Female genital multilation (fgm) by Dr Bhavishya C M.pptx

An opportunity to display about the Female genital multilation

1. FEMALE GENEITAL MULTILATION Dr. Bhavishya CM Designation- Third Year PG Scholar Department of Prasoothi Tantra and Streeroga SDM College of Ayurveda & Hospital, Udupi Under the valuable guidance of all the faculty members of PTSR 1

2. INTRODUCTION FGM is an act performed forcefully on the victim with the consent or order given by her family. FGM is violence against women and girls, sexual assault, and often it is considered to be about controlling female sexuality or a tradition to prepare a woman for marriage allegedly to purify them for their husbands.. It's a cycle of social pressure, that's hard to shake, but not impossible to end It has zero health benefit. It is usually performed by traditional practitioners (or elderly people in the community or even midwives) using a sharp object such as a knife, a razor blade or broken glass. , there is no such thing as "safe" FGM. Anaesthetic and antiseptics are generally not used unless the procedure is carried out by medical practitioners. However, medicalization of FGM is denounced by the World Health Organization. In many countries, FGM is banned by law but is still being practiced. Infact on the contrary, the practice can cause life-lasting physical as well as psychological trauma. Also, it is not prescribed by any religion. 2

3. DEFINITION The World Health Organization(WHO) defines Female genital mutilation (FGM) is a traditional harmful practice that involves the partial or total removal of external female genitalia or other injury to female genital organs for non-medical reasons. 3

4. FEMALE GENITAL MUTILATION IS CLASSIFIED INTO FOUR TYPES Type I: Also known as Clitoridectomy , this type consists of partial or total removal of the external part of the Clitoris and/or its prepuce. Type II: Also known as Excision, the external part of clitoris and Labia Minora are partially or totally removed, with or without excision of the Labia Majora . Type III: The most severe form, it is also known as Infibulation or Pharaonic type. The procedure consists of narrowing the vaginal orifice with creation of a covering seal by cutting and appositioning the Labia Minora and/or Labia Majora, with or without removal of the external part of Clitoris. The appositioning of the wound edges consists of stitching or holding the cut areas together for a certain period of time (for example, girls' legs are bound together), to create the covering seal. A small opening is left for urine and menstrual blood to escape. Type IV : This type consists of all other procedures to the genitalia of women for non-medical purposes, such as pricking, piercing, incising, scraping and cauterization. 4

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6. PREVALENCE WHO :- 130 million women worldwide. 90 million girls in african countries 3 million women annualy . Worldwide, 90% of cases include type I, type II and IV. Type III procedure account for the remaining 10% In India. Mumbai abounds with untrained midwives who continue to scar young girls. FGM is mostly carried out on young girls between infancy and age 15. 6

7. CULTURAL AND SOCIAL FACTORS FOR PERFORMING FGM The reasons why FGM is performed vary from one region to another as well as over time and include a mix of socio-cultural factors within families and communities. Where FGM is a social convention (social norm), the social pressure to conform to what others do and have been doing, as well as the need to be accepted socially and the fear of being rejected by the community, are strong motivations to perpetuate the practice. FGM is often considered a necessary part of raising a girl, and a way to prepare her for adulthood and marriage.This can include controlling her sexuality to promote premarital virginity and marital fidelity.Some people believe that the practice has religious support, although no religious scripts prescribe the practice. Religious leaders take varying positions with regard to FGM, with some contributing to its abandonment. 7

8. HEALTH RISKS Women and girls living with FGM face serious risks to their health and well-being. Women who have undergone the procedure are more likely to experience life-threatening complications during childbirth. It is unacceptable from a human rights as well as a public health perspective, regardless of who performs it . SHORT-TERM HEALTH RISKS OF FGM: Severe pain Cutting the nerve ends and sensitive genital tissue causes extreme pain. The healing period is also painful. Excessive bleeding (hemorrhage). Clitoral artery or other blood vessel is cut. Shock: Can be caused by pain, infection and/or hemorrhage. Genital tissue swelling: Due to inflammatory response or local infection. Human immunodeficiency virus (HIV): Cutting of genital tissues with the same surgical instrument without sterilization could increase the risk for transmission of HIV between girls who undergo female genital mutilation together. Urination problems: Include urinary retention and pain passing urine. Causes tissue swelling, pain or injury to the urethra. Impaired wound healing: Can lead to pain, infections and abnormal scarring. Mental health problems: The pain, shock and the use of physical force during the event, as well as a sense of betrayal when family members condone Organize the practice, are reasons why many women describe FGM as a traumatic event. 8

