The Gambia Committee on Traditional Practices Affecting the Health of Women and Children

The Gambia Committee on Traditional Practices Affecting the Health of Women and Children (GAMCOTRAP)

Context

The practice of Female Genital Mutilation (FGM) is internationally recognized as a violation of the human rights of girls and women, with significant and long-lasting consequences on their physical and mental health and wellbeing. FGM refers to all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for non-medical reasons.i An estimated 100 to 140 million girls and women worldwide have undergone FGM, with 92 million over the age of 10 and residing on the African continent. Moreover, an estimated three million girls are at risk or undergo FGM each year.

FGM is very localized, as the nature and socio-cultural significance of the practice as well as the age when girls undergo FGM are culturally-embedded and may vary significantly, even within one country. However, FGM is also a globalized challenge for the women’s rights movement, as it affects girls and women in contexts where there is a high prevalence as well as those where overall prevalence is very low. With varying prevalence, FGM is practiced in 28 African countries, in the Middle East, and in Southeast Asia. It is also practiced in Europe and North America, Australia, New Zealand, and parts of Africa where it was not previously practiced, primarily within immigrant communities from cultures where FGM has a traditionally high prevalence.

International laws and protocols have clearly identified FGM as a harmful traditional practice and a human rights violation. The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of the Child call on national governments to eliminate harmful traditional practices, and the African Union Protocol to the Charter on Human and People’s Rights on the Rights of Women explicitly calls on states to prohibit and condemn FGM through the adoption and enactment of laws aimed at its elimination. However, supporting an enabling environment for change requires a national-level commitment. To date, only 19 of the 28 African countries where FGM is practiced have enacted national legislation to eliminate its practice.

FGM has both immediate and long-term physiological and psychological health impacts. Immediate impacts can include hemorrhage, inflammatory diseases, and infections. Long-term consequences can include chronic pain, infections, cysts and abscesses, painful sexual intercourse and increased risks at childbirth, including increased child mortality and the formation of fistulae. Girls who undergo FGM often must shoulder a lifetime burden from the procedure. A multi-country study in six African countries showed that women who had undergone FGM had significantly increased health risks during childbirth, with additional risks for newborns. The study showed that an additional one to two babies per 100 deliveries die as a result of FGM. Moreover, deliveries for women who have undergone FGM are significantly more likely to be complicated by caesarean section, postpartum hemorrhage, episiotomy, extended maternal hospital stay, resuscitation of the infant, and inpatient perinatal death, than deliveries to women who have not undergone FGM.ii The consequences of FGM for most women who deliver outside the hospital setting are expected to be even more severe, especially in rural areas and places where health services are weak or women cannot easily access them.

According to most recent data, the prevalence of FGM in Gambia is 78 percent for women aged 15-49 years—with higher percentages occurring in rural areas and in border communities.iii In many communities, FGM is regarded as a rite of passage to womanhood with strong ancestral and sociocultural roots. Ninety percent of Gambians are practicing Muslims. FGM has often been perceived as a religious obligation for Muslim women, a message reinforced by a number of religious leaders. The practice of FGM is often rationalized as being for the preservation of ethnic and gender identity, femininity, female purity/virginity, and “family honor”; maintenance of cleanliness and health; and assurance of women’s marriageability. In the Gambia, FGM is carried out on girls from newborns to pre-adolescence. As in other contexts, girls and women continue to suffer from adverse health impacts of FGM. For example, a recent study of patients requiring a gynecological examination in Gambia found that 34 percent of those had undergone FGM experienced medical complications as a direct result of FGM.

Although the Government of the Gambia (GoTG) has expressed a commitment to promoting the human rights of girls and women, it has yet to enact an explicit law to eliminate FGM. GoTG has ratified almost all international and regional instruments regarding women and children’s rights, but the explicit references to legal protection of girls and women from the practice of FGM were removed from the texts of both the 2005 National Children Act and the 2010 Women’s Act. Moreover, although there is reference to the elimination of discriminatory and harmful practices that adversely affect women in the National Gender Policy for 2010-2020, there is no explicit mention of FGM in the document and only one reference to “harmful traditional practices.” Women’s rights organizations in Gambia have highlighted that while national laws against FGM are important, making FGM illegal does not eradicate it and should be done in a cautious and thoughtful way so that it does not drive FGM underground. The use of law should thus be one component of a multidisciplinary approach, and must be preceded or complemented by public education and outreach by civil society and government to change perceptions and attitudes regarding FGM. Simply put, creating the enabling environment is necessary but not sufficient for sustained change of attitudes and behaviors around the practice of FGM.

