Introduction
Somaliland is a self-governing
state on the centrally located west coast of Africa. The majority of the 3.5 million people residing
in Somaliland are followers of Islam (The
Somaliland Government, 2013).
Somaliland recently gained independence in 1991 and is in the developing
stages both politically and economically (The
Somaliland Government, 2013). Although
Somaliland seems to be on its way up society’s hypothetical ladder, several
members of the population are facing continued oppression and
discrimination. According to Maryan Qasim,
Somalia’s women’s minister, Somalia has been ranked the fifth worst place in
the world for women (Qasim, 2011). Over 95% of female individuals between the
ages of 4-11 have undergone the procedure of Female Genital Cutting (FGC), also
referred to as Female Genital Mutilation (FGM) as a continued oppressive cultural
tradition in Somaliland (Ismail, 2009). Female Genital Mutilation is the cultural
practice of cutting or altering female genitalia for the purpose of keeping
women “clean” for a future husband (Sarkis,
2003). FGM is practiced in many
Islamic countries in the Middle East, however, it is not part of Islamic
practice. Indigenous groups, Muslims, Christians,
Catholics, and Protestants alike have been tied to the practice of FGM, making
it more than just a religious tradition (Sarkis,
2003). Female Genital Cutting is
a harmful and sometimes deadly procedure that damages a women’s body and leaves
a scar on society. Implementing
Empowerment Feminist Therapy (EFT) into Somaliland’s engrained cultural beliefs
may help to empower women and men alike to understand the negative effects of FGM
and raise awareness about the detriment it poses to individuals, families, and
the country as a whole.
Context of Gender
Based Violence
There are three different procedures
which vary in the degree of mutilation that a girl in Somaliland may be
subjected to. These procedures include
circumcision which involves the removal of the prepuce, with or without a part
of the clitoris, clitoridectomy, which involves removal of part or all of the
clitoris and scraping off the labia, and infibulation, which entails removing the clitoris and labia and sewing the vagina
closed (Ismail, 2009). The
severity of Female Genital Cutting depends primarily on the person performing
the cutting and the regionally accepted cultural tradition. These vary among countries, religions, and
regions of the world (Sarkis, 2003). These procedures can be conducted soon after
the birth of a child or any time before Menarche, but is usually performed on
girls between 7-9 years old, as their tissues
have had more time to grow, making it easier to perform FGM. Female Genital Mutilation in Somaliland
usually consists of cutting a portion of the clitoris, showing it to members of
the community to ensure that enough has been cut, and sewing up the front of
the vagina leaving a small area for urine to exit (Ismail, 2009). The procedure is considered to be extremely
painful and unsanitary, with many cutters using any kind of sharp object that
is available (Ismail, 2009). There are many physical complications to be
considered including the immediate danger the child faces, reopening the wound
during marriage, and giving birth to future children. The female child who experiences the cutting
may be prone to shock, tearing of the genitals, and extreme pain. As the child grows older she faces problems
with menstruation, including the possible onset of persistent urinary tract
infections (Ismail, 2009). When the girl is ready for marriage, the husband
may forcibly penetrate the vagina or cut it open with scissors in order to
perform intercourse (Ismail, 2009). Many complications arise during pregnancy,
birth, and delivery which may lead to maternal mortality (Ismail, 2009). Many women
wait helplessly for the day they will give birth and pray that they don’t die (Qasim, 2011).
Female Genital Mutilation has an
effect on more than just the individual experiencing the cutting. Somaliland holds a cultural expectation that
women will remain virgins until they become married. Cutting the clitoris and sewing up the vagina
is proof to a future suitor that the woman has abstained from sexual
intercourse (Ismail, 2009). The ritual becomes a celebration where
members of the family can also view the physical proof that the bride has
remained sexually inactive (Qasim, 2011). As a result of FGM, the woman may become
infertile due to constant bleeding and obstruction of the fallopian tubes (Ismail, 2009). Infertility can lead to a strain on a
marriage and possible feelings of guilt and shame, which can create an onset of
continued marital problems. If the woman
does get pregnant, there are numerous complications for the fetus and the
mother. The fetus may form improperly,
become prone to hemorrhaging, and experience intrauterine death (Ismail, 2009). The mother faces the fear of obstructed
labor, uterine rupture, and maternal death
(Ismail, 2009). The family is
likely to suffer the loss of the mother and/or the baby due to Female Genital
Cutting.
The likelihood that a girl who
undergoes Female Genital Mutilation will become infected with HIV/AIDS is also
a necessary consideration for the individual and community at large (Ismail, 2009). The use of unsterilized cutting instruments
increases the likelihood that women will contract the virus. Traditional FGM
performers, which may consist of community elders, caregivers, or midwives, are
usually not aware of the dangers of using these instruments and the long term consequences
of their actions (Ismail, 2009). Female Genital Mutilation is likely to
increase the risk of HIV/AIDS due to bleeding and lack of sanitation (De Walque, 2006). As of 2004, more than 23 million people were
affected with AIDS in Sub-Saharan Africa (De
Walque, 2006), making Female Genital Mutilation and its contribution to
HIV/AIDS more than just a micro concern.
