She pulled the paper gown down, covering the woman’s genitals, and dumped the plastic speculum into the trash, and snapped off the gloves.
“You can get dressed now. Everything looks great, Mrs. Mohammed. Now, I’ll see you in two months. Don’t forget to start your vitamins next month. If you have any spotting, or anything else, call the office. One of us will be on call.”
The woman had now sat up on the table and said, “But doctor…we must talk about the baby, the circumcision…”
Last visit, the doctor had asked the regulation newborn questions, and was not surprised when she heard the answer to the circumcision question.
Mrs. Mohammed had said, “Yes, if it’s a boy… and also if it’s a girl.”
Dr. Ibraahim said, “No, we do not do that here, Mrs. Mohammed.”
But the woman explained she wanted it done, properly. Safely, hygienically, and Nala said again, “No, they do not allow it. And most doctors will not do it.”
She washed her hands and said, “I’ll see you next time, Mrs. Mohammed,” and left the room before the woman could ask again.
Nala breathed, leaning against the outside door jam. She hated this discussion. It was such a barbaric thing to do to a girl. It was bad enough for a boy, but the damage and disaster in the mutilation of a girl was unreal.
Nala went to write up the chart, but before she could leave her office to see her next patient, but Mrs. Mohammed was standing, waiting. Nala didn’t think it possible for a woman to dress so quickly, but if you had a mission, and this woman did, then you found a way.
“But doctor, we must talk…” and Nala got up and walked around from back of her desk to head out the office. Mrs. Mohammed still stood waiting. Nala walked past her, into the hallway of doors.
The woman ran after her, chasing the doctor.
“But, you are Somali! I was told that… that you, you know…” Mrs. Mohammed said. “You must understand how crucial it is for our children. There will be no marriage! No grandchildren. Nothing!”
Dr. Ibraahim sighed, and looked around the clinic. Nala was sure this conversation would be repeated over and over again throughout the clinic and then the community. It was a large group of Africans and Muslims here. Female circumcision wasn’t religious, but a cultural pattern, and brutal as far as Nala and her husband were concerned. They would never do it, never allow it either for their children or for patients. But the older women, especially the ones still tied to Africa, seemed to insist on it.
Nala couldn’t help but think back to her own early life. She remembered her grandmother preaching “…it is the only sure security for a young girl. In any war, who will be the victims? I ask you? It will be the girls raped. If they are closed, they cannot be raped, not by the enemy, not by their “boyfriends,” not by fathers or uncles! It is the only proof of their obligation of chastity!”
“Closed” was the term use once the genitals of a girl were hacked off and then she was sown shut, sort of …The old granny sucked her hand-rolled cigarette, the smoke staying in her chest for a very long time, moved her dark purple lips over her missing teeth and pronounced, “An uncut clitoris is likely to grow into a third leg,” and the old woman coughed a lung out of her chest. But then her great aunt had argued the other side of the argument, after shaking her head at the old woman.
“Ha! If they are such beasts, such lunatics, so that they cannot be trusted with their own daughters, then men should be castrated. God has made us and men, exactly the way we should be.” And so the two women went on over it again.
Nala’s husband would have agreed. He was circumcised at 13, and he thought it was close to castration as possible, done without anesthetic or pain relievers. Not that he knew what castration felt like, but it formed a building block of his belief system.
Mrs. Mohammed’s questions brought Nala back to the present, and she thought she’d have to agree to the iodine treatment plan, if indeed this woman would not leave it alone. A drop of iodine on the baby’s clitoris would mimic blood to anyone who was not inspecting very, very closely, and it would stain the diaper and linger long enough for belief. But, it was not the huge scraping of all of the genitals from between the legs and a sewing up of the outer vagina lips, leaving the tiniest hole, and a bed of infection for the rest of the girl’s life. Nala would not allow an infant to be mutilated, or anyone any age, scared for life.
The doctor lowered her voice, and said, “Knowing and performing are different things. The hospital board, they will not…it is not allowed here. They would not permit it. We tried to get a policy in place, but…” the doctor said. The policy was the iodine treatment plan.
“But, you will force me to the old woman in the back of the market. My baby’s wounds will be your nightmare.”
“Then do not do it! Mrs. Mohammed! Please!” The two women had started quietly, but now, it was easy for them to be heard in the waiting room.
“But… I want it done properly!” She was in tears. The oldest nurse came out, steered the woman over to another room while Nala walked to her next patient.
Nala leaned on the wall there to catch her breathe and collect her thoughts.
All she’d wanted was a quiet OB/GYN practice in the burbs, and now here she was in the middle of this huge debate.
