Female Genital Mutilation: Actions for Eradication.

Statement by PATH ( Program for Appropriate Technology in Health)

While we still await the accounts of successful eradication of female genital mutilation (FGM) in countries, we have learned from the achievements already realised, particularly by nation women's organizations, of the importance of abiding by several key principles:

• Reconciling strategies to the distinctive features of each culture.

• Listening to and respecting the community's own perceptions on FGM before embarking on sensitization and information campaigns can be the foundation and collaboration and change.

• Integrating strategies with other health and development efforts

• Women are frequently faced with issues of their own and their familie's survival and may not see FGM as an immediate priority. The incorporation of FGM into broader efforts to improve women's status and health such as reproductive and family health, family planning, adolescent health, safe motherhood and child health may have wider appeal. The role of education in changing attitudes and loosening the hold of tradition is worth remembering.

• Forming alliances between modern and traditional leaders

• Reasons for the continuation of FGM are related to tradition, power inequities and the ensuing compliance of women to the dictates to their communities. Dialogue and collaborative activities between modern and traditional healers will create the basis for understanding of healthy values and practices to promote in unison.

• Excercising discretion and tact in referring to deeply held beliefs

• FGM is an extremely sensitive subject and those who practise it may bery often believe in without understanding all its consequences.

• Seeking solutions from within counries complemented by international solidarity

• Although it is generally accepted that the process of eliminating FGM must be undertaken by women themselves, their activities benefit enormously from international technical support, advocacy and finance.
  Framework for action:

• Adopt clear national policies for the abolition of FGM, as a real risk to the reproductive and psychosocial health and well-being of girls and women.

• Establish national coalitions involving government representatives, professional and NGOs to co-ordinate and follow up the activities of bodies concerned with discouraging FGM invluding, where appropriate, the enactment of legislation prohibiting it.

• Support and encourage NGOs, women's groups, education and pressure groups. An initial group can act as a catalyst to start open discussion of FGM where formerly it was a taboo subjects. Advocacy on the part of such organizations can generate support from national policy makers.

• Organize information and education programmes to inform people of the harmful effects of FGM. Mass media, popular music and crafts, as well as teaching groups, have been successfully used ot target young women and men, health workers, treachers and community elders Include health workers, traditional healers and birth attendants who pracise FGM, otherwise efforts to reduce it will be undermied by indifference or even opposition.

• Emphasize the importance of sustainability of programmes and focus on integrated campaigns using consistent messages.

• Target young people, using information and education campaigns holding unmutilated women in high esteem and resisting pressures to surrender their children to FGM. Young people are often in the vanguard in creating new social norms but, at the same time, sensitivity is needed to the confusion and ambiguity and young women who ave already undergone FGM.

• Identify alternative income sources for practitioners of FGM for whom it provides a livelihood.

• Involve local and religious leaders. Experienc shows that where the local leadership is enlightened and committed, information and education activities are more successful. The involvment of religious leaders is vital for dispelling misconceptions about the religious origin of FGM.

• Enlist the participation of men so that as women's attitudes begin to change they find support among brothers, fathers, friends and partners.

• Prohibit the practice of FGM by health professional in any setting, including hosptials or other health establishments.

• Increase research into all aspects of FGM, including the incidence, prevalence, main reasons why FGM continues to be practiced in particulalr groups, health consequences and successful interventions for eliminating it.

• Inform traditional and professional health workers of the health complications caused by FGM, including how to treat women before and after childbirth. Include counselling so that those who have experienced FGM have the opportunity to express fears and concerns about their health and sexuality.

• Incorporate FGM treatment and counselling into major health programmes for women and children such as family planning, immunization and control of diarrhoeal diseases.

• Recognise and encourage alternative puberty rites, which involve gift-giving and celebration and help promote positive traditional values, without causing physical damage to the child.