Medicalization of FGM

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 Female Genital Mutilation 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”) as replacements to the severe mutilation practiced by traditional performers (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 thus rectify the situation. »

Why do health professionals practice FGM?

  • Ignorance
  • Financial Gain
  • Responding to a parental request
  • Sense of “duty to the community”, socio-cultural beliefs
  • Lack of deconstruction of the reasons for FGM

The lack of information and awareness among health professionals

This lack was highlighted by a Burkinabé doctor as a factor motivating the practice of FGM within a medical setting. 

“The lack of documentation of this phenomenon in West Africa as well as the almost total lack of awareness among health professionals who belong, moreover, to communities practicing 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 community.”

Dr. Souleymane Kabore agreed with Dr. Kaba on the lack of information available to doctors and also questioned the institutional management of the fight against FGM which does not keep the problem in the limelight.

“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 is well and truly alive in some of our health facilities.

I wonder if the institutional anchoring of the fight against FGM in Burkina is not responsible. 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

These were repeatedly raised by members in order to explain why health personnel consent to performing FGM. 

The trust placed in health professionals

This trust 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. 
  • will be better able to respond to emergencies
  • have been trained to carry out the procedure
  • operate in good sanitary conditions “

One of the members also argued that parents could turn more readily to health professionals in order to keep their daughter’s cutting secret now that FGM is illegal.

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