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HomeNewsAfricaIS MEDICALISATION THE NEW ANTI-FGM CAMPAIGNS MENACE?

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Mojatu Foundation

By Caroline Mwangi

In December 2012, the United Nations General Assembly through consensus, adopted their first resolution i.e., resolution A/RES/67/146, to ban FGM worldwide.

This resolution reflected the universal agreement that, FGM constitutes a violation of the human rights of girls and women, a position that has been widely supported by stakeholders that campaign against FGM.

Additionally, most literature on FGM bear the stamp of acquiescence that, whether practiced traditionally or at the hand of qualified medical practitioners, there are no health benefits of FGM.

Yet, medicalization of FGM is becoming a major concern in countries where FGM is traditionally practised and in countries of migration such as United Kingdom, United States and Sweden, (Matanda & Lwanga, 2022; Leye et al, 2019).

UNICEF reports that, about 1 in 4 girls i.e., 26% or 52 million survivors who have undergone FGM worldwide, were cut by medical practitioners.

The numbers are twice as high among adolescents, with 34% being adolescents between the ages of 15 to 19 years, compared to adult women between the ages of 45 to 49 years, who account for 16% of these prevalence rates, (UNICEF, 2020).

In countries where it is traditionally practised, the prevalence rates are increasing at an alarming rate, despite increased legislation against the practice.

These include Egypt (38%), Sudan (67%), Kenya (15%) and Nigeria (13%). (UNICEF, 2021). The prevalence rates in these countries continue to rise except Nigeria. 

So, what is medicalization of FGM?

This term has been defined by UNFPA as situations where FGM is practiced by any category of health professionals, whether in public, private, at home or elsewhere.

It further includes reinfibulation (i.e., resuturing after delivery or gynaecological procedures of the scarred tissue resulting from infibulation) at any point in time of a woman’s life, (UNFPA, 2018).

Health practitioners who undertake medicalization may include trained traditional birth attendants (TBAs), nurses, clinical officers, midwives, gynaecologists, physicians and assistant physicians, plastic surgeons, and other personnel both in the public and private health care sectors.

These medical personnel may either be undergoing training or working in the health sector or retired, (WHO, 2010).

Medicalization of FGM is often promoted to minimize the health risks associated with FGM, through access to health care services.

It is thus perceived as a harm reduction strategy. It also gives way for symbolic types of cutting where, severe forms of FGM are replaced with symbolic cutting. 

Proponents of this concept argue that increased medicalization highlights the risks of FGM, which in turn leads to the decrease in the prevalence of FGM.

They further contend that medicalization is an intermediate step towards the long-term goal of ending FGM.

Hence, they propose that, reducing FGM to a physical procedure performed at health facilities, reduces its visibility or the likelihood to elicit discussions within the community, which in turn reduces the social influence or control on community members, (Ve Nina et all, 2020).

However, this proposition in my view, underestimates the significance attached to FGM as a cultural norm, by practising communities.

As Leye et al correctly puts it, even though medical practitioners might be able to reduce the immediate effects of cutting such as severe pain, bleeding, and infections, it is unlikely that they would prevent the long-term consequences of FGM, particularly the mental effects FGM has on survivors, (Leye et al, 2019,4).

There are various studies that indicate that majority of survivors of FGM/C have reported mental health problems and emotional disorders such as: post traumatic health disorder, severe depression, and anxiety, (Knipscheer et al 2015; Eisold,2015).

Further, since there is no medical justification for FGM or any perceived health benefits of the practice, medical practitioners who perform FGM violate girls’ and women’s rights which include: the right to life, the right to physical integrity, the right to health, the right to non- discrimination, the right to be free from cruel, inhuman, or degrading treatment and the right to be free from violence.

Medicalized FGM may seem like an appropriate and a safe response to FGM, particularly, where it is believed that health practitioners would address the health risk associated with FGM.

However, the fact remains, that the practice involves the damage or removal of normal, healthy tissue and interferes with the natural functioning of girls’ and women’s bodies.

This therefore detracts from the safety argument. Besides, all forms of FGM are linked to the increased risk of health complications, although the risk is substantially higher with severe forms of FGM.

Some of the immediate complications of FGM include severe pain, excessive bleeding, infections, injury to the surrounding tissues, urinary problems, genital tissue swelling, shock and death.

On the other hand, long term complications may include psychological problems such as post-traumatic stress disorder, increased risk of childbirth complications, scar tissues and keloid, urinary tract infections, vaginal infections, pain during sexual intercourse among others, (WHO, 2022). 

Why medicalized FGM is a menace? 

First and foremost, FGM constitutes the damage or removal of normal, healthy tissue and interferes with the natural functioning of girls’ and women’s bodies.

Additionally, medicalized FGM does not guarantee the protection against the psychological problems suffered by survivors of FGM. This cannot be emphasised enough. 

Secondly, medicalization of FGM serves to legitimize a practice that is proscribed by law internationally, by virtue of the harm caused to those it is performed upon. 

Thirdly, medicalization violates the medical practitioners’ medical mandate to do no harm, hence making them liable for violating their medical ethics. 

Lastly, medicalization of FGM counteracts global efforts to eliminate the practice and impedes the progress that has been made towards its abandonment.

This therefore calls for concerted action to eliminate this emerging trend. 

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