The Gambia is witnessing a growing movement of communities, religious leaders, youth and women’s organizations speaking out about FGM and other harmful traditional practices. According to UNFPA/UNICEF, through the collective efforts of UN agencies and women’s rights organizations, in 2011 alone over 586 communities throughout Gambia announced their commitment to the abandonment of FGM. This momentum builds on the work of the Gambia Committee on Traditional Practices Affecting the Health of Women and Children (GAMCOTRAP), one of Gambia’s oldest women’s rights organizations, and a leader in opening spaces and facilitating conversations about the sexual and reproductive health and rights of women in Gambia. Moreover, GAMCOTRAP is recognized as a leader in West Africa in challenging the deep-seated attitudes that perpetuate the violation of women’s bodily integrity.

Organizational Background

The Gambia Committee on Traditional Practices Affecting the Health of Women and Children (GAMCOTRAP) was established as the Gambian National Chapter of the Inter-African Committee on Traditional Practices in 1984. With its head office in Serrekunda, The Gambia, GAMCOTRAP works nationwide to raise awareness with the aim of preserving beneficial practices while eliminating all forms of harmful traditional practices. GAMCOTRAP’s work extends throughout the seven administrative districts of The Gambia, including: Banjul; Kanifing Municipality; Western Region; Lower River Region; Central River Region; Upper River Region; and the North Bank Region. In 2011, the organization directly reached a total of 2,720 individuals (approximately 53 percent of whom were girls and women). It estimates that it indirectly reached over 33,000 individuals throughout the country in 2011.

GAMCOTRAP’s main activities include: 1) organizing awareness programs about the harmful effects of FGM for youth, school children, health workers, religious and community leaders, and women’s organizations; 2) coordinating peer health education programs; 3) disseminating human rights and FGM information through media, seminars, and women’s symposiums; 4) operating a trust fund for girls’ education; and 5) advocating for legislation banning FGM. Dr. Isatou Touray, the Founder and Executive Director of GAMCOTRAP, is the Chairperson of the Board of Directors of the Inter Africa Committee on Traditional Practices, a regional network encompassing 32 national chapters throughout the continent, as well as in countries in the Global North with large African immigrant populations.

The Global Fund for Women provided its first grant to GAMCOTRAP in 1997 and has awarded six grants totaling $115,000 since then. Our support has contributed to specific projects and initiatives, including providing scholarships to increase girls’ access to education and keep over 700 girls in school; training and information campaigns for circumcisers and traditional birth attendants; and an initiative to dispel links between Islam and FGM. Our support has also contributed to operating expenses and institutional strengthening, which has enabled GAMCOTRAP to retain qualified program staff and strengthen its organizational capacity. GAMCOTRAP boldly self-identifies as a feminist organization, in its core values, operations and approaches to its work. The organization unequivocally advocates for women’s leadership in all aspects of decision-making, for breaking the silence around African women’s sexuality, and in interrogating the conservative social norms that greatly shape attitudes and behavior around sexual and reproductive rights of women.

GAMCOTRAP’s model is anchored on the idea that change is gradual, especially when dealing with issues that are directly related to sexuality (e.g. FGM, early marriage, sexual and reproductive health), which are considered taboo within the Gambian context. The organization pushes for change by engaging through the traditional socio-cultural and political structures, and builds alliances by engaging key traditional and religious leaders and sensitizing them on the impact of FGM. Moreover, the leaders of GAMCOTRAP present themselves as daughters of the communities in which they work, who have undergone FGM themselves, and not as outsiders. In order to effectively engage in communities, GAMCOTRAP works to understand the dynamics of the culture and decision-making process in individual communities. In its outreach work, GAMCOTRAP emphasizes that while FGM is a cultural practice, cultural practices can and should change when communities realize that they have outlived their value. The organization addresses FGM through the use of several key messages in its outreach activities:

  • FGM is a not a religious obligation (neither Farda nor Sunnah) for Muslim women;
  • FGM negatively affects the health of women and children;
  • FGM violates the bodily rights and sexuality of women;
  • FGM is a form of violence against women and children and;
  • Allah, the Creator of the women’s body, designed it for a purpose and it should be left intact for such functions.

