In a “good month”, about 100 girls will be brought by their families to Halima Hirsi’s* underground clinic in Nairobi to be subjected to female genital mutilation (FGM).
Families come here from all over the world, willing to pay $150 a time for their daughters to be cut.
“The Somali diaspora are good people for my business,” says Hirsi, 69, the manager of the clinic, who also carries out procedures.
The clinic is located in the Eastleigh district of Nairobi, which is known locally as “little Mogadishu”. It mostly receives Somali clients from Europe – particularly the United Kingdom, Sweden and Norway – and the United States.
Hirsi works with Abdilatif Ali*, a broker or “middle man” who acts as a gateway to the clinic.
“People pay me to identify a clinic to help their young girls,” he explains. “Business is good; sometimes we can attend to over 30 clients a week.”
The parents travel thousands of miles, paying large sums of money, to ensure that their daughters undergo a procedure that can range from losing the tip of the clitoris to having the entire inner and outer labia sliced off and the opening to the vagina sewn up.
While most clients at Hirsi’s clinic opt for the former, it does cater to the latter.
‘It is like butchering a human’
When Amina Duba, now 29 and a mother of five, underwent FGM as a teenager, she was told by her aunties that the rite was going to make her a “complete woman”.
When she was cut, Amina’s vaginal opening was also completely sewn closed. This caused terrible complications when she gave birth to her children, and makes even her monthly period difficult and painful.
In short, Duba says, the lingering pain is a nightmare, and she has no money for treatment to help alleviate the agony.
Sitting on a thick mattress in the sitting room of her two-room house in the Gitathura slum in Nairobi’s Korogocho district , with her 13-year-old daughter by her side, she explains how badly the procedure has affected her life.
“It was bad and I regret it but I could do nothing because it is the parents who decide,” she says. “They removed the labia minora and majora. It is like butchering a human.”
“I would never allow my daughters to go through this … and that is why they will never be circumcised. It is all a myth about a circumcised girl being more desirable for marriage.”
‘Ready for marriage’
FGM is illegal in Kenya; it has been since both the practice and procurement of it were banned in 2011.
Theoretically, practitioners and brokers can be jailed and fined. The minimum punishment is three years imprisonment and a $2,000 fine. But there are no official statistics on the number of people who have been prosecuted, and judges can be reluctant to punish offenders who are often parents responsible for the care of their children.
Rates of FGM vary widely across the country. Only 0.4 percent of Luhya girls and 0.2 percent of Luo girls – both ethnic groups in western Kenya – are subjected to the practice. But in some eastern and northeastern counties of Kenya such as Mander and Wajir, the number rises to 90 percent.
Overall, about 21 percent of women and girls still suffer FGM in Kenya, according to the non-government organisation (NGO), 28toomany. The highest prevalence (97 percent) is in northeastern Kenya, where Amina Duba originally came from, and some parts of western Kenya – in Kisii county, it is nearly universal and girls go through the rite between the ages of five and seven. It is more prevalent in rural communities where 26 percent of women and girls undergo FGM than in cities, where prevalence is nearly 14 percent.
Instead of ending the practice, some critics say Kenya’s law against it has driven it underground.
Circumcisers from Duba’s Borana community in the Gitathura slum have started to move to other parts of Kenya where there is more acceptance of FGM.
Ibrahim Guyo, a coordinator at the NGO, SASA, which promotes awareness about issues such as FGM and women’s reproductive health, says: “FGM is secretly performed by community elders and nurses in people’s homes but the business is undergoing a slump in Nairobi because of the ban, but not in other parts of the country.”
Clients continue to come to Halima Hirsi’s clinic in Nairobi from overseas, however. And, while the traditional, female elders who perform FGM have started to move on, local demand for clinical procedures also remains strong in cities like Nairobi.
Most of the procedures she performs involve removing the tip of the clitoris – something she says takes a few minutes to do and requires about two weeks of recovery time. The more extreme procedure that involves removing all the flesh of the labia minora and majora and leaving only the entrance to the vagina can take an hour or longer, with girls needing at least 40 days of recovery time, she says.
The resulting pain and complications can last much longer than the 14 to 40 days, however.
Most girls brought to the clinic stay with relatives. But for an additional $150 to $200 they can stay in a house where Hirsi says they are looked after and “well-fed”.
“When they heal they are now considered ready for marriage,” she adds.