Gaining weight and skin bleaching: women knowledge and practices of body modification and their impact on females in the Tamboul area in Central Sudan.

Hadi, Abu Baker Ahmed Abdel Rahman Al

Introduction

Causes of female infertility are many. They include biological problems such as (e.g. Tubal blockage) and socio-cultural causes (e.g. The belief in applying magic to enhance or prohibit fertility). It is commonly perceived that somebody modification methods can lead to female infertility (Rowland 1994). Some drugs used for bleaching and gaining weight are available in pharmacies such as Insulin injections. Insulin injections are used for increasing parts of the body, such as the cheeks (Kaufman 2012; Fact Sheet 553). Other substances are unauthorized by the National Medicines and Poisons Board such as the mukhalsa injection, which is used for bleaching and inducing illegal abortion. Featherstone defined the term body modification as, ".. A long list of practices, which include piercing, tattooing, branding, cutting, binding, and inserting implants to later the appearance and form of the body. The list could be extended to include gymnastics, bodybuilding, anorexia, and fasting forms in which the body surface is not directly inscribed and altered using instruments to cut, pierce, and bind. In these practices, the outer body transformed through a variety of exercises and dietary regimes, which are generally much slower process, with the external effects, such as gaining or losing bulk, fat, or musculature, only becoming observable over longer periods of time" (Featherstone 2000, p. 1).

Body modification effects are viewed negatively or positively by different researchers who work in this field. These effects are considered appropriate in the common knowledge of the community when it comes to body modification. The community developed a sense of information through lived experiences, media, and rumors. These materials lead to renal failure, cancer, death, infertility, etc. (Shildrick 2000).

Ghannam 2004 researched on how some users do not know the complications of these substances, while others have knowledge about them. Voices of those who maintain using them are revealed here: Some of them said, "We know, but we use very insufficient amount". Health care providers informed "These drugs retain water under the skin frequently". People commented, "The body of flana (meaning in the local language a woman x or y as named by the community) is full of water". It is also noted that many people scold women who use these drugs and advise them verbally. Jamila informed that her friend Safia was skinny, but after she took the drugs, her cheeks became full. Safia became beautiful and immediately she got engaged. She had to stop using these drugs before marriage because they cause infertility. Jamila encouraged her friends to stop using these drugs few months before marriage as she experienced cycle irregularities with her period because she used them (Ghannam 2004, pp. 56-57).

Methods

The paper applies anthropological approaches for data collection in Tamboul town- Central Sudan. Observation is a practical technique to see how the body of these women looks, their purchasing attitude at the cosmetics shops. For example, the researcher observed the young female students at the secondary school drop by the cosmetics shops in Tamboul town in their way to school and after. The researcher observed how they negotiate and consult the shopkeeper about their faces and bodies and which substances or mixtures of creams may fit with their soft or harsh skin. Some shopkeepers claim that they are specialists in cosmetics; other women claim that they are specialists in aesthetics.

Ethnographic interview is used for collecting data about women experiencing infertility and unwed girls in general. Some questions about obesity and the usage of beautification substances were asked to use the unstructured interview method. In addition, some health care providers were asked about the consequences of the usage of these drugs.

According to shopkeepers, women who ask for these substances collect relevant information about the issue before using them. The shopkeepers are ready to deliver this information based on his/her experience and on the verbal communication they collect from other women. Talking to men in these shops or the neighborhood informally about the way of sharing these ideas, it seemed to be collected in an informal way.

Discussion

Respondents included, women experiencing infertility, fertile women, unmarried girls, health care providers, and cosmetics' shopkeepers. The data were collected mostly in Tamboul town where the main research on female infertility is conducted. Tamboul is a small urban setting that is located in Central Sudan.

Theoretically, body, knowledge, and power were argued as reasons behind beatification attempts. Some writings have documented to the quest of beauty issues globally such as Gilman 1999's study on aesthetic surgery, Black's 2004 and Ghannam's 2004 in the beauty industry. In Sudan, most of the writing has focused on documenting for the traditional beatification practices such as Al-Safi 2007.

