Compromise plan on circumcision of girls gets little support

REFUGEES' BELIEFS DON'T TRAVEL WELL

Defying new laws and an emotional international crusade, a group of Somali refugees here are clinging to tradition and insisting that their daughters undergo the ritual of genital cutting. As a result, a local public hospital faces a major dilemma.

Over the past two years, some Somali and other refugees have asked physicians at Harborview Medical Center about performing the rite, which some call female circumcision, but opponents condemn as female genital mutilation.

The question came up when doctors routinely asked expectant refugee mothers if they wanted their baby circumcised if it was a boy. Some mothers responded, Yes, and also if it is a girl.

This summer the hospital, which has a long history of sensitivity to diverse cultures and customs, convened a committee of doctors to discuss what to do about the requests. Their proposed compromise is to offer a simple, symbolic cut.

When that suggestion became public however, it threw the liberal city into turmoil.

How dare it even cross their mind, said Meserak Ramsey, an Ethiopian immigrant whose San Jose-based group, Forward USA, seeks to eliminate the ritual completely. What the Somalis, what the immigrants like me need is an education, not sensitivity to culture.

Yet the desire by some refugee parents for the practice persists, even though the Somali community there has essentially agreed that the practice should be ended, said Hersi Mohamed, a Somali elder.

You cannot take away the rights of families and women, Mohamed said. As leaders and elders of the community we cannot force a mother to accept the general idea of the community. She can say, `I want my girl to have letting of blood.'

Though this is an issue physicians and hospitals across the country likely are facing, Harborview is the only one to discuss the problem openly as a public health issue, rather than treating it simply as an outdated, barbaric rite that should be banned.

The issue of female genital cutting has taken on a high profile recently.

Earlier this year the U.S. government granted asylum to a young woman from Togo who said she would be cut if she returned to her country. In September, the United States joined Canada, Franceand a few other nations in outlawing the practice.

The new federal law, which goes into effect next April, sets a prison sentence of up to 5 years for anyone who circumcises, excises or infibulates the genitals of girls under age 18. Infibulation is the process in which the vagina is sewn shut except fora small opening.

Some 150,000 females of African origin in the United States have been cut, or face the possibility of being cut, according to an estimate by the Centers for Disease Control and Prevention in Atlanta.

The ritual continues in about three dozen countries in Africa, the Middle East and Southeast Asia. The World Health Organization estimates that as many as 120 million women have been cut.

A rite of passage, the cutting usually is performed on girls ages 4 to 10. It can involve a simple nick or the more drastic slicing away of all or part of genitals, including the clitoris and labia, usually without an anesthetic.

Ramsey, who says she underwent a painful cutting at age 6, said the practice causes physical and psychological problems, loss of sexuality, difficult childbirths and constant pain. Some young women have died from shock or loss of blood.

The physicians committee at Harborview says its suggestion is an attempt to offer a way to save girls from the most drastic forms of the rite.

It would be a small cut to the prepuce, the hood above the clitoris, with no tissue excised, and this would be conducted under local anesthetic for children old enough to understand the procedure and give consent in combination with informed consent of the parents, said Harborview spokeswoman Tina Mankowski.

We are trying to provide a relatively safe procedure to a population of young women who traditionally have had some horrendous things done to them, she said, but added, We are not now doing female circumcisions at Harborview, nor are we considering doing female circumcisions.

Whether the proposal would be prohibited by the new law is one of the legal questions being reviewed by the Washington state attorney general. The hospital's medical director will make no final decision on the proposal until the legal review is completed and a communitywide discussion is held, Mankowski said.

The Seattle area is home to about 3,500 members of a fast-growing Somali community. Some Somali and other African immigrants here have made it clear how deeply ingrained the practice is in their cultural and religious views.

Somali men and women told The Seattle Times their daughters would be shamed, dishonored and unmarriageable if they were not cut, an act they believe shows their purity.

They also said that if they could not get it done in the U.S. they would pay the $1,500 fare to fly their daughters to their homeland, where they face the extreme version of the cutting ritual. Some, but not all, of them said a symbolic cut on their daughters would be enough.

Mohamed, executive director of the Somali group, Afrirelief and Development, said the community has held meetings to discuss the practice.

I think the prevailing concept about it is that it should be diminished as much as possible, and possibly eradicated as far as girls are concerned, he said.

However, he added, the fact that we came as refugees doesn't mean we are going to leave our culture overnight. The bad parts of our culture we will try to shake off, gradually. Now we are at a point as leaders and elders of the community negotiating with mothers.

We do have to understand that people have to abide by the law here. We did try to get across that very fact to the community. We said, This is the United States now. The laws are going to change, and we simply cannot practice. 

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