By Jamie Rich
Sunday, March 7, 2010; B03
DOUALA, CAMEROON -- A small pack of elementary-school-age kids surrounded me every time I left my favorite lunch spot, Chez Noura. They held up old wine bottles filled with fried groundnuts. "Madame, please, I need to eat," they shouted.
I never bought the nuts. I ran the eight-foot gantlet from the Lebanese restaurant's entrance to my parked Toyota SUV, with my 2-year-old daughter, Elle, slung over my hip. Sometimes I gave the kids taffy or leftover shawarma. Usually, I quickly strapped Elle into her car seat and, like many expatriate wives in this poor West African nation, tried to avoid the swirl of desperate children.
One afternoon, however, I saw something impossible to ignore. Unaware that one side of her tank top had slid off her tiny shoulder, a young girl standing in the crowd next to my car clutched a bottle of nuts under one arm and waved to me with the other, revealing a long, wide scar where a small nipple or budding breast should have been.
My eyes darted from the girl's missing breast to her big brown eyes and back to her chest. She disappeared in the distance as I drove away. The encounter revealed to me that a Cameroonian tradition I had heard vague whispers about might actually exist: breast ironing, in which women flatten adolescent girls' developing breasts, intending to protect the girls from the dangers of sex, consensual or otherwise.
The phenomenon gained some international attention in 2006, thanks to a campaign by a nonprofit organization. Since then, the State Department has included breast ironing in its annual reports on human rights abroad. But despite the increased attention, the practice persists. It affects as many as one in four girls, according to local health activists. Some mothers massage hot grinding-stones into their daughters' chests, while others pound the tissue with heated plantain peels. Sometimes, women rub kerosene or medicinal herbs on adolescent breasts.
To understand what would drive a mother to press a hot stone into her daughter's chest, I talked to local women, girls, physicians and community organizers. Despite the pain and fear, many of the women and girls involved in breast ironing considered it a normal treatment for early breast development. Mothers told me they forcibly try to eliminate signs of puberty to protect their preteen girls from HIV and pregnancy. One mother explained that she did it out of love.
Elle and I moved to Douala from Alexandria in January 2009 to join my husband, Brian, who had spent more than two years working there and traveling back and forth to see us. I had first stumbled on the subject of breast ironing in 2006, and once we settled there I wanted to know if the practice was still a reality of life. The seemingly barbaric treatment sounded like a close cousin to female genital mutilation, which, although prevalent in other African countries, is rare in Cameroon, according to activists. Both traditions purport to preserve innocence, but those familiar with breast ironing explain that it evolved to counteract a teen-pregnancy problem.
I began looking into the practice by asking local women around Brian's office what they knew. Most of them responded with blank stares. When I asked Elle's babysitter, she became uncomfortable, clicking her tongue and shaking her head. She said she had never heard of it. A few weeks later, however, she confided that she had a cousin whose breasts had been ironed. Slowly, other women opened up, too, revealing not only the methods but also the purpose -- keeping young girls chaste.
In Cameroon, being young and pregnant is not uncommon. Additionally, an estimated 30 percent of women have unwanted pregnancies, according to local health-care workers.
Caroline Nkeih, a veterinarian and mother of four, said she knows two families with daughters who became pregnant at 12. For this reason, in her mind the merits of breast ironing outweigh any physical or emotional consequences. One afternoon at her home in the Bonaberi district of Douala, Nkeih explained why she ironed her daughter Endam's breasts two years earlier, when she was just 10 years old. "Boys can start looking at the girls, when their breasts appear. At 12 years old, they are still children, but the boys see the breasts," she said. She explained that if a girl develops at age 8 or 9, many mothers think it's necessary to "press the breasts."
Nkeih said she warmed a long wooden pestle over her gas stove and rubbed each of Endam's breasts for five minutes. She said she treated Endam twice before the breasts retreated, only to reappear a year later.
Serges Moukam has an ob-gyn practice in Douala and knows well the "poverty perpetuating" problem of teen pregnancy. Promiscuity and rape both factor into the high teen pregnancy rate, and breast ironing, Moukam said, prevents neither. In an interview in his cramped office, he said pregnant girls ages 12 to 17 make up 25 to 30 percent of his patients. "It's very rare to see a 13-year-old girl who is still a virgin," he said.
Flavien Ndonko, an anthropologist at the German Agency for Technical Cooperation, runs the nonprofit group that launched the 2006 anti-breast-ironing campaign and leads the fight against the practice in Cameroon. "It's body mutilation and against women's rights," he said. From his office in the capital, Yaounde, Ndonko listed the consequences of breast ironing, including abscesses, infection, deformation, lactation problems, cysts, possible links to breast cancer and emotional stress.
Ndonko first learned about the tradition in 2005 while training teen mothers and rape victims to work as part of a network of health activists. Breast ironing came up during discussions among the trainees. Ndonko said he realized he had uncovered an alarming problem. The following year, the German organization surveyed 5,651 girls and women, between ages 10 and 22, and found that 24 percent had experienced breast ironing. He said his organization's awareness campaign brought breast ironing "out of the kitchen," where the practice is usually carried out, and into the spotlight.
During an interview in his office, Ndonko produced a list of hundreds of victims. "They do it so girls do not become pregnant," he said. "But girls still get pregnant, even earlier than they thought." Slicing symbolically at his face with his hands, he added: "Not only breasts attract young men. What will they do? Cut lips, eyes, nose?"
Ndonko's findings matched what I encountered. During a meeting of local teenage girls in Douala, Dolvine Massah, 13, recounted the first time her mother ironed her breasts, when she was 11. She said her older brother called her to the kitchen, where her mother warmed plantains over the fire. Then, Massah said, her brother "arrested" her, forcing her lanky frame onto a wooden bench. She remembered screaming while her mother pressed the hot plantain peels onto her breasts. After a year of treatments, sometimes as many as three a week, Massah said she still feared that call to the kitchen.
Justine Kwachu, executive director and co-founder of Women in Alternative Action, a nonprofit organization in Yaounde promoting women's equality, lobbies not only for sex education but for punishment. In 2006, she began researching laws to criminalize breast ironing and other discriminatory practices. Kwachu, whose sister performed breast ironing, petitions Cameroonian parliamentarians for support of anti-discrimination legislation that proposes a 10-year prison sentence for those caught practicing the custom.
Others suggest more tolerance for the mothers. Emilia Lifaka, one of 25 female parliamentarians and the vice speaker of the National Assembly, said in a telephone interview that practices such as breast ironing call for more education, not legislation. Lifaka, who represents a region cited by local media as having a high rate of teen pregnancy, played down the prevalence of breast ironing, and said she thinks few women still do it.
Ndonko, the anthropologist and activist, painted a darker picture based on his research. He said that despite increasing awareness, he hears of new breast ironing cases "every day."
Recently, a lone preteen girl selling groundnuts approached me at my car. I still declined the nuts, but rather than ignoring her, I asked if she knew about breast ironing. She smiled, a bit embarrassed, looked down and nodded. She said her breasts had been ironed two years earlier.
Jamie Rich is a freelance writer who recently relocated to Alexandria after living in Cameroon.