Human Rights and Global Affairs
Human Rights and Global Affairs PSC 354
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BY MEGAN FOTHER1NGHAM Megan Fotheringham will gradu ate with a Master ofPublic Policy from the Terry Sanford Institute of Public Policy at Duke University in 2004 She hasfocused her gradu ate studies on international public health and is currently researching medication adherence trends among HIV positive patients Prior to graduate school Megan worked for several years in the United States Agency for International Develop ment s Bureaufor Global Health where she first became aware of and involved in issues surrounding female genital cutting CULTURE CLASHEs BALANCING LOCAL AND INTERNATIONAL INTERESTS IN ENDING FEMALE GENITAL CUTTING PRACTICES War II Western political states began working to mod ernize developing non Western nations1 and raise living standards2 President Harry Truman launched this movement in his 1949 inaugural address when he offered the United States as the standard by which all other countries should rate their development a measure that classified most of the world as underdeveloped3 The United States and other Western countries designed international de velopment programs to help recently decolonized and impoverished countries become more like the Western capitalist democracies This Western centric approach to development has dominated the last 60 years of strategic planning4 Development policies and programs have improved the standards of living for millions of individuals and saved countless people from early deaths however the underlying assumptions on which these policies are based can undermine the very goals of the programs themselves Current development programs focus on a wide range of issues including female genital cutting5 FCC practices An analysis of the international community s efforts to end FGC highlights how interna tional intervention both promotes and detracts from the eradication of this harmful practice The financial and political support that the international community invests in this issue allows for the emer gence of comprehensive national and regional strategies to combat FGC International pressure has also encouraged national and local governments to reduce FGC practices through legislation enforce ment and awareness campaigns However Western involvement in a culturally sensitive traditional practice has also spurred backlash and program setbacks as supporters of FCC react to heavy handed outside interventions Finding an appropriate balance of Western and non Western participation at both the local and international levels is key to a successful worldwide anti FCC campaign The anti FGC movement has arisen from distinct international and local cultures A comprehensive program cannot exist without both parties yet each group has separate agendas requiring markedly different approaches including varying vocabulary strategies and WITH THE RISE OF COLD WAR POLITICS following World LB JOURNAL OF PUBLIC AFFAIRS VOL XVI desired results The local audience includes EGC practicing communities local anti EGC activists and government officials while the international audience includes international organizations 10s donor organizations international nongovernmen tal organizations NGOs and Western and non Western activists This article assesses the con icts that arise when local and international anti EGC agendas and inter ests overlap in an attempt to learn how to further improve the current campaign and to provide guid ance for future interventions into traditional cul turally sensitive practices Then this article de nes EGC explains why it is practiced and introduces the evolution of the anti EGC movement over the past 30 years With this background the strengths and limitations of both international and local anti EGC efforts are analyzed The article concludes that greater attention needs to be given to coordinating local and international efforts by ensuring appropri ate language and media exposure keeping a local face on anti EGC programming and prioritizing local program goals over international agendas FEMALE GENITAL CUTTING AN OVERVIEW EGC is a traditional practice found primarily in 28 African countries although it is also practiced in Asia the Middle East and in immigrant popula tions in Europe Australia Canada and the United States EGC is practiced among people of all edu cation levels and social classes in both urban and rural societies and within various ethnic groups It transcends religious beliefs including lslam Chris tianity Judaism and traditional African religions6 The World Health Organization WHO estimates that worldwide 130 million women alive today have undergone this practice and an additional two mil lion girls are at risk of being cut every year7 The WHO has classified EGC into four proce dures Figure 1 describes these different cutting methods that young girls typically between the ages of 4 and 12 undergo EGC prevalence rates the estimated percentage of women who have undergone the procedure vary widely across the African continent ranging from Somalia s nearly universal rate of 98 percent to estimates as low as 5 percent in Uganda see figure 2 However national prevalence rates may mask different levels of sup port for EGC among certain tribal and ethnic groups in a particular country Senegal for example has a national prevalence rate of 20 percent While the dominant Wolof and Serere ethnic groups do not LB JOURNAL OF PUBLIC AFFAIRS CULTURE CLASHES 73 practice EGC a large population of people in the rural eastern part of Senegal does Within this EGC practicing population prevalence is quite high 88 percent of women in the Halpularen ethnic group have been cut8 Anthropologists believe that FGC started ap proximately 2000 years ago in what is now South ern Egypt or Northern Sudan9 While conclusive evidence does not exist to explain EGC s beginning experts have suggested that it was used to prevent female slaves from becoming pregnant10 The practice did not become widespread until the 19th and 20th centuries when it moved from Eastern to Western Africa Furthermore communities con tinue to adopt it even in the face of the expanding anti EGC movement11 HEAHH CONSEQUENCES OF FGC FGC persists today despite the significant health consequences related to the procedure Short and long term side effects from EGC range from mild to severe Short term physical side effects include im Figure 1 Types of Female Genital Cutting In 1995 the World Health Organization classified FGC operations into four broad categories described below Type1 or Clitoridectomny Excision removal of the clitoral hood with or without removal of the clitoris Type 2 or Excision Removal of the clitoris together with part or all of the labia minora Type 3 or Infibulation Removal of part or all of the external genitalia clitoris labia minora and labia majora and stitching andor narrowing of the vaginal opening leaving a small holefor urine and menstrual flow 0 Type 4 or Unclassified All other operations on the female genitalia including o Pricking piercing stretching or incising of the clitoris an dor labia o Cauterization by burning the clitoris and surrounding tissues 0 lncisionsto the vaginal wall scraping or cutting of the vagina and surrounding tissues and introduction of corrosive substances or herbs into the vagina Source