Knowledge about it is based on common knowledge exchanged by women with each other, which may be true or false (Ghannam 2004). People coined their understandings to their bodies through lived experiences. Amna said, "We as public, we have our local knowledge. Knowledge the doctors have ... we do not know". Knowledge about the body is not limited only to health care providers, "Causality has been a central concern of positivism" (Hammond & Wellington 2013, p. 19). Patients shaped knowledge for the reason of consulting doctors and other healers, hearings, mass media, etc. Accordingly, scientific knowledge becomes a 'common knowledge'. Visions on the consequences of these drugs positively and negatively are an example of common knowledge.

Women make body modifications through different methods, including surgical operations such as dilatation and curettage (D & C). In this sense, knowledge is summarized by the concept kalam nass (people say). It is a reflection of the confusion between the scientific knowledge and the local representations.

The power of the beautiful woman's attractiveness is one of the reasons why women do not confirm with doctor's advice concerning the negative effect of bleaching and other body modifying medicines. The community expectations play a role in that respect. However, women are also looking for children as their biological clock of fertility knocks every month. Inhorn argued that patriarchy the relations of power, authority of males over females as well as the gender socialization within the family are main factors driving women to use these substances (Inhorn 1996, pp. 34).

Ghannam stated that feminist movements struggled to bring attention to the female body in recent years (Ghannam 2004, p. 45). The body of the woman is the source of a power. For example, Boddy stated that the powerful bargaining card that women have is their fertility in Sudan (Boddy 1989, p. 121). Beautiful body is a source of power. The beautiful infertile woman is insulted. Some people comment, "She cannot get both: Beauty and offspring'. There are some rumors about some women that they became infertile because they used some aesthetics unauthorized substances. Contrarily, the body can be a source of powerlessness. In case the woman is sick, she becomes powerless where her underproductive body is the source of her power in the Sudanese community by giving birth to the offspring.

Bourdieu 1985's interest in the 'commodification of the body' in his study to class in France, analyzed the physical capital that can be converted into economic, social and cultural capital and is to gain access to material resources and achieving distinction (cultural values) (Ghannam 2004, p. 46). Some writings such as Black viewed aesthetics as 'commodification of the body too, where the body is used as a symbol for marketing (Black 2004, p. 161). Problematizing the concepts of slimming and fat from a Western model may lead to misunderstanding of body modification necessity as constructed in the discourses of the Sudanese women. To have children, a Sudanese woman has to get married. To do so, she must be 'normatively beautiful' to attract a husband. Paradoxically, there are changes towards losing weight. It is observed that some women are practicing exercises in Khartoum town e.g. in the evening they do the exercises at Shambat bridge that join Omdurman and Khartoum North.

A woman said, "Men are responsible for the problem. They prefer malyana (fleshy) women. This is why women use unauthorized pills for gaining more weight'. The common statement says, "al-marrah umm sagan Rahaif, en katalak al-zaif, fi baba ma tagaif', which means: You man; the woman who has thin legs, do not contact her for sex in the very cold winter because her body will not feel warm. This saying reflects how the body of the woman is perceived for satisfying men's biological needs. While men are rejecting this accusation that women are looking for justification for what they do. The analysis of norm beauty is about meaning as the question why women look for additional sources for beautifying their bodies neglecting the natural body physique?

There are standards of the beautiful female body. They differ from one person to another. Socially, as constructed in the Sudanese community, the beautiful woman is a woman who matches specific physical appearance criteria such as being safra (literally meaning light skin color); has long hair and her body physique is not thin or very tall. These descriptions associate cultural and racial affiliation to the Arab region. Several authors have suggested that there is a strong relation between self-identification and body, such as Bourdieu 1985, Martin 1989, Gilman 1999 and Ghannam, 2004). Identity conflict of the Sudanese women is always challenged: Being Arabs or being African. Regardless of attributing themselves to any of these affiliations they want to be humur (literally, red in color: A connotation again used to mean light in skin color). Women's African identities are reflected in the Sudanese poets and songs which have documented for the common-average Sudanese woman color (akhdar) (green colour or dark skin) by poets and songs such as "zoli al-akhadar". However, the white and bright face became standard, and whitening the face grew to be a measurement of beauty. Such debate had been argued by Schildrick who stated that, "identity could fit such arrange of difference" (Shildrick 2000, p. 90).

