Dr. Besser's Notebook: Women's Rights in Senegal

March, 17, 2011— -- "When everyone wears no clothes you don't notice that you are naked."

Demba Diawara speaks in parables. It makes it very hard for me to understand him-- that and the fact that he speaks Wolof, a language native to Senegal. Thankfully, I have with me to translate, Molly Melching, a 60-year old woman originally from Illinois.

Molly wears a long purple boubou and sunglasses. You might think that she would look incongruous in this little Senegalese village but in fact, I can't imagine her looking more at home anywhere in the world. We're sitting under the shade of a large neem tree talking with Demba, an elderly religious leader about something unspeakable, female genital cutting.

In many parts of the world, female genital cutting has been performed for thousands of years. The United Nations estimates that 3 million girls are cut each year. The practice is most prevalent in parts of Africa. The procedure, usually performed without any anesthetic refers to the ritual removal of part or all of the external genitalia for non-medical reasons. In its most severe form, the clitoris and labia are removed and the vagina is almost entirely sealed. It is a brutal act.

There are no medical benefits of cutting; on the contrary, it is an extremely dangerous and often debilitating procedure. Apart from the incredible pain and trauma of the act itself, girls can die from hemorrhage and infection. Complications are often life-long. Women are at increased risk of infertility, childbirth difficulties, and urinary tract problems, the worst being fistula - a connection between the urinary tract and the vagina. Women with this complication continuously leak urine, and many are forced to live away from the rest of the village. Added to all this is the inability to ever have a fulfilling sex life.

For decades, international bodies have condemned the practice and many governments have made it illegal but there is little evidence that these measures actually decreased the number of girls who get cut. In many places it was simply driven underground.

What has been effective is the work of a non-profit organization called Tostan, a Wolof word meaning "breakthrough." Tostan uses education to improve knowledge and skill training to promote effective communication. The focus of Tostan is not female genital cutting; it is literacy, problem solving, women's health, negotiating, and human rights. Students are empowered to take their knowledge and make decisions to improve their lives. There is no condemnation of traditions, beliefs or practices. Women learn the health consequences of cutting and they make the connection between human rights and the right to health.

Those who have been taught through Tostan go on to teach others, eventually spreading education within the entire community. Through this gentle process, communities reach their own conclusions: for the good of their daughters, cutting must stop. To ensure openness and trust, members of the community rise together in a public forum and declare an end to the practice.

Molly founded Tostan in 1991. She came to Senegal in 1974 right out of college and immediately fell in love with the people, the culture, and the beauty of the land. She knew this was where she wanted to spend her life. She comes from a line of teacher and took that tradition in new directions. Through Tostan she is spreading a form of education that is both extremely powerful and empowering. Since 1998, more than 6,000 villages in five African countries have publicly declared their abandonment of cutting. They estimate that these declarations have spared 800,000 girls this pain.

Molly wanted to make sure I met Demba and that is why we are sitting under the shade of the giant neem tree. Demba is the imam and spiritual leader of Malicounda Bambara. His lined faced and sharp eyes exude a sense of total peace and incredible wisdom. He was an early participant in Tostan and his village was one of the first to stand up and say to all that the tradition was over.

How did you feel, I asked him, when you learned that what you had been doing for centuries was so harmful to your daughters? That must have been very difficult.

"When everyone wears no clothes you don't notice that you are naked."

Molly explained. He is saying that there was no recognition that what they were doing was harmful. Their daughters were cut because that was what was done to ensure a good life. They thought it was prescribed in the Koran but learned after consulting Islamic scholars from Egypt that it was not. When they found that it was not required and that it was dangerous to health, change was easy.

He and his village decided to end the practice of cutting but he made an important observation. They couldn't do it alone. Their village is part of a much broader social network of villages with which they intermarry. Genital cutting was a prerequisite for a girl to find a man to marry. If their village gave up the tradition alone, their daughters would never marry. Armed with this knowledge, he set off on foot to speak with the 13 communities that formed their intermarrying network.

I asked him how he did it. Did he tell the villages that they had to stop the tradition?

"If there is a song that will sink a boat, you don't sing that song while the boat is in the water."

Molly interpreted this for me. You cannot accuse. If you do, you will fail. You must speak in the right voice.

In April Demba Diawara and Molly Melching bring their joint voice to a human rights conference at the Carter Center in Atlanta, Georgia. Molly will speak in English, Demba will speak in Wolof parables, and if people are willing to listen, they will hear a message that can change the world -- slowly, peacefully, and respectfully.