CHILD GROOMS IN IRAN
A statistical review by:
Stop Early Marriages in Iran
Worldwide, 156 million men alive today were married during their childhood; according to a recent study by UNICEF. This data of a huge number of child grooms is published while little research being done to address the issue. UNICEF statistics also show that boys’ early marriage counts 18% of total cases of child marriages before age 18. However, it should be noticed that this proportion is not fixed in different areas and in certain regions the percentages may even reverse. In some areas of India, for instance, boys marriage before their age of majority is more common than girls’ early marriage.
Across 52 countries of the World, there is no legal limitation on the marriage of girls under age 15. This number turns to 23 countries when talking about underage boys. It means that the rules of 23 countries allow the parents to force their boys to marry under the age of 15. Consequently, these boys won’t have the chance to resist against it even later when they reach the age of majority.
The international community is taking the case of child brides in priority of awareness activities because early marriage affects girls in far greater numbers than boys. However, it would be against children and human rights to ignore the boys. Same as the girls, the negative consequences of early boys marriage could be studied and measured. Boys are forced to leave school and engage with low-level jobs. This leads to the continuation of a poverty cycle. The purpose of ending child marriage is to help break the intergenerational cycle of poverty.
Iran is among the countries in which the law does not provide any specific definition of the age of majority; thus enables the boy’s guardians to make them marry before the age 15. According to article 1041 of Iranian Civil Code, the marriage of a girl before the age of 13 and of a boy before the age of 15 (puberty age) is a subject of their guardian permission and on the condition of taking proper interests into consideration and at the discretion of the competent court.
As usual, Campaign of Stop Early Marriages in Iran is going to publish a series of annual statistical reports about the situation of child marriage and other related problems up to the end of this year. A statistical view and analysis of data will help the readers to better understand the current situation.
According to the National Organization for Civil Registration, from March 2015 to March 2016 (1394), 314 boys under age 15 and 27811 boys between 15-19 have entered into marriage. Furthermore, during the same period, 1 divorce case of a boy under age 15 and 1217 divorce cases of the boys between 15-19 have been recorded. There are 2 important points that should be considered here:
- This data only refers to the cases that are registered in formal marriage/divorce registration offices. While many of the marriage cases are not formally registered before the parties come to the majority age or there are special needs for legal procedures for example in the case of childbearing.
- If the person is under age 15 when marrying and more than 15 when divorcing, this case will be recorded in the older group of age.
When studying child marriage and its consequences, it is important to pay attention to the age of both wife and husband. The age distribution table of child marriage and divorce shows that during the year 1394 (march 2015-march 2016), 314 boys under age 15 have entered marriage. Referring to the divorce data, we may assume that a number of the boys who have divorced at an age between 15-19, had been entered marriage few year earlier; when they had been under age of 15.
Rayehe Mozafarian- Samire Hanaei
Report Of Stop Early Marriage In Iran
We sit together in the hall waiting for our turn. As always in the ultrasound room, I and more clients are women. Only a few men are watching us with impatience. She is sitting next to me pushing the armrest. The pain was easily observable in his face. Her hand vessels turn out with anger every time. She pains. The hot weather rushes as always ahead. The space of hall is shut and discomfort. I look at her number. 58! To reach her turn, the doctor should see 8 persons others. Although I have no experience on this issue but I start the conversation in order to get rid of the dullness of the clockwise.
She has only 23 years old. She got married at age 16. Now she has three children and her eldest son goes to school next year. Early marriage in the rural district of Kahurestan (one of the nearby villages of Bandar Abbas) is not an unusual story. Her husband works in Dubai. He works in the shop of one of the intimate persons and sells sacks and glues and whatever the dhows want to sell. He rarely comes to Iran, just a few months in a year. In any her childbirth, he was not on her side. Last child was 8 months when her father saw her. She also works in the land of her husband’s father. They cultivate the summer crops and tomato.
My turn comes. When I came back she was not and her chair was empty. Perhaps she did not tolerate and take refuge elsewhere. As soon as said Hormozgan women, we unconsciously remember the image of colorful veils and port nice pants and costly. We remember the women covering veils with beautiful long and short dresses. Hanna tattoos on their hands and the brown cute faces of them when passing under the palm trees have been observed in films mostly.
