The Gambia : Are there opportunities to end Female Genital
Mutilation/Cutting?
Mariam Khan-Senghore
Monitoring & Evaluation Officer
UNICEF Learning Program on Social Norms
University of Pennsylvania, Philadelphia
July 5-16, 2010
1
EXECUTIVE SUMMARY
The Gambia has a population size of 1.4 million people with a growth rate of 2.7% (The
Gambia National Population Census, 2003). FGM/C prevalence rate in the Gambia is 78%
with regional and ethnic variations ranging from 44.8% to 99%. Several programmes are
currently on-going in the abandonment of FGM/C by UNICEF through the TOSTANUNICEF-Government of The Gambia Community Empowerment Programme for FGM/C
abandonment which started in 2007.
Another programme is the. UNICEF-UNFPA Joint
Programme on FGM/C which started this year. It is established under the auspices of the
Vice President and Minister for Women’s Affairs.
Several causes are responsible for the continuation of FGM/C. They ranged from social,
cultural to religious causes. However, the practice has been found to be harmful and affects
the livelihoods of most women and girls who undergo the practice. Research has found that
there is a negative correlation between the education and the practice of FGM/C. Women
who are educated are less likely to have their daughters circumcised. So programs such as
TOSTAN that uses education especially on human rights, democracy and health; and
executed in a holistic and systematic approach are successful in the abandonment of FGM/C.
During the two weeks course on the Advances in social norms and social change at the
University of Pennsylvania, several concepts on social norms and change were introduced
and case studies presented where social change took place. Also in the afternoon sessions,
participants from different countries were able to discuss case studies form their respective
countries and brainstorm on solutions to social norms that are harming the people.
This paper is an attempt to use the concepts learned and the experiences of other countries to
accelerate the abandonment of FGM/C in the Gambia.
2
Female Genital Mutilation/Cutting in The Gambia
Background:
The Gambia has a population size of 1.4 million people with a growth rate of 2.7% (The
Gambia National Population Census, 2003). The population below 18 years old is 803,000
(State of the World Children’s Report, 2009). The country is composed by several ethnic
groups and at least five (Mandinka, Fula, Serahule, Jola, and Serrer) practices some form of
FGM/C. Compounded with the low literacy rate of below 50%, and women making the most
of the illiterate masses, social norms such as FGM/C and early marriages are accepted and
practiced even by literate citizens.
According to UNICEF’s Multiple-Indicator Cluster Survey (MICSIII 2005/ 2006), FGM/C
prevalence rate in the Gambia is 78% with regional and ethnic variations. In Basse, one of the
Local Government areas where the three of the Ethnic groups namely Serahule, Fula and
mandinka are concentrated, the prevalence rate is 99% with 92% of the women believing that
the practice should continue. In terms of ethnicity, Mandinkas have the highest prevalence
rate of 96.55% followed by Jolas 91% and Fulas 88%. Prevalence rate among those who had
no education is 81% compared to 71% for those with secondary education or above showing
that education, especially of girls, is having a positive effect on FGM/C. The effect of
education is even greater on attitude towards FGM/C as 38% of those who had secondary
education or above want the practice to be discontinued compared to only 16.4% of those
without any education. Furthermore 41% of those with secondary education or above would
not like their daughter to undergo the practice compared to 21% of those without any
education.
3
It is therefore clearly evident that education (especially girls’ education) is among the
important factors affecting FGM/C in the Gambia. Let’s us bear in mind that Education can
be formal and non-formal and the type does not matter particularly in educating women and
girls about health and human rights.
