Abstract
Female genital mutilation (FGM) has long been practised in many communities in the Upper East Region of Ghana. Although the Ghanaian state has a long tradition of supporting women's rights, it has not been successful in eradicating FGM, despite a law against the practice in an amendment to the Criminal Code in 1994 and the Domestic Violence Act 2003. This qualitative study in the Upper East Region examined the role of the state in stopping the practice of FGM through legal means, and why FGM continues to be practised in the community. In-depth interviews were conducted with six state officials, a circumciser, the president of a women's advocacy organisation, and semi-structured interviews with 32 community members. Although FGM has been criminalised, political support to ensure that the law is effectively implemented has been lacking. FGM education and eradication must be given more priority and significant funding by the Ghanaian state. For interventions to be effective, legal measures need to be combined with social measures. Communities practising FGM must be involved in the planning and implementation of anti-FGM interventions. Successful eradication of the practice is possible if education and dialogue between state institutions, gender and human rights groups and practising communities is strengthened.
Résumé
Beaucoup de communautés du Haut Ghana oriental pratiquent depuis longtemps la mutilation sexuelle féminine (MSF). En dépit de sa longue tradition de soutien aux droits de la femme, l'État ghanéen n'a pas réussi à éradiquer cette pratique, en dépit d'un amendement du Code pénal l'interdisant en 1994 et la loi sur la violence familiale de 2003. Cette étude qualitative dans la région du Haut Ghana oriental a examiné le rôle de l'État pour faire cesser la MSF par des moyens juridiques et s'est demandé pourquoi cette pratique perdurait. Des entretiens approfondis ont été menés avec six fonctionnaires, un exciseur, la présidente d'une organisation de plaidoyer pour les femmes, et des entretiens semi-structurés avec 32 membres de la communauté. Bien que la MSF soit criminalisée, le soutien politique à l'application réelle de la loi fait défaut. L'éducation en matière d'excision et l'éradication de cette pratique doivent recevoir une priorité plus élevée et un financement substantiel de la part de l'État. Pour que les interventions soient efficaces, les mesures légales iront de pair avec des mesures sociales. Il faut que les communautés qui pratiquent la MSF participent à la planification et l'application des interventions anti-excision. L'éradication réussie est possible en renforçant l'éducation et le dialogue entre les institutions étatiques, les groupes de défense des femmes et des droits de l'homme, et les communautés qui pratiquent l'excision.
Resumen
Desde hace mucho, se practica la mutilación genital femenina (MGF) en muchas comunidades de la región de Alta Ghana Oriental. Aunque el estado ghanés tiene una larga tradición de apoyar los derechos de las mujeres, no ha tenido éxito erradicando la MGF, a pesar de la ley en contra de su práctica en una enmienda al Código Penal en 1994 y la Ley de Violencia Doméstica de 2003. Este estudio cualitativo en Alta Ghana Oriental examinó la función del estado en detener la práctica de la MGF por medios jurídicos, y por qué se continúa dicha práctica en la comunidad. Se realizaron entrevistas a profundidad con seis funcionarios estatales, un circuncidador y el presidente de una organización promotora de mujeres, así como entrevistas semiestructuradas con 32 miembros de la comunidad. Aunque la MGF ha sido penalizada, falta el apoyo político para asegurar el cumplimiento de la ley. Se debe dar más prioridad a la educación sobre la MGF y la erradicación de ésta, y el estado ghanés debe asignar considerables fondos a estos esfuerzos. Para que las intervenciones sean eficaces, las medidas jurídicas deben combinarse con medidas sociales. Las comunidades donde se practica la MGF deben participar en la planificación e implementación de intervenciones anti-MGF. La erradicación de la práctica es posible si se fortalece la educación y el diálogo entre instituciones estatales, grupos de género y derechos humanos y las comunidades practicantes.
