Female circumcision, or sexual mutilation of women, has had a profound effect upon the physical, social, mental and spiritual life of the 600,000 Kikuyu among whom we are working. A Colonial Secretary once said to a committee of missionaries, who were presenting a petition to the Governor of this Colony, that this custom affects 70,000,000 Africans and that it has a stronger hold on some other tribes than on the Kikuyu people. It is most difficult for an intelligent white person to comprehend the influence this custom, of unknown origin and history, has upon these people, affecting the whole warp and woof of their lives.
In the first place, what is it, what does it mean? Female circumcision, as it exists among the Kikuyu, is an operation which varies in severity, some section of the tribe practising a more drastic form than others. The following is a generally accepted description of the Major Operation:.
It involves the removal of not only the clitoris (this is termed the Minor Operation) E.L.D.), but also the labia minora and half of the labia majora, together with the surrounding tissues, resulting in permanent mutilation affecting the womans natural functions of micturition, menstruation, and parturition, with disastrous results not only to the birth rate, but also to the physique and vitality of the tribe. (1).
So we may well agree with the writer who said:.
It is beyond cavil that the operation described above fully justifies the definition suggested, namely, “The Sexual Mutilation of Women,” and this term was adopted by the Kenya Missionary Council (of Protestant Societies E.L.D.) as conveying a truer idea of the nature of the operation than then customary expression, “female circumcision”. (1).
This ceremony is the most prominent of the puberty rites which mark the transition from childhood to adult status, and takes place, in the case of females, before the onset of menstruation. The age is, therefore, not more than fourteen, usually it is about twelve. A safe margin of time is left because, to circumcise after menstruation has begun involves the owner of the girl and the operator in ceremonial uncleanliness and therefore a costly cleansing at the hands of the medicine-man.
As to the origin of the custom, nothing is known by the people. Its significance to them is chiefly on the negative side. A person who is not circumcised is ostracised by the clan, which idea is reminiscent of the penalty prescribed in the Jewish Covenant; “That soul shall be cut of from his people.” (Gen. 17:14).
On the positive side there is the underlying idea of entry upon a new and higher phase of existence when the foolishness and guild of childhood is thrown behind. The is at least passage from one state to another, and the idea of passage seems to underlie a great many Bantu customs. Circumcision would seem to have been adopted as part expression of this idea, for it is but one of many ceremonies.
After circumcision there is a period of instruction undertaken by a female sponsor, and, following this, is a big ceremony, signifying return to the clan as a full fledged “Muiritu” (young woman). This is attended by the insertion into the holes pierced in the lobes of the ears by a bunch of twigs, a formality which seems to be a sine qua non, and there is a mock ceremony of circumcision in which a blade of grass is approximated to the genitals and cut through. Parents participate in the final ceremonies, at least they enter upon a further phase of respectability there. This is also in line with the idea of passage.
The dominant motive behind most passage rites would seem to be fear of embarking upon the unknown without due ceremony and recognition of the event. Perhaps there is a propitiatory element running through the ceremonies of initiation to manhood and womanhood. It is given as a reason by some members of the tribe that circumcision of the girls ensures their bearing children. This is true in respect that without it they cannot obtain partners. (This has changed for among our Christian natives there are quite a number who are uncircumcised and have borne several children. E.L.D.).
The operation in its technique and attendant circumstances is as revolting a spectacle as one would care to witness. Medical practice does not heighten ones susceptibilities to such sights, but one must confess to a feeling of nausea at being present at this performance to which, admission having been obtained, it is introduced as being one of the supreme occasions of Kikuyu social life.
The field is crowded with spectators of all ages and sexes in various degrees of excitement and decoration, umbrellas being exclusive. It reeks with the peculiar heavy odor associated with Kikuyu assemblies. The victims are placed in a row, seated, and are fixed firmly and ingeniously by two women. The operator, an old female of many circumcision fields, emerges from somewhere in the mob and proceeds to action by a series of salutations, waving on high her Kikuyu razor, an instrument of spatulate form having a cutting edge on the distal end. The primary incision is circular, internal and parallel to the labia minora.