Empowerment Feminist Therapy will be used as a guide to empower women to
question the ritual and raise awareness on how FGM poses a threat to society.
Female Genital Mutilation is
having an impact on all women in Somaliland.
Women continue to oppress each other by initiating and condoning
FGM. The socially accepted practice is
seen as a rite of passage which Somaliland women consider to be part of their
identity (Ismail, 2009). When the Half the Sky team questions a woman
in Somaliland about why she continues to practice FGM she replies that God
won’t allow her to be uncircumcised. Although
Muslim women in Somaliland state their claim that God sanctions the
continuation of this ritual, Female Genital Mutilation is not connected to
Islamic practice (Sarkis, 2003), making it a
socially constructed custom. The goal of
EFT is to teach and empower women to
place value in themelves and their bodies in order to deconstruct the mindset
that this ritual is acceptable.
Intervention
Implementing a therapy that
focuses on institutionalized oppression, its effects on individuals, and the
lack of support/resources from the community will be the most effective way to
intervene in the lives of individuals who have experienced Female Genital
Cutting. Using Empowerment Feminist
Therapy in Somaliland will help to increase awareness about traditional gender
roles and embrace social and individual changes, which will, in turn, help to
eliminate the practice of Female Genital Mutilation. The ultimate goal of EFT is to allow the
client to be the expert and empower them to create necessary change (Worell & Remer, 2003). There are four basic principles which guide
Empowerment Feminist Therapy; interdependence of personal and social
identities, personal is political concept, interpersonal egalitarian
relationships, and valuing women’s perspectives
(Worell & Remer, 2003). Before
taking a feminist approach to therapy, the worker must explore and acknowledge
their own personal intersectionalities and privilege in order to actively
engage in the therapeutic process (Worell &
Remer, 2003). The ability to
become emotionally involved and express empathy while remaining culturally
competent is imperative in implementing Empowerment Feminist Therapy (Worell & Remer, 2003).
In applying EFT with survivors of
Female Genital Mutilation in Somaliland, the worker will attempt to understand
the context of their personal situations by examining and raising awareness
about their individual personal identities
(Worell & Remer, 2003). A
survivor of FGM may be facing intersectionalities of gender, ethnicity, social
class, age, ability, and characteristics which influence her privilege and
oppression. A young African American
woman who is living in poverty is facing triple jeopardy based on gender,
social class, and race (Marsiglia & Kulis,
2009). A young woman in
Somaliland may face intersections which include lack of education, low social
class, and debilitating geographic location.
Occupying these oppressive identities limits an individual’s ability to
gain access to necessary resources and opportunities, which may be the case of
a survivor of FGM. Acknowledging and examining
how these identities impact the woman’s access to support is why using EFT is
so crucial to the therapeutic process for women in Somaliland.
Understanding the relationship
between internalized oppression and its impacts on external experiences are the
next steps in implementing change using Empowerment
Feminst Therapy (Worell & Remer, 2003). Reframing the culturally constructed mindset
in Somaliland will help to initiate social change and challenge cultural norms (Worell & Remer, 2003). Initiating social change is important to
eradicate Female Genital Mutilation and change the engrained cultural beliefs
which condone FGM. Empowering women to
create social change will increase the effectiveness of the intervention and
help to mold new political and social changes
(Worell & Remer, 2003). Using
Empowerment Feminist Therapy in Somaliland will help to create a lasting change
where the women take control of their bodies and country.
Meeting the client where they are
is a necessary tool when taking a western view into a non-western world. The worker should not bring assumptions based
on personal privilege, but work to empower the client and share what they
believe is an effective way to create change.
Setting goals together and using written contracts to hold each other
accountable in the therapeutic process will help to ensure success in
Empowerment Feminist Therapy (Worell &
Remer, 2003). The expression of anger in
the theapuetic relationship should also be expressed and shared among worker
and client willingly (Worell & Remer, 2003). Individuals who have experienced FGM in Somililand
are likely to become very emotional throughout the therapuetic process and it
is important to validate these feelings and draw strengths from the individuals
situation. Acknowledging strengths in
individuals will help to empower women to educate other women and create
lasting social change.
Beginning
to recognize and value individual characteristics which may be encompassed by
religion and culture is the final necessary step in Empowerment Feminist
Therapy (Worell & Remer, 2003). Somaliland
women can begin to identify and value themselves and their bodies and take
control of what is rightfully theirs. Upon
doing so, they will be able to value other women in their lives, including
those who were responsible for the cutting.
