Awareness-raising, training and information for General Practitioners, midwives, outpatient and gynaecological staff and other relevant health professionals on Female Genital Mutilation (FGM).
National legislation combating FGM has to deal with the following actors: practitioners, family members allowing the practice to be performed (for example mother, father, grandmother) and health care personnel (school health personnel, doctors, midwives, nurses). One of the main difficulties is that FGM is being performed secretly, and, in this way, it remains hidden to police investigators. Additionally, even if the police were informed about violations of the law concerning FGM, evidence would still be hard to obtain. The communities where FGM is widespread (mostly communities of refugees and asylum seekers) often remain closed to official outsiders. Another contributing factor to the non-enforcement of the law is ‘cultural relativism,’ whereby no action against FGM is undertaken out of respect for different cultures and their traditions.
Because of the issue of FGM is strongly linked with attitudes and values towards marriage (bride price, dowry), sexuality, female role models and virginity, elderly women, men and mothers defend values and social norms surrounding these issues that are part of their traditions. When health professionals are tackling FGM, they need to be able to take into account the social and cultural aspects related to FGM.
This project aimed not only to deal with the health implications of FGM but also to deal with these in a rights/social context, with a view to preparing medical staff to provide psycho-social counselling, psycho-sexual support and empowerment.
The first year of the project centred on developing a training course. This was done by allocating to different partners a series of inputs: The International Centre for Reproductive Health (ICRH), which has been active in this field for some time, was tasked with identifying good practice examples; the University of Florence was tasked with documenting the clinical aspects; Consorzio Aurora undertook to complete these with a historical/contextual introduction.
1. The smooth running of this project was made difficult because of the complexity of its coordination: the administrative/management aspects of the project were sub-contracted to one partner, BCG Consultants, who seemed to be well aware of the needs of the project but was by definition not fully engaged in the project (there was a change of staff assigned to the project between year 1 and year 2); there was also a ‘technical coordinator’, Professor Massi, who was in charge of the clinical materials. Neither of these was in fact the ‘coordinator’ named in the project application. This person, Professor Stenta, had overall responsibility for the project but was more an advocacy/policy advisor. This management structure may not have been the best way to organise the project.
2. It was decided not to involve any women/NGOs in the meetings/training sessions ‘because they do not speak the same language’ as the health personnel involved. This is to some extent true, however, if the aim of the project was to ‘move beyond medical’ into social/empowerment/contextual issues, then women – especially of the beneficiary group – and NGOs experienced in working with them had much to contribute both to the materials and to the recommendations from the project. They should have been included, at the very least by sharing information on the project, and draft materals, with one or two of the major groups working in this area (eg GAMS, Centro Piemontese di Studi Africani). ICRH could also have recommended potential target groups. It is inappropriate to consider that academic texts written outside the context of the beneficiary groups will adequately reflect the issues that health personnel are likely to face, and recommendations written in an academic vacuum will not be valid.
- Training materials
- Vade mecum on FGM for health practitioners
- Brochure on FGM