Our mental image about Hormozgan women only is limited to their covers and color of skins; the local coverage that can be particularly attributed to Hormozgan women. But really are Hormozgan women hidden their real faces under their veils and colorful covers?
In 2015 in Hormozgan Province, 42 women less than 15 gave birth to a baby. From these, 18 cases were in cities and 24 cases were in villages. Also, 2975 women between the ages of 15 to 19 years living in this area gave birth to their children in this province. As a whole, Hormozgan is the province which the highest rates of child marriage occur in.
The table below lists the marriage of girls at different ages. The figures in this table are remarkable according to statistics of the marriage registration offices and national organization of civil registration. There have been recorded 9 marriages in girls less than 10, 595 marriages in girls between 10 to 14 years was recorded in just one year. While this province is one of areas that have a lot of unregistered marriages or delayed registered marriages.
Table 1: The number of registered marriages due to the ages of women at the time of marriage
One hypothesis has been always discussed:
Is early marriage one of the reasons of maternal and infant mortality?
Partly the answer to this question is yes because for having a healthy baby, the mother should have a healthy capable efficient body. Early marriage and subsequent early pregnancies cause the mothers’ body have no growth opportunities and the full development and leading to compact and short fetus. So there is no time for the evolution and productivity in order that the children do not have the process of proper development of full maturity.
The fact is that we have heard from the management of Hormozgan women less.
In most regions of Hormozgan Province, the men work in countries neighboring Persian Gulf, because of its proximity and the effective fields for economic activities and even they force to be far away from their families over many years. During this time, young women gained the responsibility of life very soon and are married at early ages due to traditional marriages and have children should manage the families in all aspects and the economical management of families, savings, responsibility for children training and animal husbandry in the absence of the husband without proper training in this field
In fact, women, as the sole administrator in their families, have the dual role.
Maryam Dehghankhalili, MD,* Soghra Fallahi, MD, Forugh Mahmudi, MD,Fariborz Ghaffarpasand, MD, Mohammad Esmaeil Shahrzad, MD, Mohsen Taghavi, MD, and Marjan Fereydooni Asl, MD
*Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center of Molecular Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
A B S T R A C T
Introduction. Female genital mutilation/cutting (FGM/C), also known as female circumcision, is an ancient traditional procedure that involves partial or total removal of the female external genitalia for nonmedical reasons. Although it is well described in African and some Arabic countries, data from Iran are scarce.
Aim. To describe the epidemiology, regional characteristics, knowledge, and attitude toward FGM/C in Southern Iran.
Methods. This cross-sectional study was conducted during a 36-month period from 2010 to 2013 in Hormozgan, a southern province of Iran near the Persian Gulf. We included 780 women in six major rural areas of the province who referred to healthcare centers for vaccination, midwifery, or family planning services. All participants underwent complete pelvic examination to determine the type of FGM. The questionnaire consisted of several sections such as demographic and baseline characteristics, and two self-report sections addressing the knowledge and attitude toward FGM/C and its complications. Baseline sociodemographic characteristics including age, educational level, marital status, religion, and nationality were the independent variables.
Results. Among the participants, 535 (68.5%) had undergone FGM/C. FGM/C was associated with higher age (P = 0.002), Afghan nationality (P = 0.003), Sunni Islam as religion (P = 0.019), illiteracy (P < 0.001), and family history of FGM/C in mother (P < 0.001), sister (P < 0.001), and grandmother (P < 0.001). Ancient traditions in the area (57.1%) were mentioned as the most important factor leading to FMG/C. Urinary tract infection was the most common reported complication (60.4%).
Conclusion. FGM/C is a common practice in rural areas of Southern Iran. It is associated with increased age, illiteracy, Sunni Islam religion, Afghan nationality, and positive family history. Lack of knowledge toward FGM/C is the main cause of its high prevalence and continuation in the area. Dehghankhalili M, Fallahi S, Mahmudi F, Ghaffarpasand F, Shahrzad ME, Taghavi M, and Fereydooni Asl M. Epidemiology, regional characteristics, knowledge, and attitude toward female genital mutilation/cutting in Southern Iran. J Sex Med 2015;12:1577–1583.