The Sudanese women differentiate between two related concepts, saha (health) referring to that the woman is not thin and the body style when a woman is shahmana or fat. If the woman is not thin and may be having extra kilos, people say, "She is in a good saha", while the concept shaham (obesity) refers to the woman who looks more than having saha- very obese. They view shah am as a sickness. A woman is identified to be fat when the body physique is filled with fatness and she appears to be plump. Such description does not fit into the concept of saha or health. Appropriate body figure is full where it should be full and people view the woman as maqasama (if flesh is well divided into organs with some fatness). Alternatively, a very thin woman is also regarded as not healthy.

Using drugs to enhance saha or whitening the face is also associated with ethical corruption. Whitened faced ladies may easily find jobs compared to other ones, as they look very attractive. Simple observation in the Sudan national TV compared to the private TV channels shows that not every Sudanese woman has the same chance to work in these programs. This claim is simply observed and recently debated. The color is perceived to discriminate equal rights and chances of job seekers. This is because priority will be given to the perceived 'white faces'. Recently, a Sudanese TV program presenter and translator claimed that she was discriminated because of her black color in one of the Sudanese TV channels (Al-Bihiri 2013).

It is noted that there is a degree of knowledge comparing between unwed girls and married women (Richard et. al, 2014). In a focus group discussion, unwed girls have frequently mentioned, "They use these substances and when it comes to fertility, God will solve it". This is because they view fertility and infertility not as a matter of a biological body since it is God decision. Accordingly, unwed girls use these drugs extensively where the concept of fertility is not highly considered before marriage. Married women know the value of children. Women experienced a big difference if they mothered children or not.

Justifying the use of these substances

Differentiating between women's categories may work in analyzing the use of these substances. Married women claim that they apply these substances in order to remain beautiful in the eyes of their husbands where polygamy threatens their family settlement.

In her study in Cairo, Ghannam stated that there are remarkable differences between female age groups in terms of displaying their beauty. For young unwed girls, beauty is a central public identity and distinction, for older married women beauty should be displayed in the domestic domain and for their men (Ghannam 2004, p. 50). 'Identity crisis' is discussed by many scholars such as Al-Amri 2013, and Al-Siddig 2011. Abu Sharaf 2009 stated that the South Sudanese women in Juba town apply whitening creams as the government armaments influenced them. Now [in 2000s] and the 2005 peace agreement, they can tend to natural beauty without appealing others standards (Abu Sharaf 2009, p. 164). Boddy stated: In Northern Sudan, women express conscious about skin color. White skin is clean, beautiful, and a mark of potential holiness. Being Caucasian, Boddy claimed that she was repeatedly told that, her chances of getting into heaven-should, she choose to become Muslim-were far greater than those of the average Sudani. This is because the Prophet Mohammed was white, and all white-skinned peoples are in the favored position of belonging to his tribal group. Ranked in order of desirability, the skin color of villagers ranges from "yellow" or light through increasingly dark shades called "red", "green", and "blue". The term aswad (black) is usually reserved for southern Sudanese or "Africans", who in earlier times might had been enslaved (Boddy 1989).

Debating conflict on Sudanese, color identity is a separate issue. For the purpose of this paper, whitening the color and lightening the skin is not influenced by the debate on Sudanese identity. The majority of ethnic groups use these drugs. Some observations revealed that many factors, other than getting married influence the choice of using bleaching substance to enhance light skin color such as fashion, media, globalization, leisure time, prostitution and may be poor awareness of the negative side effect of these substances.

There are strong voices that view these attempts for whitening the body and gaining weight as a monstrosity. Some studies have documented this trend such as Shildrick who stated, "The monster is something beyond the norm that resists the values associated to call normality of what we choose" (Shildrick 2000, p. 80). Listening to people comments on those women who whitened their bodies and faces are one may spot: "stupid", "monsters", "became uglier", as expressions frequently heard to characterize them despite the fact that the there is a common conscious about these light measures of beauty.

There is a common perception that the woman who gains extra kilos has better chances to marry. Women advise their thin daughters to gain weight. They tell them, "Gain weight in order to attract a man" said one of the informants. In addition, unwed girls use the bleaching substances to look different compared to other women; they take care for their bodies, and because of some other social and psychological influences.