Several months later, when Mrs. Mohammed’s time came to deliver, Nala was about to walk into the delivery suite, but looked at the name on the chart, and immediately found a nurse to chew out. This patient been infibulated. A delivery suite would not do. She need a full surgical suite, as she would need to be cut open, and there would be bleeding, sutures needed, and dressings way past the normal supplies at hand. And then she’d need to be sewn up again. It would always be a mess. This was the other end of Mrs. Mohammed’s request.
Nala had grown up in the culture where this was normal, but she’d also been trained, educated to know better, and she understood that harm reduction was the way to go. Usually, the women who insisted on female circumcision could be talked out of it, and if not, they could be talked into a less violent form, a nick, or nothing at all. If the mother or father insisted, then a drop of iodine would make the parents happy. It was the grandmothers she always had to work around. The men said little, if ever. The women did it because it was done to them. And so on.
After Nala was done with this delivery, she could go home to her family, wash all of this old-fashioned stuff out of her hair. Her family was an educated, enlightened crowd, able to debate a point at the dinner table, to eat properly on linen, and to read and learn about life, in all of its strangeness. Her husband was a sweet, gentle man. Her daughter, Khadra and son, Mubaarak, now comfortable with Mo only, were nearly grown, she thought, but she’d have to find spouses for them in the next five years. Thank God, there was no possibility that Mo or Khadra would have to deal with the indignities, pain, or life-long misery of genital mutilation.
Khadra and Mo were very good students, and she was rewarding them by a trip home this summer. Her sister in Somalia would be squiring them around, and Nala had no reservations about their safety, not with her sister. She was one strict bitch, and all of her daughters were going to be doctors. Nala didn’t believe in all of that seriousness so early in life, so she wanted her kids to have some fun. Plus, Nala and her husband had to work the summer holiday, so the kids would be at they own ends without someone to organize them.
And they’d only be away for two weeks.
“Khadra, you mind your auntie. Do NOT cause her ANY trouble. She has three of her own daughters! And you, son, you do the same,“ she said to the boy. She kissed them goodbye at the gate to customs and immigration, and said, “Have fun!” And so off they went to deepest darkest Africa.
Nala had terrible foreboding, but she always did whenever the children were away. She took some time to enjoy the odd dinner out with her husband, a urologist. They made a handsome pair, and while some people would speak of themselves as a Barbie and Ken match, Nala and Amir were dark-skinned and carried themselves with haughty air, Nala’s hair was always up, wrapped off her neck in a bright patterned cloth. Her daughter was taught to do the same, and elastic and stretch headbands made it easy for Khadra.
She sent emails twice a day to both children, and to her sister, and it seemed as though both children where enjoying themselves. They got to meet cousins and other extended family they never knew existed. Khadra sent word home that her cousin had real French silk stockings. Real silk! And Mo had used his time to build a jet-fueled rocket with his cousin, and the next day they would send it off into the stratosphere from the white sandy beach. Nala thanked her sister and her mother as well, for their hospitality and trouble on a daily basis.
Nala told her sister that she was worried about the kids’ safety several times, and her sister insisted that they’d be fine. She said, she send black pearls and silk, and some coffee and cocoa, even though they were sure it would be removed at customs.
On the tenth day, her emails went un-answered. Nala lost her mind. The kids where due back in 31/2 days, and they were having too much fun to answer, she figured. Especially on the beautiful beaches of the Ivory Coast. It was a paradise for them, of that she was certain.
The next day, her sister sent a short note:
“Sorry, we were delayed, and just got back from overnight in the old village. Granny has found a bride for your boy! And a young man for your girl!” she said.
Nala was furious. How dare they try to set up her children with some stranger? An uncultured, un-educated child, unknown to them completely. What a crazy half-baked idea!
“But they are family!” her husband said. ”Don’t be too hard on them. They are just wanting what is good for our children. And it doesn’t matter…whatever happens over there!” he said, and turned over in bed to face her, bending his arm to support his head.
But Nala wasn’t convinced. She said, “But they wouldn’t do anything like marry them off to some stupid uneducated youngsters, would they?”
“No! And what if they did? It’s not legal! It would be one of those village ceremonies with henna, and all of that. But they couldn’t even do that. They haven’t had the three weeks to read the banns in church. The kids have only been over there for two weeks!” He turned back over to sleep, and added, “Even if they have gone all the way to the point of verbal agreements, with cows and all, so what? Once the kids are back, nothing matters and they will go back to school and continue their studies. It will be all forgotten! I can barely remember it now…” and he turned over to go to sleep, his breathing already rhythmic and calm.
Nala was a mess. Three days to wait! How would she do it. Well, at least she’d hear from the kids tomorrow. They would send an email, surely.
