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Female circumcision in sudan
1. University of bahri
Faculty of medicine
Department of community medicine
Research about
female percussion 2014
r super adviser of
Professr : Hamza Omer Hamza
1
2. By students
1)Almawsiley Alsayed Alnore Alsayed
2)Waleed Bushra Amad
3)Hiba Hassan RehmtAllah Ahmed
4)Fadia Hassan Abd Alrahman
5)Faiza Kamal edin Alsadig
2
4. ArP Alternative rite of Passage
Dhs demographic and health surveys
ecAw education centre for the Advancement of
women
FGd Focus Group discussion
FGm Female Genital mutilation
FGm/c Female Genital mutilation / cutting
GeP Girl empowerment Programme
unFPA united nations Population Fund
uniceF united nations children’s Fund
whA world health Assembly
who world health organization
Figure album contain
4
5. Acknowledgment
We would extend our deepest gratitude to our
supervisor professor hams over hams we would to
thank all member of Bahri University for profiting us
references and to their co operative and who all
participate in research thanks
5
7. Introduction
Female circumcision(FC) was first discovered in
ancient Egyptian mummies dating 2000 B.C in the
Islamic era the custom wide spread Egypt, Arabia-
and red sea(Ethiopia) Although the practice of F.C is
mostly concentrated in Africa but there are some
cases reported outside it.
Female circumcision is one of the harmful tradition
practices that are still prevalent in number of
developing countries. In some countries where female
circumcision is widely practice. The condition
constitute a major public health problem which put a
lot of burden on the already deficient health
services
Female genital mutilation (FGM), also known as female
genital cutting and female circumcision, is defined by
the World Health Organization (WHO) as "all procedures that
involve partial or total removal of the external female genitalia or
other injury to the female genital organs for non-medical
reasons. FGM is practiced as a cultural ritual by ethnic
groups in 27 countries in sub-Saharan and Northeast Africa,
and to a lesser extent in Asia, the Middle East and within
7
8. immigrant communities elsewhere.]
It is typically carried out,
with or without an aesthesia, by a traditional circumciser using a
knife or razor. The age of the girls varies from weeks after
birth to puberty; in half the countries for which figures were
available in 2013, most girls were cut before the age of five.
Therefore F.C is bounded to result in serious
complication to the health of child
Those who escape from this dramatic complication
may be left with major disabilities which affect their
physical and psychological health effect in later life
Female circumcision in the Sudan was first seen as
social problem by British administration in 1946.With
very few exception all tribes in Sudan practice a form
of circumcision
Includes the Falata.Fur Nuba from the western of the
country
The estimation or total number of women subjected
to circumcision range between 48-114 million. At the
current rate of the population growth the estimated
of girl eligible for female genital mutilations is more
than million every year
8
9. Justification
THE practice of female circumcision in Sudan is both
very old and wide spread it is not only become part of
the customs and traditional, but also associated with
religious and believes. Not only circumcised female
harm but reflect on the family and consequently the
whole society finally due to difficulty to eradicate the
tradition of community so it is better to reduce the
practice of FC by doctor stop practice. And educate
medical student and people to leave the harmfully for
better quality of life
Objective
To assess the knowledge, attitudes and practice of
female circumcision among female between age 18-30
years old who study at Bahri University 2014.
Specific objective
1- To estimate the prevalence of F.C in Bahri
University.
2- to identify the most common area for this practice
9
10. 3- To refuse illegal practice that lead to serious
complication.
4- To minimize the usage of harmful practice by using
awareness of doctor to stop practice. This practice
me be illegal.
