Manual on Female Genital Mutilation / Cutting for health professionals

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Editorial: Universitat Autònoma de Barcelona

Año: 2010

Pág: 108

Female Genital Mutilation/Cutting (FGM/C) is an ancient practice that remains a deeply rooted tradition
in more than 28 countries in sub-Saharan Africa and has widespread in other continents along with
African diaspora. Reports and surveys have shown that about 78% of girls and women (UNICEF MICS
2007) in The Gambia undergo the practice. According to a community-based survey on the long-term
reproductive consequences of FGM/C (MRC 2001) conducted in rural Gambia, 98% of Mandinkas, 32%
of Fullas, and 4% of Wollofs shows signs of FGM/C. Other surveys conducted by other NGO´s like
GAMCOTRAP and BAFROW respectively, estimate the practice among Mandinkas and Sarahules at
100%, 96% among Jolas and 84% among Fullas. Prevalence of the practice is driven by deep-seated
traditional beliefs, rewards and the belief that it is a religious injunction in a predominantly Muslim
Prior to the 1980s FGM/C was seldom openly discussed. From late 1980s concerted efforts have been
directed at educating communities on the negative health consequences of the practice. The Women’s Bureau
in collaboration with a number of NGOs involved in addressing reproductive health, gender and
girls/women’s rights issues have been in the forefront in the fight against the practice. In the decade of
1980s to 1990s those who perceive a need to eradicate the practice and those who seek to preserve it engaged
an intense debate. Despite acceleration of the campaign against FGM/C, the practice continues in
Gambian communities.
Numerous players are involved in the effort to eliminate FGM/C, health professionals are yet to play a
proactive role. This Manual, along with an Academic Curriculum for the University of The Gambia, is
designed to set the stage for the active participation of medical doctors, graduate nurses and graduate Public
Health Officers in The Gambia in response to FGM/C.

The physical, psychological and sexual complications of FGM/C require skilled management carried
out by health care workers. In many societies where FGM/C is performed, the practice is not covered in
the training curricula of medical students, nurses, midwives and other health professionals. It is important
that these gaps in professional training and education are addressed adequately. The training gives
health workers the skills needed to identify the complications of FGM/C and to manage girls and women
who present such complications. Advanced training prepares midwives and those involved in caring for
women during pregnancy, labor, delivery and the postpartum period. Training also enables medical professionals
to open up type III FGM/C.
Moreover, integrating FGM/C into mainstream training of health professionals in the Gambia will increase
the pressure for the elimination of the practice. Training of practitioners in interpersonal communication
skills, including counseling, is crucial to their role in the prevention of FGM/C. Health education
of communities, civil society organizations, organized community groups, families and individuals on
FGM/C issues in a participatory manner is equally important. Empowering through information and education.
Female genital mutilation/cutting is underpinned by deep- rooted cultural forces which need to be understood
in their proper context by health personnel. Once health workers have gained sufficient insight
into the socio-cultural dimension of the practice, they would be able to relate to the issues in a more sensitive
manner. Their legitimated roles in the territory reinforce their capacity to enable changes towards
this issue.
The Manual for Health Professionals and Students has been developed to facilitate understanding, care
and prevention of FGM/C, a major challenges in Sexual and Reproductive Health and Rights of African
girls and women. There are basically ten modules, structured into units which follow a consistent pattern
of flow.
Through this new educational resource, Wassu Gambia Kafo (WGK) continues its historical contribution
on the training of health students and professionals so they can take an active role in promoting the
abandonment of the practice. Since the creation of this NGO, Wassu Gambia Kafo has been collaborating
through assessment and equipment donations with the School of Medicine and Allied Health Sciences
(SMAHS), creating sustainable institutional links as such as the cooperation agreement between Autonomous
University of Barcelona (UAB) and the University of The Gambia (UTG). At the same time,
WGK has been cooperating with the Team of Cuban Doctors that provides the Gambian public health
system with 80% of the professionals, who had also taken part in the elaboration of this Manual.

The Manual is published within the context of the «Transnational Applied Research Observatory. New
strategies for the prevention of FGM. A circular approach Gambia Spain. Initiation without mutilation»
, which is inline with the Gambian government development policies and thus has the backing of the
Gambian government for its implementation throughout the Country. The project is developed by WGK
and GIPE PTP (UAB), with the financial support of Social Projects “la Caixa” Foundation» and the
Provincial Council of Alava (Spain).
In progress since 2008, this program aims to implement a new strategy for addressing FGM. A strategy
based on research, awareness, prevention and empowerment in order to be women and their communities
the ones who take alternative proposals to avoid mutilation. It seeks to safeguard the fundamental
right of women to physical and mental integrity, reconciling this perspective with respect to tradition, the
right to privacy and free movement of persons.

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