In Egypt, the cutting is done on both Muslim and Christian girls and typically involves excising the clitoris and sometimes other female genitalia, often by a doctor. Side effects include haemorrhage, shock and sexual dysfunction.
Outside of Egypt and Sudan to the south, the practice is extremely rare elsewhere in most of the Arab world but is common in Eritrea, Ethiopia and Somalia.
More than 95 percent of Egyptian women had been circumcised, with the highest levels in poor families living in rural areas of the Nile valley in southern Egypt, according to an Egyptian Demographic and Health Survey conducted in 2005.
JUST A PINPRICK
The highly publicised death of Budour Shaker at the start of what activists call Egypt's "circumcision season", spanning the hot summer months when school is out of session, prompted Cairo to close a legal loophole that had allowed doctors to perform the rite for documented "health reasons".
Like Shaker, nearly three quarters of girls who are circumcised in Egypt are cut by medical personnel, including doctors and nurses who receive fees of 50 to 500 Egyptian pounds ($8.85 to $88.50), activists say.
They say that a handful of girls die each season -- either because they receive an improper dose of anaesthesia or from haemorrhage or other complications.
"Some doctors, so that they feel better about themselves and more ethical in a way, say: 'I'll prick her' so she bleeds and her parents are happy ... I've heard a lot of doctors saying if I don't do it they will go to my fellow doctor who will do it," said Yasmine Wahba, child protection officer at UNICEF.
"I think it's cuckoo," she added, referring to the logic. She said she feared the practice may now be driven underground.
Even after the government imposed its full ban on the practice, the procedures continue to happen, although an Egyptian anti-circumcision activist in southern Egypt said doctors were now demanding higher prices to compensate for increased risk.
In the southern town of Edfu, a 7-year-old girl was brought to hospital in July after she haemorrhaged while being cut in a village clinic, the health ministry said.
Health authorities are investigating reports that a nurse in a town south of Cairo had cut the genitals of three girls in a single day in procedures done in their homes. The ministry said the woman, who confessed, could face up to two years in jail.
"At least the doctors will be scared," Wahba said. "They will be scared because there is a lot of talk now of enforcing the law."
