Breast "Ironing". A harmful practice in Cameroon

BREAST „IRONING“ – A harmful practice in Cameroon

Violence against women is still a serious issue all around the world. Although the perpetrators are mostly men, there are also cases where the offenders are female. This is the case in some Western and Central African countries like in Chad, Benin, Guinea-Bissau, Guina-Conakry, Togo, Cote d'Ivoire, Kenya and Zimbabwe and mostly in Cameroon (Tapscott, 2012), where women do harm to their daughters in the form of breast “ironing”. This method consists of massaging, pressing or pounding the breasts flat with different objects like hot stones. The victims are mostly between eight and 12 years old (Tapscott, 2012) when their breasts begin to grow. The reason behind this practice is to prevent the young women to look feminine as long as possible to protect them from teenage pregnancies. Latter would mean no fully completed education and a social exclusion.

In this paper, we will focus on breast “ironing” in Cameroon. After brief information about the country, we will discuss the methods and the consequences of this practice. Subsequently, we will talk about the international and national policy and legal framework to finally see what is done to stop the further practice of breast “ironing”.

The Republic of Cameroon, from now on referred to as Cameroon, is a presidential republic with Paul Biya as President since November 1982 and is situated in Central Africa. The population accounts for about 24 million, where over 60% of the population is under the age of 25 and half of it is female. Life expectancy is still low at about 60 years for women and 57 years for men, mainly because Cameroon still faces a high rate of HIV and AIDS and an elevated maternal mortality rate (CIA World Factbook, 2016). In fact, in 2014, the maternal mortality ratio lied at 690 per 100.00 live births, placing Cameroon number 10 of the ranking of the highest maternal mortality ratios (indexmundi, 2014). By now, it decreased to 596 per 100.000 live births (UNFPA, 2015). Women are in average 19.7 years old when they bear their first child (CIA World Factbook, 2011). Although there is a noticeable shift in the society towards later marriage and increasing access to education and careers, women still face a high risk of becoming pregnant before marriage. This is mainly due to limited sex education, illegality of abortion and the unpopularity of contraceptives (Tapscott, 2012). To reduce pre-marital sex and pregnancy, girls and young women are often victims of a painful, meant to be preventive practice, the breast “ironing”.

The first time the practice of breast “ironing” - also called breast “flattening” or breast “massage”, depending on the literature - was mentioned was in the nationwide study conducted by the Cameroonian NGO Réseau National des Associations des Tantines (the National Network of Aunties, RENATA) in cooperation with Deutsche Gesellschaft für Internationale Zusammenarbeit, the German Society for International Cooperation (GIZ) in 2005. This research is unfortunately still unpublished and one of the two only studies conducted on the method. During the study, 5.661 girls and women aged between 10 and 82 years were interviewed about rape and incest in all 10 regions of Cameroon. During these interviews, the topic breast “ironing” emerged. According to GIZ, a quarter of all girls and women had already experienced breast “ironing” in their lives. In 58% of the cases, it was performed by the girl's own mother (Tapscott, 2012). The rest of the times it was executed by the sister, the aunt or the grandmother (Koczy, 2007).

Breast “ironing” is an old tradition according to Dr. Flavien Ndonko, who is a medical anthropologist. It was originally practiced as a medical measure for women to enhance the production of breast milk by massaging them (Tapscott, 2012; Koczy, 2007). However, since the late 1940's, the target of the practice has changed. The society has expanded breast “ironing” to control the sexuality of young women, to spare them an early pregnancy (Koczy, 2007) and to protect them from rape and sexual assaults (Terre des Femmes, 2016). A significant reason for this is because the onset of puberty is increasingly earlier and the age of marriage later (Tapscott, 2012). The purpose of the practice therefore is to keep the young women physically childish as long as possible to allow them to finish school.