Moreover, by involving allied religious leaders and health care providers in its interventions, the organization is able to make an even stronger case for the promotion of women’s human rights.

Program Methodologies

GAMCOTRAP’s strategies include community sensitization; action research; and capacity-building through training and information campaigns, social mobilization, and advocacy. Collectively, these strategies aim to raise public consciousness about the need to protect the rights of girls and women from the threats of FGM and other forms of gender-based violence. In particular, this case study aims to highlight three specific strategies that are raising awareness about FGM and the need to end the practice in The Gambia.

Community Engagement: Cluster Approach GAMCOTRAP utilizes a cluster approach in which communities are brought together to reach consensus to protect their girl-children. Cluster communities are characterized by a shared geographical location, shared cultural ties, a high level of socialization, and shared circumciser(s) and Traditional Birth Attendant(s). GAMCOTRAP works closely with traditional leaders and chiefs who lead the mapping process and identify clusters that encompass between eight and 19 communities each. By targeting specific clusters, GAMCOTRAP develops a long-standing relationship with the communities that it works with. This approach also supports more extensive outreach. GAMCOTRAP undertakes five to six interventions in each cluster over the course of two days, which include exercises on decision-making, values clarification, and consensus building.

This approach enables the organization to identify and train Community Based Facilitators, who continue the engagement even after GAMCOTRAP’s interventions. Moreover, this approach has enabled representatives from 564 communities in three regions to support their circumcisers to stop the practice of FGM. In many rural communities, circumcisers are also Traditional Birth Attendants, which underlines the need to engage them not only on FGM but also on other matters of women’s sexual and reproductive health. The strategy also ensures that communities act collectively to abandon the practice, so that girls or their families who choose not to undergo FGM are not socially penalized or ostracized by their communities. Overall, GAMCOTRAP has experienced notable success in getting the communities in the clusters to reach a consensus to abandon FGM through public declaration. Having observed considerable success in change of behavior and attitudes around FGM through the use of this strategy, GAMCOTRAP is now using the cluster approach to address other issues related to gender-based violence.

Shifting Cultural Norms: Pubic Declarations through “Dropping of the Knife”Ceremonies GAMCOTRAP organized the first “Dropping of the Knife” ceremony in 2007, where 18 circumcisers, supported by 63 communities, made a public declaration to stop FGM. This launched a movement of Gambian communities coming out to publicly state that FGM was a violation of the GAMCOTRAP (Gambia) - 5 rights of women and girls and to declare their commitment to stopping the practice. The second Dropping of the Knife celebration involved 60 circumcisers supported by 351 communities in the Upper River and some parts of the Central River Region South. GAMCOTROP hosted the third Dropping of the Knife celebration in 2011, where 20 circumcisers, supported by 150 communities in the Lower River Region, made a public declaration to stop FGM and other harmful traditional practices such as early and forced marriages. The next Dropping of the Knife celebration was planned for November/December 2012 and involved 25 circumcisers, along with their children and supporting communities.

Overall, more than one hundred circumcisers have dropped their knives in more than 564 Communities from the Upper River, Central River South and Lower River Regions of the Gambia.GAMCOTRAP works with circumcisers who drop their knives through enterprise development training (provided by A GAMCOTRAP partner organization) as well as grants to engage in alternative livelihoods. Moreover, the Dropping of the Knife ceremonies are also significant because the circumcisers are publicly recognized for the important roles that they play as custodians and leaders within their communities. In turn, many become advocates against FGM in their respective regions. As a result of GAMCOTRAP’s engagement, communities and individuals have been calling for a law to protect girls from FGM. The Dropping of the Knife ceremonies have received significant media attention within Gambia and internationally, and are helping to break the silence and taboo around discussing women’s sexualities.

