PETALING JAYA - Malaysian girls throughout the country are being circumcised without proper medical guidelines, including in private clinics.
Both doctors and traditional midwives interviewed by The Star's R.AGE team for its new documentary, The Hidden Cut, admitted to not having any standard procedures for female circumcision.
In some cases, box cutters and stationery store blades are used.
"So far I have not hurt any baby. The danger is minimal. Some blood will come out and I will use a cotton swab. Once there is a blood stain on the cotton, the ritual is complete," said traditional midwife Azizah Daud, who in the documentary shows how she performs the procedure using a store-bought blade.
Depending on which practitioner you go to, the procedure can range from a prick on the clitoris, to the removal of the prepuce, the fold of skin surrounding the clitoris.
The Health Ministry announced in 2012 that it would release a medical guideline for the procedure, but none of the doctors interviewed by R.AGE have received it.
"Everybody seems to have their own understanding, and that's not surprising because we do not have standardised training, unlike what we have with male circumcision," said Universiti Kebangsaan Malaysia professor Dr Harlina Halizah Siraj, who specialises in sexual and reproductive health issues.
According to Dr Harlina, doctors continue to offer the procedure to avoid parents going to traditional midwives, who might not sterilise their equipment.
Representatives of the Health Ministry came under fire earlier this year at the UN's Committee for Eliminating Discrimination Against Women (Cedaw) for calling the procedure "harmless", citing statistics that 83-85 per cent of girls do not experience complications.
Other representatives on the committee, including from Muslim-majority Bangladesh and Egypt, called for the practice to be abolished.
The Department of Islamic Development Malaysia (Jakim) had previously circulated a fatwa in 2009 by the Malaysian Fatwa Committee stating that female circumcision is wajib (compulsory), and consulted doctors and experts to create a manual for female circumcision.
"We consulted doctors on how to avoid the cruel practice that is FGM (female genital mutilation), as brought up by the World Health Organisation," said Jakim research fellow Dr Arieff Osman.
Perlis mufti Datuk Dr Mohd Asri Zainul Abidin, however, believes the procedure should not be compulsory.
"In Perlis, we considered the views of various madhhab (schools of thought) in Islam, and concluded that it's not compulsory for Muslim women to be circumcised," said Dr Asri, adding that the procedure has no "medical or scientifically-proven benefits".
"As such, I think we should not continue this practice, unless a girl is grown up and decides to do it."
Public health medicine specialist Dr Maznah Dahlui also believes the practice should be abolished, but thinks a short-term solution would be to standardise the procedure.
"Without (a standard procedure), people will use all sorts of tools - it will be difficult to control how much is cut, and that might cause injuries and complications."