Title of the initiative:

”Understanding issues around Female Genital Cutting (FGC) in Sierra Leone”

Contact person:
Yuki Suehiro, Health & HIV Sector Coordinator
CARE Sierra Leone, SWARMU

Learning objectives:
  • To better understand the complex socio-cultural dynamics around FGC in Sierra Leone
  • To exchange learnings with other organizations (public and private) on culturally adapted approaches to address FGC in Sierra Leone

Who was involved in the initiative (who facilitated, who participated)?
  • CARE Sierra Leone Program (Health Program staff including Child Survival Project (CSP) staff, HIV&AIDS Prevention Programme (HAPP) staff, Sexuality and Youth (SAY) Project staff, Health Consultant, and Health & HIV Sector Coordinator; Design, Monitoring & Evaluation (DME) Coordinator)
  • CARE USA Reproductive Health Advisor
  • CARE Ethiopia Reproductive Health Program Coordinator
  • GTZ (Sierra Leone & Kenya)
  • Ministry of Social Welfare, Gender and Children’s Affairs
  • Local organizations working on and/or interested in FGC, including AIM, AMNet, ECFAN, Greenland Counselling Services, Inter-Africa Committee, KAWDA, LAWYERS, NaMEP (National Movement for Emancipation and Progress), Sierra Leone Plan Parenthood Association, TEDEWOSIL, Torture Watch, and West Africa Fistula Foundation
  • Interested international NGOs, donors and UN agencies, including Amnesty International, IRC, LemonAid Fund, Marie Stopes, Oxfam, PLAN, Student Partnership Worldwide, Trocaire/CRS, UNICEF, and UNIFEM

Amongst all, CARE Sierra Leone Health Program played an overall facilitating role. Both GTZ Sierra Leone and LemonAid Fund got involved in the initiative more heavily than other organizations – the former through contributing to the learning forum by inviting GTZ Kenya to share their experience (the associated cost was covered by them); the latter through leading the participatory evaluation research on AIM’s FGC intervention.

What were the main activities of your initiative?

1. Participatory evaluation of existing FGC intervention in Sierra Leone:

CARE supported incorporation of ‘social analysis’ into an impact evaluation of FGC interventions in Sierra Leone. The purpose of this qualitative research whose purpose was two-hold:
  • Socio-cultural context that lead to FGC practice – To understand the socio-cultural factors that lead a family and a community to either practice or not practice FGC;
  • Evaluation of the existing known interventions (AIM – local organization working on FGC) - To understand perceptions about the organizations already working on FGC in Sierra Leone and their interventions.
During the initial consultation with potential partners, it was found that an evaluation of the project implemented by Amazonian Initiative Movement (AIM) was being undertaken by LemonAid Fund with financial support from the American Refugee Committee (ARC). As one of the two purposes of our qualitative research was to actually evaluate the existing interventions in order to learn from them, CARE decided to collaborate with already ongoing evaluation effort rather than reinvent the wheel to conduct a completely separate research for this particular aspect.

As such, the evaluation research was conducted in AIM operational communities including Lunsar (7) and non AIM operational communities (3) in Port Loko district. In evaluating the FGC interventions implemented by AIM, the research paid special attention to the community perceptions. It took advantage of the opportunity to explore some community views on FGC in general.

(For further details, please refer to the attached report.)

2. Qualitative research on FGC in Koinadugu district:

In order to better understand the socio-cultural factors that lead families and communities to participate or not to participate in FGC abolition programs, including what costs and benefits participation is perceived to bring, the CARE Sierra Leone existing projects in Koinadugu took advantage of their field activities and monitoring and evaluation exercises to further listen to the voices of community on FGC.

As the first step, group discussions on FGC were carried out among staff members of CARE Kabala sub-office because the beginning of breaking the silence on this otherwise taboo subject had to start inside CARE office. This prepared the staff to engage communities in this sensitive and difficult discussion on FGC, as well as helped us refine our research questions.

Literature review was also conducted simultaneously, with special attention to the SAY project documents including its social analysis report as well as other literature on FGC from anthropological and medical perspectives.

Interviews with community members on FGC are still ongoing. All the information collected will be analyzed, using a case study method by the end of August 2007.

3. Learning and Partnership Forum on FGC:

A 1.5-day Learning and Partnership Forum on FGC was organized in Freetown from the 6th – 7th June 2007, based on the recognition that information on the topic was too scattered to allow for the design of culturally appropriate actions to decrease the negative effects of the practice in Sierra Leone.