5- To estimate practical future of doctor to word
practice
10
12. Literature review
Before describing the different operation of FC it is
important in beginning to give brief description of the
anatomy of females genital organs
EXTERNAL GENITALIA
Female external genitalia commonly referred to as the
VULVA
Which includes THE MONS PUBS ls the mound of
hairy skin and subcutaneous fat In front of the
Pubic symphonies and pubic bone
LABIA MAJORA
12
13. These are twofold of skin under lying adipose tissue
bounding sebaceous sweat gland and few specialize
barthlotin gland
LABIA MINOR
Are two thin fold of skin that lies between the labia
majora interiorly and they divided into two forms the
prepuce and frenulum clitoris they contain sebaceous
Clitoris
13
14. Is small erectile structure the body of it contains two
crurra the corpora cavernosa which attached to the
inferior border of the pubic rami is bout 1cm long but
has highly developed nerve supply and is very
sensitive during sexual arousal
Vestibule
The cleft between the labia minora the urethra the
duct of barthlotin gland and the vagina open in the
vestibulia
Vestibulular bulbs
Are two baloney mass of erectile tissue that lie on
either side of the vaginal entrance spongiosas muscle
barthholion gland these vestibule are mucus
14
15. secreting gland producing copious amount during
inter course to act as lubricant a
Definition
FC include a range of practices
involving complete or partial removal or attention of
the external genitalia appear widely in the Africa and
other population
Classification
Normal female anatomy and how FGM Types I–III
differs from it. The procedure used varies according to
ethnicity. Information about the procedures comes
from anthropologists, local health workers, and from a
15
16. series of surveys conducted by aid agencies since the
late 1980s the surveys are based on questionnaires
completed by the women themselves, who have
responded using 50 different terms for the
procedures. Apart from the difficulty of comparing
and translating these terms across different cultures
and languages, the women may not be able to
describe what was done to them, procedures vary
according to practitioners, and there is considerable
overlap between categories. As a result no typology is
entirely accurate.
The WHO divides the main procedures into three
categories, Types I–III (see image right). The
organization maintains a fourth category, Type IV, for
piercing the clitoris or prepuce (symbolic circumcision)
and for miscellaneous procedures not related to FGM
as a ritual, such as cutting into the vagina (gishiri
cutting). A 2006 study, in which 255 girls and 282
women in Sudan were asked to describe their cutting
and were then examined, suggested that there was
significant under-reporting of the severity of the
procedures because the subjects were confusing the
WHO's Types II and III UNICEF instead uses the
following categories: (1) cut, no flesh removed
16
17. (pricking); (2) cut, some flesh removed; (3) sewn
closed; and (4) type not determined/unsure/doesn't
know
WHO Types I and II
The WHO's Type I is subdivided into two. Type I is the
removal of the clitoral hood, which is rarely, if ever,
performed alone. More common is Type Ib
(clitoridectomy), the partial or total removal of the
clitoris, along with the prepuce. Susan Izett
and NahidToubia of RAINBO, in a 1998 report for the
WHO, wrote: "the clitoris is held between the thumb
and index finger, pulled out and amputated with one
stroke of a sharp object. Bleeding is usually stopped by
packing the wound with gauzes or other substances
and applying a pressure bandage. Modern trained
practitioners may insert one or two stitches around
the clitoral artery to stop the bleeding.
Type II is partial or total removal of the clitoris
and inner labia, with or without removal of the outer
labia. Type II is known as excision in English, but in
French excision refers to all forms of FGM.WHO Type
III
17
18. III(infibulation
is the removal of all external genitalia and the fusing
of the wound, leaving a small whole (2–3 mm for the
passage of urine and menstrual blood. The inner and
outer labia are cut away, with or without excision of
the clitoris A pinhole is created by inserting something
into the wound before it closes, such as a twig or rock
salt. The wound may be sutured with surgical thread,
or agave or acacia thorns may be used to hold the
sides together; according to a 1982 study in Sudan,
eggs or sugar might be used as an adhesive. The girl's
legs are then tied from hip to ankle for 2–6 weeks until
the tissue has bonded Anthropologist Janice
Boddy witnessed the infibulation in 1976 of two
sisters in northern Sudan by a traditional circumciser
using an anaesthetic:Boddy wrote that older women
18
19. in Sudan recalled a procedure in which the circumciser
would scrape away the external genitals with a
straight razor, and with no anesthetic.]The infibulated
woman's vulva is opened for sexual intercourse, by a
penis or knife, and for childbirth. Hanny Lightfoot-
Klein, a social psychologist, interviewed 300 Sudanese
women and 100 Sudanese men in the 1980s and
described the penetration by the men of their wives'
infibulations:
The penetration of the bride's infibulations take
anywhere from 3 or 4 days to several months. Some
men are unable to penetrate their wives at all (in my
study over 15%), and the task is often accomplished by
a midwife under conditions of great secrecy, since this
reflects negatively on the man's potency. Some who
are unable to penetrate their wives manage to get
them pregnant in spite of the infibulations, and the
woman's vaginal passage is then cut open to allow
birth to take place. ... Those men who do manage to
penetrate their wives do so often, or perhaps always,
with the help of the "little knife." This creates a tear
which they gradually rip more and more until the
opening is sufficient to admit the penis. In some
women, the scar tissue is so hardened and overgrown
19
20. with keloidal formations that it can only be cut with
very strong surgical scissors, as is reported by doctors
who relate cases where they broke scalpels in the
attempt.
