Research by the Population Council on Indonesia shows that the prevalence of FGM is high (Population Council 2003).
In many countries, we see a change in the national legal framework and increas- ing political will to end female genital mutilation. Indonesia, however, is different.
The country defends a less invasive medicalised practice of female genital mutila- tion and has no legislation prohibiting such practices that remain persistent. The Indonesian authorities continue to hold an ambiguous discourse that is not moving towards a general prohibition of such practices.
As the fourth most populous country in the world, with over 240 million people, Indonesia is an emerging country located in a strategic area for global trade and intends to be a major player on the regional and international scene (participation in the G20, the negotiations on climate change). Since the end of the authoritarian regime of General Suharto in 1998, Indonesia has experienced profound social and political upheaval. This young democracy continues to face many challenges, par- ticularly geographical configuration (it is an archipelagic state composed of more than 17,000 islands), separatist violence, ethnic and religious terrorism, corruption, religious fundamentalism and poverty.
In 2006 the Director-General of Public Health banned all forms of female genital mutilation. However, in 2010 this text was overthrown by a regulation of the Ministry of Health to enable health professionals to practise female circumcision once more. The Indonesian authorities distinguish between female circumcision and female genital mutilations and consider that: ‘Female circumcision is practiced in some communities, mainly for symbolic purposes, and does not entail any form of genital mutilation. Female circumcisions beyond the symbolic framework repre- sent isolated cases where the act is performed by traditional practitioners.’ The reso- lution of November 2010 [by] the Ministry of Health was enacted to ensure the safety of the procedure, and under no circumstances to encourage or promote the
practice of female circumcision. The Government of Indonesia continues to conduct awareness campaigns about the potentially harmful effects of circumcision prac- tices for women and girls.
The Indonesian Council of Ulemas, who issued a fatwa in 2008 stating that FGM could not be prohibited, influenced this flashback. While in general it is not already obvious for a government to intervene in matters of morals and traditions in the first Muslim country (by population), it is not appropriate for a government wanting to maintain power to risk losing the support of the National Ulema Council. One can also consider that attachment to traditions and religion is a response to the upheaval known to the country and to westernization. While this may partly explain the posi- tion of the authorities, it does not free Indonesia from its obligation to guarantee the fundamental rights of women on its territory. However, the Indonesian authorities appear to maintain the same course. Indeed, public authorities with academics, reli- gious institutions, representatives of the medical community and NGOs held discus- sions. Following this process, in February 2014 the Ministry of Health issued a new regulation rescinding the 2010 Regulation and providing an advisory committee (composed of doctors and religious experts) that will develop guidelines to ensure that male and female circumcision is performed safely and prevents Female Genital Mutilation. The position of the authorities is questionable and dangerous. The argu- ment that mentoring practices for medicalization better protect women because the ban on former medical personnel performing Female Genital Mutilation has led to increased use of healing, thus exposing women to serious risk of experiencing dam- aging forms of mutilation was rejected by associations and international bodies such as the Human Rights Committee.
Indeed, the fact that doctors practice it has led people to believe that these prac- tices are safe and healthy and to promote them, thus making it more complicated to eradicate them. Moreover, a study dated 2003, conducted by the Population Council, indicated that the broad medicalization of the practice in Indonesia has potentially increased the number of Female Genital Mutilations and leads to more invasive forms of mutilation (incision, excision). Note that the Indonesian Commission on violence against women has taken a position against the continuation of these prac- tices. It considers that even the least invasive form of mutilation is violent, high- lighting the discriminatory nature behind the practice. She said the fact that parents are turning to traditional methods if doctors cannot practise circumcision is an issue in terms of promoting human rights. Development should be in the direction of promoting a new vision of female sexuality, not with the regulation of female circumcision.
In Indonesia, the practice of female genital mutilation is widespread. The Children’s Rights Committee is also deeply concerned about the continuing high number of victims of female genital mutilation in the country. According to the 2003 study cited above, which involved eight sites in six provinces, 86–100% of girls aged 15–18 had experienced some form of female genital mutilation. Moreover, approximately 92% of families surveyed supported the continuation of the practice for their daughters and for future generations; only 7% of mothers surveyed sup- ported a ban.