World Health Organization Female Genital Mutilation Report of a Technical Working Group Geneva WHO 1996 9 74 CULTURE CLASHES FGC Prevalence Rates Prevalence Country Rate Benin 50 Burkina Faso 70 Cameroon 20 Central African Republic 43 Chad 60 Cote D lvoire 43 Congo 5 Djibouti 98 Egypt 97 Eritrea 95 Ethiopia 85 Gambia 80 Ghana 30 Guinea 60 Guinea Bissau 50 Kenya 50 Liberia 60 Mali 94 Mauritania 25 Niger 20 Nigeria 40 Senegal 20 Sierra Leone 90 Somalia 98 Sudan 89 Togo 50 Uganda 5 United Republic of Tanzania 10 Source lntraAgency working Group on FGC 1999 Female Genital Cutting The Facts and the Myths FinaReport Washington DC USAID 7 mediate pain and bleeding shock anemia and in fections of the wound and urinary tract Long term physical consequences of FCC may include chronic pelvic infections excessive growth of scar tissue or cysts fistulae holes or tunnels between the bladder and the vagina or between the rectum and vagina and pain during intercourse Only a few studies have been conducted on the psychological side ef fects of FCC but the available research suggests that after undergoing FGC girls experience negative effects on self esteem and self identity They also have reported disturbances in eating sleep mood and cognition shortly after the procedure12 SPRING 2004 REASONS FOR PRACHCING FGC Despite the health risks and modern in uences FGC continues to be a persistent cultural practice For example the Egyptian FGC prevalence rate remains at 97 percent despite significant development and modernization over the past 50 years13 Contrary to expectations Egypt s increasing modernization has actually strengthened resistance to ending FGC as families turn to trained medical practitioners and modern medical techniques and facilities to perform the procedure14 Known as the medicalization of FCC many practicing communities mistakenly be lieve that conducting FGC with modern techniques eliminates the health risks thus resolving concerns about its harmful consequences Furthermore FGC practicing immigrant populations living in the United States and Europe often do not stop practicing FGC despite exposure to modern in uences and national laws forbidding the practice15 Contrary to expectation FGC incidence decline is simply not the next logical step of development FGC is not merely a residual traditional practice but serves in certain contexts as a stepping stone to a successful life16 Specific reasons for practicing FGC vary widely by community but some of the most prominent reasons include the following17 I Controlling sexuality Many different com munities believe that FGC confirms as well as preserves virginity before marriage low ers sex drive after marriage and provides greater sexual pleasure to the husband I Marriage prerequisite FGC establishes a young woman s eligibility for marriage in communities where men will not marry an uncut woman believing that she has low moral values I Misunderstood religious requirements Al though not required of any religion some religious leaders and individuals par ticularly within lslam believe that FGC improves the spirituality of women I Traditional rites FGC ceremonies considered a necessary initiation into adulthood are used as a celebration of womanhood and as a rite of passage The consequences for women who do not un dergo some form of FCC can be significant Social ostracism for uncut women is virtually guaranteed in some communities For many women remaining LB JOURNAL OF PUBLIC AFFAIRS VOL XVI uncut marginalizes their social status and denies them a voice in their community Because of the severe costs of nonparticipation substantial sup port for the practice remains with women being the main proponents of continuing FCC18 One study found that among uncut Sudanese girls the father s objections were the main reason why the child had not undergone the procedure19 THE SPREAD OPFGC Sociologist Cerry Mackie compares FCC to an in fectious disease calling it a contagious practice20 Studies have documented that when wealthier populations support FCC poorer populations adopt the practice or more drastic forms of it as a way to attain higher social status and improve mar riage prospects21 FCC proliferation is also associ ated with urbanization when previously isolated communities intermingle22 lronically FCC may spread among societies in response to the very modernization and exposure to the global com munity that development brings23 Because FCC provides social insurance that a girl may marry it continues albeit at slightly lower rates in spite of higher levels of education social class or health awareness of the girl or her parents Among cul tures that strongly define personal achievement and self fulfillment through marriage and family FCC becomes in essence a springboard toward achieving these goals2 1 HISTORY OF THE ANTIFCC MOVEMENT The first documented Western attempts to end FCC can be traced back to colonial administrations and missionaries of the early 20th century Early century colonialists adopted a cultural absolutist approach opposing FCC practices on moral grounds Local leaders passed laws and church rules in an attempt to curb the practice These efforts had limited suc cess primarily confined to communities where Christianity had taken hold However most com munities reacted in anger to the foreign intervention into their customs251n Kenya attempts to end FCC practices led to violent confrontations and fed into a larger nationalist resistance movement26 In Sudan attempts by the British colonial government to en force aban on infibulation see figure 1 resulted in rioting and destruction of a prison holding women arrested for violating the new law27 Throughout the middle of the century the international community shifted to a cultural relativist approach declining to pass judgment LB JOURNAL OF PUBLIC AFFAIRS CULTURE CLASHES 75 on the traditional practices of other cultures In 1950 the WHO declined to take a stand on FCC because the practice involved operations based on social and cultural backgrounds that should not be disturbed28 During this period FCC was simply not the focus of development efforts within international actors remaining an issue only among the medical community Doctors who were seeing the medical complications associated with FCC continued to publish articles in medical journals about the procedures harmful health effects29 De spite the lack of international attention to the issue indigenous African anti FCC movements began to develop Local women s groups led community movements to educate the public about the harmful effects associated with FCC These privately initi ated programs were launched periodically but the groups made little sustainable progress30 The rise of the Western feminist movement and its integration with the development community have sparked the now 25 year old international movement to end FCC31 Through formal and in formal channels feminism has become a new force in international politics and development32 Over the past 30 years a series of international confer ences have significantly contributed to the interna tional community s reconsideration of the status of women and harmful practices like FCC33 The WHO was the first international organiza tion to take a public position against FCC and by the 1970s it was actively working to gather health related information surrounding the