These women will also be able to accept and value their own bodies,
whether they have been mutilated or not. Women in Somaliland must accept and
trust in their own personal experiences in order to implement social changes to
create a world that recognizes and understands
the negative effects of Female Genital Mutilation.
Empowerment
Feminist Therapy seeks to implement therapuetic intervention by creating
empathy and mutual understanding among the client and worker, teach and raise
awareness about the clients identity and how that impacts their place in
society, and create political and social action by initiating local and global
awareness, while empowering the client and respecting diversity (Worell &
Remer, 2003). When considering the best
way to implement an intervention into the lives of Somaliland women who have
survived Female Genital Mutilation, this worker thinks there is no better way
than to empower women to create change for themselves, their bodies, and their
futures. Implemeting long lasting social
change and influencing political powers takes strength from within, meaning the
residents of Somaliland. Implementing a
change in thinking about FGM will be more effective than attempting to pressure
governments to outlaw the practice of Female Genital Cutting (Antonazzo,
2003). The workers job is to help raise
awareness in a therapeutic environment and stand side by side women as they are
on the forefront of creating change for the future. Working under an Empowerment Feminist Therapy
perspective is essential in implementing positive theurapuetic techiniques, as
it focuses on the women who are involved and initiates a change in thinking
(Worell & Remer, 2003).
Women
in Somaliland have begun to rise up and raise awareness on the impacts of
Female Genital Mutilation. Edna
Adan Ismail, who is trained as a nurse/midwife, has built a hospital in
Hargeisa, Somaliland, which seeks to educate women and send them back into the
community to spread awareness on the impacts of Female Genital Mutilation. This feminist approach to creating change
empowers women and helps them to regain control of their minds and bodies,
while allowing them to engage communities and change the mindset of individuals
in order to create social change. In
order to effectively implement Empowerment Feminist Therapy in Somaliland,
social workers may consider teaming up with hospital representatives to work
with clients who have experienced Female Genital Mutilation. Building a relationship with midwives in
Somaliland may prove to be an effective way to reach clients who are in need of
empowering therapy while in the hospital and after they return home. The Edna Adan Maternity and Teaching hospital
in Somaliland would benefit from educating women in the importance of social
work and sending them back to their communities as they do with midwives. Implementing a social work education program
would help Somaliland women in understanding the cultural norms about FGM,
which have cross-generational effects on all residents.
Conclusion
It
is important to be culturally sensitive while implemeting intervention and
maintain a sense of cultural competency.
Continually learning and self-examining in order to recognize privilege
and use it in an effective way is essential in Empowerment Feminist Therapy and
helps in the therapuetic relationship by keeping the worker socially and
culturally grounded. In order to
implement change while respecting and valuing culture, western workers should
help by directing financial aids toward groups that educate and empower women
and change the mindset about Female Genital Cutting (Antonazzo, 2003). Supporting grassroots campaigns that are
considerate of culture and tradition is necessary in implementing this
intervention. Workers who seek to
intervene in the lives of women and attempt to change the mindset about FGM
need to be able to think outside the box in order to educate and spread
awareness in a culturally sensitive way.
Working with and empowering the women effected and helping to identify
the macro level forces which limit gender abilities and create oppression
through inadequate funding, bureaucracies, and institutions is the building
block for implementing culturally sensitive Empowerment Feminist Therapy in
Somaliland. As the chinese proverb goes,
“If you give a man a fish he will eat for a day, if you teach him to fish, he
will eat for a lifetime.” The idea carries
through for implementing change for women’s rights in Somaliland.
References
Antonazzo, Monica. (2003). Problems with Criminalizing Female Genital
Cutting. Peace
Review 15(4):471-477.
De Walque, D. (2006). Who Gets AIDS and How? The World Bank.
Ismail, E. A. (2009). Female Genital
Mutilation Survey In Somaliland. Hargeisa, Somaliland: The Edna Adan
Maternity and Teaching Hospital.
Marsiglia, F. F., & Kulis, S. (2009). Culturally
Grounded Social Work; Diversity, Oppression, and change. Chicago: Lyceum
Books, Inc.
Qasim, M. (2011, June 17). The women of
Somalia are living in hell. Retrieved from The Guardian.
Sarkis, M. (2003). Female Genital
Cutting (FGC): An Introduction. Retrieved from The Female Genital Cutting
Education and Networking Project: http://www.fgmnetwork.org/intro/fgmintro.html
The Somaliland Government. (2013). Somaliland
Culture. Retrieved from The Somaliland Government:
http://somalilandgov.com/
Worell, J., & Remer, P. (2003). Feminist
Perspectives in Therapy; Empowering Diverse Women. Hoboken: John Wiley
& Sons, Inc.