Defibulation, or deinfibulation, reverses the closure of
the vagina; this is performed before childbirth, or at
the request of a woman seeking to have her genitals
repaired. After giving birth, women may ask that the
infibulations be restored. Reinfibulation may also be
carried out if a woman's husband is travelling away
from home for a protracted period, after divorce or to
prepare elderly women for death.
WHO Type IV
A variety of procedures are known as Type IV, which
the WHO defines as "all other harmful procedures to
the female genitalia for non-medical purposes, for
example, pricking, piercing, incising, scraping and
cauterization." These range from ritual nicking of the
clitoris (ritual circumcision) to gishiri cutting, angurya
cutting, burning or scarring the genitals, and
introducing substances into the vagina to tighten
it. Labia stretching is also categorized as Type IV FGM;
in Tanzania and the Congo girls are told to stretch the
clitoris and labia minora every day for 2–3 weeks; an
20
21. older woman uses sticks to hold the stretched parts in
place Gishiri cutting involves cutting the vagina's
anterior (front) wall to enlarge it, and angurya cuts
involve scraping tissue away from around the vagina.
Another procedure is hymenotomy, the removal of
a hymen regarded as too thick, which is practised by
the Hausa in West Africa. The WHO does not include
cosmetic procedures such as labiaplasty or procedures
used in sex reassignment surgery within its FGM
categories
Complications
FGM has no known health benefits It has immediate
and late complications, which depend on several
factors: the type of FGM; the conditions in which the
procedure took place and whether the practitioner
had medical training; whether unsterilized or surgical
single-use instruments were used; whether surgical
thread was used instead of agave or acacia thorns; the
availability of antibiotics; how small a hole was left for
the passage of urine and menstrual blood; and
whether the procedure was performed more than
once (for example, to close an opening regarded as
too wide or re-open one too small). Immediate
21
22. complications include fatal bleeding, acute urinary
retention, urinary infection, wound
infection, septicemia, tetanus and transmission
of hepatitis or HIV if instruments are non-sterile or
reused.] It is not known how many girls and women
die from the procedure; few records are kept,
complications may not be recognized, and fatalities
are rarely reported. Late complications vary
depending on the type of FGM performed. The
formation of scars and keloids can lead to strictures,
obstruction or fistula formation of the urinary and
genital tracts. Urinary tract sequelae include damage
to urethra and bladder with infections
and incontinence. Genital tract sequelae include
vaginal and pelvic infections, painful periods, pain
during sexual intercourse and infertility. Complete
obstruction of the vagina results
in hematocolpos and hematometra Other
complications include epidermoid cysts that may
become infected, neuroma formation, typically
involving nerves that supplied the clitoris, and pelvic
painFGM may complicate pregnancy and place women
22
23. at higher risk for obstetrical problems, which are more
common with the more extensive FGM
procedures.] Thus, in women with Type III who have
developed vesicovaginal or rectovaginal fistulae –
holes that allow urine and faeces to seep into the
vagina – it is difficult to obtain clear urine samples as
part of prenatal care, making the diagnosis of
conditions such as preeclampsia harder Cervical
evaluation during labour may be impeded and labour
prolonged. Third-degree laceration, anal sphincter
damage and emergency caesarean section are more
common in women who have experienced
FGM. Neonatal mortality is also increased. The WHO
estimated that an additional 10–20 babies die per
1,000 deliveries as a result of FGM; the estimate was
based on a 2006 study conducted on 28,393 women
attending delivery wards at 28 obstetric centers in
Burkina Faso, Ghana, Kenya, Nigeria, Senegal and
Sudan. In those settings all types of FGM were found
to pose an increased risk of death to the baby: 15
percent higher for Type I, 32 percent for Type II and 55
percent for Type IIIPsychological complications include
23
24. depression and post-traumatic stress disorder. In
addition, feelings of shame and betrayal can develop
when the women move outside their traditional
circles and learn that their condition is not the
norm They are more likely to report painful sexual
intercourse and reduced sexual feelings, but FGM
does not necessarily destroy sexual desire in women.
