June 16, 2010

 I. Summary

I remember my mother and her sister-in-law took us two girls, and there were four other girls. We went to Sarkapkan for the procedure. They put us in the bathroom, held our legs open, and cut something. They did it one by one with no anesthetics. I was afraid, but endured the pain. There was nothing they did for us to soothe the pain. I had one week of pain. After that just a little bit. I never went to the doctors. [They were] never concerned. I have lots of pain in this specific area they cut when I menstruate.
—Gola S., 17-year-old student, Plangan, May 29, 2009

In Iraqi Kurdistan a survey by the Ministry of Human Rights in 2009 suggests that in one district over 40 percent of women and girls aged 11-24 years have been subjected to female genital mutilation (FGM). An NGO survey covering a wider geographical area gives even higher figures. The practice involves the cutting out of the clitoris, and is carried out mainly on girls between the ages of three and 12 years at the request of their female relatives, usually by a traditional midwife using an unsterile razor blade. As Gola S. explains, girls are often unaware what is about to happen to them, they experience great pain during the procedure and afterwards, and the practice can have lasting physical, sexual and psychological health consequences.

While internationally recognized as a form of violence against women and girls, the tragedy is that FGM is perpetuated by mothers, aunts and other women who love and want the best for their children, who see the practice as ensuring that girls are marriageable, are conforming to the tenets of Islam, and are growing up to be respectable and respected members of Kurdish society.

FGM poses a difficult challenge for the government and people of Iraqi Kurdistan. It is a complex issue to address, its eradication requiring strong leadership from the authorities and partnerships across the political spectrum and with religious leaders, nongovernmental organizations (NGOs), and communities to bring about social change. First and foremost, it requires Iraqi Kurds in positions of leadership and influence to recognize and accept that FGM is a problem, one that can be addressed through concerted action that will reinforce Iraqi Kurdistan’s reputation as a society committed to the protection of the rights of women and children, and a society in which Muslims practice their faith without FGM, as is the case with the majority of Muslims across the world.

The Iraqi Kurdish authorities have taken important steps on several aspects of women’s rights and are regarded as regionally forward-looking on issues concerning women. The Kurdistan Regional Government (KRG) has set up institutions to investigate and combat domestic violence, and is one of the few governments in the region to pass laws prohibiting reduced sentences for so-called honor killings. In February 2009 amendments to the election law in Iraqi Kurdistan increased the legal quota for women in the legislature from 25 percent to 30 percent. Thirty six out of 111 members of Parliament are women. 

The regional authorities have yet, however, to show decisive leadership on FGM. Small steps taken in previous years have not been built on and, indeed, during the final years of its administration the former government’s commitment appeared to falter. In 2007 the Ministry of Justice issued a decree, binding on all police precincts in Kurdistan, that perpetrators of FGM should be arrested and punished. However, the existence of the decree is not widely known in Iraqi Kurdistan and Human Rights Watch found no evidence that it has ever been enforced.

More recently, the former regional government failed to proceed with a law banning FGM, even though in 2008 the majority of members of the Kurdistan National Assembly (KNA) supported its introduction. However, in a sign of the sensitivity of the issue they also refused to publicly debate the draft law. In early 2009, the Ministry of Health developed a comprehensive anti-FGM strategy in collaboration with an NGO. But later the Ministry of Health withdrew its support and halted efforts to combat FGM. Furthermore, the ministry charged its erstwhile NGO collaborator of ruining the reputation of Kurdistan. Indeed, concern about the reputation of Kurdistan was articulated to Human Rights Watch by the Ministry of Health and the Ministry for Religious Affairs during the course of research for this report.

One sign of government inertia is its failure to assess the extent of FGM in Iraqi Kurdistan. The government does not systematically collect statistics on FGM, either on prevalence or consequences. For example, FGM was not included in the UNICEF-supported government-implemented Multiple Indicator Cluster Survey (MICS) carried out in 2006 or in the WHO-supported Iraq Family Health Survey (IFHS) carried out in Kurdistan in 2007. However, the two surveys cited at the start of this report suggest a high rate of FGM. The Ministry of Human Rights’ finding of 40.7 percent prevalence is based on a survey of 521 girls and women in the district of Chamchamal. The larger NGO survey by the Association for Crisis Assistance and Development Cooperation (WADI) is based on a sample size of 1,408 women and girls in two provinces of Arbil and Sulaimaniya, and the area of Germian/New Kirkuk. Overall it found the prevalence of FGM among girls and women aged 14 to 19 years in these areas to be 57 percent.

