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It’s our job as health workers to ‘do no harm’

Ian Askew, WHO Director, Department of Reproductive Health and Research

Commentary
16 May 2016

Health workers often face difficult decisions and tough situations. Without the right information and support it can be hard to know what’s the right thing to do. A health-care worker might even be asked – by the patients themselves, or by their family – to perform a procedure which violates human rights and the rights of the child. This is the case when health workers are asked to perform female genital mutilation (FGM), which we refer to as “medicalization” of the practice.

Due to global migration, many more health workers in many more countries find themselves having to care for women living with FGM, and to work out how to respond to families who ask them to perform this dangerous practice on their daughters.

A harmful practice with no medical benefits

FGM describes all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons. It has no health benefits.

Ian Askew, WHO Director, Department of Reproductive Health and Research
WHO

More than 200 million girls and women alive today are living with FGM and many are at risk of suffering the associated negative health consequences as a result.

These include death, severe bleeding and problems urinating. Longer-term consequences range from cysts and infections to complications in childbirth and increased risk of newborn deaths.

FGM is a grave violation of the human rights of girls and women.

The practice is prevalent in 30 countries in Africa and in some countries in Asia and the Middle East. But today, migration is turning it into a global problem.

This means that health workers everywhere need to be prepared to provide treatment and counselling to girls and women who have undergone FGM. They need to be aware of the many negative health consequences of the practice and trained to recognize and treat them properly.

To help health workers provide the best care to girls and women living with FGM, WHO has published new guidelines on the management of health complications from female genital mutilation.

It’s important that all health workers know that there is no medical justification for female genital mutilation.

Health workers who carry out the practice are actively causing physical and psychological harm, and helping to perpetuate gender-based discrimination against girls and women. It’s our role to improve the health of women and girls, not harm it.

Nevertheless, emerging evidence suggests that medical providers in many countries are increasingly carrying out the practice. Recognizing that traditional ways of conducting FGM, some families believe it would be safer if carried out by health providers. Since health workers are subject to the same cultural norms and beliefs as the communities in which they live and practice, it may be difficult for them to refuse a family’s request.

"It’s important that all health workers know that there is no medical justification for female genital mutilation."

Ian Askew, WHO Director, Department of Reproductive Health and Research

But ways exist to support health workers, girls, women, their families, communities and even countries to end this harmful practice. Countries can create supportive legislative and regulatory frameworks, mobilize political will and funding, and improve the quality of scientific evidence through strengthening monitoring, evaluation and accountability.

WHO aims to help empower health providers through strengthening their knowledge about the practice. With the right support, health workers can act as influential agents for change.

It’s vital that all health workers uphold the Hippocratic Oath of ‘do no harm’. I urge them to join together with WHO in taking every step to end female genital mutilation worldwide. If we can end this harmful practice, we can safeguarding the rights of every girl and woman and ensure their sexual health and well-being.