Today is the International Day of Zero Tolerance for Female Genital Mutilation/cutting (FGM/C). That’s why, this week the press will drown us in news regarding this awful practice still persists in many African countries and that, in recent years, as a consequence of migration, we also can find it in many European countries, including Spain.
Recently, the UNICEF has published a report on FGM/C in which a couple of aspects caught our attention:
First of all, the striking increase of its medicalization. In Egypt, around 80% of mutilations are performed by healthcare workers, usually doctors. In other countries like Sudan, Kenya, Guinea or Nigeria, this percentage oscillates between 55% and 30%, normally undertaken by midwives or nursing staff. This medicalization is often justified as a means to cause the least harm possible to young girls/women, since it is performed in an aseptic environment and with anaesthesia. But, even though FGM/C is undertaken by healthcare workers, it is still a violation of the right to health and an act of violence against women, which, furthermore doesn’t eliminate the medical and psychological complications ensuing for women as well as for their future children. On the other hand, the fact that is it practised by healthcare personnel, considered as authorities on medical matters and whose opinions are highly respected, it is a way of “institutionalizing and legitimating” it from the medical point of view. The medicalization of FGM/C has been condemned by a number of associations including the International Federation of Gynaecology and Obstetrics, which in a resolution at the General Assembly in 1994, opposed “any attempt to medicalize the procedure or to allow its performance, under any circumstances, in health establishments or by health professionals”.
Secondly, we identify a decrease in the support to the FGM/C practice on the part of women: even though this varies according to countries, it is still high in Mali, Guinea or Sierra Leone, however, women mainly consider an end should be put to such a practice. In some countries where FGM/C prevalence is elevated (high percentage of mutilated young girls and women) like Burkina Faso, the support among women of all ages is strikingly low, and, in most countries, the majority of young women is clearly against the FGM/C practice, which represents a big step towards its total eradication.
Another relevant aspect is a high percentage of disagreement among couples and total lack of knowledge of the other spouse’s opinion regarding the need for the continuation of FGM/C practice. Even tough it has not been possible to collect data in all countries on the support to the practice by men and women separately, it varies from one country to another. Although it is the highest in all age groups in Mali, Guinea, Egypt or Mauritania, most countries are against its continuation. Strangely enough, almost in all of them, more men than women are against this practice. Thus, whenever men’s opinion is asked, this practice is more likely not to be performed. Women are usually the ones who decide on their daughters’ matters, without consulting their husbands, whereas husbands do not raise the subject since they consider it to be “women’s business”.
Regarding its evolution, this decrease in the FGM/C support is well reflected by the decline in the prevalence of mutilated women especially among women under 19 in some countries like Burkina Faso. Moreover, in some others, in certain regions as well as among certain ethnic groups, with traditional high prevalence the practice has been virtually abandoned, whereas in other areas it has remained almost unchanged.
These divergences in the evolution may reflect disparities in the degree of sensibilisation among different populations regarding what the FGM/C practice consists of and what are its eventual ensuing complications. It may depend, among other factors, on the pressure of social norms over women in certain areas and/or the eventual contact of one community which practises FGM/C with others which don’t.
In order to achieve its eradication, lessons from successful experiences must be learnt, and, above all, emphasis must be placed on the importance to inform communities, men and women, young or old, on what the FGM/C practice consists of and on its eventual ensuing complications in the middle as well as in the long run.
And, on our part, not failing to support those women and men who tirelessly work for its eradication in those countries where the FGM/C practice is still performed.
Originally written in Spanish by Carmen S. Robles.
Doctor. Member of the medicusmundi Andalucía.
Translated from Spanish by Sílvia Aymerich
 United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change, UNICEF, New York, 2013.