Access to care services

On 02 December 2022 a medical training webinar for healthcare professional on defibulation was organised by the CoP FGM.

The CoP FGM invited Dr. Jasmine Abdulcadir, an obstetrician-gynaecologist  and specialist in the field, to share her expertise and recommendations with the participants.

This training was based on a presentation of defibulation from a medical and surgical point of view, but also from a psychological point of view to be considered in the care of the patient who wishes to have a defibulation. All the recommendations are supported by the WHO (2016, 2018), which plans to renew its guidelines next year.   

This webinar was aimed at healthcare professionals (gynaecologists, general practitioners, doctors in training, midwives, student midwives, etc.) who may support girls and women affected by female genital mutilation, particularly type III – namely infibulation.  

Before proceeding to the detailed report of the webinar, an introduction of our speaker is necessary. Dr. Jasmine Abdulcadir is an obstetrician-gynecologist practicing in Switzerland; in 2010, she inaugurated the first consultations for women and girls affected by female genital mutilation (FGM) in Geneva. Among the services offered is the operation of infibulated women using the defibulation technique. These consultations receive between 20 and 30 women per month, i.e. approximately 300 patients per year, the majority of whom are suffering from type III FGM and come from East Africa.  

Why hold a medical webinar on deinfibulation?   

Infibulation can lead to physical or psychological complications for the infibulated woman. Infections, pain and difficulties during childbirth are among the most common consequences of this practice.    

On the one hand, we notice that since last year, the members of the COP FGM have shared a few observations and needs, among others: the difficulty to find doctors who do the defibulation for a type III (infibulation) in Guinea or Senegal …., the resistance in some cases by medical professionals to proceed to a defibulation, the difficulty to find services offering care to survivors of FGM, suffering from social and psychological consequences in Guinea Conakry, Mali, Burkina Faso,… The difficulty of finding free care services for FGM survivors. Even when there is the possibility of being able to pay for consultations.   

In addition, female genital mutilation (FGM) has multiple harmful consequences on the young girls and women affected by FGM. Moreover, FGM involves great violence and causes significant trauma to women that should not be overlooked. This is why it is necessary to question the experiences of these women and the way in which they are cared for as well as their culture and to understand how to combine this with their care.    

On the other hand, defibulation is a recommended intervention to reduce obstetric complications and recurrent urinary tract infections (WHO 2018 – WHO Guidelines on the management of complications of female genital mutilation). While it is quite simple and quick from a surgical point of view, it can cause great changes for the woman concerned: fear, changes to the body, stigmatisation by the community, … Moreover, reports of post-deinfibulation depression, feeling of having been raped, lack of informed consent (no translation into the patient’s language) have been noted in Belgium for example but also in several other countries.