According to several studies in the 1980s and 1990s,
women said they were able to enjoy sex, though the
risk of sexual dysfunction was higher with Type III.
Islamic attitudes to female circumcision
We can safely say that if had anything to these custom
do with Islam it would called Islamic circumcision The
Prophet Mohammed saying that Be kind with women
the mother said to be the key to entering are Paradise
and so forth
The status of women is described in the Quran menses
gestation One of the saying Prophet (Hadith which is
un confirmed is often attenuated to Om
Attiya(reduced but not destroy. Some people that FC
preserves the women's honors but this opinion is
24
25. rejected. for honors and virtue are the result of a
good upbringing.
some say that sunna is legal one they contribute Islam
because it is not harmful and has no complication. So
Fc is neither religious duty on a sunna. not even a
recommended practice All that has claimed for been
that it is an honors to women and this does not even
seem to be valid in the light of modern medical
knowledge
Female circumcision in Sudan
female circumcision in Sudan wide practiced in Sudan
has persisted it centuries because of lack of
knowledge awareness adverse physical and
psychological consequence. More over the operation
of female circumcision is carried out by non-skilled
practitioners under very adverse hygienic conditions.
Regional and ethno-cultural differences relating to FC
are small interest. but lack of numerical data
precludes detailed statistical analysis, however,
25
26. different observers noted disparity even within the
same region, specially the Hadndawa and Beni Amir
practice the severest type of infibulations, and their
neighbors Rashaidah Arabs hardly carry out and
format of circumcision among their women In western
Sudan the Ba garah Arab continued to practice Sunna
circumcision for quite long time before training to
more drastic form of infibulations, where many of the
Muslim tribe of Darfur don't perform circumcision
their female a wider form of circumcision is common
on throw out the groups and habiting Northern and
Central Sudan as well as among the Kababish Arab of
Western Sudan. The studies of FC has been done
since 1979, by many researcher as AsmaElderrer.
GasimBadri and faculty of medicine they are make
survey in different areas of Sudan and they obtain
same results pharaonic type is the more common,
followed by intermediate and Sunna very rare
operating type
26
28. Methodology
Approach
It is qualitative study on practice and attitudes toward
female students in bahry university
Study design
ls descriptive cross-sectional community base study area
This study was carried out in university of bahry which
located in Khartoum state . Number of population
1249 students. 864 are females 385 males.
Study population
Total number of study population is about 250 female
students
Sample technique
The first girl was selected randomly and other
selected by systematic random technique. Data
analyze by computer operator and corrected by
supervisor then presented in frequency tables, figures
and percentage
28
29. الفصل4 CAPTER 4
Data Analysis
Table (1) age
Valid Frequency Percent
from 18-20 150 60.0
29
30. from 21-24 90 36.0
from 25 فمافوق 10 4.0
Total 250 100.0
We show that from table and figure , age , from 18-20
= 60% , from 2-24 = 36% , up to 25= 4%
Table (2) Education study.
Valid Frequency Percent
first 52 20.8
2th 49 19.6
3th 44 17.6
4th 45 18.0
5th 55 22.0
Total 245 98.0
Total 250 100.0
30
31. We show in table and figure that level of study ,class
one 21.2% , class two 20%, class three 18%, class four
18.4% , class five 22.4%.
Table (3) Education of father
Valid Frequency Percent
Ignore 7 2.8
أbasic 31 12.4
Higher
secondary
77 30.8
University 135 54.0
Total 250 100.0
31
32. We show in table and figure that Education of father ,
Ignore 2.8% , basic 12.4 , Higher secondary , 30.8%,
University 54%
Table (4) Education of Mother.
Valid Frequency Percent
Ignore 5 2.0
Basic 35 14.0
High
Secondary
83 33.2
University 121 48.4
Total 244 97.6
Total 250 100.0
32
33. We show in table and figure that Education of
mother , ignore 2% , basic 14.3% , High Secondary
34%, University 49.6%
Table (5) Father’s job:
Valid Frequency Percent
Worker 17 6.8
Officer 94 37.6
Free worker 77 30.8
Total 188 75.2
Total 250 100.0
33
34. We show in table and figure that father’s job , worker
9%, officer 50% , free worker 41%
Table (6) mother’s job:
Valid Frequency Percent
Worker 38 15.2
House wife 212 84.8
Total 250 100.0
34
35. We show in table and figure that mother’s jobs.
Worker 15.2%, house wife 84.8%
Table (7) Do you agree on female circumcision
Valid Frequency Percent
Agree 31 12.4
Disagree 138 55.2
Total 169 67.6
Total 250 100.0
35
36. We show that in table and figure, about Do you agree
on female circumcision , we found that the student
said agree 18.3%, and disagree 81.7%.
