(February 2009) As many as 140 million girls and women worldwide have undergone female genital mutilation/cutting (FGM/C), and more than 3 million girls are at risk for cutting each year on the African continent alone. FGM/C is almost impossible for individuals to abandon without support from their social networks, most notably within their intramarrying groups. Through Tostan, an organization dedicated to empowering women, adolescent girls, and their communities, innovative and courageous individuals have mobilized communities to abandon the practice through cross-cutting educational programs and attention to human rights within each community's social context and culture.

During a PRB Discuss Online, Molly Melching, founder and executive director of Tostan, answered participants' questions on the challenges and successes of Tostan's work to curb genital cutting in Senegal and several other African countries.

Feb. 4, 2009 12 PM EST

To read this transcript in French, go to Abandon des mutilations génitales féminines : histoires collectées sur le terrain .

Transcript of Questions and Answers

L. Ritz: By chance, is this practiced by those who come to the United States to live?
Molly Melching: Yes this is a practice that is continued even in the United States. FGC is a social convention necessary for good marriage and respectability within a given ethnic group, so it does not matter where one lives. In fact people often feel they must "prove" that they have not abandoned their traditions when they move to the West and even feel added pressure to continue. It is critical to include the diaspora groups in efforts to raise awareness on FGC as they greatly influence people in the communities at home.

Ernest Nettey: In your experience, what is the relationship between FGM and religion in Africa? Is FGM more widely practised by particular religions in Africa (and in the African diaspora)?If so, what accounts for this and how can can clerics be involved in any intervention?
Molly Melching: People often believe that FGC is a practice recommended by Islam. Many participants in the Tostan program claimed that they wanted to abandon the practice but could not because it was a religious obligation. However, it is not a practice required or recommended by Islam and many well known religious leaders have spoken out against the practice. Tostan always works closely with religious leaders on a national and local level to inform people and answer their questions. We have found that as more and more participants learn the human rights violations associated with FGC and the negative health consequences, they have put pressure on religious leaders to speak up and support their efforts to abandon the practice. We believe that people at the grassroots level can exert strong pressure on all leaders (religious leaders, politicians, local authorities) to help end the practice. This is why it is important to provide in-depth and empowering education to community members in their own national language who will in turn demand action from their leaders.

palang kasmi: culture is linked to practice of FGM in Nigeria.What is the way out?
Molly Melching: When asking people why they practice FGC, they often respond - it's our tradition, it's our culture. People do many things because they have learned it from their parents and their society, often without questioning why they do it. They simply know that if they don't do something that everyone expects them to do, they could be marginalized or even excluded from their social group. Going against the expectations means risking intense disapproval and is difficult if not impossible for one person alone to do. A village mother, for example, would never dream of doing something that could harm her daughter's reputation or chance for marriage. Thus,it is important to allow people who practice FGC to discuss the pros and cons of continuing or abandoning together without judgment, shame or blame involved. If people come to consensus as a group that FGC does not help achieve their goals of health, well-being, and harmony, they then need to reach out to the entire extended family to get them on board with the decision. This is why Tostan often holds inter-village meetings that allow people to debate and decide. This often leads to public declaration where the extended family comes together and makes the decision as a unified group. The public declaration marks the moment that the social norm has changed. No one is expected to practice FGC after the declaration, so no one individual is hurt by the decision.

Kantroo Chaman: All these harmful rites and rituals spring from superstitious and backward nature of such societies. The old and irrational beliefs, lack of understanding about value of human life and absence of a modernistic view point, contribute to such inhuman practices. Added to these conditions,be-liefs of male superiority and a female reluctance to part with the traditional norms and also lack of financial amenities stringent enough to give them access to modern education and information media retards the advances in this and other fields of woman empowerment. Do you think that unless a change in the mindset of the women is brought about the advancement in this field will remain a distant dream? So what measures do you suggest to remove this stumbling block? Is it not more important to attend to it at a time when some relatively advanced societies of Asia are experiencing a revival of such movements as are trying to curb any advancement of women?
Molly Melching: Hi Kantroo, The story of the communities that have made public declarations to collectively abandon FGC is the story of how this practice can be ended, and why more and more people are confident that FGC can become a thing of the past more rapidly than previously believed. As mentionned above, literally thousands upon thousands of people in Senegal have abandoned this practice, and many more are joining the movement. What is key is that this is not a "western" imposition; this is informed and empowered African communities making decisions for themselves, together, about their health, their human rights and responsibilities, and their futures. At Tostan, we have never found that communities lack understanding of the value of human life. In fact, we have found the opposite—we work with villagers who care about others, people who seek peace and who endeavor to build strong community. We have also found them to be rational. If someone hasn't gotten all the information about something, they probably aren't irrational, they are often just uninformed. Tostan found that introducing human rights education into our program allowed people to discuss the social practices that would help them to achieve their goals for a more positive future. This meant reflecting on traditions, often for the first time, maintaining positive ones and abandoning those that are harmful.

Henry Tagoe: The conflict of culture and law push such practices underground. What can be done in areas where FGM is outlawed but is still being practiced by a section of the population due to indigenous cultural believes?
Molly Melching: Henry, it is true that we are seeing this practice move underground in many countries. However, within the communities, the practice is not underground—people know who is cut and who is not. That is why the work of communities in Senegal has succeeded—because when communities are empowered and leading a movement, they can reach the people that no outsider could reach. In one instance a village in Southeastern Senegal abandoned FGC but the cutter went to another village (that had not abandoned) to cut a girl. It was the women from her own community that took this case to court and even insisted that the woman go to prison. Since she had been part of the declaration, the others felt she had violated their trust and the pact made by the community. It is important to inform people of the law, but more important to provide empowering education in national languages before enforcing a law—especially in countries where it is highly prevalent. Otherwise the law risks being very ineffective.

Irene Maweu: A friend told me that is we encouranged MEN participation in the eradication of Female Genital Mutilation and cutting, we would have enormous progresss. Are there countries where me are in the forefront against FGM/C?
Molly Melching: Irene, this is a very good point. In our experience in 7 African countries, men have emerged as strong leaders in the movement for FGC abandonment. We include men in the Community Empowerment Program and as they learn about human rights and responsibilities and realize the suffering the women have undergone, they begin supporting the end of the practice. In fact, a brilliant village man named Demba Diawara helped Tostan to understand that there needs to be agreement among all of the communities of the social network in order for abandonment to occur. He addressed his extended family with respect and led discussions in all these communities until people came to terms with the practice. His work led to the first public declaration of 12 interconnected villages on February 14, 1998. He has been one of the major leaders in the movement ever since. Most men have told us: "We just didn't know!" As soon as the women begin explaining some of the problems they and their daughters have experienced, the men realize that the practice must not continue. Because the subject was previously taboo, no one ever discussed FGC, especially among mixed groups. It is also important to note that there is no one group that can end this practice by itself—it requires a unified decision by all members of the extended family—men, girls, grandmothers, religious leaders, village elders, minority ethnic groups, majority ethnic groups, the cutters, the diaspora—everyone must be involved. Having the support of local and national government is also critical in this process.