During the practice, a heated grindstone, pestle, or a wooden spatula and other heated objects are used to massage, press or pound the young girls' breasts. The duration of application varies across the regions and ranges from a single application to applications one to two times a day during weeks or even months (Tapscott, 2012; Terre des Femmes, 2016). Additionally, an elastic band has to be worn around the breasts to prevent them from growing (Terre des Femmes, 2016).

Moreover, breast “ironing” seems to be a “treatment” rather than a tradition. It is more likely that girls who develop early are victims of the practice; in fact, it is twice as likely to be performed on girls who start to develop breasts before they turn nine years old than those whose breasts start to develop after the age of nine according to the GIZ study. Furthermore, not every girl of a family experiences this harmful practice. It is often performed on the girl who matures first. And last, the practice is not continued by women who have experienced it themselves (Tapscott, 2012). The GIZ study further reveals that almost a quarter of all girls and women in Cameroon is impacted by this practice (Tapscott, 2012) and that 17% of women would use it on their daughters. However, the prevalence of breast “ironing” depends on the region in Cameroon. While only 7% of women and girls are affected of it in the North and Extreme North regions, 53% have suffered from it in the Littoral region around the city Douala (Terre des Femmes, 2016; Koczy, 2007). The reason for this variation is due to the urbanization. While the Northern part of Cameroon is characterized by villages where the community and the mostly big families have an eye on the girls, this social security falls apart in cities like Douala. Parents don't know what their children do during their absence and hence cannot protect them. This is the reason why the prevalence of breast “ironing” is significantly higher in cities. Young women therefore have to pay for the fear of assaults by men through the mutilation of their breasts (Terre des Femmes, 2016).

The consequences of breast “ironing” are diverse. Yet, it is difficult to find short- and long-term side effects of the harmful practice, as there are no medical studies conducted on this field. Nevertheless, scars, cysts, abscesses in the breasts, infections and fever, but also breasts of unequal forms and sagging breasts are frequent consequences. Additionally, some women report not being able or having difficulties to nurse (Terre des Femmes, 2016; Koczy, 2007). Latter subsequently affects the women economically, too, because they have to buy bottles and milk powder for their babies, which are expensive and not easy to get in West Africa (Terre des Femmes, 2016). Moreover, the method doesn't have only physical consequences; the young women suffer from psychological distress, too. The most severe are posttraumatic stress disorder (PTSD) and panic attacks. However, the consequences don't have to be a mental illness. Many of the young women feel punished and guilty for displeasing their parents (Koczy, 2007; Tapscott, 2012). They suffer from a lack of a sense of self­worth and sometimes even self-hate (Terre des Femmes, 2016). The feeling of shame and the internalization of blame (Tapscott, 2012), sometimes accompanied by social exclusion, is as harmful as the physical outcome of the practice. The fact that mothers tell their daughters that they are too young to have breasts or that it is for their best (Tapscott, 2012) intensifies the feeling of disappointing the parents if the daughters don't endure the procedure. Breasts are not seen as something natural and when they start to grow at a later time, women experience frustration, fear and shame (Tapscott, 2012), trying to hide their breasts. This of course also affects later intimate relationships, as they mostly don't want to be touched or show their body to their partner (Terre des Femmes, 2016).

Breast “ironing” is a severe form of human rights violation, because it infringes the right to live without being “subjected to torture or cruel, inhuman or degrading treatment or punishment” (Article 5, Universal Declaration of Human Rights, 1948). Furthermore, it is practiced to control the sexuality of women. Cameroon has signed and ratified a number of international instruments to protect human rights, including the rights of women and children. Besides the Universal Declaration of Human Rights (1948), the United Nations Commission on Human Rights (1988), the International Covenants on Civil and Political Rights and Economic, Social and Cultural Rights, Cameroon signed the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW, 1979) in 1983 and ratified it in 1994. Additionally, the Republic signed the Convention on the Rights of the Child (CRC, 1989) in 1990 and ratified it three years later (OHCHR, n.d.). Cameroon handed in reports to both CEDAW and CRC in the past two years and received specific recommendations regarding breast “ironing”.

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