Charlotte is a recent graduate from UCL in French and Philosophy. Her studies have had a particular focus on current ethics debates in health in UK and global health. Studying French along side this she became interested in the culture of Francophone Africa which makes up a large part of North and West Africa. FGM and the issues which surround it, for her crosses these different areas of interest.
As a western woman growing up in the nineties it seems easy to say that the continued widespread prevalence of female genital mutilation (FGM) in parts of Africa and the Middle East is something awful, shocking and distressing, which any one who can, should rush to stop. Aside from the severe pain which can often send the victim/patient into shock, the cutting often leads to haemorrhages, tetanus, dermoid cysts, abscesses and genital ulcers. Infections spread easily, including HIV, because of the use of non sterilised equipment during the ‘operation’ or healing period. The traumatic experience of the operation also often has mental repercussions on women, such as causing them to suffer from post traumatic stress disorder, anxiety, depression and fear of sex. It also leads to complications during menstruation and giving birth – on many occasions both the newborn baby and the mother dying. FGM is a glaring symbol of a harmful patriarchal culture. To be honest, even just a fleeting thought of the ‘cutting’ itself makes my stomach churn, and is enough to make me adamant that this is something which should never happen to any one, ever again.
As is typical of these kinds of issues, the situation regarding FGM and its prevention is more complicated than this. Going to another country to tell a population that their deeply ingrained cultural tradition is harmful doesn’t always work, nor is it appropriate, or something that necessarily ‘should’ be done. People become defensive, and are offended, and rightly so. Imagine if a large number of influential and wealthy people from a dry state worked with the British Government to encourage the teaching of the harms of alcohol, set up anti-alcohol drinking organisations, events and discussion groups. Even if many in the West are now realising, or want to think about, the harmful health implications of drinking too much alcohol, this external influence would likely be resented. It seems inappropriate.
Reasons another culture may have for not drinking alcohol may seem far removed from our attitude towards alcohol in the West, and tied up with their own cultural and religious traditions. What’s more, moral reasons about appropriate or correct behaviour of one country to another aside, we could argue that a policy would be far more effective if the population of countries in the West realised for themselves the harms of excessive drinking.
Furthermore, this small analogy brings no connotations of the history of colonialism, and cultural imperialism into it, which has so dominated relations between the West and Africa for well over a hundred years. Understandably in the real world, feelings of resentment may be stronger than we can imagine from the scenario I presented. This is reflected in the reaction that those who have tried to prevent FGM in the UK, whether teachers, policemen or social workers, have experienced. They are often faced with criticisms of racism and/or cultural imperialism. Communities can feel under attack, and consequently withdraw within themselves, becoming more secretive about cultural practices, and making it harder to educate them about FGM.
Moral issues aside, how much can international aid actually help? It’s important to remember that for all the government to government aid and charitable donations which have been made in Africa the poor are getting poorer and life expectancies are decreasing. If certain international development projects do have positive outcomes, it often seems the case that unintended negative consequences are unavoidable. (Moyo, D. 2009. Why Foreign Aid is Hurting Africa).
My intuitive thoughts on the importance of fighting FGM have more complicated consequences than I may have initially thought. But I’m not convinced that these complexities alone are reasons for us to give up.
One theory which is being developed by thinkers such as Professor Jo Wolff, which I think gives a better and more comfortable explanation of why we ought to help women threatened by FGM – the idea of the Human Right to Health. This was part of the original UN Charter of Human Rights, but was never much remarked upon. Only recently has it started to be taken seriously as a way of both explaining why we ought to improve the health of others and providing a plausible framework for how we should go about doing it.
The UN Charter of Human Rights says that every individual has the right to the ‘highest attainable standard of health’. It can then be understood that if an individual, a community or a government, prevents another from fulfilling their capability to lead the healthiest life possible for them, they are violating the rights of that person. Women who have no other option than to undergo FGM and whose physical and mental health suffers as a consequence, are surely being denied this right. This is a moral accusation which carries much weight. It doesn’t just say that there is something damaging which is happening to someone and through generosity others may want to help them. It highlights that often others are harmed because of the direct or indirect consequences of another’s actions and that it is imperative that these harmful actions are prevented as much as possible.
Moreover, the idea of violating an individual’s Human Right to Health is a focused criticism and in this way can help provide the framework for a more successful way of helping those in need. The UN Charter of Human Rights says that it is up to governments to ensure that the Human Rights of their population are protected. If a government doesn’t have the resources to do this or is violating the rights of its own population, for example as may be the case when a government endorses or allows FGM to take place, it is the duty of the international community to act. However, it is always the role of the international community to reach a situation where the government of a country will be able to support its own population. This means that it is the duty of the international community to think about long term solutions to help prevent FGM happening. This may be implementing hospitals, clinics and schools in a country, training doctors and teachers as well as raising awareness about other alternatives to FGM.
So the Human Right to Health, is not only for me a persuasive start to answering why we care about preventing FGM but also seems like a promising step in the right direction of understanding how it could be overcome.
It has been a good experience to stretch my skills in researching the diverse practice of FGM in Ethiopia as a Volunteer Researcher for 28 Too Many. It brings together my interest in global health and seeing how Diaspora communities often bring their cultural practises with them to the communities in which they settle.
If you are interested in volunteering with 28 Too many, look at our website for current vacancies or email us at firstname.lastname@example.org.