Key Words: Female Genital Mutilation/Cutting; Female Circumcision; Knowledge and Attitude; Determinants; Iran
Female genital mutilation/cutting (FGM/C), also known as female circumcision, is an ancient traditional procedure that involves partial or total removal of female external genitalia for nonmedical reasons [1,2]. According to the World Health Organization (WHO), there are four main types of FGM/C: type I (clitoridectomy), type II (excision), type III (inﬁbulation or pharaonic circumcision), and type IV, which are used to describe all other harmful procedures to the female genitalia in the absence of medical necessity . The nomenclature for the practice varies across regions, ideological perspectives, and research frames. We use the expression preferred by United Nation’s International Children’s Emergency Fund and United Nation’s Population Fund, the two central policymakers in the global effort to end the practice, “female genital mutilation/cutting” (FGM/C) . Since the early 1970s, Western efforts to end FGM/C have relied primarily on two frames that have inﬂuenced the discourse of FGM/C and, in turn, the ideological contestation over the practice [4,5]. FGM/C has not only been associated with violation of human rights, but has also been shown to be associated with impaired physical and mental health [6,7]. Several physical and mental complications have been associated with FGM/C including pain, bleeding, localized infection and abscess formation, pelvic inﬂammatory disease (PID), sepsis, tetanus, urinary problems such as urinary tract infection (UTI), hepatitis and human immunode ﬁciency virus (HIV) infection, and reproductive problems. Psychiatric complications include post- traumatic stress disorder (PTSD), ﬂashbacks to the event, and affective disorders [8–10].
FGM/C is a worldwide practice being mainly reported in African and Middle Eastern countries. It has been estimated that about 100 and 140 women and girls have experienced FGM/C . FGM/C is currently practiced in more than 28 countries among different ethnic and religious groups. It is estimated that about 1.5 million girls undergo FGM/C annually . Although the epidemiology has been evaluated in several countries, the predictive factors and social determinants remain unknown and undetermined. Such data would be helpful for understanding the variation in the frequency of FGM/C as well as trends for its performance despite the legislations. In addition, reports from Iran are scarce, and only few studies have addressed the issue, previously [13,14]. Accordingly, we performed the current study in order to estimate the prevalence of FGM/C and the knowledge and attitude of women toward it in Southern Iran. We also aimed to identify the correlates of these beliefs to identify high-risk subpopulations.
Materials and Methods
This cross-sectional study was carried out in a 36-month period from September 2010 to September 2013 in Hormozgan, which is a Southern region near the Persian Gulf in Iran. Hormozgan province has an area of 70,697 km2 (27,296 sq mi), with Bandar Abbas being its capital. The province has 14 islands located in the Persian Gulf and 1,000 km (620 mi) of coastline. The estimated population of the province, according to the latest census in 2011, is 1,578,183 people, and an estimated 789,712 people live in rural areas. Overall, 384,589 women live in the rural areas of the province. The current study included all the women living in six major rural areas of Hormozgan including Minab, Dehbaz, Bandar-e-Lenge, Qeshm, Bandar-e-Khamir, and Bastak. The total population size and the population of women in these six areas are 179,445 and 86,669, respectively.
We included all the women who referred to healthcare centers of these six areas, within the study period. These women referred to the health care centers to receive vaccination, midwifery, or family planning services. The women were selected consecutively and were included in the survey. The study protocol was approved by the Institutional Review Board (IRB) and the Medical Ethics Committee of Hormozgan University of Medical Sciences. All the participants provided their informed written consents before entering the study.
