Purpose: Egypt has the highest prevalence of chronic Hepatitis C virus (HCV) infections and also a high prevalence of female genital mutilation (FGM). The high prevalence chronic hepatitis C has been attributed to HCV transmission by contaminated injections for the control of schistosomiasis. HCV infection has not been well studied in the context of female genital mutilation (FGM). We sought to identify associations between FGM and HCV using the Egypt Demographic and Health Survey (EDHS), 2008. Methods: FGM was chosen as the main independent variable of interest. Other independent variables such as age, education, marital status, residence, beliefs associated with FGM, history of blood transfusion, surgery, sharing needles, and history of schistosomiasis were included in the analysis. Throughout the analysis, HCV infection was used as the main dependent variable. Results: Univariate analysis of FGM and HCV showed a statistically significant association with a Prevalence Odds Ratio of 4.82 (2.91 -7.96), after adjusting for age and schistosomiasis injection, the association between FGM and HCV remained statistically significant with an odds of 2.98 (1.76 – 5.05)Among the category for FGM performer and association with HCV infection, the OR was 4.28 (2.31 – 7.91) when the FGM was performed by a ghagaria, 3.68 (2.76 - 4.90) when the FGM was performed by daya, and 3.30 (1.81 -5.88) when the FGM was performed by a barber. Among other independent variables, a lack of education, rural residence, and having religious precepts for FGM had statistically increased odds of association with HCV infection. Conclusion: There is a statistically significant association between FGM and HCV infection. There are increased odds of HCV when the FGM is performed by providers other than doctors. Participants from a rural residence and who those who did not have any education were at increased odds of HCV. Subjects who believed in religious precepts for FGM and also who answered that FGM can continue had increased odds of association with HCV infections.

Abstract In recent decades there has been increased immigration to New Zealand of women from East Africa. These countries have the highest prevalence rates (between 90-97%) of Female Genital Mutilation (FGM) worldwide. FGM therefore has become part of the care experience of some New Zealand health providers. Information on FGM is available on the New Zealand Ministry of Health website. This study captures the experience of a group of East African women in Christchurch who have undergone FGM and given birth in Christchurch Hospitals. Two focus groups, each with ten women, were held so that women could talk about their health services experience. A narrative approach was adopted, listening to their stories in order to explore, to gain insight and to understand how these women felt during reproductive and antenatal care, childbirth and after childbirth. Interviews with three health providers sought their experiences of caring for women with FGM. The study identifies diverse potential explanations with the focus group members telling their stories and identifying issues related to FGM. Several short case histories are presented to illustrate these experiences. The thematic analysis reported four themes: satisfaction with clinical care, concern about infibulation, barriers to knowledge for women, and problems of cross-cultural communication. Health providers reported similar issues, with themes related to their own clinical experience, knowledge gaps, and need for greater cultural understanding and communication. These themes reflect the journey of the East African women with FGM in Christchurch and the challenges faced by them and their providers. This research recommends that women with FGM receive more education and support to manage their relationships with the health system and their own health. Health providers need continuing education and further support in the psychosocial, psychological and physical health needs of East African women living in Christchurch. Service outcomes should be evaluated.

