FGM: A human rights violation that affects Australian women

Angela Dawson – PHAA member and Melanie Parker – PHAA intern

Female Genital Mutilation (FGM) is a traditional practice that involves the partial or total removal of the external genitalia of women and girls or other injury to their genitals for non-medical reasons. FGM is a violation of human rights and is illegal in all states and territories of Australia. The eradication of FGM is an important target in the Sustainable Development Goals developed by the United Nations.

Around 200 million girls and women live with FGM, and three million girls may be at risk of undergoing FGM every year. FGM is strongly associated with adverse obstetric outcomes and serious immediate and long-term physical, sexual and psychosocial complications resulting in excruciating injuries, disability, and death. In Australia FGM is a public health issue demanding attention given the increased migration of women and girls from countries where FGM is prevalent in Africa, the Middle East and Asia.

Fatu Sillah is a female activist in Sydney who has described her personal experience of FGM. She has also detailed the subsequent health and social impact that FGM has made later in life. There have been high profile court cases in Australia where individuals have been charged for planning or undertaking FGM. A recent example can be found here. While there is a lack of national prevalence data in Australia, the number of affected women is estimated to be greater than 50,000. With migration rates into Australia steadily increasing from 2000 to 2019, as described at The Scanlon Institute’s migration dashboard, we must be ready to provide health care services for migrants from all communities including those where FGM is routinely practiced. Our health care services should be focused on partnering with communities to prevent FGM and care for those affected by this practice.

What is needed in Australia?

FGM prevention efforts must include comprehensive initiatives across all sectors. Educational interventions for parents in clinical and community settings can reduce abuse and neglect and improve health outcomes for young children. Behavioural change leading to the abandonment of FGM is most successful when communities are engaged. Health promotion for communities affected by FGM should be guided by the National Education Toolkit. Comprehensive legislation and health professional and community education about the law is important to prevent FGM.

Health professional education and training must be provided to address gaps in FGM related knowledge, skills, and practice. Specialist services in hospital maternity units should be provided for communities where there are women from FGM prevalent countries, to improve the identification of those affected by FGM, and ensure quality maternity care. FGM community education programs should be adequately resourced to deliver state and territory wide programs and involve men as well as women. Parenting programs tailored to the needs of new mothers and fathers from FGM prevalent nations should be co-designed and co-produced to improve their social support, self-efficacy, and to prevent FGM. A multi- sector, multi-agency approach is needed to identify children at risk or those who have been cut, and co-ordinate appropriate response and rapid referral pathways and prevention programs. Data about FGM prevalence and frequency of service use should be routinely collected to inform health service planning.

What PHAA will advocate for

  • The development of a national comprehensive sexual and reproductive, health strategy that includes action on the prevention of FGM.
  • Standardised education and in-service training for health professionals, including refresher training for health professionals on mandatory reporting on suspected child abuse including FGM.
  • Specialist hospital services in maternity units of at-risk FGM populations, to assist in identification and appropriate management of women with FGM.
  • Improved data collection to inform the provision of specialist services, tailored primary care and clear referral pathways for women affected by FGM.
  • Comprehensive community-based health promotion and support for new parents from FGM prevalent nations. Community-led or partnerships with communities involving migrants from FGM prevalent nations may also be advocated for, with public health champions from the community advocating for a reduction in FGM from within. The trust and rapport gained from education coming from people within the community is likely to be beneficial.
  • Co-ordinated legal child protection actions to effectively identify children at risk or those who have been cut, and appropriate and rapid referral pathways to the appropriate agencies for investigation and protection.
  • Research collaboration between countries of FGM prevalence and migration should be fostered to improve training and prevention programs.

This blog is based on the Public Health Association of Australia policy position statement on Female Genital Mutilation.

Photo Credit: Vonecia Carswell on Unsplash

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