In June The Economist met with a great deal of controversy for its piece “An agonising choice”, which advocated replacing total abolition campaigns against Female Genital Mutilation (FGM) with promotion of “the least nasty version”. This meant instead of advocating for a blanket ban of FGM activists should instead encourage parents to choose to have their daughters undergo a ‘symbolic nicking’ in place of more severe forms of FGM such as infibulation or excision. Unsurprisingly, advocates and NGOs were quick to condemn the piece, with CEO of the FGM Charity the Orchid project calling it a “highly regressive step” that “puts discussion back by decades”.
The response to the piece in such a prominent and influential publication has placed renewed emphasis on the ‘medicalisation’ debate surrounding FGM. Medicalised FGM, as defined by the World Health Organisation, refers to FGM procedures carried out anywhere by a health care provider, with broader definitions by groups such as ‘28 Too Many’ also including actions taken to only minimise the health risks of FGM such as facilitation of access to medical equipment or training. Most relevantly to the Economist’s piece, another key component of their medicalisation definition is replacing severe forms of FGM with “more symbolic types of cutting to reduce the health complications”.
The broader definition that ’28 Too Many’ provides hits the nail on the head when it comes to facing the challenges of FGM and how to best combat them. Whilst it is clear that the terrible risks of infection or, in worse cases, death are some of the worst outcomes surrounding FGM medicalisation campaigners fail to tackle the key nature of the issues involved. The Economist piece makes passive acknowledgment to the “good arguments” for a blanket ban; that medical procedures with no health benefit are arguably unethical and that there is revulsion at the’ misogynist roots’ of the practice which is often done to make women appear pure and desirable to men. However, the author actually fails to make reference to the key point which underpins the issue, which was highlighted recently by the UNFPA chief Dr Babatunde Osotimehin. All types of FGM violate a young women’s human right to their own body and by extension, can be called a form of child abuse.
Medicalised FGM has been a trend in recent years which campaigners and governments have been trying to combat, admittedly with mixed success. This has come in part as an unintended result of previous FGM campaigns that primarily focused on health risks, as some development practitioners have tried to reduce harm to women through infection or botched medical procedures by facilitating the use of clean equipment and staff training. Whilst these actions have come from a compassionate desire to protect young girls from harm many say the short-term nature of the approach has inadvertently leant legitimacy to the practice and the impression that, when done medically, FGM is safe and routine.
This is far from the truth, as just in May an entire hospital in Cairo was shut down by the Government after 17 year old Manar Moussa died undergoing FGM secretly by two medically trained doctors. Egypt, where an estimated 95% of women have undergone some form of FGM according to a 2005 study, introduced a law passed in 2008 forbidding FGM in all forms and saw its first prosecution under the law in 2013 when 13 year old Soheir El Batei was killed undergoing the procedure. Initially found not guilty, after campaigning by anti-FGM groups the girls’ father, who had forced her to have the procedure, and the doctor who carried it out were both arrested for manslaughter.
Whilst the author of the Economist’s piece claims that the prevalence of FGM in current times demonstrates that blanket ban policies are not working, they overlook the rapid progress which has been made in recent years. FGM has recently begun to lose its taboo and the public is more prepared to discuss it openly, with the Guardian calling 2015 “the year the world woke up” to FGM thanks to the campaigning efforts of people such as Bristol campaigner Fahma Mohamed and the BAFTA nominated “The Cruel Cut” documentary by survivor Leyla Hussein. More governments are also legislating and prosecuting every year, with 50 arrests made in Uganda in 2014 alone. The prevalence that still exists may in fact be an outcome of ‘harm reduction’ strategies from earlier years. To return to this emphasis is dangerous and apathetic, and one must wonder if the author would find ‘less nasty’ forms of FGM so harmless if they or a woman in their life were to undergo it.
Medicalising FGM does not guarantee safety, as the high numbers of women who have died by the hands of health care professionals (two in one week in August alone) reflects. Whilst it is often sourced in a desire to protect women’s health it risks being short-sighted, ignoring the huge psychological impact upon women and the difficulties still caused in later life from physical complications which affect menstrual cycles, sexual health and fertility.
The same month that Mannar Moussa died undergoing an FGM procedure in Cairo the national TV network of Saudi Arabia aired a video on how to ‘properly and humanely’ beat and discipline one’s wife. The video and its misdirected approach to the ‘humane treatment of women’ was rightly met with ridicule and condemnation. So too should arguments for medicalised FGM. The video equally misses the point, that a women’s right to the body, and by extension their life, is fundamentally the crux of the issue at hand. “Harm reduction strategies” may lessen the amount of blood spilt but do little to protect the rights of young women by guarding against the psychological scarring and physical complications that the procedure entails. It also perpetuates the idea that a woman’s right to their body is not their own. As best put by the Orchid’s project petition “belief in a ‘safer’ cut through medicalisation or a ‘lesser’ cut, does not constitute progress” as “lives are at risk and rights continue to be violated.” 2015 might have been the year woke up, but we must ensure that 2016 isn’t they year we apathetically pressed the snooze button by failing to tackle the issue at its core.
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