Kofi Awusabo-Asare: It is a good idea to take up the issue of FGM as a cause and see to its logical conclusion. My questions are: are we not driving the practice under-ground and secondly, what are we replacing the social system which accompanied the practice? It is not simply wishing away a practice and replacing with formal education only.
Molly Melching: Hi Kofi, The practice may be driven underground--but it is impossible for it to stay underground for long when communities themselves are leading and managing the abandonment movement. This is because in communities that have abandoned, they no longer want girls to be cut—which makes it more difficult for families to consider cutting their girls, even "underground". The communities themselves then denounce cases after a declaration because they have ownership of the process and are empowered to act. As to your second question, we have found that FGC is only one part of a much larger social system—and that these social systems continue even after abandonment, even if certain aspects have changed. When Tostan enters a community, we first invite the community to define and come to consensus around their goals and objectives for the future. They then learn about and debate human rights and responsibilities over a period of several months. By the end of these sessions, the participants have themselves decided which social practices will help them achieve their goals and which need to be abandoned. In other words, before the program, the participants were operating from a "script" that was handed down to them by their ancestors, society, etc. and which they had never questioned. At the end of the program, the participants have analyzed and debated their received "script" and are empowered to change this script where necessary for achieving their new, commonly determined goals. As one village woman once told me once, "Our community is not a museum - things should always change for the better when necessary."

Marie-Helene Mottin-Stlla: Focaliser les stratégies d'intervention sur les MGF sur l'approche juridique ne risque-t-il pas de renforcer la judiciarisation des rapports sociaux ? ce qui se réglait autrefois sous l'arbre à palabre devra se régler devant les tribunaux ?
Molly Melching: Au Sénégal, les milliers de villages qui ont abandonné collectivement l'excision ont pris cette décision historique avec fierté, sous l'arbre à palabres, et non pas de force, devant les tribunaux ! Lorsqu'on regarde l'exemple du pays où Tostan est né, on voit que l'histoire du processus d'abandon de l'excision ne vient pas de la mise en oeuvre d'une approche juridique, mais de l'appropriation par les communautés d'un programme d'éducation, basé sur les droits humains - en écho aux normes morales qui régissent déjà leurs modes de vie. Le processus d'abandon résulte de la prise de conscience collective des conséquences néfastes de la pratique ainsi que de l'importance de la protection des droits humains et de la possibilité d'un abandon coordonné, inter-communautaire. L'approche de l'abandon de l'excision par le modèle communautaire – « l'abandon collectif » - porte ses fruits depuis 1997. Plus de 3548 communautés au Sénégal se sont engagées dans le mouvement ! Au vu de ses résultats, cette approche respectueuse, compréhensive et positive a été retenue non seulement par le gouvernement du Sénégal, mais aussi par l'ensemble des organismes des Nations Unies dans leur déclaration conjointe interinstitutions de 2008. Les éléments fondamentaux qui ressortent de ce mouvement de masse en faveur de l'abandon de l'excision au Sénégal montrent qu'il est non seulement peu efficace mais encore contre-productif de focaliser les stratégies d'intervention des MGF sur l'approche juridique. Le processus qui mène à l'abandon de l'excision est un processus multisectoriel : à tous les échelons et dans tous les domaines, l'action est concertée. Bien évidemment la justice est concernée, dans le sens où la protection des droits humains de la personne est en jeu, mais elle est concernée au même titre que la santé, l'éducation, la protection de la femme, la solidarité. Au Sénégal, la loi de 1999 a suivi le processus d'abandon qui était en cours depuis le serment de Malicounda Bambara en 1997. La loi est venue accompagner le processus et reconnaître l'importance de l'engagement des femmes de Malicounda, Medina Cherif et Baliga. Elle a été fort controversée ; il est prouvé que la loi – non seulement du fait de la difficulté de son application mais aussi à la suite des violentes réactions qui ont suivi sa promulgation – n'a pas eu un impact direct sur la diminution de la pratique de l'excision. Dans des sociétés où la demande d'excision est universelle, la conséquence de la loi – la punition des parents ou de l'exciseuse – comporte moins de danger que la conséquence de ne pas faire exciser son enfant, qui serait alors isolé socialement et dont les perspectives de mariage seraient anéanties. Peut-on considérer l'ensemble de la population d'un pays comme des criminels ? Nous ne le croyons pas. Les populations qui pratiquent l'excision pensent par là prendre une décision qui va assurer l'avenir des jeunes filles. On a vu certains effets néfastes de la loi se traduire par l'abaissement de l'âge de l'excision et par la pratique clandestine, renforçant les risques directs pour la santé des filles (voir la stratégie coordonnée pour l'abandon de l'excision en une génération, Unicef, 2005). Cela ne veut pas dire que l'approche juridique est inadéquate ; cela dépend de ce que l'on attend comme résultats. Si l'on veut favoriser l'abandon de l'excision de la part des populations, alors l'approche juridique est insuffisante et elle peut créer des réactions qui renforcent la pratique. L'amendement, l'adoption et la mise en application des lois doivent se faire en consultation avec la populations et ses leaders religieux et traditionnels. Elles doivent être accompagnées de campagnes d'éducation et d'information afin de promouvoir le soutien général de la population en faveur de l'abandon de la pratique. Mais l'abandon de l'excision est avant tout le résultat d'un processus participatif, positif, d'évolution sociale au niveau communautaire. Les programmes, comme Tostan, qui ont réussi à faciliter ce résultat à grande échelle, ne portent pas de jugement. Voici un extrait de la déclaration conjointe des Nations Unies (OMS, HCDH, ONUSIDA, PNUD, UNCEA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM) : « Il est apparu que les programmes qui incluent des activités d'éducation permettant aux populations de faire des choix, des discussions et des débats qui prévoient des engagements publics et une diffusion organisée permettent d'obtenir le consensus et la coordination nécessaires pour un abandon durable de l'excision au niveau des communautés [...] l'éducation visant à une responsabilisation permet aux populations d'examiner leurs propres croyances et valeurs relatives à la pratique d'une manière dynamique et ouverte, qui ne soit pas ressentie ou perçue comme menaçante ».

Hanny Lightfoot-Klein: dearest Molly Melching, It's been rather a long time since we have spoken personally, but I've kept up to date on your extremely important work. At the moment I am in Pittsburgh, PA, and doing some consciousness raising among the undergrads and also graduate students and faculty at Chatham University for the next two weeks. I have brought with me the documentary the Morgan Pollok did a couple of years ago about your work and mine. I'm still writing, and lecturing and serving as expert witness in US asylum court and UK tribunals. To date I have won asylum for more than 110 women, and even more importantly, their daughters. It's a wonderful "last career" for an old lady like me. I'm 82 years old by now and still going strong. My 30 years of involvement are of course nothing compared to your 38 in Africa. I am so happy for your successes. I have always known that the 4th decade would be the crucial one, and that we are finally beginning to see some real change taking place. I have also brought with me a circumcision knife that was not among those that was buried somewhere in the desert in a laying down of knives ceremony. It was sent to me instead, and I plan to live long enough to be able to finally bury it as well. I would love to hear from you.
Molly Melching: Dearest Hanny, Wow! Thank you so much for this wonderful note. You are such an important reference in the history of FGC abandonment. Tostan recognizes that without the research and activism of those like you who spent years in the field studying FGC, this grassroots movement would not be occurring today in Senegal and other countries. We really appreciate all that you have contributed, particularly given that it was even more difficult to discuss these issues years earlier. Demba Diawara, the villager from Keur Simbara who helped show Tostan the way forward, once told me that if we had raised this issue ten years earlier in his intramarrying communities, we might not have left the community alive as the subject was so taboo. Thus we have much to thank you for. We are happy about the throwing down of knives but have found even more important the empowerment of thousands of women who are confidently abandoning this practice because they feel they have choices for the first time. How I wish I could give you a big hug from me and from all these amazing women in Senegal!