Table 1: Data on prevalence of FGM/C based on The Gambia MICS 2005/6
120
100
87
83.7
80
99
92.2
95.9
93.5
70.4
55.5
60
60.8
58.7
68.7
64.4
Prevalence among women 15-49
years
44.8
40
77.2
74.6
% of women who believe that
practice should continue
31.3
20
0
The practice of FGM/C can wreak havoc on the health of the girl/woman (severe pain,
shock, hemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention,
open sores in the genital region and injury to nearby genital tissue), overburdens the
already incapacitated health system, increases maternal and infant mortality due to its
long term complications and reduce productivity of women which translates into low
gross domestic product and hence sluggish development of the Country. An estimated
100 to 140 million girls and women worldwide are currently living with the
4
consequences of FGM. In Africa an estimated 92 million girls from 10 years of age
and above have undergone FGM. FGM is internationally recognized as a violation of
the human rights of girls and women.
Current Programmes in UNICEF Gambia on HTPs:
1. The
TOSTAN-UNICEF-Government
of
The
Gambia
project,
Community
Empowerment Programme for FGM/C abandonment started in 2007 and continued to make
progress. The initial forty Mandinka communities are nearing the completion of the
programme cycle. In 2009, the first public declaration by 22 Mandinka communities
happened in June 2009 followed by 13 communities in October 2009. For the Fulla
Programme, the communities have completed Kobi II and move on to the final Module,
Awde in 2010. In a bid to expand the programme to Sarahule communities in URR as
recommended by the Mid Term Review of the Country Programme in 2009, a baseline survey
of the Sarahule programme has been conducted.
2. In the context of the UNICEF-UNFPA Joint Programme on FGM/C, a National
Steering Committee on FGM/C has been established under the auspices of the Vice
President and Minister for Women’s Affairs. The National Steering Committee will
work towards the coordination of stakeholders and harmonization of approaches in
the fight against FGM/C and the development of a national strategy and plan of action
for the abandonment of FGM/C in the Gambia.
Section 1:
In West Africa, several countries practice FGM especially where the ethnic groups are
similar, or the countries are sharing a border e.g Senegal and Gambia and yet the prevalence
rates can vary as in 2005/6 Gambia’s prevalence is 78% whilst Senegal is 28%.
5
To understand why people are practicing FGM, the script needs to be examined. The WHO
Fact sheet no 241, February 2010 cited social, cultural and religious causes of the practice.
Cultural causes: In the Gambia, FGM/C is mostly carried out by traditional circumcisers,
who sometimes double as the traditional birth attendant. A strong bond is created between
the circumciser and the baby girl from birth. This girl will once be under the care of the same
TBA who will perform the mutilation on her at the appropriate age. If the Circumciser/TBA
lives long, she will be attending the birth of that girls’ son or daughter (probably likely as
some of these cultures also condones early marriage).
Another cultural cause is that most of the people/cultures strongly believe that an
uncircumcised girl is ‘dirty’ and will promote and encourage ridiculing of uncircumcised
girls. Incidences of discrimination have been reported where uncircumcised married women
in a FGM/C endorsed cultural setting are not allow to mingle with the women and do chores
such as cooking and collecting wood. The circumcised girl is categorized as ‘clean’ and
‘beautiful’. It is also believed that circumcised girls marry a virgin and remain faithful to her
husband due to reduced libido.
Religious causes: Religion and its leaders play different roles in either promoting or
contributing to the elimination of FGM/C. In the case of Gambia and many other countries
that practiced FGM/C, the majority of the people are Muslims. However there have been
studies done by Islamic scholars and they proved that the practice is not enforced by Islam.
Yet still, some Imams emphasise that even though it is not mandatory in Islam, it is
recommended. These claims have been found to be untrue.
Social causes: People are comfortable doing what their neighbors or people in their
communities are doing. Even though ethnicity is not wholly the contributing factor in FGM,
6
certain tribes do practice FGM/C because they live in close proximities. In the Gambia’s
case, a local government area called Basse has the highest prevalence rate at 99% with three
distinct ethnic groups living there i.e. the Fulas, Mandinkas and Serahules. In this scenario,
even though each ethnic group practices FGM/C but being in the same locality adds more
fuel to the fire and hence the high prevalence rate.
