Female Genital Mutilation in Malta - Assignment Example

?Female Genital Mutilation in Malta By Introduction The field of nursing and midwifery is faced with various challenges, which have a potential limit to effectiveness. A major challenge in this field is in the form of social issues. Social issues, also known as social problems or social situations mainly entail the perception of society of the lives of people therein. These perceptions vary from society to society. For this reason, what might be considered normal in one community might be considered unacceptable in another. This paper explores one social issue, namely female genital mutilation (FGM) in Malta, and focuses on how this infringes on human rights of women, as well as the policies, if any, that are adopted to address the issue in the country. This paper also culminates in various recommendations, based on policy, which can be utilised to combat the social issue. Female Genital Mutilation (FGM) Female Genital Mutilation (FGM) is also known as female circumcision of female genital cutting. This is a major concern for various international agencies, including World Health Organization (WHO) among others, since this oppressive practice is upheld by various regions of the world (UNICEF n.d). Nonetheless, the World Health Organization defines female genital mutilation as “all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons” (Against Violence & Abuse, n.d, P.2). This practice is injurious to the genital organs of women, as is conducted for cultural and non-cultural reasons at the expense of the health, safety, well-being, and rights of women. Female Genital Mutilation is specific to each community that practises it. Therefore, different communities practise this in varying ways. The World Health Organization has developed a broad categorization of female genital mutilation, which involves the grouping of FGM into four different types, including Type I, Type II, Type III, and Type IV (Against Violence & Abuse, n.d). Type I is also known as clitoridectomy, and involves the partial or total removal of the clitoris, including the prepuce. However, in some cases, the prepuce is not removed. Type II involves the removal of the clitoris together with part or whole of the labia minora. This is also referred to as excision. On the other hand, Type III involves the removal of most or part of the female genitalia. This form of FGM is also known as infibulation, and is considered the most severe form of all the forms of FGM. In this type of FGM, the vaginal entrance of a woman is stitched, and only a small allowance allowed for passing of urine and menstrual flow. Type IV according to WHO includes all the other procedures that are injurious to women’s genitalia, including piercing, scraping, incising, and pricking, among others, for reasons other than medical (Against Violence & Abuse, n.d) According to Ouedraogo (2008), communities that practice Female Genital Mutilation do this for various reasons, which root from the culture. Kerubo (2010) also notes that since culture is broad and all-encompassing, the reasons for FGM in various communities are deeply entrenched in the political, social, and political structures of a community. Therefore, communities that practice FGM cite religious, health and hygiene, traditional, as well as gender-related reasons. With regard to religion, there is no known religion that prescribes female genital mutilation (UNICEF, n.d). However, Kerubo (2010) argues that some Muslim communities that practise FGM have made their women believe that this is a requirement for women in Islam, and in other communities, various perceived religious beliefs contribute to the upholding and continuation of FGM. Nonetheless, FGM is practised by communities that are affiliated to various religions, including Islam, Christianity, Jews, as well as Animists (UNICEF, n.d). Another reason for practising FGM by communities is that it confers identity to a woman with regard to her culture and lineage group (Against Violence & Abuse, n.d). Additionally, in other communities, female genital mutilation is performed on women since it is believed to control the morality of women, with regard to promiscuity (Against Violence & Abuse, n.d). When a woman is circumcised in these communities, this lowers her desire for sex, thus will combat her probability of engaging in promiscuity. Ouedraogo (2008) notes that a woman, who does not undergo circumcision in such communities, is considered an outcast and unmarriageable. Nonetheless, whatever the reason for conducting FGM on a woman, there are various detrimental consequences, which affect the woman as an individual, as well as the community as a whole. Female Genital Mutilation (FGM) in Malta Malta is a small nation, an island in the Mediterranean Sea. The strategic positioning of this small nation is therefore, of great importance. This country neighbours Italy and Tunisia, as well as Egypt. Due to the strategic location of Malta, there is a high number of immigrants in the country, including African immigrants (Freeman, 2013). This therefore, has led to a high population in the country. Nonetheless, when immigrants come into a new country, they mostly will carry with them their cultures and traditions, as these are deeply embedded in their selves. For this reason, Malta, which is a European country, registers a high level of prevalence of female genital mutilation. According to Montalto (2013), most of the migrants in Malta, including the Africans are known to practise female genital mutilation. These include refugees from war-torn African countries such as Somalia, among others. Nonetheless, most of these are known to uphold female genital circumcision, basing on their native countries, which consider female genital