Each candidate is submitted to this in sequence and the operator then returns to complete the operation. A cornuate incision is made, the cornua being posterior and forming a tangent with the lower circumference of the primary wound. this incision embraces the labia majora and clitoris. The intervening tissues are now dissected off and the bleeding surface mopped at frequent intervals with a swab of leaves or with the bare palm. The candidate struggles or diverts the stimulus by furious blowing of her whistle.
The assembly breaks into the high-pitches queverring cry often heard on festive occasions, and the function is at an end. Boys, incidentally, are frequently circumcised on the same filed and on the same occasion as girls. (One may imagine the condition of the operating knife after a number have been cut, so that those who receive later administration suffer more from the haggling that becomes necessary. E.L.D.).
AFTER CARE. The operation over, the patient are led, or if collapsed, carried, to their village where they may be alone or with others who have come through the ordeal, and are attended by sponsors, female relative or friends who fulfil the double role of nurse and mentor. The wound is washed and dressed daily and it is the duty of the sponsor to see that the opposing surfaces do not unite. To secure this end a bunch of leaves is inserted. Responsibility is shared among the sponsors who must frequently fail in their duty, the surfaces being allowed to unite, causing various degrees of atresia up to complete closure. Dense bands of fibrous tissue are formed. Closure of such a degree as seriously to interfere with labor occurs in at least ten per cent of cases. This figure is arrived at following the examination by my wife of candidates for admission to the Girls Dormitory at Tumutumu.
COMPLICATIONS. The only case observed was one in which the patient had been forcibly taken and circumcised. The wound was septic and the patient was suffered great distress. It is inconceivable that general septic symptoms do not occur in many cases.
SEQUELAE. There are dysuria, dysmenorrhoea, dyspareunia, and difficult labour.
Dysuria is frequent, the vagina forming a secondary reservoir for urine which drains through what opening it can find. One notable case was in the habit of keeping a fistula patent by means of a fine wooden probe. The vagina was found on operation to be occupied by a complete vaginal calculus.
Dysmenorrhoea. Cases of closure to such a degree must also be accompanied by dysmenorrhoea which must result in haematocolpos, a cause of sterility which would persist even after removal of the primary cause. It is not known definitely whether interference ever takes place beyond the introitus, but one case of sterility has come under observation where the cervix was shut off completely from the vagina by a dense membrane, possibly of traumatic origin. It is believed that among the Meru (an adjoining tribe E.L.D.) the operation includes the vagina as well as the external genitals.
Dyspareunia. This is the most frequent sequela for which advice is sought, and it is surprising how many years of married life may be passed before relief is demanded. An average of 50 such cases is being dealt with annually at Tumutumu Hospital, and the degree of atresia varies from an opening admitting only a probe to one permitting the introduction of a finger-tip. The material available for reconstruction is often very slight. A flap of vaginal mucous membrane is usually utilized to bridge the gap made by an incision directed towards the anus. It is believed that many such cases are brought before Native Tribunals by disappointed owners, demanding a return of the goats (paid for the wife-E.L.D.).
Difficult Labour. This is the most serious aspect of the problem. Some obstruction must take place in the majority of first labours, seeing most women are stenosed to a degree, which interferes with the normal elasticity of the parts. The knife is employed for episiotomy in the villages and that in a very barbarous manner as has been seen in cases sent to hospital, where obstruction was due to other causes and episiotomy had been tried. The cutting is ill-directed and uncontrolled, as one might expect. Cases have been seen in villages where it was obvious that cutting was required and yet where the necessity was not appreciated. Two cases were seen, one where death of the child was due to lack of timely cutting, and one where both mother and child had succumbed to the long ordeal.