Historically, many women use natural material such as talih (acacia seal Del.) to induce whiteness making smoke bath with these wood material. However, the new generation looks for the quick results regardless the consequences as reflected by the older generation. Accordingly, time factor is an influential determinant of using the substances. It is also noted that codes of ethics of the community may not allow the unwed woman to do some practices that are used for lightening the skin or whitening the body such as smoke bath; because it is constructed that this practice is performed by married women only.

Substances for body modification

Some drugs are authorized can be bought from the pharmacy such Insulin drugs. Other drugs can be bought from herbal shops, which scattered in all Sudanese towns. The drug could be used for medical reasons such as allergy ointments and pills. However, the same drug may be manufactured without a label and no one knows the source.

There are different ways for selling these products and mixtures. A woman can buy a package, a tin or many creams and mix them herself. The other way, is that women buy prepared mixtures according to their financial ability. Mostly, a small spoon is used for measuring these retail quantities. In addition, there are small street shops known as tabaly, (these are small street kiosks) which sell these mixtures. Sometimes women-sellers move with these products from one house to another. Some student informed, "Women who sell food and snacks at the school, also sell us these creams".

Medical drugs have their own scientific names. Slang local names were given to these drugs. For example, Daonil tablets are used for controlling diabetes. In Sudan women call it Abu-Rajfa (Literally meaning, substance that makes the person shivers), relating to the effect of insulin which induce shivering because of hunger. Women buy it and take it as it makes the woman shivers of hunger. She eats and eats until she gains weight. The public views Sudanese female singers and TV program presenters that they are accused of using these substances. Some injections are even named after some singers such the injection X (a well-known singer), and the cream of Y (a well-known TV program presenter).

It is also noted that names are given to these drugs reflect their quick efficiency in modifying the body. For example al-jyran indahshow (neighbors were astonished of the new changes in the body), jary al-shahn (the charger), Tashahid ghadan (tomorrow you see the difference), malak za'alan (why you are angry) and this pills are used for increasing cheeks and weight. Some expressions are used for technologizing the body like machines. For example, jary al-shahn is an expression used if the woman is using the gaining weight substance and waiting for the increase to be obvious in her body. If the woman is obese, they say dafar (meaning as big as a lorry car).

Perception of the causes of infertility

Interpretations of causes of infertility, the community exchange rumors about how bleaching and gaining weight using drugs may lead to infertility. Some studies as well revealed such debates. The following are examples of how these substances can cause infertility.

a. Menses disturbances

It is commonly believed that the use of these drugs causes menses disturbances, which lead to infertility. According to Sudan Motherhood Survey "in the case of menstrual disorders, nearly half of the women not seeking treatment- at least at doctors' clinics" (FMOF 2001, p. xviii). Al-Siddig 2011 informed, "The usage of asteroids substances affects pituitary gland, which associates to releasing some ovulation hormones and accordingly it disrupts ovulation and the monthly cycle consequently".

b. Tubal Blockage

"Tubal pathology is by far the most common cause of female infertility in Africa" (Almorth 2005, p. 13). Many women report blockage Fallopian tubes as the cause of infertility. Women are very worried about surgical interventions for 'opening the tubes'. Zahra informed, "These drugs create fat around the ovaries and consequently prevent eggs fertilization". Suzan said, "My friend used these drugs to gain weight. She married seven years ago and failed to conceive". A woman said, "The effect of the drug presses on eggs. They will be invalid to be fertilized. The doctor informed me that these drugs caused tubal blockage". Omaima said, "If it is natural, it does not cause infertility, while if it is the obesity-pills, it leads to these sufferings. Fat closes the cervix and the womb causing tubal blockage".

c. Obesity

Historically, there is an old discourse about how the Sudanese woman prepares specific foods and drinks for gaining weight. These foods and drinks are made at home. The common examples are porridge locally known as madyda (made of dates), fenugreek porridge, and mows drink. Before marriage, the bride practices the habssa (confinement) for forty days in order to take care of her body through different methods. Currently, some changes are taking place. Some girls who are planning to marry may still study or work. They do not have time to practice the habssa. These changes make girls seek quick solutions. Accordingly, they opt for creams and injections for bleaching and gaining weight. Many respondents have explained that obese women will not conceive as they struggle of takayws al-mabayd (polycystic ovary syndrome (PCOS)), the Arabic expression means ovaries are covered by plastic materials. The researcher heard many women advising others that these substances lead to tubal blockage.