mutilation important. Therefore, when such migrate to foreign countries, they ensure a continuation of their cultural practices. For this reason, Montalto (2013) notes that the migrants in Malta, who hail from various African countries, especially the Muslim countries, are considered to be responsible for the prevalence of female genital mutilation in the country. In most countries, where there is a considerable level of prevalence of female genital mutilation, there is increased research on the issue, as this is considered a major human rights and social issue. Different international agencies and local organizations, including medical practitioners in such countries draw great interest in the issue, in a bid to understand and help in the efforts to combat it. However, according to Cooke (2013), this is not the case in Malta, despite a considerable high level of prevalence of female genital mutilation, as no major researches have been conducted on female genital mutilation. It is argued that the government of this country provides no major law that might require gynaecologists to record and report any cases of female genital mutilation that they come across (Cooke, 2013). Prevalence of Female Genital Mutilation (FGM) in Malta As seen, female genital mutilation in Malta is a phenomenon that is common among the minority groups in the country. These mainly include the groups that come to Malta to seek asylum, especially from wars in their countries. These are mostly Africans, who hail from countries, where female genital circumcision is practised (Montalto, 2013). Among these asylum seekers in Malta, some of the elderly women had already undergone female genital mutilation before migrating to Malta. Since these revere the practice, they ensure to perform it on their daughters, as well as all other females in their families. They perform this practice either in Malta or abroad. Due to the lack of law in Malta that could draw interest and attention to the issue of female genital mutilation in Malta, it is quite challenging to come across research findings, statistics, as well as data that pertain to female genital mutilation in Malta. By February 2012, there was neither any estimations or real data that showed the number of women in Malta that had undergone female genital mutilation, nor data on the number of women in Malta that were exposed to the risk of female genital mutilation (European Institute for Gender Equality, n.d). However, in 2009, the Migrant Health Unit in Malta released an internal report of female genital mutilation. In this report, it was indicated that approximately 242 women in Malta hailed form countries, where there was high prevalence of female genital mutilation (EIGE, n.d). Although there is insufficient data and statistics on Malta about female genital mutilation in the country, efforts have been put in place to ensure that such data is collected on all European countries. In 2012, a major study was conducted on the prevalence of female genital mutilation in various European nations, including Malta. Overall, findings showed that Malta registered the highest proportion of female applicants from FGM-practising countries out of the total number of female applicants in the study. This was more than 90% in Malta, as compared to approximately 66% in Italy (UNHCR MALTA, 2013). Nonetheless, in order to determine the approximate prevalence of female genital mutilation in Malta, this section will base on this major study. The study was conducted by the Yellow Window Management Consultants and various researchers from the International Centre for Reproductive Health, after its official commissioning by the European Institute for Gender Equality (EIGE) in 2012. The aim of this study was to fill the gaps in the prevalence of female genital mutilation data in different European nations. Another aim was to contribute to the development of strategies to combating female genital mutilation in various European nations. Nonetheless, the study involved 27 European nations, as well as Croatia (European Institute for Gender Equality, n.d). Through the study of each individual nation, it was possible to determine the policy and methods that different European countries have put in place to address the issue. In the study, the prevalence of female genital mutilation was studied with regard to data covering FGM prevalence in the country and asylum provided on the grounds of FGM in the country. In addition, interest was drawn to the presence of criminal laws in a country, which address FGM. Furthermore, the study covered the national action plan of a country with regard to FGM, and child protection interventions that are related to FGM, as well as medical records of FGM in a country. With regard to prevalence of female genital mutilation in Malta, the research study in Malta failed to obtain any statistics on the practice of FGM in the nation. Nonetheless, a major conclusion that was reached by the study was that since there was no legal provision that pertained the reporting of cases of female genital mutilation in Malta, then probably the professional secrecy law applied in this nation, thus no disclosures on cases of FGM by the research participants (European Institute for Gender Equality, n.d). Social Consequences of Female Genital Mutilation (FGM) Apart from resulting in detrimental physical and psychological effects for women, FGM also has detrimental social consequences to the affected women. First, according to Kerubo (2010), women, who have undergone FGM, experience excessive embarrassment whenever they visit a doctor or a gynaecologist. This is mainly because their private organs have been disfigured by the process of FGM, thus does not those of other normal women. This kind of embarrassment can be considered a social