CAIRO, Egypt — It was supposed to be a routine “operation.” The parents of 13-year-old Soheir al-Batea, from a village in Egypt’s Nile Delta, took her to be circumcised at the local clinic that had been recommended by friends. They had done the same with her older sister a year before. A doctor typically cuts off the whole clitoris or a part of it, sometimes in extreme cases removing the labia as well, in a procedure that is now illegal but still deemed necessary by many Egyptians to preserve the purity of the child and control sexual desire.
Dr. Raslan Fadl, a well-respected imam and employee of the nearby government hospital, performed the illegal procedure as he had done on dozens of other girls. He typically treated 10 women a day, locals said afterward. But something went wrong and Soheir, described by friends and family as bright, smart and lively, died en route to hospital.
According to the forensic report issued shortly after her death last June, an allergic reaction to penicillin administered during the controversial operation is what killed her.
This little girl’s case, like many before her, would normally have been buried and forgotten. Since female genital mutilation (FGM) was criminalized in Egypt in 2008, both parents and practitioners fearful of arrest have kept quiet when there are complications.
But now, for the first time in Egyptian history, a prosecution is under way. Both Soheir’s father, a farmer, and Dr. Fadl are to stand trial charged with illegally mutilating the child’s genitals and with manslaughter. The opening session in court is scheduled for next week.
Egypt has one of the highest rates of FGM in the world: a staggering 91 per cent of women between the ages of 15 and 49 have been cut, according to a 2013 report released by UNICEF (PDF). Genital mutilation is practiced in various forms across the African continent, from Nigeria to Somalia. In Egypt, it is most common—indeed, almost universal—in rural areas like Diyarb Buqtaris village where Soheir grew up. But it crosses all class boundaries. The West often labels the excisions an Islamic practice, but cutting occurs in Egypt in both Muslim and Christian communities, and it goes on despite the fact that the Egyptian Coptic Church and Al Azhar, the country’s leading Islamic authority, have condemned it.
In recent years there have been at least five documented fatalities related to female genital mutilation in Egypt, some of which made international headlines. In 2007, it was the deaths of two other teenage girls that forced the Egyptian government to review the law and ban the practice. In 2010, Nermine El-Hadded, also 13, bled to death in a hospital after she was operated on. Yet until this year no case has ever made it to court.
In this instance, international and local nongovernmental organizations, shocked by the way local authorities whitewashed the schoolgirl’s death, lobbied the Egyptian government intensely. “FGM was not mentioned in the initial forensic report,” says Suad Abu-Dayyeh, regional representative for Equality Now, an international organization that, together with the state-run National Population Council (NPC), petitioned Egypt’s top prosecutor to review the case. Finally, a committee of three doctors examined the incident and found evidence of FGM. But the investigations were further complicated when the parents changed their police statement to say the girl had been admitted to the clinic for genital warts, not circumcision.
“Some people in the area told us they were paid as much as 64,000 Egyptian pounds [$9,150] by the doctor to change their statement,” says Abu-Dayyeh, who visited the family—and Soheir’s grave—in October. “That is a huge amount of money for a family struggling to survive.”
In the past, barbers or local midwives often did the cutting in the back rooms of the girls’ homes. In recent years doctors have performed an estimated 80 per cent of the procedures. Even so, they may know little about the damage caused to the girl, says Vivian Fouad from the NPC. Her organization has worked to integrate a course highlighting the dangers of FGM into Egypt’s gynecological and public health curriculum. “The ‘medicalization’ of FGM is very high,” Fouad explained, and “this is very dangerous, as it gives legitimacy to the practice.” The procedure, which takes just a few minutes, costs anything between $4.50 in the countryside to $140 in private clinics in the capital: useful earnings the medics make on the side.
An American-Egyptian artist who prefers not to be named says she was circumcised in a smart clinic in the coastal city of Alexandria during the early 1990s. “I thought it was normal thing and everyone did it. It was something to be proud of,” the 31-year-old told The Daily Beast. Her mother, from the United States, had been coerced by friends into organizing the operation. The young woman says she is still suffering from psychological damage as a result of the mutilation. She was sedated during the procedure, but that is is not always the case. She said she could barely walk or urinate for four days afterwards.
Abu-Dayyeh maintains that a combination of international condemnation and pressure exerted by the NGOs forced the government to take action this time, but the current political atmosphere may have played a part as well. “In the era of the Muslim Brotherhood, the people perceived that they encouraged these practices,” Fouad said. Even though it is not addressed or endorsed in the Qur’an, genital mutilation fit into the kind of traditionalist view of Egyptian life that the Brotherhood exploited for its own ends.
In 2011, local media reported that the then-ruling Muslim Brotherhood was offering subsidized female circumcision at mobile clinics. The Daily Beast obtained a leaflet, dated April 2012, emblazoned with the logo of the Brotherhood’s Freedom and Justice Party (FJP) and detailing discount medical services being made available. At the bottom the simple paper brochure advertised female and male circumcision for just 30 Egyptian pounds ($4.50) a procedure.
It is not possible to verify the authenticity of the document but at the time members of the Islamist group, which controlled the parliament and the presidency, were making controversial statements condoning the practice. In March 2012 Azza El-Garf, one of the very few female Freedom and Justice Party parliamentarians, described FGM as “beautification surgery” that should be permitted. Her comments came at a time when the more conservative Islamist members of parliament actually wanted to legalize the procedure. In a televised debate in 2012, then-President Mohamed Morsi, who was overthrown by the military last July, brushed off female genital mutilation as a personal issue between mother and daughter.
“Before, we couldn’t even speak with the prosecutor-general,” Fouad said. “It is very clear there has been a change.”
If Dr. Fadl is found guilty he could face 10 years in jail. The law calls for those performing FGM to be fined up to $700 and given three years behind bars, but because the operation resulted in death, he faces a longer sentence. It is still unclear what the punishment of the girl’s father might be.
Ultimately, unless Egyptians are educated about the dangers of the practice and the punishment they could incur, little will change. “The problem is the mentality—even if the doctors stop doing it the families are going to still try and find someone to do it,” said the American-Egyptian artist.
One of the biggest challenges rights workers face is getting the relatives or friends to report the incidences, particularly when doctors pay people for their silence as Fadl is alleged to have done. But Fouad and Abu-Dayyeh are hopeful that the trial will be a positive step forward to deter citizens and medics alike from cutting girls.
“If we succeed in this case it will be a precedent for other cases,” says Abu-Dayyeh. “It is not fair for a young bright kid to die in this way for nothing.“
UPDATE: Egypt’s landmark trial of the doctor accused of killing 13-year-old Soheir Al-Batea while illegally performing female genital mutilation opened on Thursday in the Nile Delta city of Aga, some 60 miles from Cairo. The teenage schoolgirl died from an allergic reaction to penicillin last June during the botched operation. Her doctor, Raslan Fadl, and father, Mohamed al-bates, from a nearby village, were in court charged with manslaughter. The opening session was procedural and the trial was adjourned until June 19. The Daily Beast reported the full story in April.