The next morning, Nala paced in the office, waiting for the afternoon when the morning email would be there because of the time difference, but she couldn’t keep herself busy enough not to worry. She thought back to her own childhood, growing up there… She’d actually been engaged at three, and to seal the deal, she slept over night at the groom’s family home. He was all of ten, himself, and all she could remember of the event was the fear she had of being away from her mama. After that one night, as now damaged goods, she belonged to him, but was sent back to her own home and parents to grow up.
That arranged marriage went out the door when she went to England to study at the only place her parents and community could afford. The fact that England was an island was considered so dangerous by her family because it would sink seemed to make her schooling all the more mysterious and risky, and once in school, she was not bothered with much.
Nevertheless, she attended school and quite by accident, she’d met her husband, standing on the other side of the room at a church social, and looking beautiful to Nala, mostly because she was not engaged to him.
They were engaged with the ritual exchange of land and cows back home, and married later the following year, so that her husband’s family was sure she was not carrying another man’s child. She was inspected, her legs wide, with the old women looking. She passed. She thought there had never been anything more humiliating, but both families had insisted.
That seemed such a lifetime ago and she’d supposed it was, but now, she was sure that her precious children had been cut, mutilated, and would never be the same.
Finally, she got another email from her sister, and as many details from it as she could, but it was precious little. She re-read the email so many times, trying to figure out her sister’s meaning, moving the cultural references out of the way, trying to figure out what her sister meant. On the fourth try, she thought she knew, so she read the email out loud in an empty clinic room, then promised herself, she wouldn’t keep anyone waiting longer while she worried.
Then the next email came.
“I am so sorry! I am returning your children to you in damaged condition. I hope you will some how forgive me. I was hoping that they would be better- recovered- before we took them into city to catch the plane, but there was no time. I had to put them on the plane the way they are. They will likely need antibiotics, I am so, so sorry,” her sister wrote. The email was clear.
Nala lost her mind. How could her sister, her mother and grandmother- all of them- do this? What was wrong with them?
Nala could not wait for the plane. It was delayed. She wept, her husband tried to sooth her, but then she had not told him her fears. Her children had been cut, and there was no going back.
She packed some medical supplies to bring to the airport, and that’s when he started laughing.
“What are you doing, woman? We are picking the kids up, not performing some kind of surgery on them…!” He wouldn’t believe her.
So Nala had to explain it to him.
He nearly exploded, but helped her pack even more supplies, throwing more antibiotics, pain medication, and grabbed some IV fluids, and needles, too, but Nala just shook her head, so they left all of that behind.
It was the longest drive of their lives.
Once at the airport, they paid the earth for parking close in, but what did it matter. They would need to help both of the kids to walk. Neither one noticed the outrageous charge. They followed the signs to Terminal 3, then walked back to the door from the security wing where all of in-bound flights coming through customs and immigration would arrive.
And they waited. And then waited again. The flight their kids were on seem to be circling because of traffic above Heathrow.
The wait was interminable, but finally the flight was announced and they could see the name and number in blazing detail on the board.
Finally, the kids stumbled through the customs and immigration doors and stood, trying to find their parents. They fell into their arms, looking terrible, lacking sleep, obviously sick, obviously exhausted and in pain. Nala did everything she could not to tear their clothes off of them and check every little bit of their bodies, from head to toe.
Khadra said through a very stuffed nose and a bad voice, “We’re sick. Auntie was sure you’d be furious, but it wasn’t her fault. We just had so much fun. We didn’t sleep, or eat properly, and the last three days, we were in the village where you grew up, Mummy. It is so beautiful there!” she said, sneezing and coughing over everyone.
“I thought they’d have you’d be married off, to someone with the required 20 cows!” Nala said.
“Yeh, Auntie thought you’d freak out…“
“So you kids are okay? No one tried to… do… anything? To pierce your lips or noses or anything?”
“Yes! See?” Khadra held up her hands in the dim florescent light. Her hands were covered with brown drawings.”
They were thrilled to see that their two children were merely ill.
Later that night, she felt like she’d need to apologize to her sister for being dramatic. God knows what she’d sent for messages over the last several week. She’d have to go through all of her devices here and at the office to see what she’d written. She’d been so distracted. Finally, she sat down and wrote a note.
Her sister’s response was short and sweet.
“What? Do you think we are complete idiots, living in deepest darkest Africa back in the 1800’s, or something?”
Nala couldn’t help it, and as she sat there in her nightdress at the kitchen computer, she pulled up the hem of the gown, looked down at her missing parts, her stiches, and with a sad smile said to herself, “Well then, I’m the last. Thank God,” and dropped the hem of her nightdress.