SYLLA NDEYE ASTOU: aprés l'évaluation du plan d'action MGF 1998- 2001, la stratégie retenue pour mener les activités afin d'atteivdre l'objectif fixé ( eradication MGF AU SENEGAL d'ici 2015)que devont faire pour accélérer l'abandon de la pratique MGF au Sénégal
Molly Melching: Suite à l'évaluation du Plan d'Action National du Sénégal 1998-2001 pour l'abandon de la pratique de l'excision, et dans le cadre du mouvement d'accélération de l'abandon, le Gouvernement du Sénégal a organisé un atelier sous-régional à Dakar du 13 au 15 octobre 2008. Cet atelier, rassemblant des acteurs locaux et des représentants des pays voisins du Sénégal (Gambie, Guinée, Guinée-Bissau, Mali et Mauritanie) a été l'occasion de discuter de la mise en place d'une approche partagée par tous ces pays face à un objectif commun. Tous les participants se sont accordés sur le fait qu'une seule et même action concertée et commune permettra l'atteinte de l'objectif d'abandon total d'ici à 2015.
Cette conception d'une action transfrontalière correspond à la vision de diffusion organisée de Tostan. En effet, elle engendrera une action démultipliée, touchant les populations au travers des réseaux communautaires et culturels, en dépit des barrières géographiques et gouvernementales. Par ailleurs, nous pensons que l'éducation de base, fondée sur une approche humaine, suivi des réunions inter-villageoises et des déclarations publiques d'abandon de l'excision sont indispensables. Ces déclarations sont des manifestations-clés dans le processus d'abandon et doivent bénéficier d'une plus large publicité. La communication et l'information du grand public jouent un rôle fondamental dans la prise de conscience à un niveau global. Il serait donc souhaitable d'inviter plus de personnes à participer à ces déclarations, notamment des populations de régions voisines dans le cadre strictement national, ainsi que des représentants des régions transfrontalières dans le cas de déclarations dans des régions frontalières.

Judy Brink: Do you think the alternative rites approach works?
Molly Melching: I think alternative rites can work in areas where initiation rites are associated with the actual cutting as long as the alternative rites include empowering education for the entire community. Tostan has found that the most significant action one can undertake is a holistic, human rights based program of non formal education in national languages for all members of the community so that everyone is informed and unified in the decision to abandon the practice. Gerry Mackie, an expert on Female Genital Cutting, has written on this subject in the following book: Female Circumcision in Africa: Culture, Controversy and Change. Bettina Shell-Duncan and Ylva Hernlund, eds. pp.253-281. Boulder: Lynne Rienner Publishers. The chapter is entitled: Female Genital Cutting: The Beginning of the End. It can be found on the Tostan website under - Resources.

Dr. Josephine Alumanah: I come from an area where FGM is undertaken when women are pregnant. I had a focus group discussion (FGD) with some groups of women from the area. They all supported FGM 'because it is our tradition'. After a comment by one of the women, I decided to do an indepth interview. It was discovered that many families have abandoned the practice, unlike the result of the FGD. They do not undertake the cuttings, but all the other rituals that accompany it, for example, the paying of some money, buying cloths for certain members of the family, buying things for the wife, etc. This is insisted upon particularly if the husband is not from the town. In other words, FGM is undertaken because of the benefit, the people do not care about the act itself, but what they stand to gain. This piece of information did not come out during the FGD because nobody wanted to be the one letting out the secret. To them the tradition is still on, no matter what form it takes. What do you think?
Molly Melching: Dr. Alumanah, this is so interesting! Thanks so much for sharing this information. I attended a UNICEF conference last May featuring Cristina Bicchieri, a professor at the University of Pennsylvania who wrote a great book entitled: "The Grammar of Society". She explained that social norms are most often followed not because people have consciously chosen to do so, but rather because of the expectations of the others in the group. In some cases, people may very much want to abandon FGC but do not want to bring this up in public for fear of being seen as "traitors to their culture" in the eyes of others. Many people in the same group may secretly want to abandon but do not realize others also want to abandon and so continue to practice or refuse to admit they have abandoned so as not to feel the disapproval of society. This is what Professor Biccieri terms: "pluralistic ignorance". One village leader explained to me that she had long wanted to abandon FGC but did not dare mention this to anyone. She said she listened on the radio to declaration ceremonies for FGC abandonment and was so happy. I asked her why she had not spoken out earlier to others in the community about ending the practice. "I dared not" she said "for fear of being ridiculed." It was only when her relatives from other villages who had abandoned came and spoke with her community that they publicly discussed ending for the first time. "I was so surprised to find out that my own neighbors were ready to stop and even my best friend! Her namesake died of a hemorrhage and her own daughter went to the hospital and I didn't know it!" she told me. Perhaps people that you interviewed had the same fear of admitting to having ended the practice. Could the gifts and "benefits" perhaps have been used as a camouflage - visible signs of a ceremony needed to convince others that the practice continues? In this way, they are protecting themselves from potential outside judgement from other relatives who have not abandoned and would expect them to continue.

Sarah G. Epstein: Does your program discuss contraception with the women so they can space their children and stop when their families are complete?
Molly Melching: Yes Sally. This is very important in the Tostan program. Tostan feels it is critical that women learn about reproductive health and we address this not only in the health module but also in the first module of the program on Human Rights. We found that without first doing Human Rights education, women were afraid to discuss these issues with their husbands. Both the human rights and health modules gave the women the confidence and the information they needed to discuss convincingly with their husbands about the need for birth spacing. Tostan encourages a very gentle but firm approach and the men have been very supportive both in this area and also in ending FGC.

