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How a Woman's Fakery Helps Save Thousands

African doctor feigns ritual surgery that injures women

Call it Tounkara's List.

Like Oskar Schindler's unorthodox methods of rescuing Jews from the Nazis, for more than a quarter century, a female gynecologist, Aja Tounkara Diallo Fatimata, has been able to save thousands of women from one of Africa's most controversial and deeply held traditions: circumcision of young women.

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Her method is simple: Fake the surgery. And she has taught this simulation to midwives and traditional circumcisers across most of Africa.

Dr. Tounkara herself underwent the "rite of passage" when she was eight-years-old. She began working against it 20 years later when she saved a girl whose surgery had gone badly.

Yet Tounkara says that she could not simply campaign against an "ancestral custom," as many Western and African activists do now. She says many Western activists seem less concerned with the negative effects circumcision can have on African women's health and more concerned about their own agenda - raising issues of women's rights and sexual repression.

Rather, she decided to try to persuade parents of daughters not to allow the operation. "Then, when they argued that their relatives were just going to do it anyway, I would suggest the simulation. We would take lots of photos [to 'prove' the surgery had taken place]," she says.

Tounkara says it is not always men who demand the procedure. She claims that in Guinea, her home country, men are usually the ones trying to stop their daughters from being circumcised.

"It is invariably the women who offer the resistance," she says. Many women believe it is a ritual that binds them together, a shared experience that serves as a common bond.

Tounkara's "don't-do-it-and-don't-tell" approach is sometimes the only option available where cultural traditions remain strong. Between 100 and 120 million women are circumcised each year, according to the World Health Organization.

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Often called female genital mutilation, female circumcision is practiced by Muslims, Christians, Jews, and animists in Africa. According to some cultures, the practice preserves a woman's chastity, and without it, she is not marriageable.

But the practice is also seen as a coming-of-age ritual. Certain East Africans, for example, believe it makes adolescents aware of their sexuality. Boys and girls there are often circumcised at the same time.

Specifics of the practice vary from region to region in Africa. In areas such as Guinea's sacred forest region, circumcision is mostly performed on older women once they have passed their childbearing years.

Anti-circumcision activists say the practice is responsible for thousands of women's deaths and that it can cause severe complications during childbirth. At a recent conference in Guinea Bissau, organized by the national government and Enda, a pan-African development organization, many delegates discussed the dilemma Tounkara has tried to solve - saving lives and preserving a cultural practice.

Some who fight female circumcision have accused Tounkara of compromising their efforts, says Marie Helen Mottin Sylla, who heads the group Synergy in Gender and Development based in Dakar, Senegal. "But they are usually the ones removed from the reality of the situation," she says.

Other compromise solutions, such as circumcising women in hospitals in order to end "back-room" circumcisions, are met with cries of betrayal by anti-circumcision activists.

While a small but growing group of activists like Tounkara are looking for ways to make circumcision less damaging to women's health, they face a far larger group determined to continue circumcising despite the risks.

In Sierra Leone earlier this month, the all-female Bundo Society, into which 90 percent of the women in the country are initiated by circumcision, held mass protests calling on the government to ban all public discussion of their "secret" practices.

Meanwhile, in Senegal's Futa Toro region, people have had to cease all anti-circumcision activities, "fearing a social explosion," says Ms. Mottin Sylla.

"The community is at least now aware of options," she says. "It's the best we can do at the moment."

Tounkara says she still often performs the "simulacrum," although she claims she is no longer really tricking people. "Now they are just tricking themselves," she says.

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