ARBIL - A significant number of girls and women in Iraqi Kurdistan suffer female genital mutilation (FGM) and its destructive after-effects, Human Rights Watch said today in a new report. The Kurdistan Regional Government should take immediate action to end FGM and develop a long term plan for its eradication, including passing a law to ban the practice, Human Rights Watch said.

The 73-page report, "‘They Took Me and Told Me Nothing': Female Genital Mutilation in Iraqi Kurdistan," documents the experiences of young girls and women who undergo FGM against a backdrop of conflicting messages from some religious leaders and healthcare professionals about the practice's legitimacy and safety. The report describes the pain and fear that girls and young women experience when they are cut, and the terrible toll that it takes on their physical and emotional health. It says the regional government has been unwilling to prohibit FGM, despite its readiness to address other forms of gender-based violence, including domestic violence and so-called honor killings.

"FGM violates women's and children's rights, including their rights to life, health, and bodily integrity," said Nadya Khalife, Middle East women's rights researcher at Human Rights Watch. "It's time for the regional government to step up to the plate and take concrete actions to eliminate this harmful practice because it simply won't go away on its own."

Human Rights Watch researchers conducted interviews during May and June 2009, with 31 girls and women in four villages of northern Iraq and in the town of Halabja. Researchers also interviewed Muslim clerics, midwives, healthcare workers, and government officials. Local nongovernmental organizations say that FGM may also be practiced among other communities in the rest of Iraq, but there are no data on its prevalence outside the Kurdish region.

The prevalence of FGM in Iraqi Kurdistan is not fully known as the government does not routinely collect information on the practice. However, research conducted by local organizations indicates that the practice is widespread and affects a significant number of girls and women.

The evidence obtained by Human Rights Watch suggests that for many girls and women in Iraqi Kurdistan, FGM is an unavoidable procedure that they undergo sometimes between the ages of 3 and 12. In some cases documented by Human Rights Watch, societal pressures also led adult women to undergo the procedure, sometimes as a precondition of marriage.

Human Rights Watch met Gola, a 17-year-old student from the village of Plangan. Gola told Human Rights Watch, "I remember my mother and her sister-in-law took us two girls, and there were four other girls. We went to Sarkapkan for the procedure. They put us in the bathroom, held our legs open, and cut something. They did it one by one with no anesthetics. I was afraid, but endured the pain. I have lots of pain in this specific area they cut when I menstruate."

Young girls and women described how their mothers had taken them to the home of the village midwife, a non-licensed practitioner. They were almost never told in advance what was going to happen to them. When they arrived, the midwife, sometimes with the help of the mother, spread the girl's legs and cut her clitoris with a razor blade. Often, the midwife used the same razor to cut several girls in succession.

Doctors in Iraqi Kurdistan told Human Rights Watch that the most common type of FGM believed to be practiced there is partial or total removal of the clitoris and/or prepuce, also known as clitoridectomy. Health care workers said that an even more invasive procedure was sometimes performed on adult women in hospitals. The practice serves no medical purpose and can lead to serious physical and emotional consequences.

The previous regional government took some steps to address FGM, including a 2007 Justice Ministry decree, supposedly binding on all police precincts, that perpetrators of FGM should be arrested and punished. However, the existence of the decree is not widely known, and Human Rights Watch found no evidence that it has ever been enforced.

In 2008, the majority of members of the Kurdistan National Assembly (KNA) supported the introduction of a law banning FGM, but the bill was never enacted into law and its status is unknown. In early 2009, the Health Ministry developed a comprehensive anti-FGM strategy in collaboration with a nongovernmental organization. But the ministry later withdrew its support and halted efforts to combat FGM. A public awareness campaign about FGM and its consequences has also been inexplicably delayed.

The new government, elected in July 2009, has taken no steps to eradicate the practice.

The origins of FGM in Iraqi Kurdistan are unclear. Some girls and women interviewed by Human Rights Watch said they were told that it is rooted in a belief that anything they touch is haram, or unclean, until they go through this painful procedure, while others said that FGM was a traditional custom. Most women referred to FGM as an Islamic sunnah, an action taken to strengthen one's religion that is not obligatory.

The association of FGM with Islam has been rejected by many Muslim scholars and theologians, who say that FGM is not prescribed in the Quran and is contradictory to the teachings of Islam. Women and girls interviewed said they had received mixed messages from clerics about whether it was a religious obligation. Clerics interviewed said that when any practice interpreted as sunnah endangers people's lives, it is the duty of the clerics to stop it.

Health care workers interviewed gave mixed responses both about their concerns about the harm FGM causes and about their obligation to raise awareness about the dangers of FGM.

Two studies have been conducted recently to try to determine the prevalence of the practice. In January 2009, the former Human Rights Ministry conducted a study in the Chamchamal district with a sample of 521 students ages 11 to 24. It found that 40.7 percent of the sample had undergone the procedure - 23 percent of girls under age13, and 45 percent of those ages 14 and older.

In 2010, the Association for Crisis Assistance and Development Co-operation (WADI), a German-Iraqi human rights nongovernmental organization, published the results of a study conducted between September 2007 and May 2008 in the provinces of Arbil and Sulaimaniya, and the Germian/Kirkuk region. Interviews with 1,408 women and girls ages 14 and over found that 72.7 percent had undergone the procedure - 77.9 percent in Sulaimaniya, 81.2 percent in Germian, and 63 percent in Arbil.

The wider age range of girls and women interviewed may account in part for the higher overall percentages. The percentage was 57 percent for those ages 14 to 18 in this study.

Human Rights Watch called on the regional authorities to develop a long-term plan that involves government, health care workers, clerics, and communities in efforts to eradicate the practice. The strategy should include a law to ban FGM for children and non-consenting adult women; awareness raising programs on the health consequences of FGM; and the mainstreaming of FGM prevention into policies and programs for reproductive health, education, and literacy development.

The government also should work closely with communities and people of influence in those communities to encourage debate about the practice among men, women, and children, including awareness and understanding of the human rights of girls and women, Human Rights Watch said.

"The government not only needs to take action to end this practice, but to work for public affirmation of a new standard - not mutilating their girls," Khalife said.

"FGM is a complex issue, but its harm to girls and women is clear," Khalife said. "Eradicating it in Iraqi Kurdistan will require strong and dedicated leadership on the part of the regional government, including a clear message that FGM will no longer be tolerated."