Following the recommendations of the United Nations Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), many governments in West Africa, including Benin, Burkina Faso, Côte d'Ivoire, Ghana, Senegal and Togo, have taken steps to curb the practice of female genital mutilation (FGM) by criminalising it and by social reform through education and outreach programmes. The Convention, which was ratified by 139 countries, recommends that governments take effective measures, including educational and health care measures, to eliminate FGM. Most of them proceeded to implement this in their countries through statutory law.Citation1 Citation2 Citation3
Ghana introduced statutory law on FGM, at the time referred to as female circumcision, as the only obligatory regulatory measure following its ratification of CEDAW in 1989. A formal declaration against female circumcision and other harmful cultural practices that are detrimental to the well-being of women and children, such as widowhood rites and girl-child betrothal, was issued by President Rawlings in 1989.Citation4 In 1994, Parliament amended the Criminal Code of 1960 (Act 29) to include the offence of female circumcision as follows:
“69A (1) Whoever excises, infibulates or otherwise mutilates the whole or any part of the labia minora, labia majora and the clitoris of another person commits an offence and shall be guilty of a second degree felony and liable on conviction to imprisonment of not less than three years.” Citation5
To avoid legal prosecution, perpetrators have adopted strategies such as circumcising girls at infancy or in secrecy. Others invite circumcisers from neighbouring countries to circumcise their daughters in private in order to circumvent the law.Citation8Citation9 Prosecutions of in-country circumcisers have been few, and estimates of the current prevalence rate of the practice have become harder to determine, as cases are so rarely reported to the appropriate authorities.Citation10Citation11 Since the promulgation of the law in 1994, in fact, only two cases are on record as having been effectively investigated by the police and subsequently prosecuted in court. They include a 45-year-old farmer, who was sentenced to a five-year jail term for circumcising three girls with the consent of their parents in 2003, and a 70-year-old woman sentenced in 2004 to five years by the Bawku Circuit Court for circumcising seven girls in the Bawku East District.Citation6 Citation10
A high prevalence of FGM in northern Ghana was reported by Dorkenu in 1994. She found that 97% of the 2,325 women she interviewed had been circumcised.Citation12 The Navrongo Health Research Centre in 1995 also reported a high prevalence rate of 76% among the Kassena and 79% among the Nankana in a panel survey of women. In a panel survey in 2000 the prevalence of FGM was 53% and 54% among the Kassena and Nankana, respectively.Citation13 Today, 15 years after the passage of the law, the prevalence of FGM is still 9–15% in practising communities, despite the current strategies that have been put in place to eliminate it.Citation2 Citation14 This situation necessitated a review by parliament which culminated in the passage of the Criminal Code (Amendment) Bill in 2007.Citation4 Citation15 The bill, which is yet to receive presidential assent, seeks to amend the Criminal Code to change the reference from female circumcision to female genital mutilation. It also seeks to widen the scope of the nature of the offence and responsibility for it to include all other accomplices in the practice of FGM.Citation14
This paper analyses the Ghanaian state's approach to the eradication of FGM, and the reasons for the continuous resistance to state intervention by practising communities, and from the evidence recommend how better to confront and eliminate the practice.
Methodology
A qualitative approach was used to generate both primary and secondary data for the analysis. The primary data entailed the use of focus group discussions and in-depth interviews in the Upper East Region of Ghana. Eight in-depth interviews were conducted in the Region with five personnel of the Commission on Human Rights and Administrative Justice (CHRAJ), the police officer in-charge of the Regional Domestic Violence and Victims Support Unit (DOVVSU) and a male circumciser. The president of the Ghanaian Association for Women's Welfare (GAWW) was also interviewed. We explored the views of these state officials on the role of the state bureaucracy in the implementation of the law, how the law was being implemented, and collaborative activities to eradicate FGM, current trends in FGM practice and challenges for eradicating it. The social position of circumcisers in communities, their knowledge of FGM laws and the effect of the law on their activities were also examined.
A study we conducted previously had revealed that young people and adults, male and female, held different views on FGM,Citation16 so we interviewed people of different ages and of both sexes. The Navrongo Health Research Centre has a database of all communities (244) and members of households in the Kassena-Nankana District of the Upper East Region. First, 12 communities were randomly selected and then respondents were randomly selected by age and sex from them. Thirty-two semi-structured interviews were conducted with the selected community members. Respondents comprised eight young men and eight young women aged 15 to 24 years, and eight adult men and eight adult women aged 25 and above. The interviews focused on participants' knowledge of the 1994 law, sources of information on the law, avenues to seek redress, perceptions about the practice and the future of the practice.
