Changing attitudes to female circumcision

Razor blades, scissors, kitchen knives and even pieces of glass are used to circumcise women

A Sudanese surgeon and women's health rights campaigner has said that more work is necessary in the fight against female genital mutilation.

Whilst positive progress is being made, Dr Nahid Toubia said that the campaign must stretch beyond the cutting and into the minds of the women involved.

Speaking to BBC World Service's Health Matters programme, she said, "If every circumcision stopped tomorrow I wouldn't be happy, because it is not about the cutting, it is about the women."

Violation

Female Genital Mutilation (FGM) is a term used to describe several different traditional practises that involve young girls' genitals being cut.

The practice is widespread in Africa and has also been documented in parts of the Middle East and South Asia.

Main types of female circumcision:

The removal of the tip of the clitoris

Total removal of the clitoris and surrounding labia

The removal of the clitoris and labia and the sewing up of the vagina, leaving only a small opening for urine and menstrual blood - a process known as infibulation

Dr Toubia campaigns for the bodily integrity of women and describes the practice of female genital cutting as a human rights violation.

"This [campaign] is about women and elevating the status of women and making them equal human beings," she explained.

"Yes I want to stop circumcision, but fundamentally I want to change the consciousness of women and give them power to renegotiate a new position within the limitations of their environment."

Attitudes

The issue, she said was on the agenda for most African countries - at the level of governments, health professionals, non-governmental organisations (NGOs) and grassroots communities.

But the biggest challenge remained changing attitudes and minds at that last level - the family and village.

"By allowing your genitals to be removed [it is perceived that] you are heightened to another level of pure motherhood - a motherhood not tainted by sexuality and that is why the woman gives it away to become the matron, respected by everyone."

"By taking on this practise, which is a woman's domain, it actually empowers them. It is much more difficult to convince the women to give it up, than to convince the men."

Circumcision deaths

Dr Toubia is founder and president of Research, Action and Information Network for the Bodily Integrity of Women (Rainbo) - an international organisation that promotes and protects all aspects of women's sexual and reproductive health and rights, particularly in Africa.

Rainbo estimates that, globally, at least two million girls are at risk of genital mutilation each year - approximately 6,000 a day.

An estimated 130 million girls and women worldwide have already been mutilated - most of them living in Africa.

"FGM is the severest form of control over women's sexuality"

Dr Nahid Toubia

The traditional proponents of FGM say its purpose is to make women more virtuous by reducing sexual desire.

Campaigners against it, like Dr Toubia, condemn the practice as one of many ways African women have their sexual and reproductive rights denied within male-dominated societies.

They also highlight how it often leads to chronic debilitating conditions as well as fatal infections.

Control

In 1981, Dr Toubia became the first female surgeon in Sudan. However, it was not until she came to the UK that she began her research into FGM.

She had already seen its harmful effects in many of her young patients whilst working in Khartoum but she says, "to her deep shame", she only began campaigning against it once based outside of her country.

It is, she explained, "the severest form of control over women's sexuality."