Juliet vividly remembers what she calls the most detested day in her life. She was 15 years old. The "surgeon" was an elderly woman she had never seen before, who carried a tiny box. The doors and gates of her house were locked, and she was told she was going to be "circumcised".
She cried, trembled, prayed and protested to her mother. But she was pinned on her back on a mat on the floor while a man sat on her chest. Without anaesthetic, the elderly woman began to cut her with a blunt knife.
Juliet winces as she speaks: "I thought I was going to die. I tried to wriggle and my mother pleaded with me to allow her to do it. I couldn't stand the pain. Some women held my legs. It was very bad. I was screaming and my mother stuck a cloth in my mouth. The woman said to my mother this was the worst circumcision she had done and she prayed she wouldn't have to do it again."
Because Juliet resisted so much, the operation took two hours. Afterwards there were celebrations with abundant food and a special soup.
"I didn't know what it meant," repeats Juliet over and over, shaking her head. "People were telling my mother: `Congratulations, your daughter has been circumcised'."
Juliet went through this rite of passage into womanhood along with her younger sister in northern Nigeria in 1974. Today, seated in a hotel in Dublin, where she is seeking asylum, she recoils at the memories of that "hell on earth" experience. As a midwife, she campaigned against the practice in her homeland, and says she was forced to flee because her outspokenness on the issue led to threats. Female genital mutilation (FGM) is a widespread and long-standing tradition in communities in parts of Africa, the Middle East and south-east Asia. At worst, the practice can lead to death; at best, girls are left with health problems for the rest of their lives, including recurring infections which can lead to incontinence and difficulties in childbirth.
FGM refers to the removal of all or part of the genitalia. It ranges from ritually pricking the prepuce or hood of the clitoris, allowing an emblematic blood flow, to the removal of the clitoris, the labia majora and the labia minora. Often, scar tissue will largely block the entrance to the vagina and the urethra, leaving only a small aperture for the passage of menstrual flow or urine, and making sexual intercourse painful.
Those who carry out FGM believe that it increases a girl's chance of marriage, protects her virginity, improves fertility, makes her more beautiful or is an essential part of womanhood. It is sometimes euphemistically called "cutting the rose" and women who have had it done to them commonly refer to themselves as being "closed".
Doctors in Ireland say they are seeing an increasing number of pregnant women who have undergone FGM as girls. There are fears that the practice will "migrate" along with Ireland's African communities, as has happened in other European countries.
Already, there have been anecdotal reports of it being carried out among the Nigerian community in Co Clare. Nigerians constitute the largest group of Africans seeking asylum in Ireland, with 1,895 arriving in 1999 and 3,404 last year.
Dr Valerie Donnelly, a consultant gynaecologist and obstetrician, says that in the two Dublin maternity hospitals where she worked until recently, she would encounter about one woman a month who had undergone FGM.
PREGNANT women who have undergone FGM often need to have their scar tissue cut to allow for a normal vaginal delivery. Dr Donnelly says one patient who she tried to prepare for labour in this way had a flashback to her genital cutting and reverted to childhood.
"She ran up the bed and clung to the curtains and screamed. I hadn't even touched her. I can still see the poor little soul's face. It was my ignorance. I would never do that again," she says.
In that case, Dr Donnelly did not become aware that the woman had undergone genital mutilation until she was already in labour. She says health professionals in Ireland need to start educating themselves about the issue, and inquiring about women's status as early as possible in their pregnancies.
This would allow midwives to explain to the women what to expect during labour; inform them that Irish doctors will not stitch them to return them to their pre-delivery condition because professional guidelines preclude it; and discuss with the women and their partners the reasons why they should not have the FGM procedure carried out on their Irish-born children.
Dr Donnelly is involved in a European Commission committee which is considering putting a proposal to the European Parliament for an EU-wide ban on FGM. She says criminalisation of the practice is more problematic. It could lead to the complete breakdown of families if children were to start suing their parents for civil compensation following criminal prosecutions.
"We from the West think this is absolutely awful social control of women and gender-based violation. But there is no intention to harm on the part of the people who carry it out. It is a tradition, and we must, as Westerners, try to understand rather than condemn it," she adds.
Comhlamh, a voluntary organisation of returned development workers, which held three public meetings on the issue last week, wants FGM specifically outlawed in the Republic. Currently, it is thought likely it would be illegal under general provisions of the criminal code, although there is no case law to support this.
Comhlamh's co-ordinator, Colm O Cuanachain, says cultural sensitivities cannot obscure the fact that FGM is gender-based torture.
"This is not to say we should steamroll cultural sensitivities," he says. "Education and awareness-raising is a primary tool before we start talking about punitive sanctions, and the Government should be aware of the need to invest in programmes both in Ireland and abroad."
In countries where FGM has been criminalised, it has been driven underground, with a consequent increase in the risk of infection, trauma and death. However, advocates of its criminalisation counter that it is already underground and that publicising its illegality could help to eradicate it.
Anne Marlborough, a law lecturer at University of Limerick, who chaired one of last week's public meetings, says a specific law "would be a symbolic piece of legislation establishing what the standards are here". Marlborough says she was told by a Nigerian woman at a meeting in Ennis recently that FGM was being practised in Co Clare.
Remi Bisuga, a Nigerian refugee, fled to Ennis after her first daughter died from an infection and extensive blood loss following a "circumcision" in 1991. She and her husband, Muyiwa, feared that their second daughter, Wunmi (9), would also fall victim to the practice. Muyiwa's father belonged to a secret religious society which upheld the tradition of FGM.
Bisuga, who underwent FGM herself shortly after she was born, says the practice is barbaric. "It's very cruel and it has been difficult for me to have babies because of problems in childbirth," she says. "Initially I wasn't in favour of the culture, but I had no choice. When I lost my daughter, it really hit me."