d. Abortion

Some women document knowledge about aesthetic practices causing abortion and fetus malformation. It is commonly believed that talih smoking bath as a traditional way for cleaning the body may cause abortion. The woman burns talih wood in a hole dug in the ground, sits beside it, and covers her body with shamla (woolen blanket) for some minutes or hours. The practice may be performed for some or many days. It helps in cleaning the body and bleaching. Pregnant women in the first trimester are not allowed to do this practice, as it perceived to cause abortion: It is commonly believed that the smoke bath opens the womb inducing abortion. Hassan informed, "Talih contains some germs that induce miscarriage to pregnant women because during storing this talih material or when it is in the jungle, it may come in contact with urine of dogs. Those who sell talih then, cut it from the jungle and use without washing'.

Some kinds of chemical materials such what is known as pegan sibgha (chemical dried material used for adding colors) is used as a quick way for doing drawing on the body- mostly legs and hands- instead of henna. This type of aesthetics leads to abortion as is perceived to contain toxic materials. Pegan paste is used because of its quick effect and can show results after some minutes of using it, while henna needs applications many times and has to be left for hours before removal. These chemical materials also perceived to cause abortion and fetus malformations. "Spontaneous abortion in Sudan represents 11%' (FMOF 2001, p. ii).

Mawahib informed, "Obesity is a source of beauty. If the woman is not obese, she is not beautiful'. A woman said, "It obstructs the success of In-Vitro fertilization. It does not allow the embryo implantation'. Erhaf informed that her sister who experienced a tubal blockage is advised by doctors many times to lose some weight. Najda said, "Every time I visit the doctor, he frustrates me that I will not conceive unless I lose weight'.

Some other practices relate to body modification, are perceived to cause infertility such as unsafe abortion. Unsafe abortion is expected after using these drugs. WHO defines unsafe abortion as a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both (WHO 2011, p. 2). In this context, it relates to illegal pregnancies attempts of abortion, which is illegal in Sudan. This form of unsafe abortion is a " ... and neglected issue in the discourse about infertility forms and induced abortion. In most sub-Saharan countries pregnancy termination is illegal [...] when they resort to unsafe practices can endanger their future fertility" (Schuster & Horbst 2006, p. 6). There are different ways of terminating this unwanted pregnancy. Al-mukhalsa (medical substance that helps women to get rid of something) injection relates to this analysis as it is used for abortion and for whitening the skin. This illegal injection may be bought from shops. However, it is not offered to everybody. Building trust leads to getting it. It is very expensive. It is 600 SDG (120 $). This is related to unwed girl and mostly university students whom they conceive illegally. They cannot abort and they cannot give birth at the hospital, as the police will catch them.

Social perceptions of bleaching and methods of achievement

There are different forms of substances used for bleaching and gaining weight. At the same time, the substance such as an injection or pills can be used for two different purposes. For example, to whiten the body, gain weight, and induce abortion.

Statistics show some of the negative biological consequences of these substances. In 2010, cases of reported sicknesses associate the usage of cosmetics' creams' usage at the Khartoum Teaching Hospital for Dermatology were reported. 14.000 were admitted or treated from the toxic substances result of using creams, 590 cases of the change of the skin to the black as a result of using creams, and 5.715 cases of skin allergy cases were reported" (Idriss 2010).

a. Pills

There are different types pills used for gaining weight, for example:

1. Al-najma (the star), where they say al-najma be al-hajma (induced shock for people who recognize the change perceived to take place on those who use these pills), means a sudden unbelievable change in the body size.

2. Tashahid ghadan, means I will take the pills today and tomorrow the woman who uses this substance will amazingly gain more weight. It is a challenge that these pills help in gaining weight in one day.

3. Al-tagyl wara (big bottom), change will take place in local parts of the body such as the big buttocks.

4. Al-tagyl giddam (big front), which is used for fattening the breasts.

5. Al-Khamyra (yeast), this type make the body size increase similar to what yeast does as a chemical material when added for fermentation purposes.