Data from the earlier study,Citation16 which involved 22 focus group discussions with young men and women aged 15 to 24 years and men and women aged 25 years and above in the Kassena-Nankana District, were useful for background information on FGM and the law. The sources of these secondary data included journals from 1994 to 2009 on FGM activities, newspaper articles dating back to the passage of the law in 1994, books, internet sources and the 1992 Constitution of Ghana.
Informed consent was obtained from all participants. The in-depth interviews with state officials were all conducted in English. The focus group discussions and the semi-structured interviews with community members were conducted in the predominant local languages, Kassem and Nankam, by a team of trained research assistants. All interviews were tape recorded and transcribed in English. A coding list was generated based on common themes that arose, and these themes were systematically organised to address the objectives.
Female genital mutilation in Ghana: some background
There is no authentic and unitary history of the origins of FGM in Ghana. However, FGM is embedded in the culture of practising communities. Among practising ethnic groups in northern Ghana, FGM is either performed at puberty, during pregnancy or childbirth, or at death. It mainly serves as a rite of puberty for young girls, who after circumcision are confined and taught how to become “women” (manage their sexuality, marry and be a wife, carry out household responsibilities and care for children). Sometimes FGM is performed at death to ensure that the deceased is accepted into the ancestral world as it is believed that an uncircumcised woman might not be accepted by her ancestors. It is also believed that children from uncircumcised women grow up to become stubborn and unruly; thus, circumcision may be done at pregnancy and childbirth to prevent this.Citation10Citation16
Practitioners or circumcisers are usually elderly community members, male or female.Citation17 Some of the harmful effects of FGM which have been identified in Ghana include tetanus due to the use of unsterilised instruments, haemorrhage, septicaemia, obstruction of the urethral opening and obstructed labour during childbirth.Citation17
State apparatus for implementation of the FGM law
Certain laid down procedures are required for the prosecution of a practitioner of FGM. Under the 1994 law, the circumciser is considered the sole offender and FGM cases should be reported to the nearest police station. The Domestic Violence and Victims Support Unit (DOVVSU) of the Ghana Police Service, a special unit created to handle cases of domestic violence, is responsible for processing the suspect to the nearest circuit court for prosecution. Most of the district police commands are not yet equipped with a DOVVSU, but are still expected to handle issues of domestic violence, including FGM cases, or alternatively refer them to their regional headquarters, where DOVVSU services are available. Such cases are then processed for court, preferably a magistrate's court (Personal communication, Upper East Regional officer in-charge of DOVVSU, 27 February 2009).
Although community sensitisation and education have been identified as a means of discouraging FGM, no specific organisation has been assigned this responsibility. The Ministry of Health, Ministry of Education, Commission on Human Rights and Administrative Justice, and the National Council on Women and Development, now the Department of Women of the Ministry of Women and Children's Affairs, a key implementing body, are required to carry out gender-based activities such as empowerment programmes, anti-FGM education and other activities to promote the welfare and development of women.Citation18 The media are also required to carry out anti-FGM campaigns and report occurrences to the police.
The Ghana Federation of Women Lawyers and gender and human rights NGOs such as the Ghanaian Association for Women's Welfare and the Centre for Sustainable Development Initiatives are known to provide anti-FGM education and livelihood skills training to FGM-practising communities, and track and report FGM occurrences to the police and the Commission on Human Rights and Administrative Justice.Citation10 Community members are also required by law to report such occurrences to the police.
Findings
In our interactions with state officials and the president of the Ghanaian Association for Women's Welfare, one challenge that stood out in the implementation of the law was the issue of roles and responsibilities. State officials indicated that there was no clear definition of these within the relevant government institutions. Officials from the police and Commission on Human Rights and Administrative Justice said that the police were the sole authority responsible for all FGM cases.
