At just four-years-old, Amira Mahmoud Ahmed, like the rest of her girl friends, underwent the popular ritual of genital mutilation to ensure her chastity and, hence, marriageability. But unlike many, she died as result of the surgery.
The doctor, who was licensed to perform the operation, persuaded her father to bury Amira secretly and then fled. He has since been captured and is now facing up to seven years in prison.
Amira's death in October brings the number of known casualties from genital mutilation in Egypt this year to five, with nine girls seriously injured by the operation. These numbers, along with a government ban in July prohibiting doctors in state hospitals from performing the procedure, have sparked a new push to eradicate the practice here.
The media have prominently covered the girls' deaths. The government is training doctors and nurses and building hundreds of clinics to educate people about the negative side effects of female genital mutilation (FGM). It even plans to send cars with videos about the practice around Egypt's countryside.
A national FGM task force of about 30 women's rights activists, doctors, and academics has increased its activities by teaching grass-roots organizations how to persuade people to stop. This nongovernmental, volunteer group, begun in 1994, is also conducting research to better understand the practice and aid the government by giving it legal and monitoring support.
"You can't expect a more than 2,000-year-old practice to change overnight," says Marie Assad, the coordinator of the National FGM Task Force. "We don't have any illusions. There may be a backlash, so that's why we have to deepen and widen our efforts."
According to a recent university survey, up to 97 percent of Egypt's 30 million women undergo genital mutilation, which Egyptians call tahara, meaning purification. While many outsiders believe the practice to be Islamic, in Egypt, Muslim and Christian girls alike between 5 and 14 undergo the operation, usually by unlicensed "health barbers."
Opponents of the procedure say genital mutilation is not only medically risky but it can also create indelible psychological scars, reduce sexual pleasure, and cause severe complications during childbirth.
Despite these risks, however, persuading Egyptians to stop this deeply imbedded ritual is difficult. "We do it because we love our daughters," says one middle-class mother, whose daughter had the operation. "We want them to get married and to be happy."
Usually shrouded in silence, FGM burst into Egypt's public arena in 1994 after CNN filmed a health barber circumcising a screaming, shaking girl. Public outrage led to a widespread campaign to stop the practice.
It also started debate between the government, which wanted to ban the procedure, and Egypt's leading Islamic scholars, who encouraged it as a Muslim practice. The health ministry refrained from banning FGM completely and instead temporarily lifted the ban that prohibited the operation in public hospitals. That way, girls could undergo the procedure in more hygienic surroundings.
That's when anti-FGM activists mobilized to fight the Islamic fundamentalists and tried to eradicate a centuries-old tradition that they say dates to the pharaohs.
While these efforts will take years, independent observers say that after nearly two decades, activities to stop FGM may finally be on track.
To educate people at the community level, the FGM task force emphasizes the negative effects on women's reproductive health. Activists educate children in schools about the procedure and try to involve people from all professions in their efforts.
Meanwhile the Islamists are continuing their fight.
An Islamic fundamentalist doctor is suing the health minister for his recent reinstatement of the ban that prohibits FGM in state hospitals. "The practice is good for the woman, and it is ordained by Islam," the plaintiff, gynecologist Mounir Fawzi told Cairo's English language publication Al-Ahram Weekly in September.
Some women's rights activists believe the Islamists have politicized this issue - as they have pushed for women to wear the hejab, or head covering - because this is one fight they can win.
"It's an easy battle," says Amal Abd El-Hadi, a women's rights activist and FGM task force member. "The government won't compromise on the security front, [for example,] but on the women's front they will compromise."
To completely eradicate FGM, some women's rights activists demand more than just a change in the government's political will. They say female mutilation will only end when women's status in society improves.
"FGM is so tied to identifying women as the chattel of their husbands. They are under the shadow of the man and need to be modest and sexually proper," says Anita Fabos, a member of an FGM research group in Egypt. "[To stop this practice] women need to have control over their destiny."