half; but it is years in Secondary Education which has the greatest reduction in fertility rate for girls and the greatest delay in marriage. Educating mothers decreases child mortality and leads to healthier infants.Access to Family Planning is a basic Human Right which cannot be seen in isolation from those other basic Human Right- Female Education and the Right to Health Care.

Pictured are the Nabakisho Health Care nurses in action at a mobile clinic at Rumate where FP choices are discussed... levels of understanding of their full range of FP choices will remain hazy for many of these women who have no education.

Female Genital Mutilation -moving away from The Cut

This is a busy week for the NHP team at Lentille. Prior to the December circumcision season they are organising as many 'barazas' as they can cope with.

A Baraza is a big community meeting, under a tree, with Chiefs, Community Leaders, men, women and youth.. and much food to be consumed! The subject of discussion is alternatives to female circumcision.. last year over 2,000 people attended these meetings.. as we extend now into Isiolo District this number is expected to rise. This week 3 barazas will be organised in an attempt to keep girls in school in January- and prevent the medical horrors of The Cut which leads to so many child- birth problems. Traditionally, as soon as girls are circumcised they are taken out of school to be married -and childbirth quickly follows. Since the traditional age here for circumcision is puberty (13 years) the medical complications for these young girls giving birth when they are still growing rises further. Often the girls starve themselves during pregnancy in the hope of giving birth to a smaller baby... not a healthy state of affairs for mother or child.

However tradition is changing very fast and in the two years we have been running these barazas we have seen a huge sea-shift in the attitudes to girl-child education and a far greater understanding of the dangers of circumcision. Increasing numbers of girls are now being allowed to delay circumcision until completion of secondary school when they can themselves make an informed choice. Health care here is tied directly to education- with the buiding of the new classes at Kimanjo Secondary school parents and daughters can see a real economically viable alternative to marriage. By incorporating the new government secondary Principal, and the Primary head-teachers, into these barazas we try to join up the education/health-care work.

This year we are also trying to positively incorporate the female circumcisors into health care work by offering them incentives to become agents of referral in bringing pregnant Mums-to -be, to the clinic... so they no longer need the added revenue stream of conducting circumcisions. We look forward to following up this post on how lively these barazas are this week! Change will not come without contoversy for sure!