All the particpats were interviewed by a trained medical student visiting the healthcare centers for the research project as well as providing healthcare services. All the participants underwent complete pelvic examination in the lithotomy position by the female trained medical student and a midwife. The presence and type of FGM was identiﬁed according to the WHO classiﬁcation and was registered into the data collection forms. The data collection form consisted of several parts including demographic information, knowledge, attitude, and beliefs toward FGM/C. The age at which the FGM was performed was recorded according to the patient’s own or parents’ information. First, participants were asked, “Have you ever been circumcised?” (yes/no). Second, participants were asked, “Do you think this practice should be continued?” (yes/no). Participants who had not heard of FGM/C or female circumcision were also recorded. Our independent variables were basic sociodemographic characteristics such as age, education (illitrate, primary, high school, diploma, MS degree, above), marital status (currently married, single), religion (Shia or Sunni Islam), and nationality (Iranian, Afghan, Arab). We also recorded the family history of FGM/C in mother, sister, and grandmother.
All data were entered into a computer-based data- base and were further analyzed. Statistical package for social sciences (SPSS Inc., Chicago, IL, USA) version 16.0 was used for all statistical analyses. Data are reported as mean ± SD and proportions as appropriate. Parametric data were compared between those undergoing FGM/C and controls using independent t-test, while proportions were compared using chisquared test. A two-sided P value of less than 0.05 was considered as statistically signiﬁcant.
Overall, we included 780 women who participated in the survey, from the rural areas of Hormozgan. The mean age of the participants was 30.5 ± 14.6 (ranging from 14 to 38) years, and their mean age at which they ﬁrst had their FMG/C was 5.6 ± 3.6 (ranging from 2 to 38) years. Among the participants, 535 (68.5%) had undergone FGM/C. Thus, the estimated number of the women being circumcised in the area according to screened the population (86,669 people) would be 59,446. In other words, the prevalence was 68,589 in each 100,000 rural female population. The baseline characteristics of the study population are summarized in Table 1. Most participants were married (68.3%) and Iranian (93.1%). The great proportion of the participants were illiterate (36.6%) and had family history of FGM/C. Clitoral nicking was the most common performed procedure (28.7%) followed by type I (clitoridectomy) FGM/C (27.9%).
Table 2 demonstrates the determinants of the FGM/C in the study population. Those who have had undergone FGM/C were signiﬁcantly older (P = 0.002) when compared with controls.
FGM/C was more likely to be performed among Afghans compared with Iranians (P = 0.003) and among married women compared with singles (P < 0.001). FGM/C was associated with Sunni Islam as religion (P = 0.019) and family history of FGM/C in mother (P < 0.001), sister (P < 0.001), and grandmother (P < 0.001). The frequency of illiteracy was signiﬁcantly higher among those who have had undergone FGM/C compared with controls (P < 0.001). In the same way, the years of education were signiﬁcantly lower among FGM/C group when compared with controls (4.6 ± 1.3 vs. 9.6 ± 2.6 years; P = 0.013).
The knowledge and attitude of the participants toward FGM/C and its complications are summarized in Table 3. The most common belief regarding the performance of FGM/C was the ancient traditions of the area (57.1%). Religious instructions were mentioned by 30.3% of the participants, while increasing self-libido (25.8%) and the partners’ sexual arousal (32.1%) were other common causes of performing FGM/C. Mothers had higher intention to continue the practice compared with fathers (40.6% vs. 14.9%; P < 0.001). Overall, 70.6% of those who had undergone FGM/C reported some types of complications (Table 3). UTI was the most common reported complication (60.4%) followed by procedure bleeding (56.7%), itching (51.7%), and burning sensation (46.7%). Also, 8.8% participants reported psychiatric disorders. PTSD was the most common diagnosed mental disorder.
FGM/C is a widespread practice being an ancient tradition since antiquity. It persists today primarily in Africa and among small communities in the Middle East and Asia. According to WHO reports, about 100 million women worldwide had undergone FGM/C, while 4 and 5 million procedures are performed annually among female infants and girls . The most severe and invasive subtypes of FGM/C has been reported in Somalian and Sudanese population . Several reports have described the knowledge and attitude as well as epidemiology of the FGM/C in African and Middle East countries. However, data from Iran are scarce. To the best of our knowledge, this is the ﬁrst study from Southern Iran reporting the prevalence and determinants, as well as knowledge and attitude toward FGM/C. We found that the prevalence of FGM/C was considerably high in Southern Iran despite previous reports .
