Sexuality Education Resource Centre, Manitoba, 2011

1. ( and the Winnipeg Foundation Community Based Research on Concepts of Change With Respect to the Practice of Female Genital Cutting with an African Newcomer Community in Winnipeg SexualityEducation Resource Centre, Manitoba, 2011 Funded by Manitoba Healthy Living, Youth & Seniors and the Winnipeg Foundation

2. Today Introduction & Background “Whole Community Approach” Community-Based Research Research Paradigm Methodology Ethical Considerations Findings Learning Outcomes and Implications

3. Sexuality Education Resource Centre, Manitoba • Mission: To Promote Sexual Health Through Education • Working in Immigrant and Refugee Communities for 25 years • Health interpretation • Educational workshops for newcomer parents, youth, couples • Community-Based Research

4. Our Selves, Our Daughters Project Overall Goals Goals: To work closely with African refugee women, and allies in their communities, to enhance educational, health and socio-cultural supports to women affected by female genital cutting, and address prevention among daughters. • Community-Based Research and Consultation • Community-based education To increase cultural competence in health and service providers. • Training

5. Community-Based Research on ideas of Change with regards to FGC “If men are not involved, there won’t be any change.” GOAL: perspectives on community-level change (through an education lens) • Stemmed from community recommendations re engaging men and youth; plus evidence that change may be occurring among younger generations • Methodology evolved out of project-to-date.

6. Research Paradigm • Integrated principles of both community development and community-based research • Invitation and direction from community • Multi-level approach: grassroots, leaders, m/f • Evolving, responsive methodology • Participatory processes & co-learning • Cultural competence • Emphasis on qualitative methodology • Ethical processes – informed consent (translated/oral), honoraria, participatory analysis of results which were then shared with community • Research to action

7. CBR Methodology • Hired CBR team from community • 1 man, 2 youth (male, female) plus woman Project Facilitator • 4 weeks of training CBR Team: Simret Daniel (Project Fac. Heba Hegos Tnsiew M. Ogbamariam Samson F. Zerom

8. CBR Methodology • Methods and questions developed with CBR team • 5 focus groups • 2 adult men; 1 adult women; 1 male youth; 1 female youth • Informed consent process • Groups held in first language (by preference of participants); 1 CBR took notes, other facilitated • Notes were translated to English by the CBRs

9. Methodology Participatory Process for Data Analysis Data Analysis Feedback Meeting: • Meeting with CBRs upon first level of analysis of the transcripts Data Interpretation Feedback Meeting: • Meeting with research participants and other key community stakeholders

10. Ethical Considerations • Informed Consent – oral consent • Confidentiality of community name – continued commitment from the initial phase of the project. Yet this remains contested by some. Background of this decision: • Fears that information about FGC, once known, could further discrimination and stigmatization • Others were proud of project, supportive of having name of community used • May become moot once we engage more communities

11. Participants’ Profile • Women – N=11, ages 28 to 40 years old, in Canada between 6 mo. and 6 years, average of 3 children • Men – N=19, ages 24 to 53 years old, in Canada between 4 days and 2 years, over half were married and had 1 to 3 children. • Young women – N= 7, ages 19 to 23 years old, in Canada between 7 mo. and 2 years, most in school. • Young men – N=8, ages 19 to 22 years, half have been in Canada for one year.

12. Topics Explored • Questions more direct this time : • Common health problems • What do they know/hear about FGC? • Why does it happen (women’s, men’s, youth perspectives) • Who plays a role? • What is changing for men/youth/women – how do people feel about change • FGC Is changing all over the world – should it change? Not? If yes, who should be involved? How/methods? • “If circumcision were to end tomorrow, what would be the biggest problem for the culture? For men? Women? Youth (girls/boys)?”

13. WOMEN Many support FGC, others disagree: No, FGC is helpful. Nowadays they are saying it has harmful effects to the woman during labour. I don’t see the harm that much because their aim is to make the people free to misbehave. I don’t think it is harm, frankly. ...You can see its result. That is, the female becomes calm. Because they are reducing some amount from the feeling [sexual urge], she will become calm. I don’t think it is because of being circumcised or not circumcised. I think it is because of development change…There are women who perform extramarital sex though they are circumcised. I would say it is behaviour of the person.

14. Women Change and women’s role: The men usually don’t have a deep knowledge of what is happening to the children as … they are busy by work. This culture is changing these days. Presently, the parents are discussing about things, but before they didn’t discuss. (…)[A] few couples communicate but usually mothers decide more about necessary things for the family. Environment also colonizes people. Here when you give birth to a girl, if you want her to get circumcised, where can you find a circumciser? There is no one. Wherever you go you will be ruled by the environment. When you are in [country of origin] your grandmother or neighbours will tell you to circumcise her, and you will circumcise her. Here many people say no.

