The Price of Stigma

When it comes to discussing HIV/AIDS in Egypt, most probably you’d be faced by either one of two reactions: one that is characterized by fear, shock, and discomfort or a reaction marked by denial and disdain. I would like to discuss why.

AIDS has come to be associated with sex and death, and both topics are hard to digest in our culture. We avoid discussing sexuality-related issues in our adolescence within the family and formal education. Comprehensive sexuality education is nearly absent and only limited information are given through curriculums and has been further abridged recently. Little awareness exists of HIV, its modes of transmission, prevention, and treatment. No wonder then that most people experience feelings of discomfort and fear. However, we need to listen and understand attentively because ignorance breeds fear and fear breeds hate!

Clearly, the biggest obstacle to HIV awareness work is the stigma against people living with HIV. People living with HIV have to suffer in silence, shameful to seek help or treatment and if it was revealed that they are HIV+, they’re shunned, mistreated by their community, workplace, and even their close and loved ones. This life of isolation is the killer in the case of HIV, rather than the disease itself.

The stigma is even greater when it is coupled with being a member of Most At Risk Populations (MARPs). These are groups of people who more frequently engage in behaviors that lead to HIV transmission.  These behaviors include unprotected sex, sex with multiple partners, and using the same injecting equipment. Such populations include men who have sex with men, female sex workers and their clients, and injecting drug users.

A comprehensive survey of Egyptian youth revealed that only 21% of them would be willing to interact with a person living with HIV, which is definitely disturbing. We all need to realize that stigmatizing those groups leads to higher spread of the virus into the community, by denying those people access to health and awareness services, and not allowing them to get the care and compassion they need. We need to face this, because we might have a low number of people living with HIV in Egypt, but the risk is even greater with this level of ignorance and stigma, plus we are not gods to judge their behaviors.  

The second reaction of denial and scorn comes from the view that HIV is a Western problem and that our moral society and religiosity is enough to keep us away from it; they see that maintaining our ‘cultural norms’ is the solution to HIV, and all other problems perhaps! A mere reality check negates this view.

However, some others question the amount of funding and prioritization given to HIV aid at the expense of improving overall health systems, which may be a valid concern. However, HIV remains a global issue that affect the life of millions. It demands nothing less than our diligent, tolerant attention. 

Homophobic crimes in Egypt?

I have to admit it's always hard to ever approach homosexuality here in Egypt. Homosexual people (or behavior) here is usually seen as one of three views: deviant people who deserve to be punished or even executed; sick people who need medical attention; or normal people only with a different sexual orientation (hardly ever adopted or expressed, even by gays themselves).

I hesitated to write about the upcoming account of events, but I felt it's too disturbing to ignore. The story goes as follows:

A young boy, Kareem (16 year old) was walking by in downtown area, Cairo. He was followed by four guys who were shouting insults to the young boy calling him a faggot. The boy just ignored their insults and kept going, the thing that seemed to provoke them, so they chased him until they caught him and started slapping and beating him violently (they were older and much stronger). It's not very clear why they decided to be that violent and abusive; although it seems to be basically driven by homophobia as Kareem's appearance looked “different”. Kareem screamed and ran towards police informers nearby but they didn’t bother to help the boy.

Appalled by what they saw, a group of friends sitting at a downtown café decided to intervene and help Kareem from the brutal attack. The one who stepped in first; Mohamed was met by violence and he was slapped and hit too. He was told by the perpetrators “Why do you want to help him? Are you a faggot too?”

Since the fight started to involve more people, the police finally started to take action and step in. They automatically took the side of the perpetrators because the victim seemed to be a homosexual. They wanted to take Kareem and Mohamed (who only wanted to help) to the police station. The police seemed reluctant to arrest the perpetrators, but finally decided to take the main perpetrator for investigations.