Charlotte Feldman-Jacobs: Given the new U.S. administration, and the new Secretary of State Hillary Clinton, with whom you have worked before, what would you like to see on the U.S. foreign policy agenda in the next four years?
Molly Melching: We at Tostan believe that the new administration will fulfill its promises to increase development support to the poorest and most marginalized communities around the world. We would humbly recommend, however, that they avoid repeating mistakes of the past by leveraging the best of our collective knowledge to create a new kind of development that sees individuals and communities in the developing world not as "recipients" or "targets" but as partners and collaborators in our common search for a better world. Specifically, we would recommend:
-Using proven, cost-effective strategies to better involve local communities in all of the processes that determine how development programs are identified, conceptualized, planned, implemented, managed, and evaluated. Communities have a fundamental right to a strong voice in these areas--yet very often are not sufficiently listened to.
-Challenging US Government agencies and their partners to take a more holistic, comprehensive view of development and promote strategies that would allow programs to collaborate and reinforce one another, rather than running parallel programs seeking complementary aims without communication or discussion. To this end, the administration should seek to support programs that engage communities across a wide range of areas, providing a foundation for development that can then leverage the amazing knowledge that already exists within communities.
-Increasing the use of cross-cutting strategies that focus on relevant knowledge and practical skill sets in multiple areas—which can greatly increase sustainability and dramatically reduce development costs in the long-term. Beyond any specific goal related to a single area in health, economic development, democratic engagement, etc, a primary goal of all development programs should be to reinforce local capacity so that the community itself can lead future projects.
-Increasing the use of strategies that focus on building local and in-country skills rather than simply purchasing short-term fixes from outside "experts."
-Redefining accountability standards to be more stringent in evaluating results, while also taking into account the mounting evidence that points to the necessity of longer-term interventions. Just as transformations in civil society have taken (and continue to take) decades to happen here in the US, so too will they take such time in other countries. This does not mean that change cannot happen rapidly, just that we must be patient in waiting for movements and leaders to emerge.
-Increasing involvement of diaspora communities in development efforts in their home countries. These communities have unique insights into the realities of truly living in the global village, and their investments in their home communities can be combined with other development efforts to increase impacts. This can also be a wonderful point of entry to increase dialogue and improve relations with these communities in the US and Europe.
-Using of human rights as a tool for promoting human dignity and changing harmful social norms, notably by the US ratifying CEDAW, Convention on the Rights of Children, and upholding the Geneva conventions.
-Promoting dialogue and discussion as a means of resolving problems between countries. Solutions outside of diplomacy dramatically affect the life, lives, and livelihoods of the poor.
-Supporting financial and diplomatic involvement of the US in the renegotiation of climate change agreements post-Kyoto 2012 including funds for mitigation and adaptation projects in Sub-Saharan Africa (Senegal, Mali, Mauritania and many other countries are greatly suffering from deforestation, erosion, and desertification.)

Margaret Thuo: What is UNFPA-UNICEF Global Joint Programme and Trust Fund? Answer. The Goal of the UNFPA-UNICEF Joint Programme and Trust Fund is accelerated abandonment of FGM/C in 17 countries in Africa within a generation and demonstrated by 40% reduction of the practice among girls aged 0-15 years and at least one country declared free of FGM/C in 5 years (2008-2012). This global initiative is being implemented for five years (2008-2012).
The first 8 countries to receive support in 2008 were: Djibouti Egypt, Ethiopia, Guinea Conakry, Guinea-Bissau, Kenya, Senegal and Sudan. Other nine countries still to receive funding are: Eritrea, Somalia, Uganda, United Republic of Tanzania, Burkina Faso, Ghana, Mali, Mauritania and Gambia. UNFPA and UNICEF are calling upon development partners to support the Trust Fund so that FGM/C abandonment is scalled up and accelerated. From Margaret N. Thuo, Technical Adviser UNFPA and Coordinator, UNFPA-UNICEF Joint Programme and Trust Fund
Molly Melching: [see above]

Katrina Hann: Could you comment on the response to provisions outlawing FGM/C that result in dramatically lowering the age of girls being cut? What kind of approach do you think is appropriate both at the legal and community level?
Molly Melching: As I mentioned above, we have found that it is important to consider the timing, and to work to pass laws at the right moment so that they build upon community interest and will not be seen as an imposition on practicing communities and as unenforceable by laws. Typically, that moment can come later in the process of awareness raising and community abandonment, so that the law reinforces an existing movement rather than attempting to shift a norm through the law alone.

Rahat Bari Tooheen: Female genital mutilation/cutting is a social ill that needs to be addressed at the community as well as individual levels. However, there should be no excuses for ignorance or the practices that come out from them. Do you believe that stiff social penalties will have any measurable impact?
Molly Melching: We have seen that the social penalties that emerge naturally when communities make collective decisions are indeed one of the ways this practice changes. Once everyone in the community has been reached, and been made aware of the decision to abandon FGC, and once people are aware of the consequences of FGC, and they are aware that a national law has been passed, then we would agree that ignorance is a harder argument to make. However, we have also found that we need to be careful if we start blaming people for being ignorant. Most often they simply have not had access to information presented in an understandable and non judgmental way. I say that we have to be careful because, for example, even my own great grandparents would not have understood what germs were, and would probably have laughed at the idea behind germ theory (the man who discovered germ theory died destitute and a laughing stock). Now should I think of my great grandmother as "ignorant" and say I have no tolerance for her? Of course not. I think she was making decisions based on the information she had at the time. It may be easy to chalk up disparities to ignorance, because then it seems like it is people's own fault. But actually we have found that all communities, whether in West Africa, East Africa, or elsewhere, tend to take action when given trust and respect.

Amy Rogers: I recently watched a video about FGM/C practices in Sierre Leon and one of the alternatives they were offering the practioners who performed the ceremonies was an education. A lot of the women who were performing the FGM/C said they only did it as a source of income. So organizations were teaching these women how to read and how to farm in order to get a job. Do you personally think that this approach to solving the problem is effective? And is this being done in other African countries as well? If so are there noticable differences in the amount of people who no longer feel the need to practice FGM/C?
Molly Melching: As I mentioned above, simply educating the women who perform the FGC operation will not get rid of the problem. FGC is a social norm that is deeply rooted in a community as a whole. Evaluations have proven that these strategies of "compensating the cutter" are not effective—families either continue using others to do the cutting, or the cutters themselves return to the practice because of demand. However, working with the cutters is extremely important, as they are very influential, and often have some of the most important experience and information about the consequences of FGC. But without the support of religious leaders, traditional leaders, influential men and women, diaspora members, and everyone else, the practice will not end. In the long-term these women do need to find other sources of income--something that we at Tostan have tried to support, as we support many women by helping them generate additional income. But not as a strategy to end the practice of FGC.

Nyakikongoro Rosemary: Is there any country where FGM has been completely abandoned or combated? What strategies did they use? The question of FGM looks like a cultural spiced issue, yet it affects women’s health and its women in most cases that are behind this vice, what penalty can applied to such women and men who are doing it? How have governments in countries where they have tried to combat this vice reacted?
Molly Melching: We are now hopeful that Senegal can become mostly FGC free by 2012. Keep in mind that there will be individuals that never give up this practice, and also that this abandonment will not completely show up on the national surveys until all girls born recently have the chance to go through the age of cutting. So we may not know conclusively until 2020 or 2025, but we expect the national prevalence to continue declining in the interim. Another example that comes to mind is Niger: the practice disappeared (for the most part) from Niger in the first half of the 20th Century, but the reasons behind this aren't clear. What we do know is that it is almost impossible for this practice to change unless:
-community members have a chance to discuss the practice and its potential consequences
-community members have a way to see those in their social network publicly declare their abandonment of the practice. We also know that it is likely that an entire community will either abandon or not abandon, but less likely that only a few people will give up the practice while others continue. There may be moments where this is true, but since the practice is tied to so many important values, the group that wants to stop will either have to a) convince others to join them b) go back to cutting or c) decide to remove themselves from the group. What has been fascinating for us at Tostan is to learn the history of the abandonment of Footbinding in China, which followed a similar trajectory. This was an entrenched cultural practice that disappeared in one generation. (See Gerry Mackie article: The Beginning of the End on the Tostan website.) It is important to note that abandonment of this kind has happened not only with Tostan's program, but with other programs, at a smaller scale. As noted above, at Tostan we do not believe that social norms should be changed through outside penalties; and if penalties are involved they should be decided upon locally or, if nationally, in close consultation with the communities involved.

