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Female genital mutilation as a problem in western countries

Preventive measures against female genital mutilation among Somalian girls in Denmark

Vibeke Jorgensen

General practioner. Member of the working group on Female Genital Mutilation at the Danish National Board of Health, Hegnsvej 37, DK – 2850 Naerum, Denmark
Tel.: + 45 45 80 03 28 Fax : + 45 45 80 34 28 e-mail: vibeke.jorgensen@dadlnet.dk

Female Genital Mutilation or Female Circumcision are all procedures involving partial or total removal of the external female genitals for cultural, religious or other non therapeutic reasons.

This harmful traditional practice is no longer confined to the 28 Subsaharen African countries where it has been prevalent for centuries. Immigrants and refugees from these countries have come in increasing numbers to Europe, Australia, Canada and the USA.

Especially the number of refugees from Somalia has exploded in the last 9-10 years because of civil war and fights among the clans. Alone Denmark with its 5,2 mill. inhabitants has received around 14.500 Somalians.

Nearly 98 % of Somalian women are circumcised. Most of them infibulated, the most severe form of FGM. When the women started to come to the obstetrical departments in the beginning of the 90’es.the health personnel did not know anything about this tradition.

The Danish Medical Women’s Association saw there was a great need for information among the personnel on how to give these women the right care. Consequently we started to arrange meetings for health personnel on female circumcision. These meetings were very well attended.

It is very important that health personnel are informed about the tradition so they dare talk with the women about circumcision. They are an important link in informing the parents, why the girls should not be circumcised and that it is forbidden in Denmark.

To prevent FGM among Somalian girls in Denmark the Minister of Health commissioned the National Board of Health to form a working group to this end in 1997.

The group compiled a comprehensive manual with guidelines for the health and social sector, educators and others who meet the Somalians in their daily work.

The book was published in 1999 and has got many positive reactions. This information has really been needed as very little was written in Danish about Female Circumcision. When we showed the book at international meetings we were asked if it could be translated into English as many of the countries lacked educational material. It has now been done and it has created great interest.

A discussion video was produced in the Somalian language with Danish and later on with English subtitles. On the video members of the Somalian Community tell why Female Circumcison should not be done and that it is forbidden in Denmark. It gives information on the health risk that FGM is against Islam.

The video has been distributed free of costs at our meetings for Somalians. It has been very well accepted by the Somalian Community.

Meetings for Somalian and Danish health and social personnel have been arranged with many participants and lively discussion. We found it very important to involve the religious leaders and last year a big meeting was arranged, where the imans concluded that Female Circumcision is not a religious duty. Many Somalians felt it as a great relief and it has been very important in changing the attitude.

We had a very positive co-operation with those from the Somalian resource group, who were against FGM and wanted to fight for a change of attitude. We have absolute the feeling that the efforts have had an impact on the Somalian community. More and more are against infibulation, but there are still Somalians in favour of a milder form of circumcision, the so called Sunna, but as all forms of Female Circumcision is forbidden in Denmark this cannot be accepted.

We have been very interested in involving the men and giving them information and knowledge about the health consequences of FGM. Many of them knew very little about it as it6 has always been women’s affair.

It has been very positive that an increasing number of men now are against Female Circumcision and more men prefer an uncircumcised woman as partner.

This puncture the old argument used by the mothers and especially the grandmothers for continuing the tradition that nobody would marry an uncircumcised girl.

This gives hope for an acceleration of elimination of this harmful practice.

The project has come to an end after 3 years, but the work will continue in local groups with both Somalians and Danish health and social personnel and through all those who have gained more knowledge about the issue through our efforts.

Another result of the project was 5 weekend courses for members from the Somalian resource group, so they can go out as a kind of community health workers among their own people. They were given a basic education on different aspects of health and on FGM. Many other items concerning the life of Somalians in the Danish society were dealt with. It has been a great success. It is a way of involving the many resourceful Somalian women in community work. It is the plan to seek funding for continuation of the courses.

It is necessary to co-ordinate the efforts on a European basis concerning legislation, prevention and information on Female Circumcision.

In most European countries FGM is now forbidden either under the penal code as in Denmark or through specific laws like in UK, Sweden and Norway.

The European meetings started with the first Study Conference on Female Genital Mutilation in London 1992, resulting in the London declaration on the grave physic and psychological consequences of female circumcision and a call for eradication of this harmful tradition.

It created great awareness in the medias in UK on Female Circumcision.

The second Study conference on Female Genital Mutilation in Europe took place in Gothenborg in Sweden in 1998 under the auspices of the Regional Committees of European Union and the City of Gothenborg in collaboration with WHO

In 1998 the International Centre for Reproductive Health carried out a study on FGM among Africa Communities in Europe. Since then several meeting in order to create common guidelines for the eradication of FGM in the European Union have been held and a European Network has been established. Members of the working group from the Danish National Board of Health are part of this network.

Several other meetings either European or at national level have taken place in the last years. Experts from organisations which work for education and eradication of female genital mutilation have been invited to these meetings. Among these can be mentioned the Inter African Committee, an African based organisation and FORWARD (Foundation For Women’s Health Research and development) from UK. Representatives from WHO headquarters in Geneva have also taken part in the meetings or been one of the organisers.

It has been very inspiring to take part in these meetings. We have learnt from each other and got better tools to handle this very sensitive issue. We know whom we can contact in the other countries on this issue.

But - it takes time to change a tradition, which has existed for so many centuries, but we are on the way. We have to consider, how we can support this process in a suitable and sensitive way.

It is important that we in Europe and other Western societies work together on this issue and also involve and collaborate with the African Communities.

It is our hope that refugees, who return to their home countries will bring back a changed attitude and will work for the elimination of Female Circumcision in their country.

MWIA has for many years had resolutions against FGM and since 1994 a statement about FGM and other harmful traditional practices. The statement has been used at several international conferences and meetings to show the policy of MWIA

Women doctors can have an impact in this field by giving information on the health hazard of female genital mutilation and also in working for good practises concerning women, who are already circumcised. At European meetings on FGM we have heard about the need for women doctors to give their expertise and support to groups which work with African communities for example in UK.

The Danish Medical Women’s Association were the first to raise awareness on Female Circumcision in Denmark.

Hopefully some of the MWIA National Associations will go into the work in their country..

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