The authorities have thus far failed to demonstrate awareness of the significance of these results. Several government officials interviewed for this report, including the former minister of health and the former minister of religious affairs, insisted that FGM was an isolated problem, suggesting that they found it difficult to accept the challenge it poses.

The World Health Organization (WHO) defines FGM as “all procedures involving partial or total removal of the external female genitalia or injury to the female genital organs for non-medical reasons” and identifies four different types of FGM, ranging from the removal of the clitoris (Type I) to infibulation, the most severe form which involves the removal of the labia minora and the labia majora, and the narrowing of the vaginal orifice (Type III). It estimates that between 100 and 140 million girls and women worldwide have already been cut and currently some 3 million girls, mostly below the age of 15 years, undergo FGM every year.

Whatever the motives behind it, FGM is an act of violence. It has no medical justification, is irreversible and has lasting impact on young girls’ and women’s physical, mental, and sexual health. As women such as Gola S. told Human Rights Watch, girls undergoing the procedure are forcefully held down, their legs pried apart, and part of their genitalia cut off with a razor blade. Often the same blade is used to cut several girls. No anesthesia is applied beforehand and if anything at all is applied to the open wound afterwards, it is water, herbs, cooking oil, or ashes.

Globally, research has documented the terrible toll this procedure takes on women’s health. Excessive bleeding, severe pain, infections, and permanent scarring are just some of the health consequences that may be experienced both immediately after the procedure and later in life. Recent studies show that all types of FGM carry greater risks for pregnant women during childbirth, and increase the risk of a stillbirth. Newborn babies may suffer from early neonatal death and low birth weight. Kurdish physicians report that the impact in Kurdistan is no different. Even years afterwards, women Human Rights Watch spoke to said that they are still overwhelmed by memories of the pain and blood associated with FGM.

Human Rights Watch traveled to the Kurdistan Autonomous Region in May 2009 to carry out the research for this report, meeting girls and women who had undergone the procedure as well as traditional midwives, healthcare workers, clerics, government officials, and nongovernmental organizations. We interviewed people about the impact of FGM on their lives, explored views and representations of reasons for the practice, and met activists and others committed to its eradication. Our study did not extend to Kurdish populations in Iraq outside the Autonomous Region, or into other communities in Iraq, but nongovernmental organizations told Human Rights Watch that they suspect the practice may also exist elsewhere in the country. 

Those we spoke to gave many reasons why FGM is practiced in Iraqi Kurdistan. Some defended it in the name of Islam as sunnah (a non-obligatory action to strengthen one’s religion). Otherstold us that FGM is an ancestral tradition that is maintained to preserve cultural identity. Yet others suggested that women’s sexuality must be controlled, especially in hot climates like Iraqi Kurdistan. And still others referred to the pragmatic issue of social pressure—it is closely linked to notions of purity and girls growing up to be marriageable and respectable members of society.

FGM is not prescribed by any religion. Islam is the predominant religion in Iraqi Kurdistan—and globally the majority of Muslims do not practice FGM. Internationally, many senior Islamic scholars have spoken against the practice, including the late Muhammad Sayyed Tantawi, Grand Sheikh of Al-Azhar University, the most respected university among Sunni Muslims.

FGM has been recognized as a human rights issue for more than two decades. Various United Nations agencies, treaty monitoring bodies and other international human rights institutions have issued resolutions and statements calling for the eradication of FGM. They have urged governments, as part of their human rights obligations, to address women’s and girls’ rights by banning the practice. The Committee on the Convention of the Elimination of All Forms of Discrimination (CEDAW Committee) adopted a general recommendation on FGM in 1990 and called on States parties to include measures aimed at eradicating it in national health policies. In 2002, the United Nations General Assembly (UNGA) passed a resolution on practices affecting women’s health and urged states to enact national legislation to abolish FGM and prosecute perpetrators. The CEDAW Committee, the Human Rights Committee, the Committee on the Rights of the Child, and the Committee on Economic, Social and Cultural Rights have all identified FGM as a discriminatory practice that directly affects the ability of women and girls to enjoy their human rights. The Human Rights Committee and the Committee Against Torture have both voiced their concerns about FGM and articulated the links between FGM and cruel, inhuman, and degrading treatment.

Iraq has signed all key international human rights treaties that protect the rights of women and girls, including the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), the International Covenant on Civil and Political Rights (ICCPR), the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of the Child (CRC). These treaties place responsibility and accountability on the Iraqi government and the Kurdistan Regional Government for any human rights violations that take place in Iraqi Kurdistan, including FGM.