What followed was even worse. The police tortured Kareem and decided to perform a rectal examination to determine if he was a homosexual! This was done using violence and in front of the perpetrator! Mohamed was met by sarcasm and ridicule. Police informers harassed him. The only thing that might have saved Mohamed from further humiliation was that he had an American passport.

Finally, the police decided that the rectal exam didn’t prove Kareem to be a homosexual! (This kind of exam is based on old and false medical knowledge). Then, the police suggested a reconciliation deal with the perpetrator. Desperate to leave and end the awful experience, both Mohamed and Kareem agreed so they can get out of the terrifying police station. A police report was issued and it had a completely different story from what happened.

Now does Kareem deserve being attacked and humiliated like this? Does any human deserve this? Is being homosexual a good reason to be treated like this by the police even if you were a victim? Does someone's appearance or thoughts or identity give any person the right to attack others? Isn't the police role to protect people when they need them?!

Police torture is a common issue here, but more light is being shed on it as activists are getting more vocal about it and spreading awareness mainly using the internet and social media. But it's sad when no one is willing to advocate a person's rights if the person is thought to be homosexual! I highly doubt that torture activist would stand by Kareem.

The Egyptian penalcode has no clear articles against homosexuality however an outdated law to combat prostitution is used to prosecute homosexuals under the title of (habitual practice of debauchery). I wonder if criminalizing homosexuality help Egypt become free from homosexuals. Does this law really change anything to the better? Or it only infringes on some people’s personal freedoms and privacy?

Can someone in Egypt speak against the homophobia? Is it a “good cause”? Would this kind of activism gain any support inside Egypt?

A lot of questions worth contemplating and discussion, however homosexuality is a huge taboo and most activists fear stigmatization if they advocate it. Another taboo yet to be broken!

Cut my clitoris, please! Part II

In my last post, I talked about encountering FGM apologia and why it shouldn’t come as a surprise for me to face it. For the last couple of years, I have been reading about it and getting involved in discussions regarding FGM. One of the most notable readings is a study entitled “Investigating Women’s Sexuality in relation to FGM in Egypt” conducted in 2008 by a team of researchers led by Dr. Mawaheb El-Mouelhy, a leading activist in combating FGM. The study takes a deeper look at the terrifying practice and both men and women’s view on it.

There are a lot of justifications that people provide when you ask them why FGM is performed. Some of those are based on myth and false beliefs such as hygiene, some people think that if the clitoris is not cut, it would grow to become like a penis. Others do it because of customs. Most commonly though, they would say to control sexual desire for girls and to ensure married women’s fidelity, and also to increase the chances for a girl to get married and to be acceptable by her husband!

A contradiction emerges in people’s views of FGM. Although most of them said that FGM is important to control female sexual appetite, they asserted that the most important determinant of honor is the way a girl was raised by her family rather than practicing FGM. The most important thing for them was that the girl behaves well and keeps her virginity till marriage. Moreover, they knew that FGM was not enough to make their girls “behave well”. The honor complex is still controlling our thinking. Family honor and status is dependent on how its females behave. Family’s reputation has to be maintained, so the girls must be under strict control.

Another shocking and contradictory finding was that women and especially grandmothers are the main decision-makers of FGM. This brings me back to the story I told earlier. What makes women perpetuate this practice? Do they get jealous of each other in a way? Are they bound by tradition and custom? Were they brainwashed by patriarchal values of the society?

It is clear that the society sees female sexual desire as such an evil thing that has to be eliminated or at least controlled. Some people even likened an uncircumcised woman to a raging bull, not satisfied by one man! Men worry that if they marry an uncircumcised woman, they wouldn’t be able to satisfy her sexual needs.

It is indeed disturbing to have such thoughts going on in the community. There are currently a lot of efforts and campaigns made to combat FGM, and the procedure was officially banned by law in 2008. However, such efforts are restricted and needs a lot of years to pay off. Laws are not enough, especially with lax enforcement strategies here. Laws alone cannot change people’s beliefs and attitudes. It’s not only a matter of raising awareness. It’s a matter of changing patriarchal culture.