The estimated prevalence of FGM/C varies widely among countries where FGM/C is a routine procedure. This is contrary to the fact that all these countries are geographically neighbors . The differences in epidemiology and characteristics of FGM/C are due to social, historical, traditional, and political variations between countries. More recent studies have demonstrated that nine out of 10 women and girls in Djibouti, Egypt, Guinea, Mali, Northern Sudan, Sierra Leone, and Somalia undergo the procedure annually . It has been also reported that about 87 million girls have undergone the procedure in 27 African countries and Yemen . In the same way, the estimated number of women who have undergone FGM/C was 28,170; 24,710; and 23,240 in Nigeria, Egypt, and Ethiopia, respectively [12,18,19]. We found that 68.5% of all women in Southern rural areas of Iran have undergone some types of FGM/C. Our results are comparable with previous reports from Southern  and Northern  Iran which showed a prevalence of 70% and 55.7%. This shows that the prevalence of FMG/C is approximately high among rural areas of Iran. The mean age of the participants in the current study was 5.6 ± 3.6 years, which was lower when compared with previous reports from Iran (9.2 ± 14.2 years) . We conclude that the practice is being performed among lower age groups in Southern Iran. The 15- to 19-year age group is considered to be the most common age for FGM/C in most African countries [17,19]. We also found that the prevalence increased by age. Interestingly, we found that some of the girls received FGM after 18 or 21 years of age.
The age at which FGM is performed varies between countries and even from area to area within the same country; sometimes, it is performed soon after birth and sometimes before marriage [5,6]. We found that the procedure is mostly performed by local circumcisers (47.4%) and grandmothers (39.2%). This is consistent with other studies. Pashaei  indicated that the majority of mutilations were performed by traditional midwives and old women (96.4%) who did not use anesthesia (100%). Tag-Eldin et al.  also showed that FGM/C among Egyptian women are mostly performed by local circumcisers who do not use local anesthesia. The data of the present study demonstrate that lower educational level is signiﬁcantly associated with increased prevalence of FGM/C, which is consistent with previous reports from Iran and African countries [14,17,21–23]. The interesting ﬁnding of this study was that the FGM/C in southern rural areas of Iran was associated with Sunni Islam as religion. In other words, those with Sunni Islam are more willing to perform the procedure and continue it. Previous reports have shown that FGM/C is associated with Islam as religion [2,16]. Taking all the studies together, it could be concluded that being older, having less education, and being currently or formerly married as opposed to never married is associated with increased odds of having been circumcised. In addition, being Muslim also increases the odds for being circumcised. We have also shown that Sunni Islam is associated with higher prevalence FGM/C when compared with Shia Islam. This could be explained due to higher prevalence of Sunni Muslims in the area. The other explanation is that the Sunni Muslims are more conservative and traditional compared with Shia Muslims in these areas of Iran. It has been also shown that being older, having less education, and being Muslim are associated with higher odds of having had a daughter circumcised . We also demonstrated that positive family history of FGM/C in grandmother, mother, and sister is signiﬁcantly associated with higher prevalence of FGM/C. Consistent with previous reports, we found that type I FGM/C was the most common performed procedure in the region [1,13,14,17,20,24]. However, clitoral nicking was even more common. This shows that the practice is performed minimized in this region which is limited to nicking and scratching the clitoris.
FGM/C has been associated with several health consequences including long-term and short-term complications [8,25,26]. As many women undergo FGM in infancy, they may not experience any immediate adverse effects. Accordingly, Obermeyer  believes that FGM is associated with few number of complications and health consequences and that the hypothesized complications attributed to the FGM/C are not supported by evidence. According to the WHO , the immediate complications include infection, urine retention, severe pain, shock, hemorrhage, and death. Long-term consequences of types I and II include abscess, scar neuroma, and the formation of keloid and dermoid cysts. Long-term complications of the type III procedure include those mentioned for types I and II as well as dysmenorrhea, urinary incontinence, and vaginal stenosis. The HIV, hepatitis B, and other blood borne diseases may be transmitted through all forms of FGM [1,11]. As most of our patients were type I, the complications were minimal and limited. Chronic urinary and reproductive tract infections and PID are also linked with FGM. These problems are of particular importance because they are among the leading causes of infertility [8,25]. We also found that UTI and bleeding were the most common reported complications, while cyst formation and infertility were the least common complications. Pashaei  demonstrated that circumcised respondents suffered pain (48.2%) and bleeding (1.5%) after FGM. Several studies have showed that women undergoing FGM/C have decreased libido and higher frequency of sexual dysfunction [7,22]. This is considered among the most important mental complications of the procedure . In this study, dyspareunia and decreased libido were reported by 39.6% and 17.2% of participants, respectively. It has also been shown that clitoral reconstruction is associated with improved libido and sexual function . The important point that should be kept in mind is that although there is a global concern regarding HIV transmission via FGM, the direct causal link is still to be identiﬁed via large epidemiological studies .