Bishriya (practicing healer) informed, "Some women consult her about gaining weight. But, they do not opt to safwfa (local food recipe or powders), they need to gain weight quickly without knowing the complications, or they know, but they use them". In Tamboul town, according to rumors, some cases of unwed girls have died because of using these pills. Quotations from a focus group discussion inform that the usage of these drugs "block the path of the egg to the womb", "causes abdomen fats, which press on the womb", and "obstructs the sperm to inter the womb".

Injections

There are different types of injections e.g. Injections for increasing specific parts of the body such as insulin and injections to increase the whole body. Health practitioner informed that some women use hormonal injections for injecting chickens. Some scholars such as Gilman 1999 viewed this trend as erotic body. She stated buttocks have erotic meanings and the body conceived as sexual by the community. In the Sudan, men walking or sitting on the street comment on girls with big buttocks, "she has a big tail". Some tablets increase weight in some parts of the body and induce abortion. The researcher visited one of these shops. She requested gaining weight injection, the price of whitening injection is 350 SDG (70 $). Sellers do not give it to the buyer. They tell her that the 'doctor' will come and inject you".

Insulin injections are used for increasing specific parts of the body, such as the buttocks, cheeks, legs, and breasts. They could be bought from the pharmacy easily. As it is controllable, some women inject the face different organs in order to have what is used to be known as "moon face". Gilman 1999 studied in details the history of breast aesthetics stating the perception "small breasts equal to having no breast" (Gilman 1999, p. 237).

Body creams

People use to say "face creams", meaning that the woman or man has treated his/her face with some bleaching cream. However, nowadays the same cream is applied to whiten other parts of the body such as hands and legs. There are many creams and ointments in the market. They are sold in pharmacies and the cosmetics' shops. Some of these creams can be bought from any pharmacy as they are used for medical purposes. The researcher noticed that girls used these creams for whitening the face. Girls apply the cream to the neck, hands, legs, and feet. One girl said, "They apply the cream even to the sensitive places" (meaning the sexual organs). A pharmacist stated, "Whitening body creams are carcinogenic materials. When the woman uses these creams, they lead to cancer as they increase some unwanted substances. These creams are manufactured for medical purposes". Yet, in Sudan we found that these products are sold in "cream shops" without any prescription" (Abdel Moniem 2014; Al Mijhar Journal 2014).

Doctor Othman, the head of the Khartoum Dermatology, Hospital stated, "These unauthorized smuggled drugs cause many health problems. They contain a high percentage of cortisone. They lead to skin infections". Doctor Mergani (in the same hospital) added, "These materials enter Sudan through commercial licenses. National medicines and Poisons Board knows nothing about such creams".

Conclusion

The study concludes that apart of the perceived risk factors of using authorized or unauthorized substances for bleach and gaining weight women continue to use them. This opens the door for future research on factors that enforce the decision of the woman for using or not using these substances. It also shows the weak role of the state in controlling these smuggled drugs.

There is a common knowledge about the impacts of these drugs and the quantity used. Theoretically, in this sense, medical knowledge becomes common knowledge, which is acquired through hearings and other methods such as media. The amount of drugs, which the woman uses, and the time in which she has to start or to stop using them are perceived to influence the degree of negative of positive effect that induced using these substances.

This study revealed some social practices and medical interventions to cause female infertility. In the Sudanese community motherhood is a value that is gained through the marriage process thus, unwed girls may not seriously consider the issue of the value of children before they marry. Consequently, they continue using these harmful substances. Some informants perceive that blame after marriage will not solve the problem where motherhood is valuable comparing to beauty in the context of the Sudanese community.

Note on contributor

Abu Baker Abdel Rahman is a Junior Fellow Bayreuth International Graduate School of African Studies, BIGSAS University of Bayreuth Germany.

References

Abdel Moniem, T. 2014. Cancer through the skin: The effect of bleaching creams on the body. (In Arabic) http://www.alrakoba.net/newsaction-show-id-149966.htm. Retrieved 01/07/2015.