Ken Ozoemenam: How do we deal with situations where FGM/C continues underground because government does little or nothing to monitor existing laws and policies against it?
Molly Melching: Ken, this is indeed the situation in some of the countries where we work, and we have found that once communities abandon the practice, they will then seek to use the law to enforce the new norm when necessary. And, we have found that while law enforcers may not want to actively pursue every potential case of FGC in a region where 96% of the population practices, they will certainly respond to a case when the community engages them in dialog and asks them to intervene and apply the law.

limia: I think that to combat FGM/C we need to target the whole community. [Do] you think the effective Behavioural communication change approaches should be used?
Molly Melching: We totally agree that the whole community needs to be involved. However, we also have found that behavior change communication is not a stand-alone solution to this issue. Many of those in the Behavior Change for Communication school of thought still conceptualize the problem as one of information—if we can just get the right messages to the right people, they will change their behavior. FGC is one area where this is not the case. In fact, we have found entire communities where individually most people wanted to abandon, but no one had actually abandoned. Why? Because information and individual willingness is not enough. If a mother decides not to cut her daughter, she needs a guarantee that her daughter will not be ostracized because she isn't cut. And that guarantee can only come about when she is able to verify that others also care about the issue and want to abandon too, and find a way to publicly coordinate a shared abandonment. That is when her daughter is safe, and this is why the public declaration is so important. This does NOT mean that communication does not need to be happening at the international, national, regional, and local level. All it means is that this is not a case where we should expect behavior change. Attitude change, yes, but not behavior change. By the way, we have found that community members themselves are the best "designers" of the messages. This is because no one else knows better how to talk to your mother about a sensitive issue than you do. Can outside agents (whether from other parts of the country or other countries) help them work on these messages and test multiple approaches? Certainly. But the campaigns must be led locally and reflect a true belief. Just as we here in the US are suspicious of motives when we see others promoting a certain viewpoint, so too are the communities with whom we work. We do understand that international groups will continue to distribute prescriptive messages aimed at ending this practice, and for this reason we are increasing our training capacity so that we can share our model and help people build upon what the communities of Senegal and beyond are doing. We are also building new partnerships and strengthening existing ones so that the messages coming out complement, rather than work against the efforts in our community members.

A Thompson: Have you heard of / What do you think of a recent practice called genital "rejuvenation" that is gaining popularity among many Western women? Genital "rejuvenation" includes plastic surgical procedures based around a desire to regain virginity ... and to regain beauty & aesthetics after childbirth .... These procedures are often openly advertised by health practitioners in popular media including daily newspapers, TV commercials, and radio in cities in the U.S.Even with medical facilities and standards superior to those of many developing countries, it has been reported that these procedures carry high risks of infection, nerve damage, scarring, and non-reversible loss of sensation. Harmful beliefs and societal pressures are responsible for this practice in the U.S. as much as in other regions of the world, which include a high value placed on virginity and youthfulness; popularity of cosmetic procedures of all types (where health takes a backseat to beauty); and the widespread visibility of sexually-exploitive industries, particularly with the increase in internet technology. For these reasons, do you think that this practice should also be classified as FGM and, if so, should a zero-tolerance policy be adopted by Western health practitioners as well? Thanks.
Molly Melching: A, I'm very glad you asked this question. In general, I would say that what adult women want to do to their bodies is their own decision, and should not be compared to a practice that is almost always done to young girl children. In fact, I have in the past said that I cannot disagree with some adult African and African American women that have decided to have the practice done to themselves—while I don't personally want to do it, it is their decision and their body. Similarly, if women in the US are making this decision, I don't know how much room I have to criticize. Although I must tell you I think it is sad to see so many people who are already lovely and unique changing their appearance to respond to social pressure. And I think we need to change the appearance-driven nature of our societies so that we no longer expect this of anyone. But I also know that some women who have had difficult births have more extreme complications, and/or difficulties in finding sexual pleasure. I do not want to lump these women in with those who may be simply fulfilling the social ideal of what they are "supposed to look like". And even then, the argument to me is primarily about consent, and to compare consent you would need to look at each individual case. One more answer to your question: At Tostan we have never used the term "Zero Tolerance." In fact, we have begun to refer to February 6th as Community-Led FGC Abandonment Day to better represent that this is a community issue at heart, one that needs SUPPORT from all levels but will be LED through local and regional efforts. It bears mention that the only way Tostan has found a road to abandonment is through tolerance, not intolerance. In fact, this topic only came up in our program because we were willing to treat communities with respect and let them draw their own conclusions based on objective information. By listening to people, understanding their needs, and encouraging them to take action on their own terms, we have found success.

Richard Cincotta: I taught high school in Kenya in the late 1970s. At the time, there was a vigorous debate going on, some of it carried in the newspapers. Surprisingly, perhaps the most vocal opponent to ending FGC was a white, non-Kenyan female anthropologist who argued that meddling in such African social traditions smacked of neo-colonialism. Upon returning to the U.S., I found that, at that time, her opinions seemed to resonate within some "Marxist-academic" circles. My question is: Who are today's opponents of ending FGC, both in FGC-practicing ethnic groups, in national institutions in those countries, and abroad (the West)? And how vocal, and how well supported, are they?
Molly Melching: Richard, that is an excellent question. There remains a small but sometimes vocal group of anthropologists who have argued that for the West to be involved in this practice at all is cultural imperialism. Some of these voices are African, some American and other nationalities. Honestly Tostan has not had too much concern with their objections of imperialism or colonialism, since ours is a 99% African organization; since we didn't introduce FGC as a topic—our community members did, on their own; and since the movement for abandonment has been led at the community level, not from the West. Several anthropologists have also gone beyond charges of imperialism to argue that this practice is simply not physically harmful, and that all arguments of harm are constructed by the West. We have not given much credence to this claim, as to us the removal of a body part is harmful, and as this directly contradicts the stories and experiences we heard about from communities in Senegal. All of the arguments I have seen center on hypocrisy between the West and Africa, for example that we demonize FGC in Africa but say nothing when women do something similar in hospitals in the US. To that all I can say is that Tostan's mission is for Africa, and if the day comes that we work with US communities, and if those communities raise this as an issue, we will support them with the same fervency we have supported African communities. Ironically Tostan shares many anthropologist's concerns about imperialism, which is why our program is so deeply rooted in local traditions and culture—song, dance, poetry, theater, and dialog in local languages are at the heart of our program. We believe that communities have a fundamental right to a leading voice in their development process. Even our work in human rights and responsibilities centers on their application to African culture—far from presenting Human Rights as rules to be followed, we ask participants to debate and discuss them, decide how and if they are applied, and what actions may be appropriate.Perhaps some anthropologist would prefer that Africa be left alone. We at Tostan however are seeing that change is coming to Africa regardless of whether we are there or not, and thus we would rather be there to be an advocate for communities in helping them lead their own development.