Table No (8) If agree, what the reasons
Valid Frequency Percent
Religion 18 7.2
Social & culture 18 7.2
sex 7 2.8
Others 9 3.6
Total 52 20.8
Total 250 100.0
36
37. We found that , if agree, what the reasons, so religion
34.6%, social & culture 34.6%, sex 13.5%, others
17.3%
Table No (9) Did you learn that female circumcision
damages sexual in fertility and birth,
Valid Frequency Percent
Yes 145 58.0
no 5 2.0
Total 150 60.0
Total 250 100.0
37
38. Table No (9) Did you learn that female circumcision
damages sexual in fertility and birth, yes , 96.7%, No
3.3%
Table (10) Do you circumcision if yes go to question
No (15)
Valid Frequency Percent
yes 147 58.8
no 37 14.8
Total 184 73.6
Total 250 100.0
38
39. We show in table and figure that Do you circumcise if
yes go to question No (15) , and replay Yes 79.9% , No
20.1%
Table No (11) Education level decision makers
Valid Frequency Percent
Educate 110 44.0
Uneducated 26 10.4
Total 136 54.4
Total 250 100.0
39
40. We show in table and figure that ) Education level
decision makers. We see educate 80.9%. Uneducated
19.1.
Table No (12) If the answer is yes taken decision from
circumcise
Valid Frequency Percent
Father 16 6.4
Mother 85 34.0
Grandfathe
r &
grandmoth
er
33 13.2
Others 11 4.4
Total 145 58.0
Total 250 100.0
40
41. In table in figure we show that If the answer is yes
taken decision from circumcise, father 11%, and
mother 58.6% , grandfather & grandmother 22.8%.
other 7.6%.
Table No (13) Believes that the practice of female
circumcise should by continue
Valid Frequency Percent
yes 20 8.0
no 129 51.6
Total 149 59.6
Total 250 100.0
41
42. We show that in table and figure , Believes that the
practice of female circumcise should by continue ,
yes 86.6% , and No 13.4%.
Table No (14) Do you practice circumcision, if you are
a doctor and able to do it
Valid Frequency Percent
Agree 13 5.2
Disagree 127 50.8
Total 140 56.0
Total 250 100.0
42
43. In table and figure we show that Do you practice
circumcision, if you are a doctor and able to do it ,
agree 9.3%, disagree, 90.7%.
Table No (15) Do you will circumcision your daughters
in Future
Valid Frequency Percent
Yes 65 26.0
no 116 46.4
Total 181 72.4
Total 250 100.0
43
44. In table and figure, Do you will circumcision your
daughters in Future, the replay yes 36.9% , and No
64.1%
Table No (16) Do you proud the other that harm of
circumcision. By yourself if request
Valid Frequency Percent
yes 142 56.8
No 19 7.6
Total 161 64.4
Total 250 100.0
44
45. In table and figure We show that Do you proud the
other that harm of circumcision. By yourself if request
, yes 88.2% , No 11.8%.
Table (17) Do you think that the program of the
Ministry of Health in the successful fight against
circumcision.
Valid Frequency Percent
Yes 22 8.8
No 101 40.4
Total 123 49.2
Total 250 100.0
45
46. In table and figure we show that Do you think that the
program of the Ministry of Health in the successful
fight against circumcision, yes 17.9%, No 82.1%.
46
47. Data Analysis
We show that from table and figure, age, from 18-20 =
60%, from 2-24 = 36%, up to 25= 4%
We show in table and figure that level of study, class
one 21.2%, class two 20%, class three 18%, class four
18.4%, class five 22.4%.
We show in table and figure that Education of father,
Ignore 2.8%, basic 12.4, higher secondary, 30.8%,
University 54%
We show in table and figure that Education of mother,
ignore 2%, basic 14.3%, High Secondary 34%,
University 49.6%
We show in table and figure that father’s job, worker
9%, officer 50%, and free worker 41%
We show in table and figure that mother’s jobs.