Abu Sharaf, R. 2009. Transforming displaced women in Sudan: Politics and the body in a squatter settlement. Chicago and London: the University of Chicago press.

Al Safi, A. 2007. Traditional Sudanese medicine. Azza House: Publishers and Distributors: Khartoum--Sudan.

Al-Amri, T. 2013. Al-Rakoba website. http://www.alrakoba.net/newsaction-show-id-87177.htm. Retrieved 01/07/2015.

Al-Bihiri, F. 2013. Huriyat. http://www.hurriyatsudan.com/?p=172385http://www.hurriyatsudan.com/?p=172385. Retrieved 01/03/2015.

Al-Mijhar Journal. (Subject on website) http://almeghar.com/permalink/20131.html. Retrieved 01/ 08/2015.

Almorth, L. 2005. Gential Mutilation of girls in Sudan: Community and hospital based- Studies in Sudan on Female Genital Cutting and its consequence. Stockholm: Department of Public Health Science, Division of International health, Kornilska Institute.

Al-Siddig, Z. 2011. What is behind body modification? (In Arabic). Khartoum. http://www.sudanradio.info/php/vb.353/ showthread.php?28517%D3%E4%CF%E6%CA%D4%C7%CA-%C7%CC%E5%C7%D6-%DD%ED-%E4%D5-%C7%E1%CE%D1%D8%E6%E3. Retrieved 01/05/2015.

Black, P. 2004. The beauty industry: Gender, culture, pleasure. London and New York: Routledge.

Boddy, J. 1989. Wombs and alien spirits: Women, men and the Zar Cult in Northern Sudan,. Madison: University of Wisconsin Press.

Fact Sheet 553: Body shape changes (Lipodystrophy). National Library of Medicine. http://aidsinfonet.org/fact_sheets/view/553. Retrieved 15/12/2013.

Featherstone, M. 2000. Body modification: An introduction. In M. Featherstone (Ed.), Body modification. Sage Publications: London. Pp. 1-13.

Bourdieu, P. 1985. The social space and the genesis of groups. Theory and Society, vol. 14, no. 6, pp. 723-44.

FMOF 2001. Safe motherhood survey: National report- 1999. Khartoum: Central Bureu of Statistics.

Ghannam, F. 2004. Quest for beauty: Globalization, identity, and the producing of gendered bodies in low-income Cairo. In Sholkamy, H. & Ghannam, F. (Eds.), Health and Identity in Egypt. Cairo: American University in Cairo. Pp. 43-63.

Gilman, L. 1999. Making the body beautiful: A cultural history of aesthetic surgery. Princeton: Princeton University Press.

Idriss, E. 2010. The slow death. Khartoum medical publication. http://www.alahramsd.com/ah_news/3343.html. Retrieved 01/04/2014.

Inhorn, C. 1996. Infertility and patriarchy: The cultural politics of gender and family life in Egypt. Philadelphia: University of Pennsylvania Press.

Kaufman, F. 2012. Lumps and bumps from Insulin therapy. Medtronic. http://www.loop-blog.com/lumps-and-bumps-from-insulintherapy/ Retrieved 03/05/2012.

Martin, E. 1989. The woman in the body. Milton Keynes: Open University Press.

Richard, A. Kuffour, D., Wellington, O., Philip, M. 2014. Level of awareness of effects of the use of cosmetic bleaching products among women: A case study of Bolgatanga Municipality of Ghana. Research on Humanities and social science, vol. 4, no. 11, pp. 57-62.

Rowland, S., Baird, D., Weinberg, R., Shore, L., Shy, M., Wilcox, J. 1994. The effect of occupational exposure to mercury vapor on the fertility of female dental assistants. Occuptional Environment Medicine. Vol. 51, no. 1 pp. 28-34.

Shildrick, M. 2000. This body which is not one: Dealing with differences. In Featherstone, M. (Ed.), Body modification. London: Sage Publications. Pp. 77-92.

Schuster, S., & Horbst, V. 2006. Introduction to reproductive disruptions: Perspectives on African Studies. Curare, Zeitschrift fur Ethnomedizin und transkulturelle Psychiatrie. Vol. 29, no. 1, pp. 5-16.

WHO, 2011. Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008. http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf. Retrieved 10/12/2014.