practice34 The 1979 Meeting on Traditional Practices A ecting the Health of Women and Children held in Khartoum Sudan was the first international conference that specifically addressed FCC For the first time at an international forum delegates voted to support efforts leading to the end of all forms of the prac tice35 Hailed as a watershed event this conference greatly in uenced further discussions about FCC practices and brought the international community together to develop ways to end FCC36 Momentum and interest in FCC within the international com munity continued to grow throughout the 1980s Information on FCC began to emerge in Western media journals and academia The West acted like it had discovered a new and very dangerous epidemic FCC was sensationalized and used to confirm barbaric practices performed by backward underdeveloped societies37 By the early 1990s activists were working to move FCC from a public health issue into the larger women s rights movement In 1993 at the UN World Conference on Human Rights the international com 76 CULTURE CLASHES munity declared FGC a human rights violation38 In 1994 at the UN International Conference on Population and Development in Cairo Egypt the Program of Ac tion urged governments to prohibit FGC wherever it is practiced and to actively support anti FGC campaigns conducted within their own countries39 And in 1995 the Worlrl Conference on Women held in Beijing China declared FGC a form of violence against women The international development community had successfully tied FGC elimination to social economic and health development policies and had developed reasons for intervention under each sector by 1995 Given the paradigm shifts and the acceptance of women s rights into interna tional norms FGC is now widely seen among the international community as a practice that needs to be stopped Today there is active coordination between IOs donor organizations and NGOs to synchronize activities and efforts IOs such as WHO SPRING 2004 tional legitimacy facilitated the 1993 declaration of FGC as a human rights violation and secured reliable funding for anti FGC efforts International intervention brings prominent media exposure and facilitates information dissemination about FGC while providing expert technical assistance for anti FGC campaigns throughout the world It also holds national governments accountable for FGC practices within individual nations However the money and political support for the movement are heavily in uenced by its source the West Con icting agendas and goals between the international and local programs have led to harmful events that could have been avoided FACILITATES MEDIA EXPosuRE AND INIDRMATTON DISSEMINAHON Media exposure is an effective advocacy tool that can maintain political support and secure financial commitments for anti FGC campaigns FGC is a cause that mass media UNICEF and UNFPA play central roles in formulating the inter national community s anti FGC policy posi tions IOs also provide technical assistance and guidelines to national and local campaigns as well as host inter An analysis of the international community s efforts to endfernale genital cutting highlights how international intervention ho th promotes and detractsfrorn the eradication of this harmful practice outlets cannot resist the sensational topic attracts and holds an audience In 1980 FGC was still a relatively unknown issue among Western health experts and hu man rights activists This changed dramatically with the publication of national and regional conferences to discuss future efforts Government donor organizations like the United States Agency for International Development and the United King dom s Department for International Development are primary funding sources for anti FGC activities They also provide technical and administrative support to a wide range of IOs NGOs and local organizations International and local NGOs are the critical implementers of the policy guidelines es tablished by the IDs and donor organizations These organizations work within the actual communities to build consensus toward ending the practice INTERNATIONAL INTERVENTION A DOUBLEEDGED SWORD The international community s involvement in the FGC eradication campaign has been ablessing and a curse IOs donor governments international NGOs and activists have created a campaign that without question provided the movement with interna Fran Hosken s seminal report The Hosken Report Genital and Sexual Mutilation of Females The report broke new ground by offering a multi uni I I quot J newinfor 39 about FGC facts that generated considerable international attention The report ignited the current anti FGC campaign at the global level 12 Throughout the 1990s FGC was the subject of documentary films television and radio reports print journalism43 and Internet websites This exposure created widespread awareness of the eradication movement garnered political support and helped fundraising efforts but it has also hurt anti FGC activities Often these media reports fed into existing Western stereotypes of non Western ers For all the good the Hosken Report did to encour age the international community it has also been severely criticized for its alarmist generalizations and inflammatory comments 15 Sensationalized reports designed to shock Western audiences con tribute to the moral outrage Westerners feel about FGC and lead to well intentioned but misguided support for anti FGC campaigns 16 LB JOURNAL OF PUBLIC AFFAIRS VOL XVI One telling example occurred in 1994 at the UN International Conference on Population and Devel opment As noted earlier FGC was prominently discussed throughout this conference Delegates overwhelmingly agreed to endorse FGC eradication and to support organizations working to end the practice The Egyptian government the conference host was eager to reaffirm its anti FGC position for the gathered international community It praised the declaration and issued a statement declaring that not only was FGC rarely practiced in Egypt but that it was also quickly fading out47 The day after this statement was issued CNN broadcast on its worldwide network graphic foot age of an Egyptian girl being cut by a barber The fallout from this report was considerable Both the filmmaker and the barber were jailed The incident forced the government to take a public interna tional stand on a very private national issue and helped polarize Egyptian public opinion This event fostered deep resentment with many viewing it as an imposition of Westernized values on Egyptians Not only did this broadcast serve as a very embar rassing visual rebuff of the government s FGC declaration a day earlier but it also proved to be a significant setback to the low key anti FGC cam paign that had been working quietly and out of the public spotlight Support for FGC quickly became tied to Egyptian nationalism and suddenly became a rallying point for conservative traditionalist ad vocates in the country PROVIDES EXPERT TECHNICAL ASSISTANCE AND INNo VAHVE STRATEGIES The international community coordinates regional and international anti FGC programming It effec tively disseminates the latest technical information and best practices to local programs and organizes conferences at which activists from different countries meet to strategize and learn from program successes and failures Activists