A Skepchick writer has come out in favour of the Lisa Wade’s article in one specific way…
No one likes to be told what to do? Especially by people outside the culture if they are using language condemning a practice that is harsh.
The problem is Lisa Wade poisoned that one point with the rest of her post. “With Therapy” women will have a normal sex life doesn’t excuse protecting a practice. With therapy a broken leg will heal, doesn’t mean running someone’s leg over with a car is harmless. She covers up harm and uses language legitimising a practice and treats it as a medical procedure.
The piece in from Heina refers to Ophelia’s and Zinnia’s pieces on the topic mentioning that they are facts of FGM light. And to be fair I had just run my “primer” on FGM earlier so I figured they didn’t go into the details about it because if people asked they could just go “Look at Avi’s Stuff” rather than hammering out the same primer. That’s my defence of why they didn’t really go into the details of the subject.It does ask a question though and I think the problem is at the crux of the issue where Lisa Wade failed in her argument. It is not a strength.
Neither, however, address what I find significant in Wade’s piece. In response to Wade’s claim that “people don’t appreciate being told that they are barbaric, ignorant of their own bodies, or cruel to their children,” the latter said:…
While it is true that Wade’s piece does not discuss many of the harms of FGM, that particular point made in the Sociological Images post is not as much of a platitude as one might think. Most conversations about FGM among Westerners not had by sociologists and other such academics indeed center around some version of “Ugh, that’s so horrible and disgusting! Who would do that to children?!” at best, and, at worst, a variant of “Let’s kill the monsters that do this!” This corroborates some of what Wade initially posits: Westerners’ reactions are highly informed by their particular perspectives in ways that they might not fully comprehend. To them, it’s clear and unquestionable that FGM is bad and that its practitioners should feel bad.
To understand the problem of this I will have to tell you an anecdote. An anecdote which is at the heart of another quackery movement of the Natural Home Birth.
Majority of Indians still live in rural sectors away from the technology and wealth of big towns and cities. Around 700 million Indians are considered at or below the international poverty line. For most Indians the city is a dream, which explains Indian movies (They aren’t aimed at the city dwellers) where often laughable achievements for us are considered massive ones for the hero because the people who love these movies are not the pampered kids of the city but the hardened people of the villages who often go watch a movie as a treat or as a massive event. The ownership of a expensive phone, fighting injustice and of a car are power fantasies that best appeal to the under dog. It explains the fairy tale quality to Indian movies, because the people who love them want a little escapism. They have enough tragedy in their life without having to deal with the themes behind Schindler’s List.
The majority of childhood mortality in India is in this sector. Today roughly 5% of children born in India will die before their first year. This is a remarkable achievement. When I was born close to 10% would die before their first year. If I was born in India there would be a 1 in 10 chance I wouldn’t be here to bore you all.
So what’s the fall in part due to? A revolution in home birth. 70% of Indians undergo home birth. Naturally this is something that the average home birth advocates love to mention. That the Dais (traditional midwife) who dropped the Infant Mortality Rate (IMR) in India without answering the question as to what Indians used to do before the Dai? Dais dropped the IMR rates because the tradition behind the Traditional Midwife was destroyed through education and equipping them with modern technology and some education. The Dai just changed.
The Indian Dai is probably closer to a Nurse Practitioner Midwife than a Certificate Practitioner Midwife in the west. They are paramedical personnel given crash courses in modern obstetrics and given medical kits that they can easily use to reduce neonatal and infant mortality rates as well as maternal mortality rates. They encourage vaccination, breast feeding and often help with the supplementation of the mother’s diet through various schemes such as the ICDS and in the fight against anaemia in addition to midwife duties. This causes an effective fall in deaths. The traditional midwife despite being called that is anything but.
But in order for them to do this they had to destroy the culture of traditional midwifery. Such as the practice of anointing children with cow dung which is a Hindu religious practice that died out in the cities because we know about bacteria and other septic practices we know to be unsafe. This is a western piece of knowledge. Indians thought “fuck this noise, culture be damned, we don’t want 10% of our babies to die for the sake of culture”. So they fought the practice. We still fight the practice because it is still present. Babies fall sick, babies die from it. Priests and holy men still argue for it but the facts speak for themselves. The women who go to the trained Dai have lower maternal and infant mortality than those who go to the untrained dai often by a factor of 50% lower. The women that seek the infamous “medicalised births” as hated by the natural birth fans in the west have the absolute lowest rate with some hospitals matching western standards. Culture and tradition have made way to common sense and the thing is people have gained out of it rather than lost.
