Indonesia: End government legitimization of female genital mutilation (FGM)

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Date: 
12 Sep 2012
Update Date: 
25 Jun 2013
Update: 

8 AUGUST 2013 UPDATE: We are pleased to report that following Equality Now and Kalyanamitra’s joint submission to the Human Rights Committee (HRC), the Committee expressed concern about Indonesia’s passage of a regulation legitimizing FGM in their concluding comments. The HRC has called on the Indonesian government to repeal the regulation and to “enact a law that prohibits any form of FGM and ensure that it provides adequate penalties that reflect the gravity of this offence.” They went on to urge the government to “make efforts to prevent and eradicate harmful traditional practices including FGM, by strengthening its awareness-raising and education programmes.” (CCPR/C/IDN/CO/1, Advance unedited version)  We hope that the Indonesian government will adhere to the Committee’s recommendations and take immediate steps to protect Indonesian women and girls from this violation of their human rights.


25 JUNE 2013 UPDATE: Indonesia will be coming up for review in July 2013 at the 108th session of the Human Rights Committee which monitors implementation of the International Covenant on Civil and Political Rights (ICCPR) by State parties. Equality Now and our Indonesian partner Kalyanamitra have sent a joint submission to bring the Committee's attention to the ongoing government legitimization of FGM in Indonesia. We continue to call on the government of Indonesia to repeal the 2010 Ministry of Health regulation legitimizing the practice of FGM and to enact and implement comprehensive legislation banning FGM with strong penalties for violators.


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In November 2010, the Indonesian Ministry of Health passed a regulation [No. 1636/MENKES/PER/XI/2010 regarding “Female Circumcision”] legitimizing the practice of female genital mutilation (FGM) and authorizing medical professionals to perform it. Though this “medicalization” of FGM permits a procedure that is harmful to girls and women and represents a violation of the ethical code governing the professional conduct of nurses, midwives and other health care workers, efforts to overturn the legislation have been unsuccessful; human rights groups on the ground fear an increase in FGM due to this regulation.

>> TAKE ACTION NOW!

FGM is a harmful traditional practice that affects up to 140 million women and girls around the world. All forms of the practice violate a range of their human rights, including the right to non-discrimination, to protection from physical and mental violence, to the highest, attainable standard of health, and, in the most extreme cases, to the right to life. FGM also constitutes torture and cruel, inhuman or degrading treatment.

According to the World Health Organization (WHO), FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. In Indonesia it is generally practiced on baby girls within the first six weeks of birth, but may vary depending on local customs. Reasons given for the practice include religion, custom, “cleanliness” and suppressing sexual desire. According to a 2003 Population Council study surveying eight sites in six provinces among girls aged 15-18, 86-100% had undergone some form of FGM that commonly involves cutting or injury to the clitoris. Approximately 92% of the surveyed families expressed support for the continuation of FGM not only for their daughters but also for their future granddaughters.

The WHO, of which Indonesia is a Member State, has consistently stated that “under no circumstances should FGM be performed by health professionals or in health establishments.” In a 2010 interagency publication, Global strategy to stop health-care providers from performing female genital mutilation, a number of organizations including UN bodies and the WHO found that “[t]he involvement of health-care providers in the performance of FGM is likely to create a sense of legitimacy for the practice. It gives the impression that the procedure is good for health, or at least that it is harmless. This can further contribute to institutionalization of the practice, rendering it a routine procedure and even leading to its spread into cultural groups that currently do not practice it.”

In its 2012 consideration of Indonesia’s report the CEDAW Committee expressed its deep concern about “the serious regression with regard to the practice” of FGM and particularly the Ministry of Health’s regulation authorizing certain medical practitioners to conduct FGM. It called on the Indonesian Government to withdraw the 2010 regulation and to “adopt robust legislation which will criminalize all forms of female genital mutilation…and provide sanctions against offenders”; it went on to call for awareness raising and sensitization. In its examination of Indonesia in 2008, the Committee Against Torture also called for the Government to “adopt all adequate measures to eradicate the persistent practice of female genital mutilation, including through awareness-raising campaigns in cooperation with civil society organizations.”
 
