FLORENCE -- In his native Somalia, Dr. Omar Abdulcadir recalls, he saw all seven of his sisters undergo the girlhood ritual of genital cutting. Now, in a public hospital in Florence, he is trying to offer an alternative.
The gynecologist, who runs what he said is Europe's first and only Center for the Treatment and Prevention of Female Genital Mutilation, has found himself in the middle of a heated political and philosophical debate after he requested permission from the local medical board to perform a procedure that he said would maintain the initiation ritual associated with genital cutting but save young girls from mutilation.
Several types of female genital cutting, sometimes called female circumcision, are common in Somalia, Sierra Leone, Eritrea, and Sudan. In the most extreme form, part or all of the external genitalia is cut off and the vaginal opening stitched closed -- a practice known as infibulation.
Abdulcadir said his alternative is noninvasive and practically painless while still offering the symbolism of the ritual. It involves applying a topical anesthetic, then pricking the clitoris with a needle and drawing a drop or two of blood.
"I hope this practice will be eliminated," Abdulcadir said in a recent interview. "But I was asked by them, by these women, to do something.
"It's difficult for those who are outside these communities to understand, but in many African societies a woman is considered ugly, unmarriageable, and unclean if she hasn't undergone the ritual," he said. "If a woman doesn't undergo the ritual, she risks being rejected not only by her family but by the whole community."
Abdulcadir's proposal has raised broader questions about cultural integration and women's rights throughout Europe. As countries struggle to preserve their national identity by enacting new legislation, waves of immigrants from Africa and Asia with different cultural traditions and values continue to arrive.
Several European countries, including Britain, Norway, and Sweden, have criminalized female genital cutting, and a similar bill is being considered in Italy's Parliament.
In Italy, several women's rights groups and politicians representing both liberal and conservative parties say they believe that offering the alternative technique is a means of condoning a practice that can only be considered a barbaric act of violence against women, unacceptable to Italian society, and incompatible with Italian values.
In an appeal to the minister of health recently, lawmaker Patrizia Paoletti Tangheroni wrote: "The path to cultural integration comes from acceptance and tolerance of other cultures, but without placing our fundamental value of human rights in discussion. We must also remember that many women in the countries where infibulation is practiced have been fighting this battle for decades. The rights they have fought for, the inviolability of a woman's body cannot be put up for discussion."
Daniela Colombo, head of the Italian Association for Women in Development, a Rome-based organization that advocates for women's rights in the developing world, said there is no alternative to genital cutting.
"Taking a child in Somalia between 8 and 12 and mutilating her before marriage cannot be accepted," she said. "This is just mutilation and control of women's bodies, and no organization that works on the issue of genital mutilation would justify this."
At Abdulcadir's clinic, in the sprawling public hospital, several young women waited in the corridor outside his tiny office on a recent day. Crying babies echoed from the maternity ward at the end of the dimly lit hall.
One woman, Sofia Abdulahi Abdi, emigrated from Somalia eight years ago. Abdi, 24, who said she initially came to see Abdulcadir because of complications from an infibulation she underwent as a child, said that many Somali women living in Italy would welcome an alternative. "It's so much better, so much better than being sewn up," she said. Leaders of local immigrant communities have voiced support for Abdulcadir's proposal, but reactions to the proposal have been so charged it seems unlikely it will be approved by the local medical ethics committee when it meets next month.Even if the committee were to rule in favor of the technique, the Regional Council passed an emergency motion last week that blocks the local medical board from authorizing the procedure in hospitals in Tuscany. Still, the council has promised to extend other services offered by Abdulcadir's center to other hospitals in the region. Abdulcadir, who began working with women who had suffered genital mutilation more than 30 years ago while a medical student in Florence, said that genital cutting is so deeply embedded in the fabric of society that it is extremely difficult to curb. Many young immigrants revert to the old traditions as a means of preserving their cultural identity.
Still, he said, he will continue his fight. His next battle may take place within his own family because several of his nieces living in the United States are coming of ritual age.
"I am against this practice. I'm a doctor, and I respect the law," he said. "But I hope that those who choose to say no [to his proposal] will recognize that the problem exists and is not going away."