“FGM cases are reported to a police station or a DOVVSU office where there is one. It is a criminal case so other organisations cannot be responsible for it. They can only help educate or sensitise the public about it.” (Police officer in-charge, DOVVSU)
“Basically our act mandates us to report such (FGM) cases either to the Attorney General or the police.” (Regional commissioner, Commission on Human Rights and Administrative Justice)
“The last time I heard of an incidence of FGM was last year [2008]. That was at Walewale. This thing was done in the Brong Ahafo Region and the girl was brought to Walewale. That case was reported to CHRAJ and they are still doing investigations because the girl is no more in Walewale.” (President, Ghanaian Association for Women's Welfare)
“… It is a problem. The current practitioners are mostly from the neighbouring countries. The practitioners come in to perform and cross back and as we don't have the mandate to cross and track them down it is really difficult to get them. Moreover, when we hear that they are in a particular village, the only way is to inform the police in the form of a tip-off and they also don't get hold of them.” (Regional commissioner)
Limited support for the eradication of FGM
Budgetary provisions to institutions whose role is enforcing the law on FGM appear to be limited. The Commission on Human Rights and Administrative Justice, the National Council on Women and Development and the police all lack the needed funds for offices, trained personnel on gender issues, and transport to follow up on reported cases in practising communities, most of which are rural and not easily accessible, as well as to carry out investigations, arrest culprits in FGM cases and protect victims. A critical role for transport is to facilitate visits by staff from implementing institutions to practising communities, to carry out anti-FGM educational activities, protect women from influential community members who might pressure them to be circumcised, and to protect women from the wrath of community members who might be opposed to perpetrators being reported to the police.
“Some time back, when the National Council on Women and Development was here, they were very helpful in FGM activities with us, but these offices no longer exist at the district level.” (Two district directors, Commission on Human Rights and Administrative Justice)
Community knowledge of the law
The majority of study participants of both sexes and different ages from local communities said they were aware of the law on FGM. However, their knowledge of the reasons for the law, the content of the law and ways for women to seek redress on matters such as the appropriate institution to report FGM occurrences or to go for protection in case they are threatened with FGM and also to seek justice when their rights are violated, were not in-depth.
“They say the practice is bad, so we should stop practising it.” (Young man, age 19)
“They say a girl can lose a lot of blood or may even die from circumcision, so we should stop practising FGM.” (Woman, age 35)
“The law states that we should stop circumcision because it is harmful to the girls. This is because, when girls are circumcised, they lose a lot of blood and this can cause death; secondly, it leads the girl to complications in delivery and she can even die through anaemia.” (Circumciser)
“The law is helpful but it is because of our tradition. If I do not circumcise girls I will become sick, which is normally spiritual.” (Circumciser)
“There is an economic motive for circumcision. These people who circumcise collect a lot of food items from the girls, so they will do everything possible to convince them to circumcise.” (Focus group discussion, men)
“The obstacles are basically the entrenched belief system of the communities. They argue that our forefathers did the same thing and gave birth to us. How can you say it is wrong and why should we be the ones to stop that age-old practice? And they see it as a distinguishing feature of themselves.” (Regional commissioner)
“Yes, the laws are good. But they should go along with mass education because people still believe that the practice is part of their tradition, which should be carried out by all means.” (President, Ghanaian Association for Women's Welfare)
Changing perceptions
Ongoing efforts to eradicate FGM have created conflicting views. Communities cannot come to terms with the fact that the practice is dehumanising because they see it as a form of showing how brave a woman is and also maintaining a cultural practice which is viewed as good.