The Indonesian regulation on “Female Circumcision” runs counter to a number of Indonesian laws which include decrees enshrining international legal obligations in the national legal framework. These are Law No. 7/1984 on the ratification of the International Convention on the Elimination of All Forms of Discrimination against Women (CEDAW); Law No. 5/1998 on the ratification of the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT); Law No. 39/1999 on Human Rights; Law No. 23/2002 on Child Protection; Law No. 23/2004 on the Elimination of Domestic Violence; and Law No. 23/2009 on Health.

Indonesia is also a member of the World Health Assembly of the WHO which passed a resolution in 2008 urging all member states to accelerate work towards the elimination of FGM, to enact and enforce legislation against the practice and to prohibit performance of FGM by any person including medical professionals. The Indonesian Society of Obstetrics & Gynecology is a member of the International Federation of Gynecology and Obstetrics (FIGO) which passed a resolution opposing “any attempt to medicalize FGM or to allow its performance, under any circumstances, in health establishments or by health professionals.” In addition, the Indonesian National Nurses Association is a member of the International Council of Nurses (ICN) and the Indonesian Midwives Association is a member of the International Confederation of Midwives (ICM), both of whom also have position statements against FGM and its medicalization.

What You Can Do: 

>> TAKE ACTION NOW! Please join Equality Now and our partner Kalyanamitra in calling on the Ministry of Health and the Ministry of Women Empowerment and Child Protection to live up to their domestic and international obligations by:

  • Repealing the 2010 Ministry of Health regulation legitimizing the practice of FGM
  • Enacting and implementing comprehensive legislation banning FGM with strong penalties for violators
  • Conducting public awareness-raising and education campaigns to change cultural perception and beliefs on FGM and acknowledging FGM as a human rights violation with harmful consequences

Also join us in calling upon the Indonesian Society of Obstetrics & Gynecology, the Indonesian National Nurses Association and the Indonesian Midwives Association to live up to their international obligations as members of FIGO, ICN and ICM by:

  • Publicly condemning FGM in all its forms and its medicalization
  • Ensuring that strong measures are put into place to discipline Association  members  who practice FGM
  •  Urging the government to repeal the 2010 regulation, working with them to enact a law banning FGM and promoting a comprehensive strategy and public education against the practice

>> TAKE ACTION NOW!

Letters should go to:

Dr. Nafsiah Mboi, SpA, MPH
Minister, Health Ministry of Indonesia

Jl H.R.Rasuna Said Blok X.5 Kav. 4-9, Blok A, 2ndFloor, Kuningan 
Jakarta, Indonesia, Post Code: 12950
Tel:  +62-21-520-1590
Fax: +62-21-520-1591
Email: info@depkes.go.id

Linda Amalia Sari, S.IP
Minister, Ministry of Women Empowerment and Child Protection of Indonesia

Jalan Medan Merdeka Barat No. 15
Jakarta, Indonesia, Post Code: 10110
Tel:  +62-21-384-2638
        +62-21-380-5563
Fax: +62-21-380-5562
        +62-21-380-5559
Email: danty_anwar@yahoo.co.uk

Dr. Nurdadi Saleh
President
Perkumpulan Obstetri Dan Ginekologi Indonesia
(Indonesian Society of Obstetrics & Gynecology)

Jalan Taman Kimia No. 10
Central Jakarta
Indonesia
Tel.: +62-21-314-3684
Fax: +62-21-391-0135
Email: pogi@indo.net.id

Mrs. Dewi Irawati
Indonesian National Nurses Association
Jalan Jaya Mandala No.15
Patra Kuningan
Jakarta 12870
Indonesia
Tel:  +62-21-831-5069
Fax: +62-21-831-5070
Email: dppppni@gmail.com

Dr. Harni Koesno
President
Indonesian Midwives Association - IMA

(Ikatan Bidan Indonesia)
Jalan Johar Baru V/D13
10560 Jakarta Pusat
Indonesia
Tel:   +62-21-424-4789
         +62-21-422-6043
Fax:  +62-21-424-4214
Email: ppibi@cbn.net.id

With copies to:

Dr. Prijo Sidipratomo
Chairman, Indonesian Medical Association

Jalan Dr. Samratulangi No. 29, Menteng
Jakarta, Indonesia
Post Code:10350
Fax: +62-21-390-0473
Email: pbidi@idola.net.id; pbidi@idionline.org

Letters: 

Letter to Government Officials:

Dear [   ]:

I am deeply concerned about the November 2010 Ministry of Health regulation which legitimizes the practice of female genital mutilation (FGM) and authorizes medical professionals to perform it. “Medicalization” of FGM permits a procedure that is harmful to girls and women. It also violates the ethical code governing the professional conduct of doctors, nurses, midwives and other health care workers. Several efforts have been made to have this regulation overturned, but to no avail. I share the concerns of human rights groups on the ground that medicalization of any form of FGM legitimizes the practice thus rendering it impossible to stop the practice.

According to the World Health Organization, of which Indonesia is a member state, FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. The WHO has strongly urged health professionals not to practice any form of FGM. FGM is classified by the WHO into four major types:

Type I: Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals that includes the glans of the clitoris) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
Type II: Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina).
Type III: Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
Type IV: Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

FGM is a form of violence and discrimination against girls and women and is internationally recognized as a violation of their human rights. All forms of FGM violate a range of human rights of girls and women, including their right to sexual and bodily integrity, to non-discrimination, to protection from physical and mental violence and to the highest, attainable standard of health. FGM also constitutes cruel and degrading treatment of girls and women.

The Ministry of Health regulation runs counter to a number of Indonesian laws which include decrees enshrining international legal obligations such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) in the national legal framework.

I would like to urge you to ensure that Indonesia lives up to its domestic and international obligations by taking the following steps:

  • Repealing the 2010 Ministry of Health regulation legitimizing the practice of FGM
  • Enacting and implementing comprehensive legislation banning FGM with strong penalties for violators
  • Conducting public awareness-raising and education campaigns to change cultural perception and beliefs on FGM and acknowledging FGM as a human rights violation with harmful consequences

Yours sincerely,
 


Letter to Indonesian Medical groups (Ob/Gyns, Nurses and Midwives):

Dear [   ]:

I am deeply concerned about the November 2010 Ministry of Health regulation which legitimizes the practice of female genital mutilation (FGM) and authorizes medical professionals to perform it. “Medicalization” of FGM permits a procedure that is harmful to girls and women. It is also a violation of the ethical code governing the professional conduct of Indonesian nurses, midwives, obstetricians and gynecologists and is contrary to the resolutions against FGM adopted by the International Federation of Gynecology and Obstetrics (FIGO), the International Council of Nurses (ICN) and the International Confederation of Midwives (ICM) of which the health professional associations of Indonesia are members. Several efforts have been made to have this regulation overturned, but to no avail. I share in the concerns of human rights groups on the ground that medicalization of any form of FGM legitimizes the practice thus rendering it impossible to stop the practice.

According to the World Health Organization, of which Indonesia is a member state, FGM refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. The WHO has strongly urged health professionals not to practice any form of FGM. FGM is classified by the WHO into four major types:

Type I: Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals that includes the glans of the clitoris) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
Type II: Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are "the lips" that surround the vagina).
Type III: Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
Type IV: Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

FGM is a form of violence and discrimination against girls and women and is internationally recognized as a violation of their human rights. All forms of FGM violate a range of human rights of girls and women, including their right to sexual and bodily integrity, to non-discrimination, to protection from physical and mental violence and to the highest, attainable standard of health. FGM also constitutes cruel, inhuman and degrading treatment of girls and women.

The Ministry of Health regulation runs counter to a number of Indonesian laws which include decrees enshrining international legal obligations such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) in the national legal framework.

I urge your professional association to live up to its international obligations by:

  • Publicly condemning FGM in all its forms and its medicalization
  • Ensuring that strong measures are put into place to discipline health professional members of the association who practice FGM
  • Urging the government to repeal the 2010 regulation legitimizing the practice and working with them towards enactment of a law banning FGM and promotion of a comprehensive strategy and public education against the practice.

Yours sincerely,