Also communities intermarry and
preferably in their own ethnic group thus re-enforcing the practice. For the family of the girl
being circumcised, it is a social recognition and solidifies the relationship to the community
and sometimes ethnic identity.
The FGM/C practice in The Gambia aptly fits all the criteria of a social norm. People
conform to social norms when both empirical and normative expectations are present.
FGM/C is widely practice because nearly everyone is doing it in their communities and they
are aware of it. They also are aware that it is expected of them to practice it and not doing so
may lead to the unmarriageability of their daughters.
Comparison of the Gambia’s case on FGM can be made with the Saleema Campaign for
Shifting Norms in Sudan. The script for both countries is quite similar as FGM is linked to
marriagebility and “uncircumcised girls are termed as “Sex Slaves” or “dirty”. Looking at
the strategies employed in the project to eliminate FGM -- particularly the “re categorization’
of the uncut girl as Salemma in the media -- can be quite effective to educate girls/women on
FGM/C and its harmful effects. It will also improve their awareness about the fact that not
everyone is practicing FGM/C and there are married faithful women not circumcised; and
empower them to be able to collectively decide to abandon FGM/C. One major difference is
that in the Saleema case, Sudan had laws against the practice but there are no laws in The
Gambia prohibiting FGM. This year even though the Women’s bill was passed in the
National Assembly, the section on harmful traditional practices including FGM was a
7
sticking point and in the end had to be taken out completely for the bill to be discussed and
passed in the Assemble. This clearly signals national assembly members’ reluctance to even
discuss FGM and its harmful effects.
The Coordination game where the choice of the individual is dependent on the normative
expectations of the group can be used to show how abandonment of FGM can happen in the
Gambia.
In this game, everybody is better off not cutting their girls. They can all get
married and are healthy as all the associated health problems of FGM/C are not affecting
them. This stage is attained when there are commitment and public declarations to abandon
FGM/C and organized diffusion between villages and communities which leads to a complete
shift in norms.
State of the FGM/C world
Value to Self
Value to other
All Uncut
3
3
All cut
1
1
Self cut, other uncut
2
0
Self uncut, other cut
0
2
Section II
The Community Empowerment Project by TOSTAN in the Gambia is working at the grass
root level in one LGA, Basse where the prevalence is at 99% by educating communities on
human rights and health together with different activities such as adult literacy, income
generating activities, etc. Discussions are also encouraged among people to come to a
common understanding of what is good for all and not just individual interests. In this way,
FGM is broached in a sensitive and respectful manner and its effects are made known to the
8
people. When the information is given to them, it is entirely their choice to abandon the
practice and also start diffusing the message to neighboring villages and the communities
they intermarry. When a consensus is reached, a public declaration is done by communities
to abandon FGM.
The TOSTAN strategy uses the social convention theory and as a social norm by inciting
genuine discussions which lead to decisions and finally commitment to end FGM/C (verbally
and action). The project also started with a few villages where facilitators open avenues for
discussions with human rights, democracy and health modules. People are encouraged to
reflect on their personal actions, empirical beliefs and expectation and also about their
reference group’s beliefs and expectations. Throughout the cycle of the project, respect,
integrity and sensitivity is maintained so not to alienate the values and traditions of the
participants. Ownership of the project is assured through the formation of the Community
Management Committee where the majority is women. These strategies are in line with the
Universal Declaration of Human Rights and Convention on the Elimination of All Forms of
Discrimination against Women (CEDAW). FGM is recognized internationally as a violation
of the human rights of girls and women. It reflects deep-rooted inequality between the sexes,
and constitutes an extreme form of discrimination against women.. The network analysis
strategy is also employed before intervening in a village, the most influential or central
people such as the Imam is consulted and in Molly’s presentation, she cited a scenario in a
conservative village, she sought out the religious leader’s permission and he gave his blessing
to the project and pledge his unwavering support which impacted a lot on the success of the
project.