But it is a “western” practice that we are doing. These things aren’t native to India. We are “forcing” a new practice and eliminating an old one.
This is where I must point out why we think like this. There is no such thing as western and eastern medicine. That is a misnomer flogged by the alt. med groups to portray Eastern Medicine as a different ethic and science to western medicine when it is really quackery. There are things that are “Asian” in origin that are now part of medicine (Short list? Cataract Surgery, Rhinoplasty, Internal Fixation, Septoplasty, Pleural Drainage, Tracheostomy, Opiate medication, Vaccinations…) but we don’t flog those as eastern medicine. There is medicine and there is quackery.
There is an idea that these notions are solely western. That we are forcing our beliefs on others because we automatically think our culture is superior and that we suffer from sort of white man’s burden. When it is not the case. It is high arrogance that we assume that people cannot grasp the benefits of doing something. Asian, Arab and African people are not infants, we can hear bad news about our actions. It’s incredibly irritating to hear someone say that we are going to get insulted by hearing that we have problems. If you think like that then you are confusing “being insulted” by something with “denying a problem exists”.
Things that are wrong with Indian culture? Caste System. Female Infanticide. Corruption. Sexual Violence. Repression of Women… Plenty of things. Coming out and criticising them may not be what some people want to hear but it is what they NEED to hear. The caste system is older than western civilisation. Greece and Rome fell and Europe was plunged into an age where people we considered advanced for the age started living in hovels in the ruins of civilisations that built arches and domes (Architecturally speaking, to a dark age european the dome would have been akin to witchcraft since it’s construction was not known). It took nearly a 1000 years to get back to an equivalent stage of development. European society fell and rose and all the while the caste system has been there. It pre-dates Judaism but it is evil as evil can be. Calling it for what it is may hurt the feelings of those who believe in it, but it is evil and the damage it causes harms countless millions. And there are people who fight that in India who call it evil. Me going there and saying it is evil will get me called a variety of choice words by people who think caste is important but it will also get people who fight caste to come and agree with me. Me going there and supporting those who think the caste system is important and vital is just a dick move. The equivalent argument Lisa Wade made was like saying “Oh? Untouchables can make more money than Brahmins so we shouldn’t outright portray all the untouchables life as worse than slavery”.
What does this mean with regards to Female Genital Mutilation (FGM)?
You are confusing a knee jerk response of people who see such horrible things. Most of my readers live in a bubble (even in India since city life is so much different from rural) of luxury that they often don’t realise. It is easy to look at something horrific and go “STAHP NAO”. Because that’s what a reaction is. It’s knee jerk. It’s not thought out. I argued as much on the Lisa Wade piece where people didn’t grasp why many countries don’t outright ban a practice citing the binding of chinese women’s feet as an example (and mentioning Sati too) without realising that those bans were enacted centuries ago. I got accused of mansplainin even… You are looking at the end result of a campaign. In addition to call Chinese laws harsh is to understate the fact that the country isn’t a free nation and is a totalitarian state. Not as much now as it used to be but it was once a place where different cultures were not respected. It made it easy for it to solve problems like out of control birth rates and indeed foot binding with incredibly draconian laws. Laws that simply would not arise in a democracy. Let’s take Sati. It took more than 500 years to stamp out and even now the occasional one still occurs. If we look at Slavery in the USA and anti-black racism you still notice that racists are still around. Slavery was halted nearly 160 years ago. It took a little over a hundred years to stop apartheid in the USA. Culture changes slowly and anyone out in the field knows that. FGM is not going to go away and there will be millions of women who undergo the procedure over the next hundred years or so but it will be a smaller and smaller number. The work we do know will create a core of women to fight against the practice and to create the political drive for change and elimination of this practice. We are not going to defeat it in my lifetime. We will probably make my child’s or my grandchild’s world a FGM free one but for that you need to lay groundwork.
