To write a blog on the medicalization of female genital mutilation was not easy! There are vast numbers of articles dedicated to the topic. I therefore decided to keep the blog short and to include several interesting articles that you can read following this short introduction.
The UNFPA describes the medicalization of female genital mutilation (FGM) as “situations in which FGM is practised by any category of health care provider, whether in a public or a private clinic, at home or elsewhere. It also includes the procedure of reinfibulation at any point in time in a woman’s life,” and continues by saying that “FGM can never be ‘safe,’ however, and there is no medical justification for the practice.”
The countries with the highest percentage of medicalized FGM are Sudan (67%), Egypt (38%), Guinea (15%), Kenya (15%) and Nigeria (13%), and rates are rising in all these countries except Nigeria.
Almost 80 percent of FGM in Egypt is done by health professionals, with approximately 67 percent done by physicians. In Sudan it is mostly done by nurses, midwives or other healthcare providers.
The departure point for healthcare professionals should always be to do NO harm.
Performing FGM, regardless of the type, is always harmful. Therefore, FGM done by health care professionals seriously hinders the effort to eliminate the practice and is against the principles of the Hippocratic Oath that all physicians are guided by.
Medicalization of FGM is not just a concern in Africa, but in Asia as well, especially Malaysia and Indonesia. 28 Too Many describes about “one-third or more of women in many of these nations having had their daughters cut by trained medical staff.” Approximately 2 million girls in Indonesia go through FGM on an annual basis. In 2010, the Ministry of Health issued an advisory instructing health professionals on the “correct” way of performing the “circumcision” of females (1636/MENKES/PER/XI/2010). There are suggestions that the government revoked the regulation in 2013, but no evidence of this has been found. The article listed under the sources provides more detail on the history of this ruling in the country.
The article Debating medicalization of Female Genital Mutilation/Cutting, addresses the complexity of the issue in more detail. Is medicalization harm reduction or human rights abuse? The conclusion is that strategies to address the medicalization of FGM are crucial in reaching the SDG Target of eliminating FGM by 2030.
Governments, policy makers and professional bodies therefore have an important responsibility to address this topic, and it needs to be approached at various levels:
- Legal framework and stricter adherence to the law;
- Closer partnerships between all actors (government, health care professionals, law enforcement, social services, etc.);
- Specific training of healthcare professionals and traditional practitioners to understand the consequences of FGM as well as the ethical aspect of performing FGM;
- Enhanced surveillance/data capturing to enable a more complete overview of FGM at a global level.
Hibo Wardere dedicates a chapter in her book Cut to the topic. Her statement: “…medicalizing FGM will do nothing but collude in the subordination of women in a patriarchal society, when women around the world are fighting for rights that are equal to those of men.”
Finally, Dr Morissanda Kouyate, in the preface of the book Female Mutilation (author Hilary Burrage), writes the following: “What can I do to participate actively in this wonderful adventure to free the world from one of the most absurd traditions, detrimental to the rights, the health and the life of women and girls?”
The answer: become educated on this very complex topic and speak up where possible.
Sources:
- https://www.unfpa.org/resources/brief-medicalization-female-genital-mutilation
- https://www.28toomany.org/thematic/medicalisation/
- https://www.unicef.org/sites/default/files/2019-02/Factsheet%20FGM-Medicalization-2018-06-15.pdf
- https://tbinternet.ohchr.org/Treaties/CRC/Shared%20Documents/IDN/INT_CRC_NGO_IDN_16628_E.pdf
- https://biblio.ugent.be/publication/8645555/file/8645586
- Cut: Hibo Wardere
- Female Mutilation: Hilary Burrage