We found that the most common reason for performing FGM/C was tradition (57.1%), cleanliness or making the girl Halal (40.1%), and partner’s sexual arousal (32.1%). Religion was mentioned by 30.3% of the participants, while increasing self sexual pleasure was reported by 25.8% of the participants. Pashaei et al. demonstrated that the reasons for FGM/C were tradition and customs (66.7%), cleanliness (17.2%), religion (2.8%), health (2.6%), and control of the sexual desire (1%). It is clear that tradition, religion, and social pressure were the main motives for performing FGM/C. In a study by Tag-Eldin et al. , the reasons for FGM were mainly religious (33.9%), cleanliness of the girls (8.9%), and social and cultural traditions (17.9% and 15.9%). Mohammed et al.  also reported that among Egyptian women, tradition, cleanliness, and virginity were the most common motives for FGM/C continuation (100%), followed by men’s desire, esthetic factors, marriage, and religion factors (45.2–100%). Our ﬁnding is consistent with a previous survey in Iran which showed that FGM/C is a social practice rather than a religious obligation . Generally, there is no reason for FGM/C in Islam. It clear that Islam forbids damaging the human body, and there is no scriptural evidence in the religion to support of FGM/C . The interesting ﬁnding was that 40.6% of the mothers mentioned that they would continue the practice for other children. This shows that lack of knowledge contributes to continuation of the practice in the region. More than 80% of the participants also mentioned that their mothers and grandmothers were the main decision makers for this practice. Regarding the role of the mothers and grandmothers in FGM/C, the results are similar to those reported by Tag-Eldin et al.  and Herieka and Dhar . Therefore, according to our ﬁndings, interventional programs should put emphasis on women’s education on FGM/C hazards.
There were some limitations in our study. The current study was cross-sectional which included the women in the area in order to determine the characteristics of FGM/C in the area. We used a self-reported questionnaire for determining the knowledge and attitude of the participants toward FGM/C. We performed pelvic examination to determine the type of the procedure. This methodology only enables us to report the prevalence of sexual dysfunction among the participants according to their own opinion. Thus, we cannot comment on the association between sexual dysfunction and FGM/C. The other shortcoming of our study is that we did not include the spouses or the fathers of the participants of the study. The role of male partners in continuing the practice is an important issue which is not addressed in the current study. However, this is the ﬁrst large study on FGM/C in Southern Iran which provides valuable information on characteristics and knowledge toward FGM/C in Iran. Further population interventional studies based on education and media are required to decrease the incidence of FGM/C in the area.
In conclusion, FGM/C is a common practice in rural areas of Southern Iran and is associated with increased age, illiteracy, Sunni Islam religion, Afghan nationality, and positive family history. Lack of knowledge toward FGM/C is the cause of this high prevalence. Increasing the target population knowledge regarding FGM/C via public media and schools would be necessary to cease the continuation of the practice in the region.
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After announcing numerous reports through various associations and publishing materials, finally one of the provincial governors of Hormozgan was well informed:
Director General of the Office of Social and Cultural Affairs of Hormozgan Governorate has stated that we will have meetings with scholars on circumcision of girls.
Director General of the Office of Social and Cultural Affairs of Hormozgan governorate has stated that there is no definite statistics on the circumcision of girls, but the majority of the people of the province adhere to this issue. He has said that since this issue is based on religious principles, it is very difficult to get into this issue and it is opposed to this unless the attitudes of the scholars and religious leaders of these societies change. We have plans in this regard. One of the plans is to send advisers to have meetings with scholars and elders in these areas and say that female circumcision has a very negative psychological impact.