Cut my clitoris, please!

A campaign poster against FGM

So there I was, giving training at one of those sexuality education sessions. It was an introductory session, I was trying to be careful as possible as these young people are going to publicly discuss sexuality-related issues for the first time in their lives (in a health context of course)!

I came up with an information sharing game, to make it easier for them to participate and learn. I prepared a set of statements in the form of scientific facts. Then, I split each statement into two parts and distributed all the parts to the trainees, then asked them to find the other half of the statement they have.

One of the statements said: “Female genital cutting (FGM) could lead to bleeding, infertility, and loss of sexual appetite (berood ginsi).” After each of them found his/her matching half of the statement, I asked each of them to read the statement out loud. One of the girls said it out loud, but after she did, she shook her head and said “I’m not convinced, how can this happen?”

I went on explaining how the conditions and the delicacy of this surgery could lead to such fate. I also explained the function of the clitoris and how its cutting leads to loss of sexual desire.

“But isn’t this [loss of sexual desire] better to happen for women?” exclaimed the girl. I was surprised to be honest, even though I should have expected it, I guess it surprises me every time, especially when this kind of comment comes from a girl/woman! I think her only excuse is that she most probably haven’t started a sexual life yet, and she would know it better first hand and she wouldn’t have her children undergo the same awful procedure!

FGM prevalence in Africa

However, one shouldn’t be exactly surprised with this kind of FGM apologia in Egypt. The practice is indeed widely prevalent with shocking numbers. Egypt Demographic and Health Survey in 2008 demonstrates that the prevalence among women aged 15 to 49 is 91%. Although the practice seems to be declining among the younger generation, the phenomenon is widespread. With such rates, then definitely majority of the community supports it and have good reasons behind it. 

I am going to delve into it more in the upcoming post. Wait for Part II of this post! 

Sexuality Education Woes in Egypt

The talk about sexuality hardly ever surfaces in Egypt. Even when an article or a speech is given by an enlightened intellectual, waves of rejection and censure usually follow. Discussing sexuality usually stirs accusations of spreading vice and encouraging promiscuity. Consequently, the debate on sexuality education here is starkly lacking and flawed, just like the process of sex education itself.

The government and other religious and social institutions ignore basic human rights such as the right of information and the right to health when they fail to deliver comprehensive sexuality education information to the people, especially young people who are most vulnerable due to the sensitive changes they are going through.

Public education ignores sexuality information, except for a class on human reproduction during preparatory school and some skewed information on sexually transmitted infections. A lot of young people remember that awkward science class where the teacher was too embarrassed to effectively convey useful lessons on sexuality, or skipped the class altogether.

Civil society organizations have recently recognized the importance of delivering sexuality education programs to young people. Evidently, these programs only reach a very small segment of young people in Egypt, who make up about 40% of the total population. Apart from quantity, quality remains a major challenge. Educating young people on sexuality includes a wide array of topics, such as puberty changes; understanding the body and its functions; exploring identity; sexually transmitted infections, gender based violence; partner communication, etc. Sex Ed is often combined with life skills education to enhance young people’s ability to make right decisions about their lives and how to communicate these with partners.

Reality is unfortunately far from this. Instead of providing a positive approach to sexuality, it is often portrayed as an evil desire that needs to be controlled. Instead of promoting tolerance and understanding, it’s not uncommon to find Sex Ed programs that foster negative attitudes towards sexuality and gender. For example, gender equality is poorly delivered; premarital sex is a taboo; homosexuality is defined as a disease that afflicts young people; and safer sex practices are often omitted.

Without going too into too much detail, there is a litany of reasons behind this. Clearly, Sex Ed has a lot of prerequisites that must precede it such as teaching human rights, privacy, tolerance, and gender equality. 

Finally, sexuality is closely associated with people’s happiness and productivity. Providing comprehensive information regarding sexuality is a goal that must be achieved equally and effectively for a better nation.