However, because of the diversity in Indonesia, there is no ‘standard model’
for female genital mutilation, although some common elements stand out. It should also be noted that a recent and comprehensive study is lacking. Many refer mainly to the data of three studies: a study conducted in 1998, the aforementioned 2003 study and one led by an academic and Indonesian doctor in 2009. An Amnesty International report on women’s health in Indonesia from 2010 confirms the persistence of the practice and certain characteristics of female genital mutila- tion, presented in these studies. In Indonesia, the practice of female genital muti- lation is seen as both a religious norm and a tradition passed from generation to generation because of the support of the elderly, without there being any question- ing its meaning. Even when the main argument is religion, the mothers inter- viewed cannot quote the text on which the practice is based. They act based on what they have been told. There is also a fear of being stigmatised (for the girl and her family) in the case of non-compliance with this standard. Widely practised in Muslim communities, even in areas where moderate Islam prevails, female geni- tal mutilation is also practised in other groups, such as the non-Muslim Javanese communities.
The mandatory nature of this debate is standard among religious leaders but the practice itself is not challenged. Some mothers, often those who are most educated and living in urban areas, consider this a recommendation, while others, usually less educated and living in urban or rural areas, believe that it is an obligation. Other reasons put forward in support of this practice are the desire to avoid diseases, the need to clean the external genitals, which are considered dirty, and to reduce sexual desire in women so that they remain chaste and faithful to their future husband. It does not appear that the decision to practise female genital mutilation is more or less supported by the father or the mother, and both may be reluctant. According to the 2003 study, female genital mutilation was practised primarily by traditional birth attendants and circumcisers (68%), but also by health professionals (mostly mid- wives), with differences evident by region. TBAs were the majority, except in the city of Padang and in the region of Padang Pariaman (West Sumatra), where they were midwives, and in the city of Makassar (South Sulawesi), where they were traditional practitioners. The study noted that medicalization was already underway throughout the territory. Furthermore, the practice seems to be trivialised by the fact that it is presented as a component of the ‘package of birth’ alongside medical examination of the infant, vaccinations and ear piercings.
Note that the realisation of Female Genital Mutilation is usually celebrated with a family party, and the Islamic Foundation Assalaam offers toys and treats to girls at that time.
It is noteworthy here that the age at which FGM is practised varies from one region to another. This happens mostly before the fifth birthday of the girl and very often during her first year. In the city of Makassar and Bone District (South Sulawesi), the practice is often late, between 5 and 9 years, with a few cases occur- ring after 10 years. Studies show that the practices found in Indonesia vary from one area to another and relate to FGM type I (partial or total removal of the clitoris or only the cap), which are the majority, and type IV (quilting, piercing, incising,
scraping genitals). Health-care professionals tend to practice the most invasive forms (incision, excision) and mainly use scissors. TBAs usually engage incision (62%). The more traditional circumcisers use a knife, not necessarily to incise or cut, but to rub or scratch. Different practitioners can also use bamboo knives, razor blades, needles, coins, plant roots or just their fingers and nails. Opinions differ on the need to consider the bleeding as a marker that ‘circumcision’ is complete; this necessarily has an impact on the type of method used. Without being able to deter- mine the consequences in the short or long term on women’s health, observations have revealed real compromise to the bodily integrity of the girls without any medi- cal necessity. Nevertheless, medical professionals point out that even the least inva- sive forms of female genital mutilation can have health consequences (urinary tract infection, cysts, infertility).
The Indonesian authorities have consistently played with words. On the one hand, they promote a less invasive form of FGM, even when this may affect the physical integrity of girls. Furthermore, supervision of the practice has failed to eradicate the most harmful practices. In addition, the discourse behind FGM leads to internalisation of the inequality between men and women; ‘uncircumcised’
women are supposed to be unclean and the sexual desire of women should be con- trolled. The eradication advocacy campaigns are usually conducted by optimizing the use of the place of women within the family and within society.
The authorities should adopt legislation prohibiting such practices. Such legisla- tion would include parents not wanting to subject their daughters to the practice, therefore helping to withstand the pressure of the family or the community. The authorities must also continue to implement awareness programmes to change atti- tudes. The voices of those who oppose these practices, including members of the medical and religious communities, must be heard. Collective statements against the continuation of these practices, and involving various stakeholders, represent an important element in changing attitudes. In addition to legislation prohibiting all forms of female genital mutilation and broad awareness of this issue, the Child Rights Committee has asked the Indonesian government to provide assistance to victims and to put in place mechanisms for effective complaint. It would certainly help some Indonesian institutions—such as the Ministry of Women and Child Protection, the Commission on Violence against Women or Child Protection Commission—to see their role strengthened so that they can act effectively against these practices.