9. LONG-TERM HEALTH RISKS OF FGM Pain: Due to tissue damage and scarring that may result in trapped or unprotected nerve endings. Chronic genital infections: With consequent chronic pain, and vaginal discharge and itching. Cysts, abscesses and genital ulcers may also appear Chronic reproductive tract infections: May cause chronic back and pelvic pain Urinary tract infections: Ascend to the kidneys, potentially resulting in renal failure, septicaemia and death. An increased risk of repeated urinary tract infections is well documented in both girls and adult women who have undergone FGM Painful urination: Due to obstruction of the urethra and recurrent urinary tract infections.Vaginal problems i.e., discharge, itching, bacterial vaginosis and other infections.Causes menstrual problems. Excessive scar tissue ( keloids ): Excessive scar tissue can form at the site of the cutting. Sexual health problems: Causes due to removal of, or damage to, highly sensitive genital tissue.Leads to scar formation, pain and traumatic memories. Childbirth complications: FGM is associated with an increased risk of caesarean section, postpartum haemorrhage . 9

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11. WHAT IS OUR RESPONSIBILITY? All professionals have a responsibility toward safeguarding children If concerned a girl is at risk you have a duty to seek urgent guidance and inform the Child Protection Team, or Safeguarding Board. If a child is admitted after mutilation advice should be sought urgently from the local social services, local police child protection unit or National Society for Prevention of Cruelty to Children. This should include addressing concern for other children in the family who may not have undergone the procedure. For all cases, a psychological assessment should be included for any women who has undergone FGM and they should be offered referral to a psychologist. Practitioners should seek medico-legal advise from their defense union if unsure of their position. Remember most women do not choose mutilation and the procedure is carried out in childhood. The practice is seen by some cultures as normal, is traditional, and in some communities is viewed as a coming of age' ritual. The woman will not only have suffered through experiencing female genital mutilation, but also through migration and separation, and in some cases war. It is important to remain non-judgmental, and offer support. 11

12. WORLD HEALTH ORGANIZATION (WHO) RESPONSE WHO is strongly opposed to health professionals performing FGM and urges all health workers to uphold the medical code of ethics to “do no harm”. In 2008, the World Health Assembly passed resolution WHA61.16 on the elimination of FGM, emphasizing the need for concerted action in all sectors-health, education, finance, justice and women's affairs. WHO efforts to eliminate female genital mutilation focus on : Strengthening the health sector response : developing and implementing guidelines, tools, training and policy to ensure that health care providers can provide medical care and counselling to girls and women living with FGM and communicate for prevention of the practice Building evidence: generating knowledge about the causes, consequences and costs of the practice, including why health care providers carry out the practice, how to abandon the practice, and how to care for those who have experienced FGM. Increasing advocacy : developing publications and advocacy tools for international, regional and local efforts to end FGM, including tools for policy makers and advocates to estimate the health burden of FGM and the potential public health benefits and cost savings of preventing FGM 12

13. Cont… WHO together with 9 other United Nations partners, issued a statement on the elimination of FGM to support increased advocacy for its abandonment, called: "Eliminating female genital mutilation: an interagency statement". This statement provided evidence collected over the previous decade about the practice of FGM In 2010, WHO published a "Global strategy to stop health care providers from performing female genital mutilation" in collaboration with other key UN agencies and international organizations. WHO supports countries to implement this strategy.. In May 2016, WHO in collaboration with the UNFPA-UNICEF joint programme on FGM launched the first evidence-based guidelines on the management of health complications from FGM. The guidelines were developed based on a systematic review of the best available evidence on health interventions for women living with FGM In 2018, WHO launched a clinical handbook on FGM to improve knowledge, attitudes, and skills of health care providers in preventing and managing the complications of FGM. THE INTERNATIONAL ORGANIZATIONS RESPONSE ENDING FEMALE GENITAL MUTILATION BY 2030. In 2012, the UN General Assembly designated Feb 6th as the International Day of Zero Tolerance for FGM, aiming to amplify efforts on eliminating this practice ENDING FEMALE GENITAL MUTILATION BY 2030... This year, the UNFPA and UNICEF join the programmed on the elimination of FGM by 2030. Delivering the Global Promise launched the 2023 theme; "Partnership with Men and Boys to Transform Social and Gender Norms to End FGM". 13

14. PREVENTION TO FGM Challenge the discriminatory reasons fgm is practiced Change traditions with the support of older generations Educate girls on their right to decide what happens to their body Speak out about the risks and realities of fgm Spread understanding that religion does not demand fgm Tackle the secrecy that allows cutting to continue Keep pushing for fgm to be banned. 14

15. CONCLUSION A greater understanding of FGM will help health professionals to improve the health care provided and cease further alienation of the women involved. Increasing awareness by educating the communities involved could help to challenge themselves harmful practices. Even though FGM may be normative and considered to be of cultural significance in some settings, the practice is always a violation of human rights, with the risk of causing trauma and leading to problems related to girls' and women's mental health and well-being. FGM has been associated with medical, sociocultural , and economic consequences. Elimination of FGM is possible through directing resources in an efficient manner. 15

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17. Thank You 17