The 5th Congress of the Mukwege International Chair took place from December 3 to 6 in Montreal and was co-organized by the International health Unit (IHU/USI), the Hygeia Observatory, and UdeM International. The Mukwege Chair aims to develop interdisciplinary research on gender-based sexual violence and to bring together knowledge on this issue from different partners and universities worldwide. During this 5th edition, experts from Canada and other countries shared their expertise and recommendations to end these harmful practices and better support survivors.
Context and Challenges
Female genital mutilation (FGM) encompasses “all procedures involving the partial or total removal of the external female genitalia, or other injuries to the female genital organs for non-medical reasons” (World Health Organization, 2008). Girls and women who undergo FGM may face short- and long-term complications regarding their sexual and reproductive health and mental health1. While predominantly concentrated in many countries in Africa and the Middle East, FGM is a global issue.
The discussions addressed the problem of FGM from several angles, including the journey of reconstruction after female genital mutilation/excision (FGM/E) in a migration context. In Canada, as in other immigrant-receiving countries, there are resources available for survivors and specific training for healthcare providers dealing with these medical cases. It was noted that the work of community organizations in supporting immigrant women is crucial. It is essential to direct these women to appropriate resources and care, considering other forms of oppression they may face (sexism, racism, etc.) by adopting an intersectional perspective.
Other discussions focused on the situation in West Africa, where FGM remains a widespread cultural practice and a public health issue due to its negative impact on women's health. Behavioral change regarding this practice is possible by challenging this patriarchal custom that reinforces gender inequalities.
Several barriers to abandoning this practice were raised, such as the lack of consensus on the definition of FGM, how it affects access to care and how healthcare professionals can approach reconstruction and/or the support of women and girls post-FGM.
Plenary lecture at the 5th Mukwege International Chair Congress. Credit: 5CCIM.
Several solutions were identified:
• Increase research on FGM to expand knowledge on the complications of FGM. Research helps improve our understanding of the potential physical, psychological, and sexual complications of these practices. Sharing knowledge contributes to developing more tailored treatments and more efficient intervention strategies to eliminate FGM globally.
• Adopt a holistic approach for survivors: The effects of FGM on girls and women are not only physical, but can also impact their mental health and the quality of their daily lives. The holistic approach, as developed by Dr. Denis Mukwege's Panzi Foundation in the Democratic Republic of Congo, promotes rehabilitation and empowerment for women. It includes continuous medical care, psychological support to help women overcome the trauma caused by these procedures, legal assistance to help them seek justice, and socio-economic support to ensure their autonomy. Empowering women is a crucial lever to end FGM in a sustainable way. By strengthening their access to education and active participation in decision-making, women can better defend their rights and influence social norms within their communities.
• Enact laws to ban these practices: The adoption of laws against FGM is a critical element in the fight for its elimination. They encourage women and healthcare professionals to report FGM cases. For example, in Burkina Faso, the situation improved following the adoption of such a law in 1996 (According to UNICEF, in 2010, 76% of women in Burkina Faso had undergone FGM, compared to 67.6% in 2015).
• Mobilize local communities: This is the goal of USI’s engagement in the fight against FGM through its intervention projects. USI and its partners work closely with governments, religious leaders, and local communities. Mobilizing communities enables them to act collectively to eliminate this practice and address the needs of women and girls who suffer from its consequences, particularly regarding sexual and reproductive health and gender equality. In this regard, they support governments, health systems, and healthcare facilities in implementing holistic care programs and training healthcare professionals to provide appropriate and respectful care for survivors.
• Develop sustainable collaborations: The elimination of FGM can only be achieved through coordinated efforts involving governments, communities, healthcare professionals, and civil society organizations. Long-term strategies are essential to achieving the Sustainable Development Goals related to health (SDG 3), gender equality (SDG 5), and justice (SDG 16), thus ensuring a more just and inclusive future.
Recommendations partially drawn from the plenary session – Rebuilding After Excision in the Context of Migration by Jasmine Abdulcadir, Associate Professor, Head of the Unit for Obstetrical-Gynecological Emergencies. Consultation on Female Genital Mutilation and Vulvar Surgery, University Hospitals of Geneva, Switzerland, and from the symposium – Challenges and Approaches for Quality Care for Women in Canada Living with Female Genital Mutilation/Excision (FGM/E), moderated by Bilkis Vissandjee, Professor at the Faculty of Nursing, University of Montreal.
Sources: 1. World Health Organization (WHO). (2024). Female Genital Mutilation. World Health Organization. www.who.int/news-room/fact-sheets/detail/female-genital-mutilation