CHICAGO TRIBUNE, Chicago, October 28, 1996.

Page 1.



By Tom Brune. Special to the Tribune
Monday, October 28, 1996; 6:00 a.m. CST

Dateline: SEATTLE

Defying new laws and an emotional international crusade, a group
of Somali refugees here are clinging to tradition and insisting
that their daughters undergo the ritual of genital cutting. As a
result, a local public hospital faces a major dilemma.

Over the past two years, some Somali and other refugees have
asked physicians at Harborview Medical Center about performing
the rite, which some call female circumcision, but opponents
condemn as female genital mutilation.

The question came up when doctors routinely asked expectant
refugee mothers if they wanted their baby circumcised if it was a
boy. Some mothers responded, "Yes, and also if it is a girl."

This summer the hospital, which has a long history of sensitivity
to diverse cultures and customs, convened a committee of doctors
to discuss what to do about the requests.  Their proposed
compromise is to offer a simple, symbolic cut.

When that suggestion became public however, it threw the liberal
city into turmoil.

"How dare it even cross their mind," said Meserak Ramsey, an
Ethiopian immigrant whose San Jose-based group, Forward USA,
seeks to eliminate the ritual completely.  "What the Somalis,
what the immigrants like me need is an education, not sensitivity
to culture."

Yet the desire by some refugee parents for the practice persists,
even though the Somali community there has essentially agreed
that the practice should be ended, said Hersi Mohamed, a Somali

"You cannot take away the rights of families and women," Mohamed
said.  "As leaders and elders of the community we cannot force a
mother to accept the general idea of the community. She can say,
`I want my girl to have letting of blood.' "

Though this is an issue physicians and hospitals across the
country likely are facing, Harborview is the only one to discuss
the problem openly as a public health issue, rather than treating
it simply as an outdated, barbaric rite that should be banned.

The issue of female genital cutting has taken on a high profile

Earlier this year the U.S. government granted asylum to a young
woman from Togo who said she would be cut if she returned to her
country.  In September, the United States joined Canada, France
and a few other nations in outlawing the practice.

The new federal law, which goes into effect next April, sets a
prison sentence of up to 5 years for anyone who "circumcises,
excises or infibulates" the genitals of girls under age 18.
Infibulation is the process in which the vagina is sewn shut
except for a small opening.

Some 150,000 females of African origin in the United States have
been cut, or face the possibility of being cut, according to an
estimate by the Centers for Disease Control and Prevention in

The ritual continues in about three dozen countries in Africa,
the Middle East and Southeast Asia. The World Health Organization
estimates that as many as 120 million women have been cut.

A rite of passage, the cutting usually is performed on girls ages
4 to 10. It can involve a simple nick or the more drastic slicing
away of all or part of genitals, including the clitoris and
labia, usually without an anesthetic.

Ramsey, who says she underwent a painful cutting at age 6, said
the practice causes physical and psychological problems, loss of
sexuality, difficult childbirths and constant pain. Some young
women have died from shock or loss of blood.

The physicians committee at Harborview says its suggestion is an
attempt to offer a way to save girls from the most drastic forms
of the rite.

"It would be a small cut to the prepuce, the hood above the
clitoris, with no tissue excised, and this would be conducted
under local anesthetic for children old enough to understand the
procedure and give consent in combination with informed consent
of the parents," said Harborview spokeswoman Tina Mankowski.

"We are trying to provide a relatively safe procedure to a
population of young women who traditionally have had some
horrendous things done to them," she said, but added, "We are not
now doing female circumcisions at Harborview, nor are we
considering doing female circumcisions."

Whether the proposal would be prohibited by the new law is one of
the legal questions being reviewed by the Washington state
attorney general.  The hospital's medical director will make no
final decision on the proposal until the legal review is
completed and a communitywide discussion is held, Mankowski said.

The Seattle area is home to about 3,500 members of a fast-growing
Somali community.  Some Somali and other African immigrants here
have made it clear how deeply ingrained the practice is in their
cultural and religious views.

Somali men and women told The Seattle Times their daughters would
be shamed, dishonored and unmarriageable if they were not cut, an
act they believe shows their purity.

They also said that if they could not get it done in the U.S.
they would pay the $1,500 fare to fly their daughters to their
homeland, where they face the extreme version of the cutting
ritual.  Some, but not all, of them said a symbolic cut on their
daughters would be enough.

Mohamed, executive director of the Somali group, Afrirelief and
Development, said the community has held meetings to discuss the

"I think the prevailing concept about it is that it should be
diminished as much as possible, and possibly eradicated as far as
girls are concerned," he said.

However, he added, "the fact that we came as refugees doesn't
mean we are going to leave our culture overnight. The bad parts
of our culture we will try to shake off, gradually. Now we are at
a point as leaders and elders of the community negotiating with

"We do have to understand that people have to abide by the law
here.  We did try to get across that very fact to the community.
We said, `This is the United States now. The laws are going to
change, and we simply cannot practice.'"

(File revised 7 December 2003)