How do we explain the medicalization?
To understand why medicalization is spreading, it is important to understand the arguments of people, including health professionals, in favour of the practice.
The "lesser harm" solution:
In places where the abandonment of FGM does not seem immediately achievable, medicalization can be seen as a “harm-reduction strategy” (Shell-Duncan B. , 2001) that would reduce the medical risks and complications for women who would have been affected by FGM anyway.
A way to minimize the operation:
Medicalization could make it possible to reduce the FGM performed on the girl or woman by encouraging more symbolic gestures (“nicking”) to the severe mutilation practiced by traditional excisers (Shell-Duncan B, Njue C, Moore Z., Population Council, 2017, ).
Indeed, some members presented “the medicalization of FGM as the perverse effect of a certain type of awareness-raising campaign, when the promoters still lacked the necessary hindsight to be able to analyze all the medium- and long-term consequences and rectify the situation. »
Why do health professionals practice FGM?
- Financial Gain
- Responding to a parental request
- Sense of “duty to community”, socio-cultural beliefs
- Lack of deconstruction of the reasons for FGM
The lack of information and awareness among health professionals
Was highlighted by a Burkinabé doctor as a factor motivating the practice of FGM in a medical setting.
“The lack of documentation of this phenomenon in West Africa as well as the almost total lack of awareness among health personnel who belong, moreover, to the communities that practice FGM could constitute a favourable environment for the medicalisation of FGM. These ill-informed health personnel, motivated by their socio-cultural beliefs or by financial gain, could feel that it is their duty to support a request for FGM made by the populations. »
Dr. Souleymane Kabore agreed with Dr. Kaba on the lack of information of doctors and also questioned the institutional management of the fight against FGM which would also work to forget the problem.
“We don’t talk about it at all. There are no communication tools adapted to this practice in our health structures. However, according to some persistent rumours, the medicalization of FGM would be beautiful and well practiced in some of our health facilities.
I wonder if the institutional anchoring of the fight against FGM in Burkina is not for something. Indeed, the fight against FGM is mainly housed in the Ministry for the Promotion of Women and National Solidarity, which works in partnership with the Ministry of Health.
In any case, we should start by documenting and quantifying this phenomenon so that decision-makers can become aware of it. »
Social pressure and respect for community social norms
Were repeatedly raised by members to explain that health personnel consent to FGM.
The trust placed in health professionals
Has prompted parents to choose medicalization, according to a report by the Population Council in Nigeria (Obianwu O., Adetunji A., Dirisu O., Population Council, 2018).
Nearly all of the parents we interviewed had never heard of or been involved in complications from FGM/C. “The parents we interviewed had never heard of FGM/C or had never been concerned about it. Many parents say they trust health professionals for any health-related procedure or advice and, with regard to medicalized FGM/C, they feel that health professionals will be better equipped to perform it. This trust that parents talk about has multiple dimensions. They feel that :
- Health professionals will be better qualified to carry out the procedure.
- They’ll be able to respond more easily to emergencies…
- Have been trained to carry out the procedure
- Operate in good sanitary conditions “
One of the members also argued that parents can turn more to health professionals to keep their daughter’s cutting secret now that FGM is illegal.
« The Community of Practice on Female Genital Mutilation » is part of the « Building Bridges between Africa and Europe to tackle FGM » project, supported by the « UNFPA-UNICEF Joint Programme on the Elimination of FGM ».
The project is coordinated by AIDOS in partnership with GAMS Belgium.
The views expressed on this website are those of the authors and do not necessarily reflect the official policy or position of the UNFPA, UNICEF or any other agency or organization.
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