J Kishore: Female genital mutilation/cutting is mainly religious and cultural in origin. Changing [one's] religion or culture is a difficult task but one has to do it. What action one has to take in this direction?
Molly Melching: Hi J, I think my answers above have hopefully addressed this question. Religion and culture do take time to change, and can only change authentically and productively through internal means. Our program helps to facilitate this process so that communities can help decide what they want to work towards, and what they can leave behind.

Mala: Dear Molly I have been working on raising awareness of the practice of FGM within the health professionals. This year i am finishing my dissertation on FGM. I am looking at [the] Vagina and how different societies and FGM communities view it. [The] Vagina is seen as a sexual organ by most but the anatomy of physiology is much more complex. I feel an open discussion about [one's body] needs to be included in the teaching programme. [I] wonder how you feel about it? I would be so interested in your comments.Mala Morjaria (Midwife/Sexual health specialist,Practice Nurse and a National Childbirth Antenatal teacher.
Molly Melching: Hi Mala, thanks for your question and your work. It is important that health professionals around the world be informed about this practice and trained to handle it both medically, and also in terms of understanding and respecting the realities of their patients. A large part of Tostan's education program centers on helping participants understand the human body, disease and illness, the reproductive cycle, and many other related areas. While we are very careful to be respectful (for example facilitators have the option to use an "envelope of discretion" to show pictures that may been perceived as disrespectful or upsetting to certain community members), we have found that there is extremely high interest in this area, and very little objection from the community. I feel that this module is a key component in allowing women to discuss the issue of FGC fully.

Mbeinda Diop Lamotte: Depuis que la lutte contre les mutilations génitales féminines a commencé, les progrès sont en dents de scie. Ne devrait-on pas prendre plus au sérieux l'aspect sociologique? Il y'a recrudescence, parce que c'est un problème de croyance et parmi ceux qui tiennent à la pratique, on peut citer des gens dits modernes, mais qui tiennent à leur cultures.
je pense que d'autres stratégies pas encore usitées doivent être explorées.
Molly Melching: Merci Mbeinda. Nous pensons qu'en ce moment le Sénégal est en train d'expérimenter une réelle prise d'élan dans le processus d'abandon de l'excision. Il n'est plus question d'évolution en dents de scie en ce qui nous concerne. En effet, notre stratégie est très précisément centrée sur les réalités sociologiques des populations concernées. C'est un peu la faute de Tostan si nous ne sommes pas plus connus du grand public. Mais suite à l'évaluation de l'UNICEF qui a été rendue publique la semaine dernière - une évaluation qui prouve de manière incontestable l'efficacité de notre approche - nous commençons à mettre en place des stratégies nationales et internationales qui nous permettront de partager les expériences de Tostan et de nos partenaires communautaires, afin que tous puissent mieux comprendre ce mouvement d'abandon de l'excision cette marche vers un développement durable et un épanouissement des communautés. Les communautés n'ont de cesse de nous dire que le moment est arrivé et qu'ils comptent sur nous tous pour les accompagner et les aider à réaliser leur avenir.

Prof. Julie Cwikel: As someone who has researched this area, it seems to me that one of the stumbling blocks is the lack of re-education and training of the women who perform FGM and for whom this supplies a modest income. Has anyone thought of retraining them to offer semi-professional support to pregnant and birthing women in order to help to decrease preventable maternal mortality?
Molly Melching: Tostan believes that female genital cutting needs to be approached at the community level. Education and the empowerment of women over time through a holistic program can lead communities to abandon FGC together. This is critical for community-led growth, growth that leads to well-being and improved living conditions in general. We do not believe that the practitioners, non-practitioners or the women who perform the FGC should be singled out from their communities. And simply re-training women who perform the FGC operation will not end the harmful practice. These women, along with their communities, need to be educated in basic yet critical topics of democracy, human rights, problem solving, health, hygiene, and management skills. These topics along with the creation of Community Management Committees (as Tostan calls them) ensure that a community works together for the present and the future by encouraging and empowering people to make important decisions and create income-generating activities that support their families. Although they certainly participate in the practice, cutters do not cause the practice. They in fact offer a supply in response to the community's demand. Certainly, as members of the community, they have a role in creating that demand—but are not the sole reason for the practice. As long as communities want to do this practice, they will find ways to do it, even if one of the cutters has "laid down" her knife.

Esia-Donkoh, Kobina: Female Genital Mutilation (FGM) is perceived to be a developing country issue. But i am aware also of Genetal re-Modelling (GM) practiced in developing countries. Is FGM practice the issue of practice or the personnel/practitioners involved?
Molly Melching: Hi Esia, I responded to this question in the pre-questioning phase. You will find my answer appearing shortly. Thanks so much for your interest and a good question.

Pfor Angela Okolo: Do you work on this with a focus group in the communities?
What do the men think about the practice of FGM? What do the women who have had this practice inflicted on them think? Are they ready to join in the campaign?
Molly Melching: Hi Professor Okolo, as you will see in some of my other responses, the campaign was started and is being continued by the women who once carried it out. Men are sometimes shocked by the practice, as they are not typically involved in it. Men have become some of our most dynamic leaders in this area.

APPOLONIA ADEYEMI: What is the international community doing to tackle situations where government officials take neutral positions and are inactive on issues of female genital cutting because of strong cultural beliefs, which they do not want to be seen countering and how is this being tackled, considering that this attitude, action or inaction could send the wrong signal to the general population?
Molly Melching: Hi Appolonia, This is an interesting question. In our experience, these officials respond best to the people who elect them. So when movements begin to abandon the practice, and the community approaches these officials in peaceful, constructive ways, they tend to respond well. As I have mentioned in several other answers, we do not think it is the sole responsibility of the government officials to begin enforcing the laws. In some countries this would mean arresting millions of people, even their own families. So it is simply not feasible. What is required is a joint effort of all involved to end the practice in unison. Similarly, while their inaction does send a message (that they are not holding people accountable to this law), their inaction does not cause the practice alone.

rafat salami: some communities i know justify female circumcision by saying that it reduces promiscuity. some circumcised women also do not think it is harmful. they think we can advocate for safer ways of doing it. how can we address such matters in communities who do not think it is important to stop female circumcision?
Molly Melching: Rafat, A great question—one I expected to see much earlier. There have at times been arguments to "medicalize" the practice of FGC so that it can be done in hospitals "safely." The communities we work with have rejected this argument because while it is only a partial solution—no medical practice is 100% safe—and it does nothing to address what they see as a key part of the equation—the human rights of the girl involved. The promiscuity argument is a prominent one, but one that is not credible when communities investigate further. We do think that women who have been cut have the right to determine what they believe about the practice, as it pertains to their experience. This is one major reason why we have never used the term "mutilation"—we do not want to call women who have been cut "mutilated." It is important to note that Tostan works with populations who do not abandon the practice, and populations who don't practice at all. Abandonment is not a pre-requisite for being in our program or having access to full services from Tostan. Our entire model is based on real decisions being taken from the heart--the heart of individuals and the heart of the community and its social network. If people are seen to be "faking," it simply won't work, and the movement would disappeared long ago.