Worker 15.2%, house wife 84.8%
We show that in table and figure, about do you agree
on female circumcision, we found that the student
said agree 18.3%, and disagree 81.7%.
47
48. We found that, if agree, what the reasons, so religion
34.6%, social & culture 34.6%, sex 13.5%, others
17.3%
Did you learn that female circumcision damages
sexual in fertility and birth, yes, 96.7%, No 3.3%
We show in table and figure that Do you circumcise if
yes go to question No (10) , and replay Yes 79.9% , No
20.1%
We show in table and figure that) Education level
decision makers. We see educate 80.9%. Uneducated
19.1.
In table in figure we show that if the answer is yes
taken decision from circumcise, father 11%, and
mother 58.6%, grandfather & grandmother 22.8%.
Other 7.6%.
We show that in table and figure , Believes that the
practice of female circumcise should by continue ,
yes 86.6% , and No 13.4%.
48
49. In table and figure we show that Do you practice
circumcision, if you are a doctor and able to do it,
agree 9.3%, disagree, 90.7%.
In table and figure, do you will circumcision your
daughters in Future, the replay yes 36.9%, and No
64.1%?
In table and figure we show that do you proud the
other that harm of circumcision. By yourself if
request, yes 88.2%, No 11.8%.
In table and figure we show that Do you think that the
program of the Ministry of Health in the successful
fight against circumcision, yes 17.9%, No 82.1%.
49
51. Dissection
It is clear that female genital mutilation has serious
physical and mental health consequences in Sudan
For women. It is rare for women to survive mutilation
without complications, be they short or
Long term, physical or psychological. Doctors must
give their patients help and support, and
Provide psycho-sexual and gynecological advice as
appropriate
so some of community re fuse that
51
53. Recommendation
The urgent and unqualified need to prevent and end
all forms of female genital mutilation is
Being pursued at all levels, from campaigns by
international organizations, to groups of
Women refusing to have their daughters mutilated.
Individual doctors have an important role to play in
efforts to support communities to abandon female
genital mutilation (Bahri Medical Student). In addition
to identifying girls who may be at risk of genital
mutilation, they can work as part of inter-agency
teams to change opinion amongst communities where
it is practiced. Doctors can also raise awareness of the
harmful effects of female genital mutilation, within
their practice, amongst the public, medical
professionals,decision-makers, governments, political,
religious and village leaders, as well as traditional
healers and birth attendants. They can also speak at
community events on the health risks of female
genital mutilation.
53
54. Government and the local agencies need to
strengthen public awareness around the existing laws
in relation to FGM and the process of reporting cases
of FGM to the authorities. The government also needs
to enforce the laws more diligently at local and
national levels.More girl empowerment programmers
are needed, to help girls resist the social pressure to
undergo FGM. These can be as simple as clubs in
schools to teach life-skills, and offer information and
social skills training to resist family pressure.
More ARP programs are also needed, to extend the
coverage of the current activities.Schools provide an
excellent avenue to address FGM and encourage the
young people to reject it
54
56. Conclusion
The findings of this study show that, despite stiff social
resistance, progress towards abandonment of FGM
can be achieved through well-focused, incremental
programmer’s Stronger enforcement of the existing
laws prohibiting FGM and promoting children’s rights
is needed Despite school attendance being relatively
high in Sudan local agencies and partners should also
target some of the more marginalized in communities,
in particular those families outside the school
networks many of whom have limited levels of literacy
Appendix
56
57. Questionnaire
1-age
a. From 18-23 ( ) b. from 21-24 ( ) c. Up to 25 ( )
2-Education study.
First ( ) second ( ) third ( ) fourth ( ) fifth ( )
3- Education of father
Ignore ( ) basic ( ) secondary ( ) university ( )
4- Education of Mother.
Ignore ( ) basic ( ) secondary ( ) university
5- Father’s job:
Worker ( ) employment ( ) free worker ( )
6-mother’s job:
Employment ( ) housekeeper ( )
7-Do you agree on female circumcision
Yes ( ) No ( )
8-If agree, what the reasons
Relegation ( ) social & cultural ( ) sexual ( ) other ( )
57
58. 9- Did you learn that female circumcision damages sexual
in fertility and birth,
Yes ( ) No ( )
10- Do you circumcision if yes go to question No (15)
Yes ( ) No ( )
11- Education level decision makers
Education ( ) undulation ( )
12- Believes that the practice of female circumcise should
by continue
Father ( ) mother ( ) grandmother & grandfather ( ) Others ( )
13-Do you practice circumcision, if you are a doctor and
able to do it
Yes ( ) No ( )
14-Do you will circumcision your daughters in Future
Yes ( ) No ( )
15-Do you proud the other that harm of circumcision. By
yourself if request
Yes ( ) No ( )
16-Do you think that the program of the Ministry of
Health in the successful fight against circumcision.