condition that is undesirable, as this makes the women affected feel out of place or odd whenever they interact with other people, who do not practise FGM. As an undesirable social condition, this also impacts negatively on their psychology, as they lose their self-esteem and confidence in the presence of FGM non-practising people. Secondly, FGM is entrenched in social convention of the ethnic groups that practise it. Therefore, failure by a girl to undergo FGM results in the girls being considered outcasts in their community. FGM is believed to accord identity to women, thus failure to undergo this means one does not belong to the community. In addition, in such communities, there is name-calling for uncircumcised girls, and these are alienated from the community, as most of their peers will avoid interacting with them (Norwegian Knowledge Center for the Health Services, 2010). Nonetheless, alienation is a negative social condition, which negatively influences the affected women. Thirdly, in the FGM practising communities, the practice is believed to enhance the power and status of women in the community, at the family level. This is also believed to strengthen their relationship with their husbands and other community members (Ouedraogo, 2008). Therefore, girls that fail to undergo FGM are considered unmarriageable. These are also considered lesser women, thus have lower status. Additionally, their relations with other community members are weak, as less people will want to associate and identify with them (Ouedraogo, 2008). Therefore, such stigmatization of uncircumcised girls results in them feeling rejected, and losing their power as women. Such rejection and powerlessness is an undesirable social condition that might make the affected women lose a grip on their worth as women. Nonetheless, social consequences of FGM might not be easily noticeable as physical consequences. Factors Contributing to the Continuation of Female Genital Mutilation (FGM) There are various factors that have resulted in the persistence of FGM. Social custom is a major factor. In FGM-practising communities, FGM is mandatory, thus this elicits social pressure, whereby most women will want to satisfy the social custom by getting circumcised (Against Violence & Abuse, n.d). Additionally, in the cultures that practise FGM, it is believed that this enhances the premarital purity of women. Therefore, uncircumcised women are considered impure and unmarriageable. To avoid this, most women will opt to get circumcised. Therefore, the cultural influence in FGM-practising communities forces women to adhere to the requirement of getting circumcised (Against Violence & Abuse, n.d). According to Kerubo (2010), the attitude of women towards FGM is another contributor to the continuation of FGM. Nonetheless, this is influenced by other factors such as education and social status. With regard to education, women with lower educational level easily accept circumcision, and do not consider the detrimental consequences. Such will not consider FGM as oppressive or depriving them of their rights, as they lack enlightenment and empowerment from formal education. Therefore, the more education women are in an FGM-practising community, the higher the prevalence of FGM. Ouedraogo (2008) and Kerubo (2010) note that, low socioeconomic status of women in FGM-practising communities promotes the practice. This includes the financial capacity and social rank of a woman in her community. Highly empowered women hold a high socioeconomic status in the community, as compared to underpowered women (Kerubo, 2010). Lack of knowledge on various issues in society, as well as lack of independence from men by the low socioeconomic status women makes lack the ability to challenge oppressive laws or customs in their community. With regard to FGM, these women are most likely to accept FGM even though it is injurious, as they have no other options. These will also fear losing the economic and social support from those they depend on (Ouedraogo, 2008). Nonetheless, the continuation of FGM increases with decreasing educational level and socioeconomic status of women. Health Care Public Policy that Addresses FGM in Malta Until 2012, Malta has lacked any policy document that deals with FGM (EIGE, n.d). However, the National Sexual Health Policy (2010) in Malta considers FGM as one of the emerging realities surrounding sexual health, which needs to be addressed. FGM in Malta is considered to be a result of those residents that originate from communities, where FGM is practised. Although policy on FGM lacks presently, the Jesuit Refugee Service and Migrant Health Unit in Malta promote education of people on FGM (EIGE, n.d). Nonetheless, recently, the Labour Minister of Malta, Chris Fearne, has launched a bill in parliament that pertains to FGM in the country (Montalto, 2013). This bill proposes the introduction of law banning FGM in Malta. In the bill, it is also proposed that it becomes illegal for Maltese people to arrange to perform FGM abroad. A liability of imprisonment between three to seven years is also proposed. If the procedure causes death, more years of imprisonment are proposed (Hamilton, 2013). This bill is yet to become a law in Malta, so, it is not practised in the country yet. However, this might help to combat FGM in Malta, as people will fear imprisonment. On the contrast, this can be considered a coercive method that might lead to people conducting FGM in the privacy of their homes, with inexperienced practitioners, thus causing more detrimental effects. Public Policy Solutions related to Health Care There are various policy solutions that a country can adopt to provide solutions in its healthcare system. First, collaboration with communities is important, and includes various