use these forums to discuss new initiatives and adapt them for implementation in other countries Without access to these resources anti FGC campaigns would remain disjointed and lack regional and international coordination Not surprisingly with such heavy international involvement there is an overrepresentation of Western opinions and attitudes within the anti FGC campaign Western feminist and cultural interpre tations of the issue often drive the movement s strategic decisions Local activists are often at a dis advantage and subjected to internationally driven solutions that are funded by Western money De spite the dominance of Western financial support LB JOURNAL OF PUBLIC AFFAIRS CULTURE CLASHES 77 there remains serious disagreement among some activists about the appropriate approach to end FGC Most international activists and organizations operate under the eradication now approach This is in opposition to the gradualist approach which works to minimize the physical damage by trying to eliminate the most severe forms of FCC Some local activists argue that encouraging a move toward Type 1 cutting instead of complete eradi cation would be a more effective way to eliminate the more extreme Type 3 known as infibulation see figure l5 They argue that if offered an all or nothing option most people would be resistant to any change thus leaving young girls subject to the more damaging forms of FCC HOLDS NAHONAL GOVERNMENTS ACCOIINTABLE The international community is in a unique position to pressure national governments to promote anti FGC campaigns Until recently many countries did not have explicit statutes outlawingFGC practices Unable to effectively lobby national governments themselves anti FGC activists have successfully implemented the boomerang effect 51 by applying external pressure on the national governments For example interna tional pressure came down on nations in 1996 when the United States linked its annual foreign aid alloca tions to national anti FGC policies convincing many governments to adopt legislation52 International attention also lends legitimacy to local efforts In 1997 First Lady Hillary Rodham Clinton visited anti FGC programs in Senegal to praise and encourage the activists The attention of such a prominent member of the international community lent considerable legitimacy to the small grassroots campaign The event generated considerable media attention in Senegal and in the international arena53 However Ms Clinton s visit also highlights the danger of pressuring international agendas onto populations not yet ready to support such moves Ms Clinton s visit attracted growing international attention to the emerging anti FGC movement within Senegal lOs UNICEF in particular stepped in and urged the legislature to pass a law banning FGC54 After intense debates the international com munity s lobbying efforts succeeded and FCC was criminalized in 199955 Off the record legislators admitted that the law was passed primarily to ap pease Western demands and because of the United States linking of foreign aid to national anti FGC policies56 Notably Senegal s law was approved a month before the US State Department released its annual country reports on human rights which are 78 CULTURE CLASHES used by Congress and US agencies to determine military and nancial assistance budgets57 Predictably supporters of FCC in Senegal were opposed to the law Surprisingly many anti FGC advocates also opposed the law These advocates believing that the law was passed too quickly feared that public opinion was not yet behind the law and that local anti FGC efforts would be un dermined lndeed backlash against the law arose almost immediately Traditional leaders vowed to go to jail before renouncing FGC One village held a ceremony and cut 120 girls just before the law was passed58 Because SPRING 2004 lent example of the strengths and weaknesses of local intervention and highlights the crucial role local involvement plays in garnering the necessary momentum for ending FGC ENGAGES LEADERS AND INSTITUTIONS Given the cultural sensitivity surrounding FGC it is counterproductive to implement programs without consulting and involving regional and local leaders and the affected individuals themselves Working with those who want to maintain traditions and re solving their concerns is the only way that permanent change will be incorpo of public opposition en forcement of the law was effectively impossible In one case a father charged his wife and mother in law with cutting his daughter against his wish es and had them arrested Public outcry and pro tests forced the charges to be dropped59 The law divided the nation into Given the cultural sensitivity surrounding fema le genital cutting it is counterproductive to implement programs without consulting and involving regional and local leaders and the affected individuals themselves rated into local culture Tostan an NGO based in Thies Senegal devel oped an approach to end ing FGC that the WHO has declared one of the most promising models yet to be developed61 In the mid 1990s Tostan began a basic education program in Eastern Sene pro and anti FGC camps and threatened to drive the practice underground making it even more difficult to end The backlash and anger over the anti FGC law prompted a strategy revision by local NGOs and 10 offices in Senegal Specifically the anti FGC ef forts were scaled back for several months and the UNICEF country office worked to distance itself from UNICEF headquarters public support of the law60 Currently Senegal is not enforcing the anti FGC law The government is waiting until public opinion becomes more supportive of the law before pushing for greater enforcement LOCAL INTERVENTION ACCEss WITH LIMITED SCOPE Local intervention is necessary for successful imple mentation of effective and sustainable anti FGC programs Pure international top down approaches will simply not work for the anti FGC movement While local intervention moves slowly and can have a limited outreach its strength is rooted in its ability to engage indigenous leaders to change local institutions and public opinion rooted inFGC traditions by building a consensus for change and working with the individuals themselves Current anti FGC programming in Senegal offers an excel gal that focused on group participation and em phasized women s empowerment while teaching primary health skills A female village facilitator whom all the participants knew and felt comfort able with conducted the lessons The education program initially included two sessions on FCC and was intended to help women express their feelings about the procedure In 1997 when participants in the village of Malicounda began to speak about FGC during the education program they realized that they all wanted the practice to end The women began to engage other village members as well as political and religious leaders in this dialogue Slowly a consensus to stop the practice was built After a period of eight months in which no child had been cut the village decided to publicly declare its deci sion to stop practicing FGC an event now known as the Malicounda Declaration62 The events in Senegal highlight the importance of engaging local institutions support networks and respected leaders in order to create a successful anti FGC program Without local buy in and the support of religious