He remarked: At the meetings of the Social Security Staff, we opened the girls’ discussion about the circumcision, and the mindset was getting more prepared. We had meetings with advisers and talked, and now it’s better to have an interventionist approach in this regard.
This despite the fact that the director of public relations at Bandar Abbas University of Medical Sciences (Norouzian ) had said: Female circumcision is not routine and it is not known, and if it is done in the family, it is completely secretly, not in the doctor’s office. This action is a moral, legal, medical, and health mistake, and if we know who is doing these activities, we will surely avoid it, but because it is done in secret, it is unidentifiable. Because this is not common practice, public education cannot be provided, but in the past 20 years when this was done in Kong Bandar, one of the health center personnel at that time was able to educate and inform the inhabitants of the port about the progress of this action.
Also, Pari Sayyadi, Director General of the Office of Women and Family Affairs of Hormozgan Province has stated:
The statistics provided by some sites are far from reality. We have not seen such a case during the periodic trips we have to the provincial towns. I myself have witnessed cases of female genital mutilation in other provinces that I did not name, but about women 40 years ago. Of course, in the same provinces, that is not common.
A new announcement of a meeting with scholars shows that officials and practitioners have finally accepted the practice of circumcision in the province. It is hoped that such news will be heard in other provinces like Kermanshah, Kurdistan and East Azerbaijan.
Statistics show that with different distributions, about 60% of women living in Hormozgan Province tend to circumcise their daughters; this figure in other provinces is about 30%. In 1394 (2015), some news reported that a girl in Buchan was referred to the hospital due to the severity of the injuries caused by hemorrhage and severe hemorrhage. It was hoped that such an accident would alarm the authorities!
Female sexual abortion is prohibited in many countries of the world. In Iran, according to some current laws, Diyah (blood money) is also granted to female genital mutilation.
Article 664 of the Islamic Penal Code, adopted in 2013, also states that “the removal of either side of the woman’s genitals causes half of the woman’s full diyah (blood money), and the interruption and destruction of some part of the body has Diyah.”In this decree, there is no difference between virgin and non-virgin, young and adult, healthy and defective, such as rebellion and coronation.
In addition to this article, other provisions of the same law have addressed similar issues:
Article 704: Eliminating the power of ejaculation or reproduction of a man or pregnancy of a woman or destroying the pleasures of male or female intercourse leads to Arsh.
Article 708: Eliminating or permanent or temporary damaging other senses such as trickling, sleeping, and menstrual periods, as well as causing diseases such as tremor, thirst, hunger, fear and faint lead to Arsh.
Article 449: “Arsh” is a non-tangled diyah which amount is not specified in the Shari’ah. The court determined the extent of the crime in terms of the type and quality of the crime and its impact on the health of the innocent and the amount of damage incurred by considering the deceased and with the opinion of the expert. The rules of determined Diyah are subject to Arsh, unless otherwise provided in this law.
By Rayehe Mozafarian
More than 7000 communities across Africa are working to abandon FGM. But there are some other countries in the Middle East and Asia where FGM is also common as a tradition. Despite the efforts of some organizations in the Middle East and Asia mutual cooperation between the respective governments and international organizations is difficult in some countries such as Iran, Saudi Arabia, Pakistan and etc.
FGM is tradition and culture which is still continued by women themselves. Although FGM is also men’s demand it can only be kept alive if women are complicit. There are no reports that FGM is done by doctors, educated nurses or midwives in Iran. The studies show that girls are mostly mutilated by native women.
Local surgeon women who do this operation and have learned it hereditary are known as Daye. Most of them are old women who learned it from their mothers or grandmothers. In modern times one thing is particularly important to note that the process of becoming and being Daye still continues. “Becoming Daye” can be defined as the process in which a woman with her own desire, social craving, illness and death of a former Daye or etc. accepts responsibility for the mutilation of girls and after a while the others will know her as Daye. There will by Dayes for at least another 40 years as in some villages, young Dayes still accept this responsibility.
