General

Working towards zero tolerance for female genital mutilation in Sudan


WorldHealth Organization, February 6, 2018 
Nine
years ago, one community in Sudan decided to follow WHO recommendations and
abandon the practice of female genital mutilation (FGM).

Since
then, Tuti Island, a community of 21 000 residents located at the juncture
where the White Nile and Blue Nile rivers merge, has been held up as a trailblazer
in a growing movement to end FGM.
 
School
Girls waiting for their turn for a health checkup as part of School Health
Program in El-Obeid, North Kordofan state, Sudan 2017
. WHO/M.
Elamin

 

Today,
more than 1000 communities in Sudan have abandoned the practice which has no
health benefits and continues to violate the human rights of 200 million women
and girls in Africa, the Middle East and Asia.
“Tuti
Island is a shining example of how a community can initiate and sustain an
effort to end FGM,” says Dr Wisal Ahmed, team leader in WHO Sudan’s Women’s
Health Unit. “We hope the other communities who have declared abandonment in
the past four years can also sustain progress.”
Sudan has
one of the highest rates of FGM in the world, with most girls undergoing the
practice between 5–9 years of age. Eighty-seven percent of women aged 15–49
years have been cut, and the majority have undergone the severest form –
infibulation – where the genitals are stitched up after cutting, leaving only a
small opening for urine to pass.
However,
there are indications that the practice is decreasing among younger girls,
explains Dr Ahmed. “Only a third of girls aged 0–14 years undergo FGM compared
to 9 out of 10 girls aged 15–49 years.”
A
multisector programme to target the country’s high FGM prevalence
Five
years ago, WHO, joined the UNICEF and UNFPA programme supporting the Government
of Sudan, called “Sudan Free From Female Genital Cutting”. As part of the
programme, funded by the United Kingdom of Great Britain and Northern Ireland’s
Department for International Development (DFID), WHO has been working to
strengthen the health sector’s response to FGM by halting “medicalization” –
when the practice is performed by midwives and other healthcare providers.
“FGM is a
human rights violation breaching the health profession’s code of ethics to ‘do
no harm’. WHO and partner UN agencies are opposed to the medicalization of
FGM,” says Dr Naeema Al-Gaseer, WHO Country Representative for Sudan.
 

 
Midwifery
students attending a class in a Midwifery School in Bara, North Kordofan state
, Sudan 2017
. WHO/M.
Elamin.
 

Working
with the Sudan Ministry of Health, midwifery schools, and health professional
associations and regulatory bodies, WHO is ensuring health professionals adhere
to the recommendations laid out in its Global strategy to stop health-care
providers from performing female genital mutilation.
Global
strategy to stop health-care providers from performing female genital
mutilation
As part
of pre-licence training, all paramedical and midwives in the country now
receive information about the harms of FGM. To date, nearly 1000 health
professionals have undergone the training. And, more than 2700 medical
professionals in Sudan have pledged to abandon FGM and its medicalization.
Using WHO
recommendations on the management of health complications from FGM, the country
is also working to ensure women who have undergone FGM receive the care,
treatment and counselling they need, and are not repeatedly harmed when seeking
care, especially after childbirth.
WHO
recommendations on the management of health complications from FGM
Educating
young girls about the dangers of FGM is another component of the multisector
programme. Since more than 70% of girls in Sudan attend primary school, WHO, in
partnership with the Ministry of Education and Ministry of Health, developed
and integrated FGM content within the school curriculum. Now girls learn that
FGM is not a religious rite and has significant short- and long-term negative
health consequences.