and local village leaders any behavior and tradition changes in Malicounda would have been superficial and unsustainable BIHLDS A CRITICAL MASS or SUPPORTERS Researchers hypothesize that even if every indi LB JOURNAL OF PUBLIC AFFAIRS VOL XVI vidual in a community wanted to end the practice FGC would continue inde nitely without collective action Traditions like FGC can prevail even among groups who say that they disapprove of its practice It is virtually impossible for one family to indepen dently decide not to have its daughters undergo FGC the social price is simply too high63 In Senegal the Malicounda women worked within the existing power structures and institu tions to build a consensus for change Malicounda s decision to make a public declaration was pivotal lt in uenced other villages to follow suit and began building a critical mass of communities committed to ending the practice Six years after this initial dec laration over 1000 Senegalese villages have issued their own public declarations and have agreed to stop cutting their chil dren64 This growing community is helping to protect uncut girls from becoming social outcasts Des ite the success in Sene gal effective anti FGC program ming cannot be entirely local if it is to reach women throughout all FCC practicing countries In 1993 at the UN World Conference on Human Rights the international community declared female genital cutting a human rights violation CULTURE CLASHES 79 be based on the most effective advocacy tool for the different audiences68 ENsuRE APPROPRIATE LANGUAGE AND MEDIA EXPosuRE Even minute details such as vocabulary should vary depending on the audience While inappro priate at the local level value laden language at the international level is helpful in maintaining political support for the movement Value laden language includes using the term female genital mutilation FGM as opposed to female genital cutting or female circumcision Using FGM at the international level emphasizes the negative aspects of the practice which in turn maintains political and financial support However because practicing communi ties simply do not view FGC as mutilation using this term at the local level is quite offensive and generates more resistance and anger hurting the program at its most critical point As dis cussed earlier the Hosken Report used inflammatory language which was an effective tool to attract and keep international Local efforts move slowly have a limited reach and are difficult to coordinate with other programs Tostan literally moves village by village Local organizations also have a hard time tapping into resources and techni cal support that are located at the international level of the campaign RECOMMENDATIONS Given colonial history and the Western ethnocen trisms experienced by many nations in their most cynical and destructive forms it is not surprising that Western driven interventions are often not welcome in non Western nations and may do more harm than good65 The non Western world sees Western disgust and an oversimplified analysis of FCC practices as arrogant intrusions into private practices66 lnterventions into traditional and cul turally sensitive practices inevitably lead to cries of neocolonialism and paternalism from those who resist the change and are frustrated that the focus on FGC draws attention away from more pressing development issues67 The international community must be cognizant of this fact and work to minimize that impression Strategic anti FGC J U 39 U decisions at the local and international levels must LB JOURNAL OF PUBLIC AFFAIRS attention Yet CNN s report during the ICDP conference demonstrates how local audiences often receive one sided in ammatory reporting which can lead to severe negative consequences KEEP A LOCAL FACE 0N ANHFGC PROGRAMMING International conferences primarily address interna tional program needs by formulating overarching strategies coordinating regional efforts and training advisors Activists at this level should continue to emphasize the local needs as well Experts agree that the most effective approach to ending FGC is building a comprehensive educational program at the com munity level that allows local groups to decide for themselves when and how to stop practicing FGC59 To minimize the perception that the movement is solely a Western driven neocolonialist imposition the face of the anti FCC movement should be locally based with actual interventions implemented by local activists The international community should work behind the scenes to help local leaders finance and design effective campaigns for the local audience By allowing the people to create and implement this movement themselves it is more likely that sustain able changes will occur resulting in permanent FGC quot longafterinternational quot quot inter est have disappeare 80 CULTURE CLASHES PRIORIHZE LOCAL PROGRAM GOALS OVER INIERNAHONAL AGENDAS Activists should be aware of the potential danger of international agendas overriding local campaign interests Ms Clinton s visit to Senegal highlights how prominent international actors can lend sup port and grant legitimacy to local efforts However her visit also focused unwanted international atten tion on Senegal s anti FGC efforts The international community s subsequent intervention and pressure to pass and enforce anti FGC laws before the Sen egalese public was willing to accept them posed a dangerous threat to the local anti FGC movement In this case the international agenda to achieve a legal declaration against FGC was placed above the good of the local program Delaying anti FGC leg islation for a few more years in Senegal might have led to a greater public acceptance of the law once it was passed making it an effective tool to end FGC practices As it stands now the law is unenforceable and remains a hindrance A successful anti FCC campaign requires both ef fective local and international efforts Current anti FGC campaigns are advancing small scale progress is occurring in communities throughout the African continent Unfortunately the domestic programs of individual countries often remain secondary to the movement s global agenda when anti FGC policies are driven by international norms not by local consensus building7o A comprehensive and successful anti FGC program cannot exist without addressing both the local community interests and international agendas Understanding the strengths and weaknesses of each group helps us learn how to further improve the current campaign as well as provide guidance on how to design future interven tions into traditional culturally sensitive practices that may be harmful to women LBJ NOTES 1 This paper uses the term Western to refer to coun tries that are also commonly called firstworld nations developed countries and northern states The term nonWestern refers to countries also called second and third world nations developing countries and southern states N Sandra Harding Gender Development and Post Enlightenment Philosophies of Science H ypatia A journal of Feminist Philosophy vol 13 no 3 Summer 1998 p 146 Rosi Braidotti et al Women the Environment and Sus P 1 0 SPRING 2004 tainable Development New Jersey ZED Books 1995 pp 2021 Parvin Ghorayshi and Claire Belanger eds Women Work and Gender Relations in Developing Countries A Global Perspective Connecticut Greenwood Press 1996 p 16 The