Three decades into a global campaign to end the cultural practice of female genital mutilation and cutting worldwide, the desired change is yet to be achieved.
Various studies suggest that the practice is on the decline in many countries. But prevalence has increased Chad, Mali and Sierra Leone. The results are also mixed within countries. While the overall prevalence in Ethiopia has gone down, the prevalence among certain ethnic groups stays more or less unchanged.
The same is true of Tanzania. The national prevalence has decreased from 18% in 1996 to 10% in 2016 while the prevalence in Arusha and Manyara regions remains high at 41% and 58% respectively.
This doesn't mean that campaigns against these practices have not had any effect - just possibly not always the desired effect. Understanding what has changed or stayed the same, and why, could reveal better ways to protect women's health and social status.
A study in Tanzania
The prevalence of the practice among the Maasai of northern Tanzania has remained the same or even increased based on demographic and health survey data. Data from 2010 showed there was no decrease since 2005 and there was even a slight increase of 4.1% in Arusha, in the north of the country. This was despite spirited campaigning and interventions going on in the region. We set out to qualitatively interrogate what was going on there.
Among the Maasai, circumcision of both boys and girls functions as a rite of passage from childhood to adulthood. It traditionally culminates in a three day public ceremony during which the youngsters are coached on their new roles and responsibilities in the community.
Efforts by civil society and the Tanzanian government to discourage the practice out of health and human rights concerns have not always had the desired impact to prevent all Maasai girls from being cut. But our study found that these efforts have an important influence on the cultural meaning of the cut. They also modified the place and time when the cut takes place and altered the context of the ceremonial rite of passage.
What is more, these efforts have unintentionally put women's health at risk by driving the practice underground.
Dodging the law
Most Maasai people are aware of the international campaign to end female genital cutting. They are also aware that the practice is illegal for minors in Tanzania. To avoid prosecution, our research found, many families cut their daughters in secret - often many years before girls reach adolescence.
At this early age, children will not yet have started attending school. Older girls are forced to miss school during the recovery period and the family would thus be found out. Pre-school girls can go under the radar because they can be secretly confined to the home during recovery.
Other families wait until the girl reaches adolescence but cut her a few weeks before the ceremony or choose a smaller cut. Both strategies are meant to ensure that the girl is physically well enough to participate in the public ceremony where local government officials are often sent in to ensure the female genital cutting ban is being enforced.
The fact that many girls are cut before the ceremony to avoid prosecution allows others to avoid the cut altogether without risking social exclusion. Our ethnographic research found that some families take part in the public ceremony when their daughter reaches adolescence on the false claim that she was cut in secret weeks or years before.
Parents who object to the cut can use the protection of the law to refuse. But this can create tensions in the family, a high price for their daughters to pay.
Changes in the meaning
Whether daughters are cut when they are babies or just weeks before the ceremony, the cut no longer takes place during the rite of passage. Girls are not considered women until the ceremony, and thus it is the ceremony, rather than the actual genital cutting, that signifies the passage into womanhood.
This is a change from tradition when the cut used to be an integral part of the meaning. If genital cutting no longer equates to the transition from girlhood to womanhood, why then do so many families continue to put their daughters under the knife?
For some, it is still the combination of being cut (at whichever age) and going through the ceremony (at the beginning of adolescence) that admits girls to adulthood. Others believe that being cut prevents illness and reduces promiscuity.
The majority, however, say that it's a matter of identity: to be a full member of Maasai society, one needs to be circumcised.
Reverse and perverse effects
Our research also found a link between resistance to the cut and antipathy to non-Maasai involvement in trying to stop the practice. Many Maasai see efforts to stop the practice as part of a long history of interference stretching back to colonial times.
Women's organisations trying to end cutting complained to us that insensitive interventions by outsiders have resulted in suspicion and defensiveness, and made their work more difficult.
One of the aims of efforts to stop female genital cutting is to improve the health and well-being of girls and women.
During my doctorate research among the Samburu in northern Kenya I found that girls were increasingly cut at a younger age as well. But in contrast to Tanzania, here the ceremony is often abandoned. Girls are left with only the painful part of what used to be a ceremony full of teachings on socio-cultural life and roles. More research is needed here to understand this outcome.
Way forward
Well meaning efforts by outsiders can have adverse effects. Using repressive measures and top down approaches that are not embedded in local contexts can drive a cultural practice underground and impede change.
The international community needs to trust that the Maasai (and any other group of people) are willing to change. Indeed, they are already changing according to their own aspirations for the future of their communities by coming up with alternative rites of passage themselves, for example.
We witnessed various initiation rites for girls that included all the ceremonial aspects, but in which the genital cut was replaced with a little incision in the thighs or just pouring of milk. Families themselves came up with this without a top down alternative rite of passage initiative.
The role of outsiders is to offer support in ways that advance this cause but on their own terms and without being insulted in the process.