Yes ( ) No ( )
58
61. Summary
FGM is usually carried out in countries belt
circumcision and are in some countries under the
name Khvad both are cut with a mean level differed
in pieces
The study was conducted to find out the number of
the affected cases do, risks and suffering and
students' awareness of the dangers of medicine and
work to reduce them in the community
Used in the study simple random method in the
same 250 number used statistical analysis software
to analyze and display data
Study showed that (a) of the sample subjected to
genital mutilation and the proportion of (a) of the
community wants to continue the habit and the
proportion of () in the risk of FGM percentage ()
knows deterring
Habit assets related to the community, culture high
percentage () and the role of mothers which is the
biggest in Atkhaz decision percentage () also showed
lack of success of the ministry's program in-fighting
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62. habit percentage () and it was probably awareness
through discussion groups better because illiterate
mothers were percentage ()
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64. *British Medical Association. Child protection – a
toolkit for doctors, 2009. Available at
http//: www.bma.org.uk/ethics
*HM Government. Multi-Agency Practice Guidelines:
Female Genital Mutilation, 2011.
Available at http//:www.dh.gov.uk or
http//:www.fco.gov.uk/fgm
nursing and midwifery staff, 2006. Available at
http//: www.rcn.org.uk
*Royal College of Obstetricians and Gynecologists.
Female Genital Mutilation and its
Management, Green-top guideline No. 53, 2009.
Available at www.rcog.org.uk
*Wikipedia web site, February 2013
• "Factsheet on FGM", World Health Organization, February 2013.
• End FGM campaign, Amnesty International.
• British National Society for the Prevention of Cruelty to Children 24-hour national helpline for
children at risk of FGM: 0800 028 3550
• FORWARD, London, charity specializing in FGM research (FORWARD's list of hospitals and
clinics in the UK offering specialist FGM services).
64
65. • Desert Flower Foundation ("First Desert Flower Center opens in Berlin", 16 September 2013;
first dedicated FGM clinic in Europe).
• A/RES/48/104. Declaration on the Elimination of Violence against Women: Article 2: section
(a)—Declaration on the Elimination of Violence Against Women
Bibliographies
• "Circumcision, female", The Kinsey Institute (bibliography 1960s–1980s).
• Westley, David M. "Female circumcision and infibulations in Africa", Electronic Journal of
Africana Bibliography, 4, 1999 (bibliography up to 1997).
Books and news
• Gollaher, David. Circumcision: A History of the World's Most Controversial Surgery, Basic
Books, 2000.
• CNN. Report on FGM in Egypt, February 2009.
• Guardian. FGM archive; Guardian interactive, 22 July 2013.
• Haworth, Abigail. "The day I saw 248 girls suffering genital mutilation", The Guardian, 18
November 2012.
• Sembène, Ousmane. Moolaadé, 2004, a film about abandoning FGM.
• Sinclair, Stephanie. '"Inside a Female-Circumcision Ceremony", The New York
Times magazine, April 2006, slideshow of images from Indonesia (article).
• Walker, Alice. Possessing the Secret of Joy, New Press, 1993 (novel).
• UNICEF. "Towards the abandonment of female genital mutilation in five African countries",
October 2010.
Personal stories
• Ali, Ayaan Hirsi. Infidel: My Life, Simon & Schuster, 2007: Ali experiences FGM at the hands
of her grandmother.
• Dirie, Waris. Desert Flower, Harper Perennial, 1999: autobiographical novel.
• Dirie, Waris. Desert Dawn, Little, Brown, 2003: Dirie's work as UN Special Ambassador
against FGM.
• Dirie, Waris. Desert Children, Virago, 2007: FGM in Europe
65
66. • Kasinga, Fauziya, and Bashir, Layli Miller. Do They Hear You When You Cry, Delacorte
Press, 1998.
• El Saadawi, Nawal. Woman at Point Zero, Zed Books, 1975.
66