Daye with several other women (in most cases the mother) as an assistant or helper circumcise the girls. For reducing injuries, the assistant holds the girl’s hand and feet strongly to prevent additional movements. In some cases, it has been reported that FGM is done by the closest person for instance the mother, grandmother or aunts.
FGM is usually done with a razor and without anesthesia medicine. It is rare that they use other kinds of sharp instrument. These women have different approaches to disinfect the place of cut. They often use Betadine, but in places where accessory to disinfection is difficult they use ashes of fire or cloths, natural soil and the smoke of turpentine.
In my travels to different parts of south, I visited various villages to find Daye and inquire about FGM. It can be estimated that there is at least one Daye in each village and in some can be found more.
I asked a Daye: “Why did you circumcise your granddaughter?” her face was broken and aging, laughed and said: “We have mercy, they cry and I can do the operation”. It was the points of view which should be corrected. In fact, I need to find the root of their passion for doing FGM which was completely different with my experience. Barbarity and cruelty were not a good reason.
Most people who have never seen these women think of them as butchers, violent, cruel and heartless but for me that I am in search of “why the continuation of FGM” for many years – and the presence of a Daye is one of the fundamental factors – the image of these women is different. Before I was so involved in the issue of FGM, I was surprised by the cruelty of these women. This image had changed when I traveled and talked to them myself. Their laughter, their hospitality, their warm greeting, shaking hands and kissing on their hands, all of them had no signs of cruelty and violence. They were deprived of the best education and facilities like all other disadvantages areas. But they would like to learn and continue their firm beliefs and circumcise the girls to practice and respect their religious tradition.
While most researchers believe that female genital mutilation is not rooted in Islam, people in areas where circumcision is carried out do so according to the Hadith of the Prophet and the Imams of the Shafi’i School to show thier commitment to religion. Although there is no compelling reason to do circumcision in Islam on girls.
What’s the solution?
4 steps to prevent the continuation of FGM must be considered. 4 social groups will be involved to improve their awareness.
- Stop the process of becoming a Daye
One of the important factors in development of each country is to reduce maternal mortality. This index is a good measure to show the extension of accessibility and availability of facilities, especially for pregnant women. So each country try to develop its potential to show its development such as access to health centers, facilitate transport and routes, especially in rural areas (rural network), emergency medical services, the cost of health care, women’s literacy status, etc.
In the eighties and nineties, the Ministry of Health and Medical Sciences decided to work together to improve the health of pregnant mothers and also promote the development of Iran. Then they start to find and identify local midwives in each villages and stop them assisting deliveries at home. These midwives were forced to sign a strong commitment to withdraw from their responsibilities. The project was very successful. The village can be found below where delivery takes place at home. This story can be repeated in the same situation for eliminating FGM in Iran. If the government wants, they can find the Daye, get them more right information then stop them to continue their jobs. Because more nurses who are active in FGM they worked as maternal health care.
- Improving the knowledge of women:
Another important aspect in reducing the prevalence of FGM is informing the women of the communities. Women’s literacy rates are not high in these areas so it is necessary to organize rural educational workshop and inform them of the dangers of FGM. Very good examples of these activities for the prevention of FGM are organized in Iraqi Kurdistan since more than 10 years ago with the participation of government and non-governmental organizations. Women gather together in each village, they watch an educational film, talk about their experiences and their sexual health issues and finally the session ends with the presentation of gifts. This session does not mean that the activists leave areas forever, after informing women the prevention process will be monitored.
- Informing religious leaders
Another social group who have an impact on the eradication of FGM are the Mullahs and religious leaders. The importance of this segment of society is due to its dominance on the traditions and religious traditions, Hadith and Quran and more importantly they have close relations with the men of the community. These religious leaders can make men aware of the dangers of FGM and persuade them to discontinue FGM with their religious messages.
- Doctors, midwives and nurses:
Experience has shown that residents of deprived areas share their physical health problems with the doctors and trust them to talk about everything. So the doctors explain about the danger of FGM and sexual hygiene. Because the doctors are being sent from different regions and FGM is underground, it is necessary to inform nursing and medical students.