Global experience of FGM eradication efforts around the world shows that effective action plans must be multifaceted. Families subject their daughters to cutting because they feel it is the right thing to do—they believe that it helps girls become complete members of society. They also believe that girls who are not cut may be considered unclean and unmarriageable. Addressing these concerns requires the Kurdish authorities and persons with influence—religious leaders, healthcare workers, teachers and community leaders—to work with communities to encourage debate about the practice among men, women and children, including awareness and understanding of the human rights of girls and women, and the health and psychological costs that FGM imposes on them. Stimulating this social debate involves concerted and sustained action by the authorities, working along multiple channels, in close coordination with NGOs and other key parts of civil society. Recent global practice suggests that securing public affirmation on the part of communities of their collective commitment to ending FGM is an important moment, allowing communities to effectively establish a new convention—the convention of not mutilating their girls. 

The authorities need to also send a clear and public message that the practice is outlawed by introducing a legislative ban on FGM for girls and non-consenting adult women. This should provide a clear definition of FGM, explicitly state that it is prohibited, and identify perpetrators and penalties. It should contain provisions that will protect girls and women at risk. The Kurdistan Regional Government should engage and support the efforts of local organizations to eradicate FGM and strengthen their ability to respond to gender-based violence. Meanwhile, the Iraqi government needs to work closely with the regional authorities, both to support its work for FGM eradication and, in coordination, to develop its own FGM eradication strategy for minority populations outside the Autonomous Region. Without these measures, violations of women’s and girls’ human rights will continue.

Methodology

This report is based on field research conducted in the northern territories of Iraq, known as Iraqi Kurdistan. Fifty-four interviews took place in four villages, two in each of the Iraqi Kurdistan districts of Ranya and Germian, and in the southern town of Halabja in May and June 2009.  

Nongovernmental organizations working on FGM in Iraqi Kurdistan note that FGM may exist among Kurds who live in other parts of Iraq and in other communities. However, there is insufficient data to determine whether or not the practice is widespread outside the Autonomous Region. Human Right Watch did not investigate the prevalence of FGM in other parts of Iraq because there is, as yet, no data at all on the practice elsewhere in the country.

During this 10-day investigation, two female researchers interviewed thirty-one girls and women who had undergone FGM. The research included interviews with health professionals, traditional midwives, and Muslim clerics. Meetings were also held with the then minister for endowments and religious affairs of the Kurdistan Regional Government (KRG), Muhammad Ahmad Saeed Shakaly, the former KRG minster for health, ‘Abd al-Rahman Osman Yunis, the then KRG minister for human rights, Yusif Aziz, and the former head of the Special Women’s Committee in the Kurdistan National Assembly (KNA), Paxshan Zangana, in the regional capital of Arbil.[1]

Human Rights Watch conducted interviews with women and midwives in the Kurdish language with the help of two female translators. Interviews with professionals and religious clerics were carried out in Arabic and English.

Some interviews were conducted in the homes of women and midwives, mostly in group settings. For privacy reasons, mothers, daughters, other female family members, and sometimes neighbors gathered in one room of the house, away from other household members, while we carried out one-on-one interviews with them. Other interviews took place in the offices of nongovernmental organizations in Halabja and Sumoud, in the district of Germian. Health professionals were interviewed in their clinics and other professional settings, and clerics were interviewed at home and in mosques.

We have changed the names and withheld other key identifying details of women, girls and midwives in order to protect their identities. All participants were informed of the purpose of the interview and the way in which their stories would be documented and reported. Participants were informed of their right to stop the interview at any time or to decline to answer specific questions posed. All participants gave their verbal consent to be interviewed, and no one received any remuneration from Human Rights Watch.

A Note on Terminology

The term female genital mutilation (FGM) is used throughout this report. This terminology is utilized by many human rights groups and health advocates to emphasize the physical, emotional, and psychological consequences associated with this procedure, and to identify the practice as a human rights violation.[2] However, the report will use the phrase “female circumcision” at times, as this is how the practice is referred to in Kurdistan. This was the term women used during discussions (xatena in Kurdish meaning circumcision).

The word “midwife” will also be used to connote a traditional midwife. A traditional midwife is a non-licensed birth attendant who may also perform minor healthcare procedures.

[1] Government officials cited in this report served as officials in the former government prior to legislative elections that took place in Iraqi Kurdistan in July 2009.

[2] Population Reference Bureau, “Female Genital Mutilation/Cutting: Data and Trends,” December 2008, http://www.prb.org/pdf08/fgm-wallchart.pdf (accessed June 5, 2009), p.2.