Indonesia should stop allowing doctors, midwives and other health workers to carry out female genital mutilation (FGM) on children and babies as young as six months, the United Nations Human Rights Committee (OHCHR) has said.
The committee also urged the country to pass legislation banning any form of FGM and to put in place penalties that reflect the “gravity of this offence”, which campaigners say is a serious human rights violation. OHCHR made its comments on Friday in observations on the state of the International Covenant on Civil and Political Rights.
The “medicalisation” of FGM – a term used for when the practice is performed by health practitioners – has emerged as a trend in several countries and campaigners say it is setting back global efforts to eradicate the ancient ritual. It is also seen as one of the biggest risk factors as it is often seen as legitimising FGM.
But Indonesia says it is better medically trained people carry out the procedure to avoid parents resorting to traditional circumcisers who might endanger their daughters' health.
“Medicalised FGM is on the rise,” Efua Dorkenoo, advocacy director of Equality Now’s FGM programme told Thomson Reuters Foundation. This is not just the case in Indonesia, but also in Kenya, Nigeria and in countries where bodies representing health professionals fail to take strong action against it, she added.
In Indonesia’s case, medicalised FGM was allowed following a fatwa – a ruling by a religious authority – and this came after a ban on FGM was reversed on the grounds it had led to an increase in the practice by non-medical practitioners.
Following the fatwa, the ministry of health issued a regulation in 2010 permitting medicalised FGM, which goes against a number of international resolutions and treaties such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), of which Indonesia is a signatory, according to Equality Now.
“We tried all kinds of actions – not just [through] the government but ... through international medical associations to bring pressure in terms of violations of various treaties that they have ratified on this [the medicalisation of FGM] – and they’ve not been successful,” Dorkenoo said.
“So this is a continuing action to get them to change the situation.”
FGM ranges from practices such as pricking or scraping to the most extreme form that involves cutting the clitoris and labia and sewing up the vaginal opening.
In Indonesia, the practice may involve cutting, pricking or scraping the clitoral hood until bleeding occurs. Amnesty International reports that, in some cases, a small piece of the clitoris may be cut.
Indonesians call the procedure circumcision. Supporters say it should not be compared to more severe forms of FGM found elsewhere in the world.
DATA IS KEY
A major UNICEF report on FGM published last month – the biggest global overview to date – highlighted the danger of medicalising FGM, saying it was a growing concern in several countries.
However it did not include Indonesia because of insufficient data.
“The key is the data,” Dorkenoo said. “In Indonesia ... you have bits of data and maybe it is based on very small [amounts of] anecdotal information.”
Such patchy data, coupled with a reluctance to talk about the issue and strong pressure put on governments by religious leaders are some of the reasons why the scale of FGM has been more difficult to assess in countries like Indonesia, but also in the Middle East.
“Africa has been more engaged with the issue (of FGM) because (international) organisations took it up and moved fast and established, for example, the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC),” Dorkenoo said.
“There's been that kind of activist engagement and that brought FGM onto the policy agenda. We know that FGM is practiced across the Middle East and in Indonesia, Malaysia and even Pakistan ... but there's been a kind of denial around it.”
Egypt is by far the country where the practice of FGM is the most medicalised even though FGM is illegal there. The latest data, from 2008, showed that 77 percent of girls who underwent FGM were cut by a doctor, nurse, midwife or other health worker.
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