Meskerem Bekele, Ethiopia: In our country Ethiopia all kinds of FGM/C practiced. From those countries which practiced FGM, Afar and Somali region practiced the most severe type of FGM which known as infibulations. As the research and our organization supervisory visit [showed] us there is some improvement in these areas also. But in these regions and in other regions of our country people, even educated people, believe that type two kind of FGM should be continuing. Last time when we discussed [this on] our radio program, which is produced by Population Media Center Ethiopia and broadcasted in the national media, even educated person’s agree that for the continuation of Type two (which is known as in our country Sunna type). These are some of their [reasons] for the continuations of type two FGM/C :
_ We couldn’t totally avoid what [is] our society’s norm.
_ Our elders use it to control their girls from unwanted sex or before marriage sex.
_ We society people also want to control our [children] so we should use this method.
_We men are tired and boring in every aspect of our life. We couldn’t make love for our ladies because of life pressure so why our ladies suffer because of sexual feelings? So we do use FGM for their purpose.
_How can we totally stop such kind of practice in once? We must do this step by step.
These and others are their comments and questions. So how could we practice zero tolerance in our country case? What strategy we can use? Specially through media?
Molly Melching: Hi Meskerem. As you will see in my response to A Thompson below, we at Tostan do not use the "Zero Tolerance" approach. And when we expanded our program to East Africa—specifically Somalia and Djibouti—we were told that the only reason we were accepted was because we did not judge people for carrying out this practice, and met them where they are.As I noted above in my response to Limia, my recommendation to you would be use media and other communications avenues to reinforce work at the community level, rather than trying to convince people to abandon through messages. You can also use the radio to encourage discussions and dialog. And remember that social change takes time. In the North of Senegal, it took us almost 6 years of careful, grassroots work before communities began discussing abandonment. As you mention, these are deeply felt, deeply held traditions, and each person in each community may perceive them differently. And, even if you were to find a "magic" message that worked for many people, as I mentioned above they may still not be able to abandon, because they also need to find a way to coordinate their abandonment without risking social condemnation. Social norms are often practiced without full knowledge of "why"--for example hand shaking in the West. I can go ask 100 of my friends why they shake hands, and none or very few of them will give me the real reason: because they are supposed to. Now imagine that I ask them "Hey! why are you still shaking hands? Are you ignorant? Stupid? Don't you know this is dangerous?! Zero Tolerance for Hand-Shakers!" Their answers will quickly become defensive, and they will begin to find all kinds of reasons and justifications--my father did this, we do this at my church, etc. What is ironic is that these practices—both FGC and handshaking—DO have incredibly complex value systems associated with them. But we wont always get those as responses on a survey.So while it is fascinating to look at all the reasons people gave to you for keeping this practice, keep in mind that these may not always be the actual reason. Each person's decision will be motivated by a lifetime of experience and complex layers of moral norms, social norms, legal norms, etc. And as I mentioned above in relation to Dr. Bicchieri's article, many people will not have made an active decision based on a careful argument. They will simply do the practice because they perceive it to be "normal."

Fatou Diouf: Bonjour Moly question n° 1vous fait du bon travail au Senegal,mais malgré les efforts déployés, il persiste des poches de résistance.A votre avis, qu'est-ce qui justifie cette situation ? question n02 le Senegal est entrain de préparer le lancement de la campagne sur l'accélération de l'abandon. des MGF. Qu'elles activités pertinentes suggérez-vous dans le programme de cette campagne? question n°3 Il a été constaté que la reconversion des excissesuses en matrone n'a pas permis l'abandon définitif des MGF. Ne pensez-vous pas que le financement de projets porteurs selon la spécificité de la zone serait plus efficace?
Molly Melching: Bonjour Fatou, Question 1 - L'expérience de Tostan nous a montré que l'abandon de l'excision ne peut se faire qu'à partir d'un consensus de la famille étendue. Il arrive que des familles veuillent abandonner l'excision mais sans consulter les autres membres de leur groupe, il est quasiment impossible de prendre cette décision. C'est pour cela que Tostan facilite des rencontres inter-familles dans leur pays et même avec les ressortissants de la Diaspora. Pour Tostan, l'étincelle qui déclenche cette prise de décision est le Programme de Renforcement des Capacités Communautaires, tout particulièerement le module sur les Droits Humains. C'est pour cela que nous nous sommes fixé pour objectif d'atteindre les zones où les populations n'ont pas encore pu bénéficier d'un programme d'éducation de base en langues nationales. Question 2 - Nous prévoyons de faire un séminaire de partage au mois de mars avec tous les partenaires de la société civile et du gouvernement sur l'approche qui a abouti à ce mouvement historique pour l'abandon de l'excision. Actuellement nous mettons en oeuvre le programme Tostan dans plus de 450 communautés à travers tout le pays et nous soutenons les participants du programme dans leurs activités de sensibilisation auprès des populations ne bénéficiant pas directement du programme. Plusieurs déclarations d'abandon de l'excision sont prévues pour 2009. Une déclaration nationale d'abandon est prévue en 2012. Question 3 - La compensation financière ou la reconversion des exciseuses n'a jamais été au centre de la stratégie de Tostan pour l'abandon de l'excision. Nous pensons que l'abandon durable ne se fera qu'à partir d'une décision collective de tous les membres de la communauté et de la famille étendue - jeunes, adultes, leaders traditonnels et religieux, et exciseuses. Les évaluations de Population Council ont montré que la stratégie qui se concentre sur les exciseuses n'a pas donné de résultats durables.

AISSA: Pourquoi cette pratique perdure ?? traumatisante pour la personne humaine ?? qui n'est soutenue ni par le bible ni par le coran? Encouraagee par l'egoisme masculin?
Molly Melching: L'excision est une pratique qui dure depuis plus de 2,000 ans. Elle est donc profondément ancrée dans les normes sociales des groupes ethniques qui la considèrent comme un critère de respectabilité et de bonne réputation pour leurs filles. D'après notre expérience, la seule façon de promouvoir l'abandon de l'exicision, c'est l'éducation!

Sarah G. Epstein: Molly,In the hygiene portion of the TOSTAN program, are village women informed about contraception and how to access birth control clinics?
Molly Melching: Sally, These subjects are addressed in the health module of the Tostan program. Very important. We wish our participants had more access to good health facilities. Unfortunately this is not the case in most of the areas where we work.

Susan Tordella-Williams: Molly- How are you, it's Susan Tordella-Williams. What can we do from the USA to support your efforts in Africa?
Molly Melching: Hello Susan!Many people in the US help Tostan by contributing funds to adopt villages so that community members can benefit from our Community Empowerment Program which lasts three years. All information on this can be found on the Tostan website - www.tostan.org. The support from individual donors like yourself have greatly contributed to ending FGC in Senegal and other African countries.

