Female Genital Mutilation And Economics (An Oxford Against Cutting Seminar)

It was a pleasure this morning to be the speaker for a Zoom seminar hosted by  Oxford Against Cutting and chaired by their Community Outreach Director, Kaddy Touray.  Our theme was Female Genital Mutilation and Economics.
I addressed two aspects of this theme: first, the economic factors and impacts of FGM for individuals and families; and second, these factors and impacts for wider communities and nations. Below is a summary of my talk and of some of the discussion which followed it:

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Female Genital Mutilation And Economics

Violence against women and girls comes at a truly shocking cost.  These are some recent estimates of the economic impact globally:

• In 2019 the World Bank reported that gender-based violence (GBV) or violence against women and girls (VAWG), is a global pandemic that affects 1 in 3 women in their lifetime.

The numbers  are staggering:

• 35% of women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence.
• Globally, 7% of women have been sexually assaulted by someone other than a partner.
• Globally, as many as 38% of murders of women are committed by an intimate partner.
• 200 million women have experienced female genital mutilation (FGM).

“This issue is not only devastating for survivors of violence and their families, but also entails significant social and economic costs. In some countries, violence against women is estimated to cost countries up to 3.7% of their GDP – more than double what most governments spend on education.”

Source: Gender-Based Violence (Violence Against Women and Girls), The World Bank, 25 September 2019

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And this year (2020) the World Health Organisation (WHO) revealed that

the cost of treating the total health impacts of FGM alone would amount to $1.4 billion globally per year (even apart from other sorts of costs).

That would mean individual countries devoting nearly 10 per cent of their yearly expenditure to treat FGM; for some countries, it could be as high as 30 per cent.

Source: FGM Cost Calculator (WHO, 2020)

But it’s not ‘only’ the costs of FGM to nation states that require careful attention.

If we want to stop (FGM) we must acknowledge that Economics is also what underlies the long history of FGM itself.

It’s money (and power / influence) which have always driven the practice.  The girl or woman who undergoes FGM becomes an economic commodity.

Whatever those involved may want to believe, with FGM a girl’s  body, reputation, autonomy and future are being traded for others’ financial benefit.

In communities where FGM is practised, it is usually an expected precursor at some stage in the girl’s life to early marriage, as a first or subsequent wife.   It is believed to guarantee so-called ‘purity’ – i.e. virginity.

FGM may also be instigated, often by the mother, in times of war and disorder, in the belief it will prevent rape – which would similarly lead to loss of value (as ‘impure’) when the girl is later put up for marriage.

FGM may be regarded as a traditional (or even a ‘cultural’) practice by some, but in reality it is a violent crime against girls and women, and a very serious human rights violation.

FGM is patriarchy incarnate – the literal imposition of (some) men’s will on women’s bodies.

And as we have seen, it is also a massive economic cost at every level of society, something I have been investigating now for several years.  Nonetheless, even now precise overall figures of these costs in communities often remain to be ascertained.

Many locations where FGM is prevalent do not have adequate health provision; they do not maintain full medical records – and the clinical priority when FGM demands acute care will not be long-term impact record-keeping and there may be reluctance to equate FGM with harm, let alone economic cost, etc.

But there are some general indicators of why FGM costs so much:

For instance:

• FGM may coincide with or result in early marriage and the loss of educational and personal opportunities.
• FGM is known to increase the likelihood of maternal and infant mortality, perhaps even in some cases considerably so.
• When a mother dies her child has much less chance of living beyond the age of one, or even ten.
• Women with FGM may have physical and mental health problems throughout their lives, and in the very worst instances may suffer, for instance, obstetric fistula – which effectively, like possible psychosis/PTSD, excludes them from their community, and leaves children without adequate care.
• Women with suboptimal physical or psychological health are unable to contribute fully to their family groups or to their communities.
• The medical care of women with FGM takes human and economic resources which could otherwise be better used elsewhere. The same applies to the administrative and other civic costs.
• Women with FGM are thought to lose on average a few weeks of life expectancy.
• FGM reinforces gendered stereotypes in communities which hold back optimal productive socioeconomic engagement by both women and men..

