December 28, 1996 Tug of Taboos: African Genital Rite Vs. American Law By CELIA W. DUGGER HOUSTON -- Just six months after arriving in Houston from a Somalian refugee camp, Ahmed Guled's family has eased into the American mainstream. His children attend the Pilgrim Elementary School. They spend afternoons with Power Ranger reruns. The baby girl toddles around in a Gap T-shirt and denim miniskirt. Guled himself holds dear the all-American dream that his children will go to college and prosper in the United States. But he also clings to an ancient tradition that is customary in parts of Africa -- and that became a federal crime this year. He believes his daughters must have their clitorises cut off and their genital lips stitched together to preserve their virginity and to follow what he believes his Muslim faith requires of him. "It's my responsibility," he said. "If I don't do it, I will have failed my children." Caseworkers and federal health officials say stopping the practice of female genital cutting among the small, but growing, population of African refugees and immigrants in the United States will take more than simply passing a law. It will mean finding a way to change the minds of parents like Guled. The Centers for Disease Control and Prevention estimated this year that more than 150,000 women and girls of African origin or ancestry in the United States may be at risk of having the rite performed on them or have already been cut, though it cautions that no field surveys have yet been done to confirm that statistic, based on 1990 Census Bureau population data. The rite is commonplace in 28 countries that span Africa's midsection, though it varies widely in its prevalence and severity. Some ethnic groups do not follow the custom at all, while others do so almost without exception. Like other refugees in Houston, Guled, who was a math teacher in his homeland, said he would, if necessary, take his 17-month-old daughter Ikram out of the country when the time comes in six or seven years. His elder daughter, 11-year-old Faduma, was initiated before the family fled Somalia after a bomb fell on their home in Mogadishu. One recent afternoon his older children clustered around the television, while his wife, Halima Ali Haqi Sheeky, who is 28, shyly explained the purpose of the cutting. Ikram was curled up in her lap, placidly sucking her thumb. "We were taught that this was a way of ensuring a girl's good behavior," she said. "It prevents them from running wild. Women should be meek, simple and quiet, not aggressive and outgoing. This is something we just accept." Two Strategies Meant to Stop the Practice Picture: Congress this year adopted a dual strategy to combat the practice in the United States. It directed federal health agencies to develop a plan to reach out to the immigrant communities and educate them about the harm of genital cutting. And it criminalized the practice, making it punishable by up to five years in prison. But the law will be difficult to enforce. While refugees are often impoverished, those who are able to save enough money to take their daughters out of the country for cutting are probably not violating the law as it is written, some human-rights lawyers say. Justice department officials said they were not sure how the law, which goes into effect in March, would apply in such a case. "It hasn't come across as something to even think about before," said Marsha Liss, a trial lawyer in the child exploitation section of the justice department's criminal division. Doctors who spot cases of genital cutting are likely to be reluctant to report parents to authorities for fear of breaking up close-knit families and sending well-meaning mothers and fathers to prison, child-abuse experts say. Also, the population from African nations where genital cutting is common are scattered across the United States, making it difficult to concentrate enforcement efforts. Besides Houston, they live in Los Angeles, New York, Washington, Chicago, Philadelphia, Atlanta and other cities. Secrecy Impedes Effort to Eliminate Rite Picture: But perhaps the principal complicating factors are the secretiveness of those who believe genital cutting is an essential rite of passage, and the hidden nature of the wounds and scars themselves. With the recent attention to the issue in the media, immigrants and refugees said they are intensely aware that their custom is forbidden in the United States. Guled said that he heard the practice was prohibited in the United States on BBC radio early this year while he was still living in a refugee camp in Kenya. Only in recent months have federal agencies begun gathering information about the practice. The U.S. Department of Health and Human Services recently surveyed state child-abuse agencies. Thirty have replied so far. Only two reported a case that involved the practice, federal officials said. In Hawaii, child-protection authorities intervened in time to stop the cutting; in Georgia the mother who cut her daughter's genitals was an American, not an African, said Joyce Goldberg, a spokeswoman for the state Department of Human Resources. Several doctors in the United States and in Canada, where there is a large Somali population and where the practice is also illegal, said in interviews they had seen girls who have been genitally cut. But the wounds were healed, they said, and it was difficult to know when they were subjected to the practice. Carolyn Levitt, a pediatrician in St. Paul, Minn., said a 14-year-old Ethiopian girl came in complaining of a burning sensation when she urinated. When a nurse practitioner examined her, she was shocked to discover that the girl's genital lips were largely fused. "She said, 'Oh my gosh, what am I seeing?"' the doctor recalled. "Then she called me in. I found a warm, conversant teenager who said convincingly that nothing had happened. She wasn't asking for help. And she didn't seem like a victim." Dr. Levitt did not report the girl's family to child-protection authorities. She couldn't say for sure whether the girl's urinary complaint was related to the cutting. Other doctors say parents have asked them how