15. Youth- Females Culture of sexual freedoms When I came to Canada, I used to be scared by seeing the new way of dressing; I used to cover my face in order not to see them. [laugh]…here when I see people kissing on the street, I was shocked! [laughter] Many questions about sexual and reproductive health Is it legal to use birth control? How to use a condom, or when to use it Some don’t have access to birth control because many don’t have a family doctor

16. Youth- Females FGC: Two diverging positions: My aunt used to tell me before: a female must be circumcised. Because if a girl is not circumcised, she will have more interest for sex, she will not be able to control her feelings. It is not about if the woman’s feeling is more than or less than a man, it is about the outcome. I think female circumcision is not important…In [other country] there are different kinds of female circumcision; [if] one is completed - she has to be opened in order to be married, if she is not opened she can’t be able to have sex. It is a scary thing, but I will not do that to my daughter! I don’t think it will stop her from doing it. Many women who are circumcised are doing whatever they want to do. So I don’t see the point.

17. Youth- Females Change • Receive strong messaging re: FGC from older women/mothers • Not targeted in anti-FGM campaigns Youth usually don’t attend in campaigns. Who invited them? • Lack of information and belief about health impacts of FGC I don’t think it brings problems to labor. Labor is a natural process. So this labor problem happens naturally. There is no link between circumcision and labor. No, I think she can’t become infertile because of circumcision. The fertility part of the woman’s body is not on the place where circumcision is done. • Access to education Now the time is civilizing, there is education…women are also exposed to higher education levels. She also has the chance of choosing whatever good plan for her. Before there were not all these chances because they used to marry early.

18. Youth- Females (cont’d) Change: • Culture and place The place where a person is living also plays a significant role. For example, in [country of origin] since every mother circumcises her daughter, you follow it My mother couldn’t say no because we will be stigmatized and the people will tell her your daughters will become like such and such. • Unheard Voices: They tell us, “You don’t know, you are young”….They don’t listen to us even when we try to discuss. They say that it is our culture. The culture which stayed for thousands of years can’t be stopped by us, who has come to the world just now • Men: strong influence on continuation • Men: less emphasis on virginity • Education, evidence of harms If you know, then you can stop it. What evidence do you have to stop it?...evaluate the benefits and harms…First we need knowledge even to inform the next generation

19. Youth- Males When I was back home I use to hear a lot about female circumcision , but this is the first time I hear this topic in Canada. I remember our government used to do educational sessions to various regions back home. I heard that women loss their sexual desire once they get circumcised (…) Female circumcision differs from a tribe to another - every one has his own way of practicing it. I think they do it because they believe that it’s a good thing to perform it because they got the approval from culture. Simply because culture tells them to do it.

20. Youth- Males Impact of FGC on men-women relationships I know marriage is a unity of man and women but I feel that this doesn’t show when we come to circumcision, because this unity will be missing one side … the women who only feels no unity but soon after she won’t take it any more then divorce accrue. It will have a very bad effect for her and also for the man; she will feel that she is just a receiver with the feeling of pain and no sexual pleasure.

21. Youth- Males Overall, supportive of change It is a must for circumcision to change. It must change. I guess we youth especially men most of us will accept to get married to a girl who is not virgin. But won’t accept to get married to a woman who is circumcised, unless there is a strong love between both of you, then no concern will be found. Drivers of change Getting team leaders, community leaders, youth association leaders, to work for educating their community members.

22. Men Men’s perspectives on FGC: [Our parents] believed that a girl if is not circumcised she tends to be highly motivated for any sexual activity. I know they were doing it to protect their daughters; they had a strong believe that their daughter won’t be raped easily. Virginity is the dignity of the women, to keep her dignity. Men’s role: Most of the time it’s women that decides in circumcising their daughters. Men don’t know that if his daughter was circumcised.

23. Men Change: When we come to marriage choices I think people are starting to understand many sexual problems that were affecting marriage choices. Educational sessions won’t be enough. I don’t think teachers will do be able to terminate this practice alone without the help of church leaders and elders, mosque leaders and elders. Community leaders and elders. Circumcision will take long time to stop, but this time could be shortened through educational sessions and workshops only.

24. Learnings and Implications • Community-Based Research • Education Content: • All sectors of the community would benefit from sexual and reproductive health information • Main topics to consider with all groups are: • Explore views of FGC and reasons behind the practice • Discuss the impact of FGC in all aspects (SRH, relationships) • Address change and prevention beyond legislative frameworks (e.g., consider FGC change within other changes faced in the settlement process)

25. Learnings and Implications • Implications for specific sectors: • Women: Explore issues related to intimacy and couple’s conflict • Men: Address intimacy and sexuality; explore role of men in circumcision • Young women: Address meaning of ‘virginity’ in new social context. • Young men: Address meaning of ‘virginity’; discuss changes to views of sexuality as result of migration; explore intimacy and female circumcision

26. Learnings and Implications • Education Approach: • Engagement of community leaders in education and as conduit/brokers in education with the community • Engagement of religious leaders – word of caution • Gender and age specific groups • Yet, design sessions for “whole community” participation.

27. For More Information • Contact us • Full reports can be found: • Our Selves, Our Daughters Community Engagement and Consultations Report • Our Selves, Our Daughters Phase 1 Final Report http://www.serc.mb.ca/SP/WA/7 Phase 2 report soon to be posted… Or go to www.serc.mb.ca, click on “SERC for Service Providers,” click on Immigrant and Refugee Services (left side) and then scroll to bottom, under “Reports”