But you have to fight it. It is a horrible practice and the reason women do it to each other because women have always done it to each other. Now the problem in fighting the issue is that you need legislative changes in the country where these things happen to go along with changes on the ground. The current problem is that there is very little drive in these nations to stop the practice and in some cases there is a government green light to do these things. You aren’t fighting downhill like against smallpox or polio. You are fighting this fight uphill. You need governments on board to produce systems to stop this kind of thing.
Yes education is vital. Yes I understand, White Man’s Burden was written about my people you know… But education is fantastic. Because education of people works. To treat people in developing nations as somehow incapable of learning is just harmful. They are you, only with a lack of opportunity. Education gives them the tools to know why the things they fight are bad. I noticed a comment on the Skepchic article where someone says that they don’t like the term “education” because it has historical baggage of civilising the savages. Which is why we are going to play a little game. Because this notion is one of the major problems you face when you want to try and spread awareness and information about a disease.
A simple little game. You are denizens of the Internets, your Google Fu is strong which is why we shall not test it. Even medics get some of these wrong. I am going to expose a little lack of education in our privileged upbringings. Just to point out why we do certain things the way we do it and often don’t realise it.
1. What is the most common genetic defect in Humans?
2. How do Shoes save lives?
Please do not Google this. Just answer honestly in the comments what you think it is. It’s vital that you are honest about it and don’t go find out because it demonstrates the point that you don’t honestly know. Pass it onto your friends. See what they say. Let’s get this going and put down some answers in the comments. I will give the right answers in a few days but for now just let’s see what you savages know.
Education is a weapon, it is the deadliest of weapons against this sort of thing. There are people in India who hang themselves from hooks to teach people that the men who con them are nothing more than just men. Education killed smallpox. Education killed polio. It fought leprosy and it will kill it. It is fighting AIDS and every other disease and ailment of mankind. It will kill FGM. It just needs to begin right now. And Lisa Wade’s piece was not education. It actually misrepresented pieces which talked about sexual dysfunction and ignored parts of papers which spoke about known side effects of the procedure. Education is my deadliest weapon and slaughters billions of things that make human lives miserable and short. To claim that sharing it with those who lack it is just painful to hear. It is an elegant weapon for a very civilised age. Maybe it’s my upbringing but in hinduism education is considered divine. Knowledge is the domain of the creator’s wife, you don’t pray to the creator. There are no temples to him. No prayers or rituals. Everything is aimed at his wife whose domain is knowledge (The prime gods are Brahma, Vishnu and Shiva. Brahma is not prayed to. They are the Creator, Preserver and Destroyer. Their wives are Saraswathi, Lakshmi and Parvathi who are the domains of Knowledge, Wealth and Destruction and Rage) Maybe that’s why I think education is awesome and why everyone should be educated… But I know for a fact that people take it for granted. Education will help us fight FGM by telling people the problems with FGM and and the problems with doing it to women and create a understanding that the practice is wrong.
And this is all FGM we are talking about. Not just infibulation. Clitoral stimulation is vital to the sexual health of women. Sure you can lose the clitoris and still have a vaginal orgasm but you have lost a method of pleasure.
Yes I understand that people are frustrated that nothing has changed in our lifetime but remember this. WE HAVE JUST STARTED FIGHTING THIS. We are at stage 0. We are at the beginning. We have just inserted the token, we have just picked out the scotty dog. We are laying groundwork for the future. It is a journey of Snakes and Ladders and we have just rolled the dice. We have a way yet to go but the first roll of the dice is the hardest because sometimes you end up back at square one. There is progress, you just don’t see it yet. We haven’t been fighting long enough to create the kind of change that satisfies us.