So who benefits from FGM?

• The operator – whether s/he is a traditional ‘cutter’ or a medical person with an (usually illegal) sideline in FGM
• The family of the girl – ?especially the father – both because a bride price may be paid and because the girl then becomes the responsibility of someone else.
• The husband who acquires a new / extra wife – who may have had to pay ‘bride price’ to her father, or who may acquire a dowry from her family to pay for her upkeep
• The local community, if the ‘cutting’ includes celebrations and expenditure on goods and services

And who doesn’t benefit?

• The girl / young woman
• The husband, because his new wife may be ill or disabled because of the FGM
• Future children, because their mother is not in good health
• The community, because the woman has married early, is less educated and her health may not be good
• The local economy, for the same reasons, and because of the drain on local resources if the woman’s ill health, and sometimes that of her children, has been compromised
• The nation / state because of the demands on health, enforcement and other agencies if the issues arising from FGM are addressed; and because the national economy will suffer.

What can we do about all this, if we want to stop FGM?

Here are a few ideas:

Cutters:
Recognise that being a traditional ‘cutter’ brings not only income but also, often, status.

That’s why senior women in a community are unlikely to give up their occupation just because instead they’ve been given a few goats to help earn a living.

Either, other forms of respect and status must be convincingly awarded, or FGM must be made a shameful thing to do.

Ideally, a ‘cutter’ can be persuaded to stop doing FGM and become instead a leader in her community to promote good health and girls’ education.  But that takes patience, time and high-level investment in the idea.

Or, if the operator is a health professional, insist that all such professionals are fully aware of both the (in most countries) law against FGM, and that there is adequate initial and in-service training on the dangers of FGM.

Prosecution and reporting to professional bodies should be the aim to prevent medicalization of FGM, wherever it is done – but on the more positive side, salaries for medics must be adequate paid regularly (sometimes they are not).

Families:
It’s essential that families realise the value of education for girls, and permit marriage for any child only as an adult.

Many community-led campaigns now focus on this ‘value of education’ message, introducing e.g. ARPs – Alternative Rites of Passage – which usually involve the family and whole community, where the girls is not harmed and they are encouraged to continue their education. In carefully developed and appropriate contexts ARPs scan be helpful.  For these campaigns to be successful it is critical that the economic benefits of further education are understood and seen to be real.

Husbands:
If bride price must be paid, the men must be persuaded that a ‘cut’ girl is someone whose health has been harmed; there should not be a premium price (eg payment of more cattle) for girls who have had FGM – rather the converse.

An uncut woman is generally healthier and can contribute more to her family and partner; and a woman with FGM is unlikely to be as willing an intimate partner as an uncut woman.  FGM has been the cause of countless broken marriages, where men seek ‘solace’ elsewhere, with the probable increase in expenditures of various sorts which that may entails.

The local community:
In some communities, but not all, FGM is accompanied by ‘celebrations’, and may e.g. be timed to coincide with periods of plenty, such as harvest time (when growers get their profits).  Providers of services and goods such as new clothing and special food may rely on this celebration for income.

Depending on the location and customs of the community, other occasions for using these services need to be found. (Alternative Rites of Passage can be useful here.)

And what about the wider costs of FGM?
To those of us who campaign for FGM (and other gendered violence)  to end, the humanitarian and human rights issues are all that matter.

But to others in the wider community or nation state that argument may not be enough.  These politicians and policy makers are constantly presented with such pleas to stop all manner of things.  For some senior decision-makers the economic arguments will be more persuasive.

Arguing that FGM costs money/ resources that could better be spent on other desirable services may be a stronger position to take.  The politicians may need positive reasons to abolish FGM, especially when some of their voters still want it to continue.

Giving policy makers and politicians the facts about cost, so they can argue for better services if FGM has been eradicated, may be the best way to get the authorities and leaders onside with the end FGM campaigners.

[Some links above updated in July 2021.]

Read more about FGM and Economics

Read more about FGM as Patriarchy Incarnate

This article was also published in Mojatu Magazine, M039, p.4

FGM and Economics, by Hilary Burrage

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