As such, the key objectives of the forum were:
  • To fill the knowledge gaps on FGC
  • To share the experiences and learn from each other the existing interventions regarding FGC
  • To network and create partnership among the organizations interested in working on FGC

The forum brought interested people and organizations together to exchange experiences and expertise and to generate more profound understanding of FGC. Background of the participants and presenters varied: There were presentations and discussions from a variety of different view points such as human rights, anthropological, medical and economical perspectives. CARE Ethiopia, CARE USA Reproductive Health Advisor, and GTZ Kenya joined to share their experiences with FGC in different parts of Africa through which we widened our understanding of potential approaches. Voices of some ex-practitioners from AIM operational communities also shed some light on the reality in the field.

At the forum, it was discovered that much more effort was already undertaken by local organizations to address this issue than had previously thought. The recent creation of the network of local organizations working on FGC (i.e., NaMEP) was such an example, and the forum provided an excellent opportunity for NaMEP to widely publicise their activities and thus further expand the network. Throughout the forum, highlighted was the passion and very strong desire of local and international organizations as well as public sector partners such as the Ministry of Social Welfare, Gender, and Children’s Affairs (MSWGCA) to further engage in and collaborate on mitigation efforts.

(For further details, please refer to the attached report.)

What knowledge did you create in your initiative, if any?

Major areas in which we created or are creating knowledge include:
  • Community (including project participants’) perceptions around the existing FGC interventions: Why did / would people participate or not participate in the FGC abolition/sensitization programs? What benefits do the participants, their families, and their communities derive? What costs or negative outcomes are derived from participating in such programs for the direct participants? For the family? For the communities? The views and attitudes toward the organizations doing FGC interventions: What are the positive and negative opinions about the organizations doing FGC interventions? What is expected from the organizations doing FGC interventions? How are the organizations meeting these expectations?
  • The beliefs, values and attitudes surrounding FGC including: Do people feel the tradition of FGC should be continued or stopped? Why? What benefits does a family derive from FGC on their daughters? What benefits does the girl herself derive? Conversely, what costs or negative outcomes are derived from the practice for the family? For the girl? Has there been any shift in the age at which girls are initiated? If so, why? Is FGC an institution (defined as complexes of norms and behaviours that persist over time by serving some collectively valued purposes) or behaviour? If so, what are the collectively valued purposes?
  • Impact of the existing FGC interventions: How have existing interventions been impacting on the people’s beliefs, values and attitudes surrounding FGC and also women in general?
  • Community perceptions around gender, sexuality, rights and responsibility issues including: What are the rights and responsibilities associated with a good life and good health? Who has responsibility to uphold rights for men, women and children? How do women define their identity as ‘women’? How do women define ‘empowerment’?

Some of the interesting findings are highlighted below while more details are found in the attached reports. More information will be made available upon completion of the ongoing qualitative research in Koinadugu district.

  • Age at which girls are initiated: The age of initiation varies by family and initiates may be from 3 to 18 or even older with average 15. The age of the child being initiated has great deal to do with the wealth of family. Poorer families tend to initiate all their girls together and may initiate them from as young as 2 years old (Bondu-nappies). The expenditure for younger girls is less-fewer dresses and jewellery so economic constraints play a role as well as a belief that babies experience less pain and the fact that parents receive more resistance from older girls.
  • Community perceptions around AIM interventions: Many perceived AIM as a human rights group who helps women and girls and works to stop the practice of FGC. For some practitioners, however, AIM is perceived to be a threat to their livelihood. They went so far as to kidnap one of the project participants (ex-practitioners) and keep her and her child without food for two days as well as send death threat to the head of AIM. People participate in AIM interventions for a number of reasons, including their sensitization work, religious lessons, and new livelihood opportunities offered by AIM.
  • Beliefs, values and attitudes surrounding FGC: Respect for tradition, ancestors and elders are the most often sited reasons for those following the practice. Some like the dancing, visibility and acknowledgement that accompanies initiation. Top three advantages of FGC young people cited include: Gain respect; becoming mature; and cleanliness. Inclusion and feeling of acceptance and sisterhood with other initiates is also an important factor. Main disadvantage cited by them is pain /discomfort. On the other hand, benefit perceived by the family are: marriageability, bride price, and information source for parents to learn if their daughter is a virgin or not.

What methods did you use to create this knowledge?