initiatives by the government and healthcare practitioners to engage communities in addressing different healthcare issues (National Policy Consensus Centre, 2004). This should be participatory, and conducted by both local and national organizations. In the case of FGM, the main avenues to engaging the community can be through community dialogues. Nonetheless, through collaboration with communities, the community members, government, and healthcare providers identify obstacles, as well as the possible strategies that can effectively address the issue. Second, development of laws to address the issue is another possible public policy solution (National Policy Consensus Centre, 2004). The government in collaboration with the healthcare practitioners can develop different laws that pertain to healthcare issues that are considered problematic in a country. Such laws will provide direct control, thus people will be forced to act in ways that do not enhance the healthcare issue that is experienced. This however, is coercive in nature, as everyone is expected to adhere to the set law, without any compromise whatsoever. Finally, awareness creation and education of the issue among the people can be used as a policy regarding a healthcare issue. In this case, the healthcare in partnership with the government and other organizations will make the masses aware of a particular healthcare issue, and disseminate all the relevant knowledge pertaining to the issue. Based on the perceptions of the people of the issue, the government and healthcare practitioners will develop strategies that will work effectively to address the issue (National Policy Consensus Centre, 2004). This way, force is not used. Public Policy Recommendation According to National Policy Consensus Centre (2004), an effective public policy is one based on the creation of awareness of the people about the specific issue, followed by educating them on the issue, and disseminating all the relevant information on the issue. After this, the strategies to address the issue effectively are developed based on the perceptions of the people on the specific issue. This could be effective, as it is not costly. Additionally, this involves the people, and it is not coercive. Furthermore, it is based on knowledge, as people will be made aware of the issue and receive considerable education on the issue. This way, they will be able to practise the knowledge acquired to help in combating the issue. Overall, in the case of FGM, I am of the view that the Public Policy developed to combat the practice should be based on the social codes, perceptions, and attitude of the population. With regard to attitudes, it is women that are at the heart of the FGM problematics. Therefore, although the whole population should be made aware of FGM as a problem in the short-term, the attitudes of women toward the practice should be changed. In this case therefore, the aspects of education and socioeconomic status of women emerge. Therefore, the Public Policy to address FGM should take into consideration transforming the attitude of women toward FGM through ensuring they acquire basic education, as well as economic independence. Although this might not be feasible in a short period, it could be adopted as a long-term strategy, whose results will be felt in the future generations. Therefore, Malta and other FGM-practising countries could adopt this as a recommendation to combat FGM. References Against Violence & Abuse (AVA). (n.d). Policy Briefing on Female Genital Mutilation (FGM). http://www.avaproject.org.uk/media/37352/policy%20briefing%20on%20female%20genital%20mutilation.pdf Cooke, P. (2013). Female genital mutilation ‘not officially addressed.’ Times of Malta, 18 March. Retrieved from http://www.timesofmalta.com/articles/view/20130318/local/Female-genital-mutilation-not-officially-addressed-.461966#.Ur3UuijAGO5 European Institute for Gender Equality (EIGE) (n.d). Current Situation of female mutilation in Malta. Retrieved from http://bookshop.europa.eu/en/current-situation-of-female-genital-mutilation-in-malta-pbMH3112942/ Freeman, C. (2013). EU immigration: 'Malta is the smallest state, and we are carrying a burden that is much bigger than any other country’. Retrieved from http://www.telegraph.co.uk/news/worldnews/europe/malta/10192458/EU-immigration-Malta-is-the-smallest-state-and-we-are-carrying-a-burden-that-is-much-bigger-than-any-other-country.html Hamilton, D. (2013). MCWO in full support of bill proposing ban on female genital mutilation. National, Thursday 4 July. Kerubo, K. (2010). Female Genital Mutilation- Effects On Women and Young Girls. Retrieved from https://www.theseus.fi/bitstream/handle/10024/22952/Karhu_Rose.pdf?sequence=1 Montalto, T. (2013). Tighten female genital mutilation bill, says human rights lawyer. Maltatoday, 5 December. Retrieved from http://www.maltatoday.com.mt/en/newsdetails/news/national/Tighten-female-genital-mutilation-bill-says-human-rights-lawyer-20131205 National Policy Consensus Centre (2004). Improving Healthcare Access. Retrieved from http://www.policyconsensus.org/publications/reports/docs/Healthcare.pdf Norwegian Knowledge Center for the Health Services. (2010). Psychological, Social, and Sexual Consequences of Female Genital mutilation: A Systematic Review of Quantitative Studies. PDF. Ouedraogo, S. (2008). Social Effect and Female Genital Mutilation (FGM). Retrieved from http://mpra.ub.uni-muenchen.de/17847/1/MPRA_paper_17847.pdf UNHCR MALTA (2013). Female Genital Mutilation in the EU. Retrieved from http://www.unhcr.org.mt/component/content/article/81-making-a-difference/663-female-genital-mutilation-in-the-eu UNICEF (n.d). Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change. Retrieved from http://www.unicef.org/media/files/FGCM_Lo_res.pdf Read More