Educating health care personnel about female circumcision

Immigrant women who have been circumcised constantly appear at maternity hospitals

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By Antti Kivimäki
     
      Finnish health care professionals continue to get only sporadic guidance on how to prevent the practice of female circumcision. Circumcising girls is considered to be aggravated assault and battery under Finnish law.
      Circumcised immigrant women constantly come to Finnish hospitals to give birth, and the risk that girls might be sent to their countries of origin to be circumcised has been known for a long time.
      “If a girl is born, I try to emphasise while washing and weighing her that the daughter is perfect just like this”, says one Finnish midwife.
     
Two midwives interviewed by Helsingin Sanomat care for circumcised immigrant women - mostly Somalis - at an average rate of about two a month. In spite of this, the midwives have not been given instructions on how to talk about the procedure.
      Practical actions, such as cutting open the scarred mucous membrane before the birth, have been learned from colleagues with work experience. The matter was discussed for about two hours in midwife training, and even that was only thanks to personal interest on the part of the teacher.
     
No systematic training is offered at institutions of the social and health care sector, or to future doctors. Two employees of the Finnish League for Human Rights travel and speak about the subject to personnel in the social and health care branch with the help of a grant from the Finnish Slot Machine Association.
      “Although we train, the people change, and the matter is forgotten. This is a problem especially outside the Helsinki area”, says researcher, Dr. Marja Tiilikainen of the Department of Social Sciences at the university of Helsinki.
     
National guidelines are under preparation at the Ministry of Social Affairs and Health to unify instructions aimed at preventing the circumcision of girls. It is not yet sure if the programme will be ready this year, and who it will implement it. The policy line taken by the Finnish League for Human Rights is one of quiet information.
      “You can’t change attitudes if you insult the communities”, says Janneke Johansson, an expert at the Finnish League for Human Rights.
     
The league’s expert with a Somali background, Saido Mohamed, convenes small groups of immigrant women and informs them that female circumcision is a crime in Finland even when the girl is sent abroad for the procedure. In addition, she emphasises the damage that it causes health.
      The procedure is not referred to as female genital mutilation, so that women who have already been circumcised might keep their dignity, and dialogue would be possible. The work has yielded results. In the mid-1990s Mulki Mölsä, a Somali-born doctor, interviewed Somali women living in Finland.
      Only 10 per cent of unmarried women, and 33 per cent of married women said that they would not have their daughters circumcised.
      “At that time there were no clear instructions, and it would be naive to imagine that girls would not have been sent abroad”, Johansson says.
     
Nowadays, it is considered exceptional within the Somali community for someone to send a girl to Africa to be circumcised. Officially, these reports are rumours.
      There is no precedent in Finland in which a parent would have been imprisoned for involvement in the mutilation of a daughter. There have been such cases in Sweden and France.
      “It is no longer taboo in the Somali community to talk about circumcision. People have learned that Islam does not require it. The mothers of small children say openly that they do not plan to have their daughters circumcised”, Saido Mohamed says.
     
Day care and school personnel and health care professionals have asked employees of the Human Rights League for advice when they have heard that a girl is going to Africa for a holiday.
      A couple of times, those who have made contact have said later that after discussions with the people involved, the girls in question were not sent to Africa for a holiday after all.
      “Have we saved a girl, or not? In preventative work it is impossible to evaluate results”, Johansson says.
     
Helsingin Sanomat / First published in print 13.3.2010


Previously in HS International Edition:
  Health care personnel to be given guidelines on female circumcision (14.9.2004)
  Fewer operations to fix damage from "female circumcision" at public health clinics (7.9.2007)
  Somali midwife wants schools to work to prevent female circumcision (22.2.2001)

Links:
  Finnish League for Human Rights

ANTTI KIVIMÄKI / Helsingin Sanomat
antti.kivimaki@hs.fi