tradition of altering female genitalia has been referred to at different times in the international com munity as female circumcision FC female genital mutilation FGM female genital cutting FCC and female genital surgery FGS FGM is the preferred terminology among activists However donor agen cies such as USAID have chosen to avoid using FGM because the reference to mutilation communicates a sense of judgment on current practitioners of FCC It also implies a certain level of cultural imperialism when Western activists enter the picture and implies 11 1 1 o1 11111 um ones Donor agencies consi der it judgmental pejora tive and not conductive to discussion and collabora tion Many international organizations now use the neutral term female genital cutting in order to avoid stigmatizing women who choose to participate in the practice US Agency for International Develop ment USAID Global Health USAID Policy on Female Genital Cutting OnlineAvailable http wwwusaid gov pophealth pop techaieas fgchtmlAccessed November 1 2002 Nahid Toubia Caring for Women with Circumcision A Technical Manualfor Health Care Providers New York Rainbo 1999 p 12 NancyAli AshaMohamud and Nancy Yinger Female Genital Mutilation Programmes to Date What Works and What Doan t Geneva World Health Organization 1999 US Department of State Female Genital Mutilation FGM or Female Genital Cutting FGC Individual Country Reports Online Available http WWW stategovgwi rls rep crfgm Accessed October Evidence of FGC s origins while not conclusive in clude a Greek papyrus housed in the British Museum circa 163 BC that suggests girlswere circumcised just before they received their dowries Strabo described in bulation practices among the Egyptians in 25 BC and Paulus ofAegineta an early medical writer living in Alexandria recorded Egyptian circumci sion practices in the sixth century AD Alice Irene Muir Leach A Thesis on The Pharaonic and Sunna Forms of Circumcision as Performed on Females in the AngloEgyptian Sudan Queen s University Belfast 1947 see also Mary Knight Curing Cut or Ritual Mutilation Isis vol 92 no 2 June 2001 pp 317338 ElizabethHeger Boyle Female Genital Cutting Cultural Conflictin theGlobalCommunityMarylandThejohns Hopkins University Press 2002 p 28 LB JOURNAL OF PUBLIC AFFAIRS VOL XVI 11 H N H m H H H UI H O H 1 H on Population Reference Bureau PRB Abandoning Fe male Genital Cutting Prevalence Attitudes and E orts to End the Practice Washington DC August 2001 p 4 Nahid Toubia and Anika RahmarL Female Genital Mutilation A Guide to Laws and Polici Worldwide New York Zed Books 2000 pp 89 Ellen Gruenbaum The Female Circumcision Contro versy An Anthropological Perspective Philadelphia University of Pennsylvania Press 2001 p 31 Boyle Cultural Conflict in the Global Community p 133 For a particularly interesting example of FGC practices in the United States see Doriane Lambelet Coleman The Seattle Compromise Multicultural Sensitivity andAmericanization Duke Law Iournal vol 47 no 4 February 1998 pp 717783 In the United Kingdom a 1983 survey of Somali immigrants reported that 60 percent would prefer to infibulate their daughters Anke Van Der Kwaak Female Circumcision and Gender Identity A Questionable Alliance Social Science and Medicine vol 35 no6 September 1992 p 784 Many male childrenare also circumcised This practice also is considered a critical part of their socialization and development ofadult men However the damage done to the male genitalia removal of the foreskin is painful yet minor in comparison with the type of circumcision female children undergo ie there is no reduction in sexual pleasure or limitation of bodily functions including urinationandejaculation Infibu lation as described in gure 1 removes all external genitalia subjects the body to serious trauma and has been compared anatomically as the equivalent of cutting off half of the penis Toubia and RahmarL Female Genital Mutilation p 21 Gruenbaum Female Circumcision Controversy pp156 157 See also Toubia and RahmarL Female Genital Mutilation pp 57 Ahmed Abdel Magied and Muna Omran The Uncircumcised Female is an Ideal State of Circumcision A Case Study from Sudan Ahfad Iournal vol 16 no 2 December 1999 Online Avail able ContemporaryWomen s Issues AccessedApril 9 2003 and Gerry Mackie Female Genital Cutting The Beginning ofthe End in Female quotCircumcisionquot in Africa eds Bettina ShellDuncan and Ylva Hernlund Boulder Lynne Rienner Publishers 2000 p 268 A survey of Sudanese men and women found the overwhelming majority of respondents favored continuation of the practice 88 and 83 percent respectively Asma El Dareer Woman Why Do You Weep Circumcision and Its Consequences London ZED Press 1982 p 66 See also Gruenbaum Female Circumcision Controversy pp 19 20 and Rogaia Mustafa Abusharaf Virtuous Cuts Female Genital Circumcision in an African Ontology Di erences A journal of Feminist Cultural Studies vol 12 no 1 LBJ JOURNAL OF PUBLIC AFFAIRS H o O N P r lt3an gt1 on 0 CULTURE CLASHES 81 Spring 2001 p 112 Moreover in Mali where 94 of women of childbearing age are circumcised 80 of circumcised women want the practice to continue while 13 of circumcised women think the practice should be stopped Only 53 of women who are not lnanlnrll I AI 1 1 A If 1 Center for Reproductive Law and Policy Women of the World Laws andPolicies A ecting their Reproductive LivesiFrancophone Africa Washington DC 2000 L Almroth et al A Community Based Study on the Change of Practice of Female Genital Mutilation in a Sudanese Village International journal of Gynecology and Obstetrics vol 74 no 2 August 2001 p 183 Mackie Female Genital Cutting p 268 Women from certain ethnic groups in Sudan also believe that undergoing the Type 3 infibulation proce dure see figure 1 gives thema superior social status a r rquot FGC Nonpracticing tribes migrating from Southwestern Sudan in 1917 had by 1947 adopted FGC as a way to assimilate in their new surroundings See Leach Thesis p 8 Ellen Gruenbaum The Islamic Move ment Development and Health Education Recent Changes in the Health of Rural Women in Central Sudan Social Science and Medicine vol 33 6 1991 p 644 Gruenbaum Female Circumcision Controversy pp 104105 205 Gerry Mackie Ending Footbinding and In bulation A Convention Account American Sociological Review vol 61 no 6 December 1996 p 1015 Lindy Williams and Teresa Sobieszczyk Attitudes Surrounding the Continuation of Female Circumcision in the Sudan Passing the Tradition to the Next Generation journal of Marriage and the Family vol 59 no 4 November 1997 p 969 and El Dareer quotWoman Why Do You Weep pp 89 Daniel Gordon Female Circumcision and Genital Operations in Egypt and the Sudan A Dilemma for Medical Anthropology Medical Anthropology Quar terly vol 5 no 1 March 1991 p 12 Lindy Williams and Teresa Sobieszczyk Attitudes Surrounding the Continuation of Female Circumci sion in the Sudan p 969 Nahid Toubia ed Women ofthe Arab World The Com ing Challenge New Jersey Zed Books Ltd 1988 pp 99102 Toubia and Rahman Female Genital Mutilation p 9 John C Caldwell Pat Caldwell and LO Orubuloye Female Genital Mutilation Conditions of Decline Population Resmrch and Policy Review vol 19 no 3 June 2000 pp 238239 Boyle Cultural Conflict in the Global Community p 92 and Leach Thesis p 58 Caldwell et al Female Genital Mutilation Condi tions of Decline p 240 Toubia and Rahman Female Genital Mutilation