When MSF went to Port Sudan and set up their landmark Obstetrics unit that fought against Infibulation women didn’t come in because MSF refused to reinfibulate after the procedure was done. They had almost zero cases. Now they see 300 cases a week and oversee 25 deliveries of women who are not reinfibulated. They also were accompanied by local education schemes where they told women that the procedure was wrong and harmful. Alongside prevention they were out undoing the stitches from infibulation. Word of mouth quickly spread and women who had the procedure now work for them and tell others what they have done and all the changes that have happened. They tell women that they won’t do that to their daughters. They tell their sons that the reason for the procedure is stupid. They are changing the culture by punching at an individual level. Eventually these women will influence the politics and make changes there. Then the avalanche of change will occur. And the speed of change will pick up. For instance? In South India the female foeticide and infanticide rate was as high as the North. Now? Out of 1000 males there will be 980 female babies. Just 20 are aborted. In parts of the north the rate is sometimes as high as a 200 abortions… The change was rapid once the groundwork was laid out. The South had the advantage of more infrastructure since Madras was once the British Capital rather than Delhi or Bombay or Calcutta. So the changes were enacted rapidly while the North lags behind due to the initial infrastructure gap and compounding issues such as corruption, caste warfare, naxalite insurgency and outright religious shenanigans.
And I must repeat this because so many people don’t realise this. The majority of aid workers who work in developing nations are not international. They are local workers. The people who come from abroad are usually skilled workers who are simply unavailable locally. You are not some white hero showing up to Last Samurai/Dance with Wolves/Avatar the situation. You are a technical consultant. A medical mercenary. Your job is to provide a temporary service while they train up the local equivalent of you. You may even train up your own replacement. Your job there is highly temporary. Even during major disasters. Once the situation is under control and there is no threat of escalation you usually go home. EVERY and I mean EVERY medical charity worth anything in this day and age is armed with a host of locals who actually do the heavy lifting. Now in some places there may be no experts but honestly those are rare. They are the exception rather than the norm.
The WHO is a massive international organisation, but it works through grassroots organisations which it trains and equips and provides technical support to. MSF set up grassroots services using it’s colossal technical expertise considering it has the largest pool of doctors, nurses and paramedical staff. Orbis do the same with opthalmology. The Red Cross may have the biggest presence but it’s because it actually is a massive international grass roots organisation where it uses it’s massive international clout and indeed works with bodies such as MSF and WHO to do grass root level aid and train up replacements. Just because you work for one of these organisations doesn’t mean you have no grassroots contact. You are more than likely to BE a grassroots employee. Someone from the culture, the area and often from the villages hired to spread education and the necessary changes. Even kids are involved because I know of a lot of vaccine related education in Africa that is taught to children who put on skits on immunity (Like “RAWR I AM A MACROPHAGE I AM GOING TO EAT YOU! YOU EVIL BACTERIA! OM NOM NOM NOM! skits) that’s devastatingly cute but also informative to their parents.
Change will occur. You can speak of knowledge (The Lisa Wade article was NOT knowledge since it misrepresented some papers. Zinnia read through it a bit more thoroughly than me because I had one of my qualification exams today and I needed to study.) while still condemning a practice. You can call something barbaric and still support a grassroots change. It is a bad practice, it needs to stop. Medically and Scientifically it is a procedure with only disadvantages in every single iteration of it except in some rare cases. Saying so is only insulting if you think you are divinely required to do something or you know that somehow not doing this procedure would do some nebulous and horrid thing to society. There are probably more Africans, Arabs and Asians who fight this than people in Europe and the Americas. It’s just that you notice people in Europe and America because they are the voices you hear since they exist in your monkey sphere. But here is the thing? If you guys didn’t make so much of a fuss about FGM I wouldn’t have had to write my original primer which still condemned the act but informed people about the different types. Now I understand that I don’t have the reach of people like Zinnia or Ophelia because I just moved to the bigger stage but I know a few hundred people will see this and I hope some people will see my way. But these people will spread the word and the way we think will change. We will stop having the knee jerk responses to either say “KILL EM ALL” or “YOU ARE BEING A WHITE SAHIB” and realise that the reality is that change is occurring. It’s just that we are impatient.
People don’t like being told they are wrong. But you have to tell them. We had to tell people who smoked that their habit was dangerous. We had to tell racists that that their views are bigotry. We have to tell pro-lifers that their views harm women. And we have to tell people that FGM is a terrible practice that only does harm. Just because you don’t like what we say, doesn’t change the fact of what we say. The cardinal rule when responding to anything that raises ire is to count to ten and in that time think about why someone would do this and think of ways to change it.