Originally posted on the PRB blog.

(February 2014) Feb. 6, the International Day of Zero Tolerance to Female Genital Mutilation/Cutting (FGM/C), holds a special place in my heart because FGM/C is the first issue I worked on when I began my career in global health. In a rural part of northern Ghana (where I will always call "home"), I managed a study, the Navrongo FGC Trial, which explored different strategies to end the practice. We tried approaches involving education, livelihood, and a combination of both. As part of these activities, our team often engaged with the community following film shows, community dramas, or singing competitions.

One thing from those discussions has always stuck with me. The elders in the community (mostly mothers and grandmothers) said that the practice was tied to cultural norms like being able to perform certain rites during a parent's funeral. However, more important, they did this so that their teenage daughters wouldn't "roam in the night"— their euphemism for being promiscuous, as the dark evening hours in a rural village without electricity gave young girls the perfect opportunity to meet up with their boyfriends. When we later talked to the girls about what was going on in their lives and why they might be engaging in this behavior, they said that their parents were poor and couldn’t buy them simple things like soap or shoes to wear to school and well…the boys would.

So underlying this harmful practice was a cycle of fear and poverty, and a community simply trying to ensure the well-being of their children. The elders even said to us: Sure we can stop this thing, but we need to protect our girls, what else can we do? Over the years, many of us have worked hard to find that answer and to protect the millions of girls worldwide who are at risk for cutting each year, over 3 million on the African continent alone.

It’s now been about 10 years since I left Ghana. But the other day I read an article that brought me back to those discussions in the village. The article was on breast ironing, a practice in which mothers and other female relatives use a hot stone or pestle to flatten out the developing breasts of young girls. Breast ironing is most common in Cameroon but is also practiced in other parts of the world. Mothers say that they do this in order protect their growing daughters from rape and unwanted advances from men, to keep them from getting pregnant, to keep them in school, to make sure they have a good life.

So again there is more to it than what we see on the surface. These problems are not only about preventing rape or promiscuity, but about issues yet another layer down. They are about poverty, gender norms, societal expectations, inequities, and so much more. The parallel between breast ironing and FGM/C struck me like a ton of bricks. And my first thought was not, I can’t believe this is happening. But rather, where has the world gone wrong? Why is it a reality that mothers have to fear the rape of their daughters by fellow community members? Why are young girls in such desperate circumstances that early or transactional sex is a natural choice? And most important, why do such extreme measures seem to be the best recourse? After all, how often do we jump to the solution of cutting off someone’s tongue if they talk too much or blinding someone to protect them from seeing evil in the world?

We should be talking about why men are raping young girls in the first place, how to empower adolescents and provide them with healthy alternatives to meet their needs, why women in so many places lack basic dignities and rights, and what is needed so that, to be blunt, cutting off our daughters’ body parts no longer surfaces as the most viable solution.

Feb. 6 offers us an opportunity to reflect on our efforts and remind ourselves to understand the root causes of the problems people face. And to then work with communities to find meaningful solutions that speak to their realities and address their underlying fears, concerns, and challenges.


Reshma Naik is a senior policy analyst in International Programs, and former acting principal investigator of the Navrongo FGC Trial.