p 10 m 0 m r m Equot m g 9 Ln 9 O CULTURE CLASHES Abusharaf Virtuous Cuts p 135 Caldwell et al Female Genital Mutilation Condi tions of Decline p 240 Margaret C Snyder and Mary Tadesse African Women and Development A HistoryNew Jersey ZedBooks 1995 p 8 and Shirin Rai Gender and the Political Economy of Development London Polity 2002 p 166 F Tina l39n rthAE39r39 fr Directions in International Feminism New Jersey ZED Books 1995 p 2 Gruenbaum Female Circumcision Controversy p 215 Several prominent conferences include the 1975 World Conference of the UN Decade for Women Mexico City the 1977 UN Convention on the Elimination ofall Forms ofDiscrimination Against Women the 1980 Second World Conference of the UN Decade for Women Copenhagem the 1985 Third World Conference to Review andAppraise the Achievements of the UN Decade for Women Nairobi the 1995 Fourth World Conference on Women Beijing PRB Abandoning p 4 For further discussion see Caldwell et al Female Genital Mutilation Conditions of Decline p 241 Toubia and RahmarL Female Genital Mutilation pp 1012 and Susan Moller OkirL Feminism Women s Human Rights and Cultural Differences Hypatia A Journal of Feminist Philosophy vol 13 no 2 Spring 1998 pp 32 Boyle Cultural Con ict in the Global Community pp 66 and 70 Gruenbaum Female Circumcision Controversy p 177 vs 9 SPRlNG 2004 of Africa and Female Genital Cutting on American Television News Magazines In Images ofAfrica Ste reotypes and Realities ed Daniel M Mengara Eritrea Africa World Press 2001 p 229 1u1repeatin eneral ized stereotypes and not taking a scienti c approach whenaddressing FGC inA frica Ghorayshi WomerL Work and Gender Relations p 35 For example Hoskins wrote thatAfrica is a regionwhere absolute patriarchy is the rule where women are deprived of property and land rights where polygamy and wife abuse are the rule and where male domination is absolute both in the village as well as in national governments It is therefore clear that men are responsible for the worsening conditions in Africa women and children are the abused and voiceless victims The time to blame colonial powers is long since over but the time for African men to take a look at themselves as persons and human beings in our modern world is long overdue as quoted in Abusharaf Virtuous Cuts p 112 Grise Scarred for Life p 258 Aida Sief El Dawla The Political and Legal Struggle over Female Genital Mutilation in Egypt Five Years Since the ICPD Reproductive Health Matters vol 7 no 13 1999 pp 133136 See Elizabeth Warnock Fernea In Search of Islamic Feminism One Woman s Global Journey New York Anchor Books 1998 p 269 and Wesley H Clark et al The Decline of Female Circumcision in Egypt Evidence andInterpretation PopulationCouncil Policy Research 37 Nahid Toubia ed Women of the Arab World p 101 DiViSiOl ll Working Papers N0132Washingt0n DC 38 Susan Moller Okin Feminism Women s Human 1999 p39 439 Rights and Cultural Differences p 32 Caldwell 49 Gruenbaum PEmulE CiYCMT CiSiW Controversy PP et al Female Genital Mutilation Conditions of 209210 DeChneH p39 24039 50 See Chapter 3 of Toubia and Rahman Female Genital 39 Caldwell et al Female Genital Mutilation Condi Mufil fitm fOr further discussion Hons Of DeChneH 13 24 51 The boomerang effect occurs when national govern 40 Toubia and Rahmam Pgmule Genital Mutilation pp ments are unresponsive to activist and NGO efforts to 1012 mrrecthnmanr39 39 39 39 quot recourse the activists turn to international allies to 4139 Ibldquot Female Gemt ZMu39tll twilquot 1239 apply pressure on the state from the outside For 42 Gruenbaum Female Circummswn Controversy pp further discussion see MargaretEKeckandKathryn Sikkink Activists Beyond Borders New York Cornell 43 In 1996 the New York Tima issued an in depth report UniVerSity Press 1998 1313 123913 about the asylum case of Fauziya Kasinga a young 5 N Bettina ShellDuncan and Ylva Hernlund Female woman from Togo who ed her country in order to avoid a forced marriage thatwould have required her to undergo FGCAfter activists learned of her plight Fauziya found a judge who believed her story and ranted her asylum The story was widely covered in the United States and played a major role in making Americans aware of FGC as well as reviving political support for eradicating FGC altogether Susan Moller OkirL Feminism Women s Human Rights and Cultural Differences p 32 44 Martha S Grise Scarred for Life Representations P r Circumcision in Africa Dimensions of the Practice and Debates in Female quotCircumcisionquot in Africa eds Bettina ShellDuncan and Ylva Hernlund Boulder Lynne Rienner Publishers 2000 p 33 Tostan Population Council Breakthrough in Senegal Ending Female Genital Cutting in 31 Villages Nairobi Kenya 1999 pp 5859 David Hecht When a Law Sweeps irL Tradition Lashes Back The Christian ScienceMonitorFebruary 4 1999 LBJ JOURNAL OF PUBLIC AFFAIRS VOL XVI 55 Article 299 of the Senegal Penal Code passed on Janu ary 13 1999 reads in part six months to ve years of imprisonment is the punishment for anyone having violated or attempting to violate the physical integrity of the genital organs of a person of the female sex by total or partial cutting of one or many of its elements by in bulatiorL by making them less sensitive or by any other means when these acts lead to death the penalty of forced labor for life will be pronounced Tostan Brmkthrough in Senegal p 69 Bettina ShellDuncan and Ylva Hernlund Female Circumcision in Africa p 33 Ln 0 Ln 1 David Hecht Ban on Female Circumcision Back fires The Christian Science Monitor February 8 1999 Noy Thrupkaew Senegalese Women Win Ban on Female Genital Cutting Sojourner vol 24 no 7 1999 pp 2526 US Department of State Female Genital Mutilation FGM or Female Genital Cutting FGC online Hecht Banon Female Circumcision Backfires Spe cifically UNICEF Executive Director Carol Bellamy publicly praised Senegal s ban of FGC practices She said that Senegal s example is a dramatic message that women acting in their communities can be a 1 1 1 11 wenul mum mum Ln 0 Ln 0 O O that deny their rights and those of their children Senegal s action is of great significance because it re ects the resolve of African women to end a cruel and unacceptable practice which violates the right of all girls to free safe and healthy lives see UNICEF Newsline Senegal Bans Female Genital Mutila tion http wwwuniceforg newline 99prlhtm 1 November 2002 O i Tostan Tostan Program Chosen as Best Practice by World Hmlth Organization Online Available http www tostanorg newsoctober2703htmAccessed Febru ary 20 2004 Tostan Brmkthrough in Senegal pp 3334 5255 OO mN FGC is a type of Schelling convention in which the 39 quot r unillc The Schelling convention describes a social behavior phenomenon Suppose all audience members in a particular city stand up to watch movies at the local theatre Even if someone does not want to stand up and would prefer to sit in her chair because everyone else is standing she must also stand in order to watch thp 39lm ialuiin 39 39 r 39 39 acceptable action No one acting on his or her own initiative can succeed in getting the audience to all sit down Sitting down is only beneficial if enough people sit at the same time This particular social practice can be changed if a critical mass of people agrees to all sit down together Those who were not initially convinced to sit will see that sitting still allows one