“It is a mixed bag. The men at our community durbars are filled with revulsion at the sight of the pictures we show them and they are disgusted at the descriptions that are given by the public health education on it. The elderly women, who even themselves might have been victims, as we speak to them do not even want to look you in the eye, because it appears you are just telling them what they went through. The young girls are confused because, what you are telling them, they have been trained all along towards the practice only to be told that the practice is dehumanising and injurious and deadly, totally confusing to them.” (Regional commissioner)
“Women within this age range (35 years) who are not circumcised don't feel happy, their colleagues who have done it call them cowards or men or incomplete women. As for those who have done it, they encourage the younger ones to go for the circumcision because they claim it is good. And sometimes they even assist the young girls to circumcise.” (Circumciser)
“I now know the effects of the practice, so I have come to realise that the practice is bad and would not advise any girl to get circumcised.” (Circumcised woman, age 25)
“The practice cannot be stopped because fathers own their daughters and if they wish to circumcise them, no one has the right to prevent them from carrying that wish out.” (Focus group discussion, young women)
“I think it should be continued. I have no clitoris; so why is it that my daughter should not be circumcised? My daughter will be circumcised.” (Woman, age 60)
“When a woman is circumcised, we the young men would not find her attractive and she could also become infected with diseases, so the practice should be stopped.” (Focus group discussion, young men)
Discussion
There is evidence that FGM is on the decline, which is promising. But while having a law criminalising FGM is necessary, it is not sufficient for elimination purposes. The 1994 Act, which restricted the extent of the crime only to the circumciser, led to very few arrests, as FGM is a social practice and families protected the circumcisers. It also drove the practice underground. The prosecution of circumcisers has been slow and most often delayed, thus leading to possible loss of evidence, which is vital for prosecution of cases. Thus, we believe that the amendment to the 1994 Act in the 2007 bill, which seeks to extend the offence to encompass parents and other community members connected to the practice, is in the right direction.
However, the state institutions responsible for investigating and prosecuting FGM, especially at district level, either did not exist, had been shut down or were not functioning effectively. In addition, at all levels there was a lack of clear definition of roles and responsibilities, as well as a lack of funds and trained personnel, which makes it difficult for institutions to sustain a commitment to the cause and to effectively implement and monitor the eradication process. Political support for passing laws to eradicate FGM is evident, but the political support to ensure that the laws are effectively implemented has been lacking. It is therefore crucial that FGM education and eradication are given more priority and significant funding by the Ghanaian state.Citation19
The lack of in-depth knowledge of the law among community members that this study found is not surprising, considering that the key institutions responsible for education on this issue do not exist in most communities. The criminalisation strategy and existing educational efforts have had a noticeable but limited effect on community beliefs, which explains why the practice is ongoing. Studies in Kenya show that while laws banning FGM are important, a grassroots, community-level approach is best, as top-down legal policies have been shown to be ineffective in changing people's attitudes.Citation20 Thus, there is a need to adopt an approach that would deal directly with the target group if significant change is to be realised.
For interventions to be effective, legal measures need to be combined with social measures. We recommend that communities practising FGM are involved in the planning and implementation of anti-FGM interventions. Listening to and respecting communities' own perceptions on FGM before embarking on sensitisation and information campaigns can be a foundation for collaboration and change, as noted in other interventions.Citation21 Community participation is essential if they are to be expected to serve as partners by reporting incidences, providing support to potential victims and contributing to a comprehensive response. Without them, there can only be limited prevention.Citation22
Successful eradication of FGM is possible if education and dialogue between state institutions, gender and human rights groups and practising communities is strengthened. Finally, applying the principle of extra-territorial jurisdiction of the law where parents who, in a bid to evade the law, take their children for excision in neighbouring countries, would be strengthened through strong collaborative efforts between Ghana and her neighbours.
Acknowledgements
This work is based on Matilda Aberese Ako's MA thesis in Women Gender and Development, submitted to the Institute of Social Studies, Netherlands, sponsored by the Dutch government. Part of the information was presented at the annual meeting of the American Association of Public Health, Boston MA, in 2006. We wish to thank Professor Thanh-Dam Truong, who supervised the thesis, the Dutch government, and the Navrongo Health Research Centre, which provided financial support for the study. We wish to thank officials of the Commission on Human Rights and Administrative Justice, the Upper East Regional Officer of DOVVSU and the President of the Ghanaian Association for Women's Welfare, who granted us interviews. We also thank the circumciser and other community members who willingly participated in the study.
Related Research Data
References
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