Another strategy being integrated in the Gambia TOSTAN’s project is the diffusion model
where the village/community (already publicly declared abandonment of FGM/C) engages
9
other villages/communities (where they intermarry) to change their expectations and together
engage the critical mass to have uniform empirical and normative expectations. This also
creates network relations..
The only sticking point with the TOSTAN project in The Gambia is that they are only in one
region with the highest prevalence rate (99%) and support (92%). According to Pr. Mackie’s
presentation, these settings might be difficult to change the normative expectations. Research
has shown that countries/villages with low prevalence and low support had more spontaneous
abandonment of FGM/C.
Section III
A good strategy for TOSTAN in The Gambia is to continue on the education module for
Basse where they are since 2007. By the end of 2009, 35 communities have done public
declarations to abandon FGM/C. However change is slow and there is a new trend emerging
of babies as young as a week old undergoing FGM/C. Ten years ago, FGM/C was a rite of
passage and celebrated publicly. Girls aged between 6 to 13 years old were sent away to the
circumciser and stay there for a month to learn how to cook, take care of themselves, be a
good wife, etc but now the practice is going underground and in isolated cases, people take
their daughters to the Medical doctors for such operations. However a modified strategy
would be to expand to a region such as Janjanbureh (prevalence of 77.2%) and it shares a
border with Basse. In Janjanbureh, the abandonment of the practice can be expedited because
data shows that these people are ready to change (low support rate of 74.6%) and with its
close proximity to Basse, it can be use as tipping point for the majority to change. Pr. Mackie
explained in his paper “Lessons learned from comparison of FGM/C abandonment programs
in five countries” that a core group such as the Janjanbureh people can be the first movers
10
who through organised diffusion can tip the entire region and neighbours in Basse and
Kuntaur (prevalence rate of 68.7%) to shift into full commitment to abandon FGM/C.
Applying social network analysis, Janjanbureh can be used as a bridge to other regions. Its
geographical location is more central than Basse and share borders with four regions who all
practice FGM/C.
Using the network analysis again structural similarities or differences can be highlighted and
since TOSTAN has been successful in Senegal, the lessons learned from Senegal’s
experience can be apply to the Gambia to avoid pitfalls. Capacity building is needed for the
women in The Gambia undergoing TOSTAN programs as it was done for Senegal. The
TOSTAN Senegal programme linked women to movements within their country and across
borders which help them to ‘belong’ to a wider circle and also develop capacity that can
contribute to the development of their community e.g. the Senegalese woman sent to India to
learn how to fix solar panels.
As in the Saleema project, the media can be engaged sensitise people about the benefits of
being uncut. Even though this initiative might still be a little premature for the Gambia as we
are slowly gathering public support for the abandonment of FGM/C, it is worthwhile to
consider. When the critical mass has reached a tipping point, a public media campaign such
as the Saleema might be just the right push towards a landslide total abandonment.
Lastly, as UNICEF and UNFPA is embarking on a joint program for accelerated
abandonment of FGM/C, a systematic approach of using non-directive and holistic approach
as the TOSTAN programme should be emulated. Also a guideline for the tools and concepts
needs to be developed and provided for uniform action against FGM/C. It is proven and
stated clearly in Pr. Mackie’s paper “Lessons learned from comparison of FGM/C
11
abandonment programs in five countries” that “effective abandonment activities are holistic,
non-directive, and positive, and thereby establish credibility, helping to overcome powerfully
self-enforcing beliefs”.
Senegal set 2015 as the year for total abandonment of FGM/C. They have come a long way
and have a lot of political backing towards this goal. The Gambia needs intense advocacy at
the highest level for policies, budgets and laws for the abandonment of FGM/C. The joint
program with UNFPA has a component for policy advocacy and this has to be executed
efficiently to get the ball rolling. Senegal and The Gambia share borders and we are the same
people that share the same cultures and values. If it works in Senegal, then it can work in
the Gambia.
12