An appeals court in Mansoura, Egypt sentenced Dr. Ruslan Fadl to two years in prison Monday for his role in the death of 13-year-old Suhair al-Bataa. Al-Bataa died in June 2013 of complications from the female genital mutilation (FGM) procedure she endured in Fadl’s clinic at the behest of her father, who was sentenced to three months of house arrest for violating Egypt’s 2008 ban on FGM.
UNICEF estimates that FGM affects over 160 million women and girls worldwide and is concentrated primarily within 29 countries and their diasporas. The specifics of the procedure vary, but can include removal of the labia or clitoris, as well as sealing off the vaginal opening. Contrary to popular assumption, FGM is not specifically associated with Islam. Many Muslim countries, like the Gulf states, have no tradition of FGM, and non-Muslims living in regions where FGM is most prevalent often undergo it as well. Proponents of the procedure tend to believe it benefits families by minimizing the sexual desire that could make a woman less marriageable or adulterous.
Fadl’s sentencing is the first of its kind in Egypt. Indeed, legal repercussions for FGM are a rarity even in Western countries, where laws against it purport to defend girls in diaspora communities. But it seems unlikely that legal avenues will be the instrument of FGM’s demise. The practice is already illegal in many of the countries where it is most common, but these laws are generally ineffective. Even if local legislatures and judiciaries took a harder hand on the issue, enforcement would require the cooperation of families — often, the very people who endorse and even seek out the procedure for their daughters.
So while Monday’s conviction was heralded as a massive victory and important precedent in the global fight against FGM, its wider impact remains unclear. Namely because it isn’t applicable to the majority of situations in which FGM occurs. For one thing, Fadl’s two-year sentence (and year-long clinic closure) is more a condemnation for Al-Bataa’s death than FGM. Had she survived, the incident would likely not have been reported. Furthermore, Al-Bataa’s experience was statistically rare since it took place in a medical clinic. Although around 75% of FGMs in Egypt are performed by a medical professional, only one-third occur in clinical settings. Had Fadl performed the procedure in al-Bataa’s home, it’s highly possible there would have been insubstantial evidence to convict him. (Fadl was even found not guilty in local courts before being convicted on appeal.) Outside of Egypt, FGM is rarely performed by medical professionals and is often carried out by village elders using implements like scissors or kitchen knives. Thus, even if the ruling does have a deterrent affect among physicians, it will have less bearing on more typical instances of FGM.
The larger issue underlying FGM is cultural — it is extremely difficult to upend a long-established societal tradition. For one thing, strict patriarchal attitudes in areas where FGM is common perpetuate the notion that a woman’s chastity is linked to her marriageability, which is in turn linked to her livelihood and economic welfare. Limited educational resources also help the practice continue, as do strict social taboos. In an essay about undergoing childhood FGM, Pakistani journalist Mariya Karimjee eloquently describes not understanding exactly what happened to her genitals until her teenage years, since candid discussions of women’s sexuality are so rare among women in her sect. Only with access to accurate anatomical information can FGM victims deduce that their circumstances diverge from global norms.
It makes sense, then, that the most successful interventions to stop FGM have targeted misperceptions rooted in local cultures. Grassroots education campaigns in Togo and Iraqi Kurdistan, which were funded by German NGOs and run by local partners, have yielded impressive results. The initiatives make the biggest splash when they enlist the help of influential locals, many of whom have undergone FGM themselves or have performed the procedure. One project in Iraqi Kurdistan produced a film tailored to local sensibilities about the problems surrounding FGM. Another in Togo minimized harm to the local social structure by providing loans to former practitioners so they could maintain their elite status within their communities even without performing FGM.
Beyond small-scale educational campaigns, general development is key. Statistics show that rising income and education levels diminish FGM. So does a pluralistic society; the more exposure a community has to others who do not endorse FGM, the less likely they are to perpetuate the practice themselves. This is perhaps the most significant result of the appellate court ruling in Egypt — while a strong legal framework won’t squelch FGM, increased discussion on the topic will.