On 24 June 1997, an Egyptian court overturned a government directive banning the practice by health workers of female genital mutilation (FGM), also known as female circumcision. The ban was instituted in July 1996 by Health Minister Ismail Sallam. In his decision overturning the ban, Judge Abdul Aziz Hamade stated that "doctors' right to perform their profession according to the law—which allows them to do surgery—cannot be restricted by a ministerial decree." Sheikh Youssef El-Badri, the lead plaintiff in the lawsuit against the Minister of Health, immediately proclaimed that he would use the court's decision in another pending lawsuit of his against the Minister of Education "to have him remove from school books any mention of the negative impact of circumcision, and replace it with the correct teaching that circumcision is a must and that it should be practiced." Just four days prior to the decision, an 11 year-old girl died in Egypt at the hands of a doctor during the course of a circumcision. The Minister of Health has announced his intention to appeal Judge Hamade's decision and has stated that the Ministry will not allow FGM to be performed in hospitals while the appeal is pending.
Egypt has long been a battleground for progressive and reactionary forces in relation to the campaign to stop FGM. In September 1994, during the United Nations International Conference on Population and Development which was held in Cairo, a Cable News Network (CNN) broadcast from Egypt of a young girl screaming as a barber cut her clitoris prompted an international outcry. Then Minister of Health Ali Abdel Fattah subsequently stated that FGM should be banned and that those who perform it should be punished. Yet one month later, apparently under pressure from Islamists, the Minister issued a directive permitting public hospitals in Egypt to perform FGM, effectively overturning a ban which had been in place since 1959. After a national and international campaign of protest, in October 1995 this directive was rescinded and replaced by a new directive instructing public hospitals not to perform FGM and stating that the role of medical personnel would be limited to providing counseling and guidance to limit the practice. In rescinding the directive, which he did in accordance with the recommendations of an advisory committee comprised of religious and medical authorities, Minister Ali Abdel Fattah made reference to the physical and psychological harm caused by FGM. His successor, the present Health Minister Ismail Sallam, extended the scope of the directive in July 1996 to cover private as well as public hospitals, banning any licensed medical professional from performing FGM.
Although Islam is often referred to in debates concerning FGM, there is no mention of the practice in the Quran. Mohammed Al Tantawi, when he was Grand Mufti of Egypt, issued a fatwa (religious opinion) in which he stated that the Quran contained nothing on female circumcision and that as the hadith (the sayings of the Prophet Mohammed) were weak on this subject, one should defer to the opinion of doctors. Mohammed Al Tantawi now serves as the sheikh of Al Azhar, widely considered to be the leading Islamic university in the world. The World Health Organization has expressed unequivocal opposition to the medicalization of FGM in any setting.
It is estimated that more than 100 million girls and women around the world have undergone female genital mutilation. FGM takes place in different forms in different countries: the partial or total removal of the clitoris (clitoridectomy), the removal of the entire clitoris and the cutting of the labia minora (excision), or in its most extreme form the removal of all external genitalia and the stitching together of the two sides of the vulva, leaving only a very small vaginal opening (infibulation). In Egypt, a 1995 Demographic Health Survey of more than 14,000 married Egyptian women between the ages of 14 and 49 found that 97% had been subjected to genital mutilation. In Egypt, the practice takes the form of clitoridectomy or excision. According to the Egyptian Organization for Human Rights, almost 3,600 girls every day are subjected to FGM. Dozens of FGM-related deaths have been reported by the Egyptian press. In mid-October 1996, two young girls aged three and four reportedly bled to death in the small Egyptian town of Armant after a doctor tried to circumcise them at their homes.
An extreme form of many traditional practices used around the world to deny women independence and equality, FGM is defended in the cultures where it is practiced as a rite of passage and a social prerequisite of marriage, and it is used to control women's sexuality by safeguarding virginity and suppressing sexual desire. But women and men who come from cultures which practice FGM are increasingly giving voice to the devastating harm inflicted by FGM, and movements for its eradication are growing. The Cairo Family Planning Association initiated the campaign against FGM in Egypt in 1980, by organizing a ground-breaking seminar entitled "Bodily Mutilation of Young Females" which was held in Cairo. Since 1994, an increasing number of non-governmental organizations, including human rights and feminist organizations, have joined together in their efforts to eradicate FGM in Egypt working through the national FGM Task Force.
Equality Now issued its first Women's Action on Egypt in March 1995, in consultation with the FGM Task Force, calling on then Minister of Health Ali Abdel Fattah to revoke the directive of October 1994 which medicalized FGM. Members of Equality Now's Women's Action Network appealed to the Minister from countries around the world including Austria, Canada, Kenya, Peru, the United States and Zaire. He responded to these letters acknowledging the "unacceptable disastrous repercussions on female child health" created by FGM and identifying efforts to combat the practice as one of his first priorities. In light of recent developments in Egypt, the dialogue should continue.
Contact doctors and medical associations in your community and inform them of the recent court decision in Egypt asserting a doctor's right to perform FGM. Ask them to adopt and send organizational resolutions and to write letters to the Egyptian Medical Syndicate, the professional association in Egypt which licenses doctors to practice medicine. Call on the Egyptian Medical Syndicate to clarify publicly and to all doctors in Egypt that professional ethics prohibit the performance of FGM as a dangerous practice which serves no medical purpose and causes great harm. Cite the World Health Organization's opposition to FGM as well as the Hippocratic Oath which requires that doctors do no harm. Please also write to the Minister of Health and express support for his timely action to appeal the court decision and to ensure that FGM is not performed in hospitals pending the appeal. Letters should be addressed to:
Professor Hamdey El-Sayed, President
Egyptian Medical Syndicate (Dar Al Hekma)
Kaser Al Eini Street
Fax: 202-356-2751/ Tel: 202-354-0738
His Excellency Dr. Ismail Sallam
Minister of Health
Magles El Shaab Street