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FGM is usually carried out for reasons of cultural or gender identity, and is entrenched in tribal life in some areas.Long-standing traditional beliefs about hygiene, aesthetics and health also play a role in the continuance of FGM.Exceptions include Kenya, which is notable for its abundance of nongovernmental organisations, many headed by women, and Uganda, where women play prominent roles in educational and literary circles.

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AIDS-related deaths are often kept quiet, with 'tuberculosis' used euphemistically as a socially acceptable catch-all diagnosis.

Also, many of the AIDS clinics and counselling centres that exist still operate anonymously; if a sign were hung out, many victims wouldn't enter for fear of recognition.

In Kenya, an estimated 50% of women - most in the northeast, near Somalia - have undergone FGM.

In Tanzania, the figures are estimated at between 10% and 18%, while in Uganda, it's about 5%.

The extended family also forms an essential support network in the absence of government social security systems.

Given that average per capita income in the region ranges between about US0 in Burundi and US0 in Kenya (compared with about US,000 in the UK), the system works remarkably well, with surprisingly few destitute people on the streets in most areas.

Women always work, either outside the home or tending to the family and garden, and many students don't have the opportunity to finish secondary school.

Throughout the region tourism provides employment opportunities, though good positions are for the lucky few, and both unemployment and underemployment are rife.

In Uganda alone, there are almost one million AIDS orphans under 15 years of age - one of the highest figures in the world - and an estimated 53,000 children 14 years old or younger living with HIV/AIDS.

The figures elsewhere in the region are just as sobering.

Also look for Three Swahili Women: Life Histories from Mombasa; Kenya by Sarah Mirza and Margaret Strobel.

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