to have their daughters circumcised. In New York City, Peggy McHugh, director of the child-protection team at Bellevue Hospital Center, said a father asked her for a referral to a doctor who would cut his 3-year-old daughter. "I told him this was not done here in America," she said; then she asked him if he planned to bring in a son to have tribal scars etched in his face. "He was not pleased with me. He said I just didn't understand what he wanted." Alternative Is Offered for Cultural Sensitivity Picture: In Seattle, after Somali mothers repeatedly asked that their daughters be cut, a group of doctors at Harborview Medical Center agreed this summer to consider making a ritual nick of the prepuce, a fold of skin that caps the clitoris and that is analogous to the foreskin of the penis, with no removal of tissue. They said they saw the procedure as an alternative to cutting, which ranges from removal of the clitoris to the most extreme form, infibulation, which involves sewing up the genital lips to leave only a tiny hole for passage of urine and menstrual blood. But this month the hospital abandoned the proposal after being inundated with hundreds of letters, postcards, and calls protesting it. Retiring Rep. Patricia Schroeder, D-Colo., had also written the hospital, saying that she believed its proposal would violate the new law. "Harborview's role in considering the need for a culturally sensitive, safe alternative to the practices of female circumcision or female genital mutilation has now been concluded," the hospital said in a news release, clearly hoping to end the public furor. The law itself has been sharply debated among many Africans who have settled in the United States. Even some opposed to the practice say they are offended that Congress adopted a law that seems specifically directed at Africans, rather than relying on general statutes prohibiting violence against children, as France has done. Others feel that Americans have unfairly stereotyped Africans as people who mutilate their children. JoAnne D'Alisera, an anthropologist who has done extensive field work among Sierra Leonean immigrants in the Washington area, said American co-workers often bluntly ask them if they have been cut. For the Sierra Leoneans, genital cutting is part of an elaborate, highly secret initiation rite. The questions about it are seen as a profound invasion of their privacy. "One woman felt people were looking at her and talking to her as if all she was was a big genital that had been mutilated," Ms. D'Alisera said. Among Somali refugees resettled by the U.S. government in Houston, some say they will abandon the practice, while others say they must continue it. Workers at the Refugee Services Alliance, an agency that helps settle refugees, say language barriers, cultural differences and poverty all conspire to isolate the refugees. "What these women need is people who will educate them, not only about circumcision, but how to survive and assimilate in American society and still keep their culture and religion," said Miriam Diria, a worker who is herself an ethnic Somali from Ethiopia. In recent months the U.S. Department of Health and Human Services has organized meetings with advocates for refugees and nonprofit groups that work closely with Africans to develop strategies for combating the practice. The groups may, for example, ask Muslim religious leaders to explain to immigrants that the Koran does not require the practice. Jo Ivey Boufford, principal deputy assistant secretary for health, said that while there is no specific budget for the effort, the agency will fund some nonprofit groups to conduct educational campaigns. But human-rights advocates say the lack of a specific budget is a sign that the government is more interested in criminalizing a cultural practice than helping people break an ancient habit. "The government should put its money where its mouth is," said Seble Dawit, director of Alliances -- An African Women's Network in New York City. Daughter Protected by Mother's Memories Picture: There is no monolithic view on genital cutting among the Somali refugees in Houston. Fahria Abdi, 33, has decided she wants nothing more to do with it. She arrived in Houston with her 5-year-old daughter Sahra three months ago. She speaks no English and is struggling to survive on welfare in an apartment that is empty except for mattresses. She was separated from her husband in the anarchy that engulfed her homeland four years ago. She does not know if he is alive or dead. She does not know what will become of her in America. But she does know she will never have her daughter cut. Mrs. Abdi herself was stitched up as a child. To show the pain that trauma caused her she ran her fingers down her cheeks to track the tears. She said the consummation of her marriage took more than a week of prolonged nightly attempts at penetration that left her torn and bleeding. Childbirth was agony. "After I have had all this pain, why should my daughter go through it?" she said. Several other Somali women who had also been infibulated -- and who are widowed or separated from their husbands -- said they would not have that extreme form of cutting done to their daughters. The damage to their own lives was too great. But they did continue to want the tip of their daughters' clitorises clipped off. Halima Eidl, 20, arrived in Houston in 1993, a war widow who lost a leg to bullet wounds. She married the young doctor who ministered to her in the hospital and obtained a false leg for her. He was later shot and killed in the chaos. Like Mrs. Abdi, she and her 21/2-year-old daughter Rashaida are here alone, scraping by on welfare. Mrs. Eidl still believes a milder form of the cutting she endured is necessary so that Rashaida does not later run off with boys and have babies before marriage. She was disappointed that Medicaid refused to cover the procedure. She does not know how she will pay for the tickets to take Rashaida to Africa, but she will try to find a way. "I asked the doctor to do it for me," she said. "He told me, 'We don't do it here. We only give medicine.' "So we can go to Kenya to have it done."