Health Risks Of Female Genital Mutilation

Health risks of female genital mutilation

WHO defines female genital mutilation (MGF) as all procedures consisting of partial or total resection of female external genitals, as well as other injuries to female genital organs for non -medical reasons. MGF is considered internationally as a violation of the human rights of women and girls. WHO, in turn, establishes several types of MGF:

• Type 1: Partial or total resection of the clitoris glans.
• Type 2: Like the 1st minor lips resection.
• Type 3 or infibulation: narrowing of vaginal opening.
• Type 4: Other harmful procedures such as puncture, drilling or incision.

Epidemiology

This practice is usually carried out mainly in sub -Saharan Africa countries, and to a lesser extent in some countries in the Middle East and Asia. According to WHO data, more than 200 million live girls and women have currently suffered the MGF.

In Spain, the situation is similar to other countries of the European Union, although according to INE2 data, immigration comes mainly from Morocco, South America and other countries in Europe. If we count the population that came to Spain in 2016 from sub -Saharan countries we would be around 150.000 people. Keep in mind that most of the immigrants who come are male, looking for a job to send money to their families. Due to the data that we have most cases of MGF in Spain they are given in these immigrants families.

Therefore, it is a challenge for health personnel to face these situations, which can range from girls to which the MGF has already been performed in their countries of origin to girls who are performed genital mutilation in Spain.

Motivation to perform an MGF. A real case 

To understand the reasons that MGF is practiced we will exemplify it with the first sentence in Spain for MGF3, from 2011.

In 2009 the Mrs. Nyuma arrived from Gambia to Spain with her daughter to meet her husband with her husband. Mamadou. In that year the couple contacted a healer, who could not know their identity, to practice the MGF to their daughter. Parents during the trial argued reasons of belief.

According to their cultural values, women who do not have mutilated genitals are impure and not suitable for marriage. In addition, as counted in the conviction, the mother did not know how to speak Spanish and the only way to socialize was to integrate into the Gambian community, so that she was pressed to perform the MGF to her daughter. Finally, the father and two years were sentenced to six years in prison.

From this example we can draw the conclusion that the MGF is carried out for cultural and religious reasons mainly. But also that some women do them so as not to be excluded from the rest of society, something that in Spain should stop at the root helping the immigrant to feel accepted by our society from the beginning.

Health risks

Health complications can be both physical and psychological. They are usually classified as:

• Acute complications are: pain, hemorrhagic shock, urinary retention, wound infections, fractures, traumatic stress.
• Subacute complications: anemia, viral hepatitis, HIV, repeated urinary infections, retardation in girls, abscesses, ulcers, fear, anguish, posttraumatic stress.
• Long -term complications: renal failure due to urinary repetition infections, urinary incontinence, dysmenorrhea, salpingitis, primary trigger, decreased sexual desire, anorgasmia, infertility, difficulty during childbirth, feelings of shame, night terrors, anxiety and depression disorders and depression.

Nor should we forget the possible social exclusion that women who refuse to perform the MGF can happen.

Detection and prevention

Given this practice with so much cultural roots in certain ethnicities, the preventive work by health professionals is especially complex, having to perform a double action at the individual and community level, always based on the guides and recommendations that different institutions perform periodically.

It is essential.

An especially interesting measure for the prevention of the MGF in our environment is the so -called preventive commitment. In this document, the professional certifies the good health of the girl, while parents commit to care for their daughter and not perform an MGF. It is recommended to use this document provided there is a risk situation, such as parents are in favor of the MGF or the next realization of a trip to the country of origin.

The preventive commitment has no legal validity, but it has the so -called "symbolic efficacy", whose utility lies in its use to oppose the practice of an MGF on a trip to the country of origin. Taking into account its similarity with an official document, it can be used as a reason not to be able to perform the MGF before the insistence of (usually) the grandmothers of girls, main agents of the transmission of this practice that perceive as intrinsic to their culture.

However, just as important is to know.

Medical-surgical performance

At the situation of detecting a case, it is importantminor, leaving this under the tutelage of the state. It is therefore recommended to make an assessment of the case by case, with a multidisciplinary team.

A measure that is increasingly offered to the victims of an MGF is the surgical reconstruction of the damaged organs. The concrete technique depends on the type of MGF performed, but it is tried to obtain both the reconstruction of the genitals and the recovery of the Clonian function.

Even in Crying MGF in which much of the genitals are mutilated, the entire tissue with sexual response is not eliminated8, so you can try to restore the Clonian function together with the vulvar restoration that is normally performed.

conclusion

MGF is an extremely harmful practice for women and attempts against their sexual freedom and human rights, in addition to having serious medical and psychological sequelae.

Although it is normally carried out in other countries other than ours, its prevention by health professionals is necessary, and for this a greater training in this issue is fundamental. Although there are specific guides, such as some that we use in this text, it is essential that professionals know them and use them in their daily practice, in order to reduce the number of women affected by this practice.