National Advocacy and Partnerships: Strengthening the Enabling Environment through Advocacy. Since its inception, GAMCOTRAP has worked to strengthen the enabling environment for elimination of FGM through advocacy and outreach to key decision-makers at national and international levels. The organization’s social mobilization initiatives use existing international and national instruments ratified by The Gambia (i.e. Convention on the Rights of the Child; CEDAW; African Charter on the Rights and Welfare of the Child; and the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa) as well as the National Policy for the Advancement of Gambian Women to advocate that FGM is a human rights violation.

GAMCOTRAP initiated the drafting of a specific bill against FGM for the Government of the Gambia to consider. This draft continues to be discussed at various levels, and is currently undergoing revisions in preparation for submission to the National Assembly. GAMCOTRAP has conducted consultative trainings with Security Officers, including the Child Protection Unit of the Police, the Army and Immigration Officers, to engage them in creating a protective environment for children against FGM. The organization works closely with the Ministry of Women’s Affairs, and has worked with various departments in the Department of State for Basic and Secondary Education on developing a module to sensitize primary school students on FGM. An ongoing priority for GAMCOTRAP is the strategic and constructive engagement with key religious leaders and Islamic scholars, particularly given their role in informing social and cultural norms, and in advising policies and procedures. A key outcome of engagement is that communities are now increasingly demanding greater accountability for government policies and services, overall.

In August 2012, GAMCOTRAP received a letter from the Office of the President of the Gambia acknowledging the receipt of the organization’s 2011 final report. The letter, signed by the representative of the Secretary General, stated, I have been directed to convey that the report is duly noted and to assure you of Government’s full support of the crusade against FGM. Furthermore, Government will take appropriate action in consultation with traditional and religious leaders in this regard. Although there is still considerable work to be done to eliminate the practice of FGM in The Gambia, this letter is a powerful and significant recognition of the impact of GAMCOTRAP’s work over the past 28 years.

Learnings

GAMCOTRAP works at various levels and is compelled by community engagement, building relationships of trust, and engaging within traditional structures. In some instances, the national government and certain religious leaders have seen the organization as a threat. However, by working in a steadfast manner to build partnerships, working directly with traditional and religious authorities, and encouraging communities to advocate for women’s rights, it is progressively transforming conversations around women’s rights in Gambia.

The case study of GAMCOTRAP highlighted several aspects of the organization’s work that contribute to the Sub-Saharan Africa team’s learning and regional strategy on sexual and reproductive health and rights. GAMCOTRAP’s cluster approach has facilitated geographically expansive coverage, and it provides a space and opportunity to engage traditional and religious leaders in the mapping process – a crucial precursor to GAMCOTRAP’s interventions. Building trust and a sense of ownership amongst community gatekeepers is essential for addressing sensitive topics such as FGM, and GAMCOTRAP’s work highlights one such strategy.

The cluster approach also demonstrates an awareness of the complex and culturally-embedded nature of the practice. In supporting alternative livelihood options for former circumcisers, GAMCOTRAP’s strategy underlines that SRHR issues are closely interlinked with economic issues, and that it is necessary to address the economic realities that contribute to the perpetuation of some harmful traditional practices Moreover, by engaging former circumcisers and their communities in the public Dropping the Knife ceremonies, GAMCOTRAP affirms the progressive role that these individuals can play in promoting women’s human rights, rather than demonizing them for being circumcisers. Throughout most of Sub-Saharan Africa, public conversations about issues related to women’s sexual and reproductive health are often very sensitive, if not taboo. GAMCOTRAP’s strategies demonstrate examples of culturally-appropriate and affirming approaches to addressing very challenging issues such as FGM.

The Sub-Saharan Africa team is particularly interested in strengthening the enabling environment for SRHR and a key strategy is to support organizations working to increase women’s access to information, resources, and services while building community ownership and commitment in order to sustain the promotion of women’s human rights. The Sub-Saharan Africa team’s support to GAMCOTRAP’s work is reflective of our commitment to expanding support to women’s rights organizations working to advance SRHR, particularly because of ways in which SHRH intersects with so many aspects of the daily lives of girls and women throughout the region.

Citations

 
 

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