Targeting health sector to tackle the menace of female genital mutilation

Dear Editor,

Female genital mutilation (FGM) encompasses of various techniques, which are deliberately performed to modify or inflict injury to the female genital organs for non-medical purpose.^[1]

In excess of 200 million girls and women alive today have been subjected to it across different nations in the African, Middle East, and Asian region, where the practice is extremely rampant.^[1]

Further, more than 3 million girls within the age-group of 0–15 years are at the potential risk for FGM each year. [1,2]

Even though, a major proportion of these procedures are performed by traditional personnel (have a crucial role in community like conducting delivery, etc.), it is quite alarming that even health professionals perform it under the idea that it is well tolerated, if done under aseptic conditions. [1,3] It is extremely important to realize that the procedure has no health benefits and causes only harms due to the immediate (like pain, bleeding, fever, infections, shock, death, etc.) and long-term (viz. urinary or vaginal or menstrual complaint, scarring, sexual problems, childbirth-related complications in the future, necessity to undergo subsequent surgeries, psychological concerns, etc.) complications.^[1],[3]

A wide range of sociocultural factors have encouraged the harmful practice such as being a social convention in some community for generations together; prevalent misconceptions like indispensable part of raising a girl, act to prepare girl for her adulthood and marriage, religious background, or enhances the purity of a girl after removal of unclean body part; a tool to ensure premarital virginity and marital fidelity; and support by the local stakeholders like community or religious leaders or circumcisers.^[1],[3]

At the same time, it has been recognized as a technique that causes serious violation of the human rights of girls and women, and aggravates the deeply-rooted sex inequality.^[4]

Acknowledging the magnitude of the problem, its universal distribution due to migration of people and long-term complications associated with the procedure, a large number of international agencies are working in collaboration and have developed monitoring bodies (to keep a check on its incidence) or even revised existing legal provisions to prevent violation of their human rights. [1,2] It is a fact that, if the societies in which these practices are prevalent, decides to discard it on their own, the problem can be easily tackled and hence the WHO has urged health professionals not to perform any such procedures.^[1]

Further, health workers can play a significant role in addressing this public health menace, provided they can recognize it and offer prompt treatment.^[5] However, most of the health workers are either not aware or have never been trained in those aspects, and, thus, women continue to experience long-term mental health consequences due to the procedure. [1,5] In-fact, the WHO has developed specific recommendations to aid the health professionals in extending specific care to the girls and women who have undergone the procedure.^[5] In addition, it aims to consolidate the health sector response, generate evidence to deal with the problem rationally, and enhance advocacy through national and international support.^[1],[3]

To conclude, the practice of FGM is a cause of global public health concern and a wide range of individual, sociocultural factors have played an important role in its continuation. Thus, it is high time to deal with the problem in an evidence-based manner and rope in all the stakeholders, especially the health sector.

Acknowledgement

S.R.S. contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

P.S.S. contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

J.R. contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest to declare

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.188513