to see the movie and provides a certain level of comfort and will begin to sit as well SoorL LBJ JOURNAL OF PUBLIC AFFAIRS CULTURE CLASHES 83 sitting becomes aconventional practice and those who A A A JUWC PEI I peelp sure to sit as well In applying this concept to FGC if one achieves a critical mass of public opinion uncut girls can receive the same social benefits as cut girls Researchers argue that once a critical mass emerges FGC should end relatively instantaneously within one generation Mackie Female Genital Cutting 255 it 64 Tostan Tostan 2002 Annual Report Online Available http wwwtostanorg 2002AnnualReportpdf Accessed February 20 2004 65 Gruenbaum Female Circumcision Controversy p 16 66 Ibid pp 50 52 67 Ibid p 1 68 Toubia and Rahman Female Genital Mutilation pp 7984 69 Ibid Female Genital Mutilation p 68 70 Boyle Cultural Conflict in the Global Community p 84 REFERENCES Abusharaf Rogaia Mustafa Virtuous Cuts Female Genital Circumcision in an African Ontology Dif ferences A journal ofFeminist Cultural Studies vol 12 no 1 Spring 2001 pp 112138 Ali Nancy Asha Mohamud and Nancy Yinger Female Genital Mutilation Programmes to Date What Works and What Doan t Geneva World Health Organiza tiorL 1999 Almroth L V Almroth BerggrerL OM Hassanein N El Hadi SSE Al Said SSA Hassan UB Lithell and S Bergstrom A Community Based Study on the Change of Practice of Female Genital Mutilation in a Sudanese Village International journal 0 Gy necology and Obstetrics vol 74 no 2 August 2001 pp 179185 Ashworth Georgina A Diplomacy of the Oppressed New Directions in International Feminism New Jersey ZED Books 1995 Boyle Elizabeth Heger Female Genital Cutting Cultural Conflict in the Global Community Maryland TheJohns Hopkins University Press 2002 Braidotti Rosi Ewa Charkiewicz Sabine Hausler and SaskiaWieringa Women theEnvironment and Sustain able Development New Jersey ZED Books 1995 Caldwell John C Pat Caldwell and LO Orubuloye Female Genital Mutilation Conditions of Decline Population Resmrch and Policy Review vol 19 no 3 June 2000 pp 233 254 Center for Reproductive Law and Policy Women of the World Laws and Polici A ecting Their Reproductive LivesiFrancophone Africa Washington DC 2000 84 CULTURE CLASHES Clark Wesley H Omaima ElGibaly Barbara Ibrahim and BarbaraSMenschTheDeclineofFemaleCircumci sion in Egypt Evidence and Interpretation Population Council Policy Research Division Working Papers No 132 Washington DC 1999 Coleman Doriane Lambelet The Seattle Compromise Multicultural Sensitivity and Americanization Duke Law Journal vol 47 no 4 February 1998 pp 717783 El Dareer Asma Woman Why Do You Weep Circumcision and Its Consequences London ZED Press 1982 Fernea Elizabeth Warnock In Search oflslamic Feminism One Woman s Global Journey New York Anchor Books 1998 Ghorayshi Parvin and Claire Belanger eds Women Work and Gender Relations in Developing Countries A Global Perspective Connecticut Greenwood Press 1996 GordorL Daniel Female Circumcisionand Genital Opera tions in Egypt and the Sudan A Dilemma for Medical Anthropology Medical Anthropology Quarterly vol 5 no 1 March 1991 pp 314 Grise Martha S Scarred for Life Representations of Africa and Female Genital Cutting on American Television News Magazines In Images ofAfrica Ste reotypa and Realities ed Daniel M Mengara Eritrea Africa World Press 2001 Gruenbaum Ellen The Islamic Movement Development and Health Education Recent Changes in the Health of Rural Women in Central Sudan Social Science and Medicine vol 33 6 1991 pp 637645 The Female Circumcision Controversy An An thropological Perspective Philadelphia University of Pennsylvania Press 2001 Harding Sandra Gender Development and PostEn lightenment Philosophies of Science Hypatia A Journal of Feminist Philosophy vol 13 no 3 Summer 1998 pp 146163 Hecht David When a Law Sweeps irL Tradition Lashes Back The Christian Science Monitor February 4 1999 Ban on Female Circumcision Backfires The Christian Science Monitor February 8 1999 Keck Margaret E and Kathryn Sikkink Activists Beyond Borders New York Cornell University Press 1998 Knight Mary Curing Cut or Ritual Mutilation Isis vol 92 no 2 June 2001 pp 317338 Leacl39L Alice Irene Muir A Thesis on the Pharaonic and Sunna Forms of Circumcision as Performed on Females in the AngloEgyptian Sudan Queen s University Belfast 1947 Mackie Gerry Ending Footbinding and Infibulation A Convention Account American Sociological Review vol 61 no 6 December 1996 pp 9991017 Female Genital Cutting The Beginning SPRNG 2004 of the End In Female quotCircumcisionquot in Africa eds Bettina ShellDuncan and Ylva Hernlund Boulder Lynne Rienner Publishers 2000 Magied Ahmed Abdel and Muna Omran The Uncir cumcised Female is an Ideal State of Circumcision A Case Study from Sudan Ahfad Journal vol 16 no 2 December 1999 Okin Susan Moller Feminism Women s Human Rights and Cultural Differences Hypatia Aournal of Fem i nist Philosophy vol 13 no 2 Spring 1998 p 32 Population Reference Bureau PRB Abandoning Female Genital Cutting Prevalence Attitudes andE orts to End the Practice Washington DC August 2001 Rai Shirin GenderandthePolitical EconomyofDevelopment London Polity 2002 ShellDuncarL Bettina and Ylva Hernlund Female Circumcision in Africa Dimensions of the Practice and Debates In Female quotCircum cision in Africa eds Bettina ShellDuncan and Ylva Hernlund Boulder Lynne Rienner Publishers 2000 Sief El Dawla Aida The Political and Legal Struggle over Female Genital Mutilation in Egypt Five Years Since the ICPD Reproductive Health Matters vol 7 no 13 1999 pp 133136 Snyder Margaret C and Mary Tadesse African Women and Development A History New Jersey Zed Books 1995 Thrupkaew Noy Senegalese Women Win Ban on Fe male Genital Cutting Sojourner vol 24 no 7 1999 pp 2526 Tostan Population Council Breakthrough in Senegal Ending Female Genital Cutting in 31 Villages Nairobi Kenya 1999 Tostan Women s Health and Human Rights Online Available http wwwtostan org Accessed February 20 2004 Toubia Nahid ed Women ofthe Arab World The Coming Challenge New Jersey Zed Books Ltd 1988 Caringfor Women with Circumcision A Tech nical Manual for Health Care Providers New York Rainbo 1999 Toubia Nahid and Anika Rahman Female Genital Mu tilation A Guide to Laws and Polici5 Worldwide New York Zed Books 2000 UNICEF Senegal Bans Female Genital Mutilation Online Available http wwwuniceforg newline 99prl h m Accessed November 1 2002 US Agency for International Development USAID Global Hmlth USAID Policy on Female Genital Cut ting Online Available httpwwwusaidgov pophealth pop techareas fgchtml Accessed November 1 2002 US Department ofState Female Genital Mutilation FGM or Female Genital Cutting FGC Individual Country LBJ JOURNAL OF PUBLIC AFFAIRS VOL XVI CULTURE CLASHES 85 Surrounding the Continuation of Female Circumci sion in the Sudan Passing the Tradition to the Next Generation journal of Marriage and the Family vol 59 no 4 November 1997 pp 966981 World Health Organization Female Genital Mutilation Report ofa Technical Working Group Geneva 1996 Reports Online Available http WWWstategov gWi rls repcrfgm Accessed October 11 2002 Van Der Kwaak Anke Female Circumcision and Gender Identity A Questionable Alliance Social Science and Medicine vol 35 no 6 September 1992 pp 777787 Williams Lindy and Teresa Sobieszczyk Attitudes LB JOURNAL OF PUBLIC AFFAIRS
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