Andrea Parra: Historically, there has been a "missionary or savior"'s approach to the issue of FGM. Feminist from the North and the West are set to "save" African women from themselves. Most attempts resulting in criminalization of the practice end up also criminalizing women as in the majority of the countries where it is practiced it's done so by women. How can we approach the issue from a perspective of true solidarity and eliminate the "us/them" division?
Molly Melching: Great question Andrea. Tostan does not use a judgmental approach but rather informs and educates people so that they can make their own decisions. When people themselves make the decision to abandon because they understand the human rights and health issues involved, the decision is sustainable. Former practioners themselves are then the ones reaching out to their relatives and neighbors to recruit others for abandonment, not outsiders. All Tostan field staff (over 800 people) are local African volunteers who live in villages of their own ethnic group for 3 years. Participants are thus empowered by their peers. Tostan facilitates this process of deliberation and consensus around this and other important issues in the communities.

Jennifer Wilen: Just to play devil's advocate....I wonder how many of the villages who have publically abandoned FGM/C have ACTUALLY abandoned the practice? Do you have any sense of this?
Molly Melching: Jennifer I am sure many people are asking this same question. Recently an external evaluation implemented by Macro Int (the organization that actually does the DHS studies in African countries) indicated that over 75% of those who abandoned through public declaration 10 years ago in Senegal really did abandon. This has made us very confident in promoting the strategies that we have developed in partnership with communities in Senegal and other African countries. UNICEF has played a major role in supporting this movement over the past 10 years.

Ghislaine Ouedraogo: Molly, I applaud your work at the community level. It truly is grassroots development, at its purest state. How would you propose men be added to the fight against FGM in Islamic and non-Islamic societies alike? Ghislaine Ouedraogo NYC
Molly Melching: Ghislaine thanks for your support! Men play a very important role in the abandonment process and we include them in almost all activities of the program. Tostan made a mistake years ago by focusing only on women's rights and this alienated many men. In 2000, we rewrote our modules to discuss PEOPLE'S RIGHTS - those of women, men and children. The response was amazing. The men were so much more supportive when they realized they had human rights and responsibilities and they became much more involved in the movement for human dignity for ALL. Village religious and traditional leaders are now some of the most active in the promotion of human rights and health for women in the countries where we work.

Nina Smart: Have You considered working with grassroots organizations in Sierra Leone where majority of women undergo FGM as part of initiation into the female secret society? What approach to eradication may seem effective?
Molly Melching: Nina, The case of Sierra Leone is very special. However, we think that our respectful and holistic approach would work there because it doesn't set out to target just this practice. Several NGOs from Sierra Leone came on a study trip to Tostan last year and spent a week learning about the program and discussing with participants who had abandoned the practice. They were quite enthusiastic. We have implemented the Tostan program in the Forest Region of Guinea with similar ethnic groups as Sierra Leone and they are already planning their first declaration for the abandonment of FGC this year. It would be great if you could witness this declaration as I'm sure it would give you many ideas!

Susan Tordella-Williams: Molly- congratulations again on the Tostan team receiving the coveted Hilton Prize. How has that changed your work and visibility in the NGO world?
Molly Melching: Winning the Conrad N Hilton Humanitarian Prize was an immeasurably significant moment for Tostan. It put us onto the international stage in a major way but more importantly recognized the work of thousands of community members, local facilitators, and our staff over the past two decades. Our work has remained the same--to help communities lead their own development, but the Prize fund, the visibility and respect that came with it have allowed our expansion to happen much more swiftly.

Andrea Parra: The practice of FGM was documented within a Colombian indigenous community, the Embera Chami, is there any work been done to link the experience of activists in Africa on this issue and the ones in Latin America?
Molly Melching: Thank you for your question, very interesting to hear that. Yes, we believe that communities around the world can always benefit from exchange and dialog with others. It is important to understand that often, a default response to hearing about another ethnic group or country that has changed their behavior is to simply say "well, things are different there—it wouldn't work here." But we have seen that when people are given the chance to visit and have one-on-one discussions with others who have made brave, difficult choices, it really can make a difference. Not only are these encounters inspiring, but they also help to redefine what is possible. Once you have met people that gave up this practice on their own terms and while maintaining their culture and dignity, it is much harder to argue that this would be impossible. The demonstration effect is huge, whether from neighbor to neighbor, or from Africa to Colombia.

Susan Tordella-Williams: Is Tostan's training center being used regularly? How many countries have sent trainers to be trained in the Tostan method?
Molly Melching: Tostan's training center is busy most of the time. We train trainers, facilitators, local elected officials, and participants from all over Senegal, but have also received trainers from Mauritania, The Gambia, Somalia, Djibouti, Guinea Bissau and Guinea.

Jennifer Wilen: How do you feel about penalizing cutters who violate laws e.g. the women in Burkina Faso who were imprisoned last year? Is this an effective method of prevention?
Molly Melching: In many ways, these sorts of questions can only be answered case by case—i.e. did the cutter know fully about the law? Was she pressured by the family? What other circumstances were involved? Has the law been applied fairly and consistently? This is why it is crucial to have fair and balanced judiciary systems that can apply the laws of the state in a consistent manner but taking each set of circumstances into account. As I noted in my responses to other questions, I do not feel that legal enforcement of laws against FGC are the best way to address this issue, at least not as a first point of entry. After communities have been informed, and after many have declared abandonment, then perhaps is the time to enforce the law. But as I mentioned elsewhere, it is almost impossible to enforce a law on FGC when prevalence in practicing groups normally hovers around 80-90%. A side note: it is important not to let the national data confuse the issue. In Senegal, for example, you will see a prevalence of 28% in the last DHS. However, that does not mean that this percentage is evenly distributed. In fact, it is the opposite. In many areas, it is nearly zero, while in others it is above 90%. Enforcement in the 5% areas is feasible; in the 90% areas impossible.

Nina Smart: How do international organizations deal with religious and traditional leaders who have direct influence in the lives of the people who perpetuate the practice? What are the best approaches You found to be effective?
Molly Melching: International organizations can identify local religious leaders who have been active in movements to support FGC abandonment and facilitate their travel to other regions and countries to discuss with people who share the same belief. Tostan sent several religious leaders to Egypt to discuss fgc with highly respected religious authorities and they came back empowered by the conversations and debates held.

Nina Smart: How do You assess the role of law-makers, parliamentarians, in the process of FGM eradication? How does the position taken by the state influence the actions of groups where FGM is practiced? My interest is in Sierra Leone
Molly Melching: Law-makers and parliamentarians are critical, but not key, to the process of FGC abandonment. It often depends on whether or not they themselves come from practicing groups or not. If not, their efforts will be seen as culturally motivated. If they are from a practicing community and want to abandon, this could be influential--however it would depend on their tone. If their message was one accusing communities of being "barbaric" or "primitive" or "ignorant", and seeking to "eradicate" or "fight" them, then those messages would likely not be received well at the local level. However if that person was committed to positive change and continued to express their opinions while also showing respect in other ways, he or she may find success. It should be said Sierra Leone is a special case because this practice is associated with secret societies. But the general principles I have outlined in my other responses would likely still apply.