Methods used to create the above knowledge include: key informant interviews, focus group discussions, lifeline exercise, community / village mapping exercise, story telling, singing and role play, drawings, dialogue between and among project participants, direct observation of demonstration of activities and events; case study; literature review; and quantitative survey (as a part of SAY project endline survey)

Who did you share this knowledge with?
  • Within CARE Sierra Leone Program
  • All those participated in the learning & partnership forum on FGC, including Ministry of Social Welfare, Gender and Children’s Affairs; local organizations working on and/or interested in FGC; Interested international NGOs, donors and UN agencies; CARE Reproductive Health Unit and CARE Ethiopia
  • German Development Bank (KfW) which expressed their strong interest to support the expansion of CARE’s existing project to include FGC component

What methods did you use to share this knowledge?
  • Presentation and discussion at the learning & partnership forum on FGC (Including the presentation of the evaluation findings by project participants (ex-practitioners) using role play and songs
  • Dissemination of the report
  • Participation at the meeting of the local network (NaMEP)
  • One-on-one discussion with potential partners, including KfW, GTZ, and UNICEF

Who used the knowledge you created or shared?

Most of the above-mentioned, including CARE Sierra Leone, local organizations including NaMEP and KfW

How did they use this knowledge?

The knowledge created / shared was used in different ways:
  • Program / strategy development – e.g., development of the concept paper to KfW (CARE Sierra Leone); development of the strategy (NaMEP)
  • Designing cultural appropriate actions to decrease the negative effects of the practice in Sierra Leone
  • Resource mobilization – e.g., submission of the concept paper to KfW (CARE Sierra Leone); presentation of the strategy and proposal to KfW (NaMEP); information basis for project appraisal to include support to address FGC (KfW)
  • Advocacy and sensitization – e.g., bringing to the notice of the Government and other stakeholders about the major findings and recommendations; sharing information with other people for sensitization purpose
  • Review and improvement of the current strategies / activities – e.g., using the new strategies to succeed (especially, those who are already working on FGC, AIM, etc.)
  • Partnership creation / network expansion – e.g., NaMEP increased the membership; CARE initiated further discussion with interested partners including UNICEF
  • Creation of imperative for further learning and knowledge sharing – e.g., identification of further knowledge gaps to be filled

What lessons about knowledge sharing did you learn from your initiative?
  • Two heads are better than one - The biggest discovery out of the learning & partnership forum was the fact that much more effort was undertaken by local organizations to address this issue than had previously thought. We are always zealous about creation of new knowledge but tend to put less effort to share this knowledge with others. Quite often, knowledge is there, but the issue is an access to this knowledge…
  • Knowledge is power to make any difference - Overwhelmingly strong engagement of the participants in the discussion and their enthusiasm during the learning & partnership forum implied that people had long awaited an opportunity to break the silence and to create partnership in achieving change.
  • Knowledge sharing is a powerful means for action - the learning & partnership forum resulted in strong advocacy, partnership creation, and mobilization of the resources for action. Especially when approaching politically and socially sensitive topics such as FGC, knowledge sharing seems the most appropriate first step to bring many stakeholders together: It provides a comfortable space for both those who are uneasy about the topic and those who are already heavily involved in it.
  • Power relations among different organizations play a role in partnership creation and knowledge sharing – Different organizations (donors vs. international NGOs vs. national NGOs) have different agenda, whether distinct or hidden, in participating in the knowledge sharing activities. Especially when knowledge sharing activities are organized by donors or sizable international NGOs like CARE, knowledge sharing could be solely seen as a ‘resource mobilization’ opportunity, so the organizers/facilitators need to use necessary tactics to keep participants’ focus on ‘learning’ and ‘sharing’ rather than ‘lobbying’. Likewise, the strong voice of more influential partners such as donors could lead to creation of a biased view among participants, and again, this is where the importance of good facilitation skills / tactics comes in.
What future activities are you planning based on these lessons?
  • Continued support to knowledge sharing on FGC and other topics through: organizing similar forums; support to strengthening of the network that has been established; regular consultations and meetings; exchange of information resources and materials, etc.
  • Continued support to knowledge creation through: completion of the ongoing qualitative research on FGC in Koinadugu district; facilitating more dialogue among CARE staff, which may result in mainstreaming of FGC in existing CARE SL projects; facilitating / coordinating technical assistance to the local organizations working on FGC, etc.
  • Continued support to networking efforts: addressing specifically the ownership issue – bringing more partners with technical expertise while international organizations will keep low profile as ‘observers’; building our own capacity to provide a ‘balanced’ facilitation / leadership – making use of lessons learned and expertise within CARE to influence the network for quality programming & approach while respecting ownership of the network members