CONCLUSIONS. Circumcision of girls is responsible for a great deal of unnecessary pain and suffering, and for a good deal of obvious morbidity, probably much more than one suspects as its constitutional effects must be considerable. Such severe trauma, followed by sepsis, cannot but be followed by general disability. There is also the psychological effect which must be great. It is responsible for mortality, both maternal and foetal, of the later particularly the first-born. It is impossible to estimate to what extent it is responsible, but it must be quite a considerable one since there is no doubt that it account for much difficult labour and the ratio of stillbirths is in direct proportion to the latter.
There is a sociological aspect which the problem presents, and one which bears significance for the whole tribe, and therefore for the whole Colony. The rite is undoubtedly on a low social plane. To see it is to confirm that, and members of the tribe whom one knows to be people of intelligence are strong in their condemnation of the practice. The basic idea of entering upon a new and higher phase of existence is one that can be used as an occasion for education along sound social and moral lines, but not while female circumcision co-exists with it. That is quite inconsistent with the attainment of a social or moral status better than the tribe already possess. (2).
Another doctor of experience writes:.
If the operation is performed unskilfully or is subjected to much sepsis afterwards it may leave anything from a massive cartilaginous plaque involving the whole front of the vulva and urethra, to ragged scarred areas involving the pubis and vulva generally. Certain operators in certain tribes have a habit of scarifying the anterior wall of the vagina and surrounding parts. The obstruction caused by the more severe types of scarring are formidable and the child can in primipara be safely delivered only after free incision on either side of the vulva.
The obstruction is of two types. One is that the vulva is narrowed and the elastic labia majora are replaced anteriorly at any rate by an inelastic scar. The other type of obstruction is that the mass lying below the symphysis pubis prevents the extension of the head as the passage through the outlet of the pelvis occurs. These factors do play quite an important part in the death rate amongst the first born, for intracranial injuries must be frequent. A feeling is becoming more prevalent that the sot parts play a greater part than was previously accepted in birth injuries. The scarring seems so extensive at times that it must have some effect in disturbing the bony outlet by narrowing the public arch. (3).
From an article on Artificial Atresia in Kikuyu Women I will take a few sentences.
It results from the diabolical practice of female circumcision. The operation in this district consists of slicing off the whole external genital parts of the girls, after which the operator proceeds of gouge out as much of the lining membrane of the vagina as the can get hold of. The results after healing are simply deplorable, and have to be seen to be realized. (4) All such women are unable to have marital relationship with their husbands; but it must not be thought that this represents all the case against the continuation of this harmful custom.
It is responsible for a large percentage of infantile mortality, of this district at any rate, to say nothing of other districts of the reserves. The hard cicatricial tissue which persists around the external opening results, in those women who can actually conceive, in prolonging labour beyond its normal length and the child being still-born. (4) Another result is the general deformity and change in the anatomical relationship that follows. The anus is drawn forward in many of these cases, and the surgeon has to exercise care lest he should cut into the rectum itself. The exact position of the urethra in relation to the small external opening is very difficult to decide. (4).
I feel that the conditions described above require the evidence of more than one medical man for you to be able to believe that such customs exist, hence my quoting a number of writers, all of whom I know personally. We may not see on our Station much of the evil results the others have described, as we are farther away from the center of these practice, yet we see enough to confirm what has been stated above. We have seen mothers and babes die because the mother was unable to bring forth on account of the old scar tissue. We have seen vesico-vaginal fistulae for which we were unable to render any relief, and these women have to continue through life, a burden to themselves and a nuisance to others-all because custom has ordained that they must do so and so.
There is much sadness in this land, but we see a mighty small portion of all that exists about us. Ignorance is profound, fear so enthralls them that they must follow out the prescribed procedures, and blind devotion to customs causes them to go ways and to follow leaders that are plainly inimical to all that is for their interests. They think vomiting helps labor, so liquid sheep dung is given the woman. She will sit over a fire, as the heat may help to bring the baby-then we have the burns to treat.
She may be brought in to us in extremis-cold, almost unconscious, alive with maggots, pulse scarcely palpable-all this because she had been in a serious condition and was not expected to recovery, so she had been carried out into the bush that she might not defile the village by her death. Out in the dark night, shivering with the cold that creeps over the earth in the evening, alone with the ravenous hyenas that do not always wait for the unhappy victim to die before making an evening meal, there she had lain until someone brought relief, generally of a temporary nature as flesh had endured all that was possible and more too and the spirit soon departed from the marred body.
Homoeopathy has undoubtedly done much to relieve suffering among these women, but Divine power alone can change the hearts of these people so that they will be willing to leave the old and seek a new way that will save untold suffering and spare young men and women who will be willing to teach these benighted people of the new way that will bring to them eternal joy and eternal life, free from all suffering.
