The momentous efforts of World Health Organisation (WHO) helped eradicate the West African Ebola outbreak, which claimed more than 11,000 lives in the span of two years. On 29 October 2019, the King’s Think Tank Global Health Policy Centre facilitated a simulation of this response. Iya Saidou Conde and Alexandre Robert, two Ebola healthcare workers, helped conduct the ‘Ebola Outbreak Response: Table-Top Simulation’ at Bush House.
FGM. Three letters that have a power to send chills down any spine. It is incomprehensible that someone else could choose to excise a part of a human body, a piece of flesh, and someone’s womanhood.
Also known as female circumcision, FGM involves the partial or total removal of the external female genitalia, ie clitoridectomy and infibulation. Mainly preponderant throughout Africa, but also in the Middle East and Asia, it also occurs on our doorstep due to the constant migrations of vulnerable populations to Europe, in particular asylum seekers and refugees. The girls at risk can be as young as the age of 5. This is not a medical procedure: it has no health benefits. Neither does it stem from any religious beliefs. The justification for this procedure is solely cultural.
So why am I writing about this? Does it affect us? You and I are privileged to be in a position where it is our prerogative to speak out on behalf of those who have no voice. Freedom of speech is not a luxury – we own it. We have a power to raise awareness and protect our equals in this world. These cultures can seem worlds away from ours, which may marginalize the issue. Furthermore FGM is not always a priority and comes second to so many other forms of violence. Although strategies and conventions have focused on this cruelty, the fact remains, that according to the WHO, over 125 million girls and women in the world at this moment have been cut and numbers are perpetually increasing. Having access to this knowledge, how can we remain passive?
Before attacking this custom and banning it, it is important to understand why it prevails, as it is difficult to persuade those who uphold and carry out this practice to uproot a deeply entrenched custom overnight. It is still a sensitive topic in many countries, and one that must be addressed with prudence and diplomacy.
For the parents who submit their child to FGM, it may not be considered harmful, an assault or a violation. It is the belief that this is what must be done as a rite of passage to allow a girl to transition to womanhood (cultural and gender identity) or to prevent her from tendencies such as promiscuity or sexual deviation. It is seen as part of a “cleansing process”, to hinder bodily secretions and odours accompanied with maturity. Moreover, it is a means to ensure the purity of the female when presenting her to potential partners. These may be considered as protective measures, but the essence is that it remains a violation of human and women’s rights (it contravenes the UN Convention on the Rights of the Child), the right to life, physical integrity and health.
The social convention theory illustrates how it has become the norm to carry out this practice on girls without their consent, or their realisation of the potential future impact on their lives. This is thus the challenge: to convince not just a minority of the population, be they male or female, to break free from the social norm, but to educate the majority so that they understand the damage, and change their ideology in order to introduce a reversal of expectations. This is established through dialogue.
The United Kingdom is home to a wealth of cultures, including some for whom this practice is commonplace. The country therefore has an important role to play in eradicating this brutal act.
Educating our teachers, healthcare professionals and students at school to remain vigilant about the early signs of those at risk of an imminent procedure or to the symptoms of those who have just been cut is paramount. Signs such as a lack of integration into society, isolation from participating in physical activities, long trips to countries performing this rite and subsequent social withdrawal should be looked out for. It is imperative to provide support in the face of further complications: lasting physical effects, reluctance to seek medical attention, infection and other organ damage, as well as emotional or psychological repercussions.
Resources should be available for those who require legal guidance, and stricter measures put in place for offenders to be prosecuted. In 2003, the Female Genital Mutilation Act declared it illegal to arrange FGM outside of the UK regardless of whether it was legal in the country it takes place. However despite the criminal penalty being up to 14 years imprisonment in the UK for taking girls abroad, until this day no convictions have ensued.
We must recognise that in cultures where FGM is prevalent, avoiding the procedure can be considered as defiant, and individuals concerned are threatened with punishment. This changes the shape of their society from one of safety, to one of endangerment. However culture cannot be a means of justification for breaking the law or violating ones rights.
Abolishing female circumcision involves a multi-disciplinary approach: prosecutions, medical examinations, reporting of violence…
International governments have the manpower to support local communities to introduce educational campaigns. But we must circumvent the existing issues with these campaigns: they are mostly short term and small scale. It is time to think big: implement programmes, but monitor progress and evaluate their effects. Targeting those in power such as tribal leaders, healers, soldiers, and turning those people into role models will influence the communities who seek guidance in these leaders to follow suit. The other side of this coin however is the economic incentive for these matriarchs of society who are well paid for the procedure. Hence despite the steps taken to educate the local population, there is still a need for solutions. This is the ideal intersection for change and collaboration, partnerships and networks intertwined are key.
The access to media and other communications also enables us to propagate a message like a ripple in a pond across borders and achieve a much-required change and combat gender-based violence. There is a movement, but a more urgent effort is crucial to reach all corners of the world.
Most people, when asked to think about deadly and debilitative diseases rife in the developing world, would jump immediately to Malaria. This would be a logical conclusion, as of course Malaria is an infamous killer, and is responsible for about 450,000 deaths a year. AIDS and Tuberculosis should not be forgotten, but it is parasitic worms and other mosquito-borne diseases, which often get overlooked, thus preventing neglected tropical diseases (NTDs) from receiving the time and funding that could eradicate them completely. Continue reading “The World’s Most Neglected Tropical Diseases: What They Are, and What Is Being Done To Eradicate Them”
In our increasingly globalised world, health is no longer an internal issue; it needs to be examined through a host of different lenses. Governments invest a lot of money in health, ranging from richer countries such as Canada with universal healthcare provision, to India with state-provided public health to the opposite end of the spectrum in places like Angola, where there is effectively no state healthcare provision. Add to this the effect of health outcomes in countries near and far, and the issue escalates from local to global pretty quickly. Today, departments of defence, labour, and even tourism have a stake in the global health profile. Continue reading “Health Diplomacy: A Path to a Better Model”
On Thursday February the 5th, King’s Think Tank hosted the first global health event of the second semester, welcoming the expertise of world-renowned health economists and lecturers. Speakers included Mr. Robert Yates, Senior Fellow in Chatham House and Project Director of the UHC Policy Forum, Dr. Josephine Borghi
Health Economist at the London School of Hygiene and Tropical Medicine, and Dr. Sridhar Venkatapuram, Lecturer in Global Health and Philosophy, at King’s College London. Continue reading “Universal Health Coverage: The Future of Africa?”
Ebola and polio are the only two diseases currently considered global public health emergencies by the World Health Organisation (WHO). The world’s attention is on the growing threat of Ebola, and the global community’s woefully slow response. On the other hand, it seems the world has largely forgotten the hundreds of thousands of children who have died in Pakistan, from what most would consider a preventable disease. Continue reading “Polio in Pakistan: The Overshadowed Emergency”