Female genital mutilation (FGM) is defined by the World Health Organisation as the deliberate total or partial removal of the external female genitalia, or other deliberate injury to the female genitalia, which is carried out for non-therapeutic purposes. The practice is widely condemned. Even though the adverse effects of the practice have been well documented in many small studies and case reports, FGM is still common in many countries. The effects of this practice are also being felt in many developed countries due to substantial migration in recent years. One of the limiting factors in encouraging eradication is the availability of high quality evidence of the effects of the practice on the process of childbirth. By highlighting the effects of FGM on the process of childbirth, the objective was to encourage policy makers, in co-operation with many relevant organisations, to work together to eradicate the procedure. This original study investigates the effects of FGM on the process of childbirth using a large international epidemiological case control study involving three centres in three different countries. The inclusion criteria were strict and comprised of agreement by the woman and or her husband to participate in the study, for a normal singleton pregnancy at term with a cephalic presentation which resulted in a normal baby, for the women with and without FGM during the period of study. Women who did not fulfil these criteria were excluded. Maternal outcome measures included length of labour, obstruction to the progress of labour, operative delivery, urine retention, perineal complications, intrapartum and postpartum haemorrhage and blood loss during the process of labour. Newborn outcome measures included birth status at delivery, Apgar scores at 5 and 10 minutes, requirement for resuscitation, admission to special care unit and time taken from delivery to the first breast feed. Psychological sequelae were not assessed. The total number of participants in these three centres was 1,970 women; 526 with no FGM (control) and 1444 with different types of FGM. Every effort was taken to keep confidentiality and not to interfere with management of labour during data collection. The results indicate a highly significant difference between the two groups when comparing length of the process of labour, mode of delivery and the need for instrumental deliveries, episiotomies and tears, blood loss during and after delivery, the need for catheterisation following deliveries and duration of hospital stay following birth. Adverse effects were not confined to women and were found to have extended to the new-borns in the two groups again with highly significant difference with regard to birth trauma, requirement for resuscitation and medical attention. The time taken for the first breast contact was different in the two groups with possible effects which may be difficult to establish and require further research. The data provide clear evidence that the practice of FGM is associated with clinical adverse effects, which are not only confined to women but involve the newborn as well. It is hoped that this systematic and comprehensive collection of evidence will make a substantial contribution to the world wide effort to eradicate this harmful practice.

Female genital mutilation (FGM) has been illegal in Tanzania since 1998; nonetheless this procedure is still being performed in some regions of the country. Since the prohibition of this practice it has become harder to detect the practitioners. Nurses are one of the professions who can identify the women who have been exposed to FGM, which creates an opportunity to provide care for these women and educate them about the practice. The aim of this study is to describe Tanzanian nursing students’ views on FGM. Data was collected with focus group interviews with second and third year students at a nursing school in northwest Tanzania. Data was analysed inductively by content analysis. The results, the students’ views on FGM, were categorised into four themes; ‘FGM creates suffering’, ‘the right to sexual integrity’, ‘the role of nurses’ and ‘educating the patient and the community’. The findings clearly demonstrate that the students’ negative attitudes toward the practice are based on their knowledge of its harmful implications on health. For further research, it may be of interest to study nursing students’ views of the practice in more FGM-prevalent regions of Tanzania. / <p>Röda Korsets sjuksköterskeförening stipendium 2017</p>

When professionals meet people from other cultures, there are some problematic issues that may appear, especially when considering human rights. Every individual has the right to live as they choose, and have the right to their own culture and traditions even if they have immigrated to another country. Female genital mutilation is a tradition that violates human rights. In this study we will look at what conflicts of values that professionals can have while meeting clients who have been mutilated. We have made qualitative interviews with four professionals working in a small town in Sweden in an area where many immigrants live. Professionals who meet people that have been genital mutilated have to balance respect for the individual with official restrictions and law. Knowledge about other countries and cultures can be important in the meeting between the professional and the client. Many conflicts of values appear and in this study we lift some of these conflicts.

Female genital mutilation is an important human rights and health issue in both Canada and Africa. The Canadian government has made efforts towards eradicating this practice by making it a criminal offense, a “remedy” popularly used in Africa as well. Despite the efforts made by governments, law enforcement, along with international human rights organizations, female genital mutilation persists among African immigrants living in Canada and is still practiced by some in Africa. Using international and government laws and policies, documents, case study reports and articles, this thesis questions why the criminalization of female genital mutilation has not reduced this practice among Africans and immigrants living in Canada. Using qualitative case study research methodology as well as the theories of cultural relativism and feminist human rights, this thesis suggests that cultural practices are resistant to change, even among families who move to societies where the practices are legally criminalized and socially rejected. As such, the strategy of eradicating this cultural practice through criminalization has been largely unsuccessful because of strong social forces as exemplified in myths, cultural reasons and the medicalization of female genital mutilation. This thesis concludes by proposing the need to address the status of females among groups who perpetuate this practice and adopting other measures to supplement the laws which are already in place. / February 2016

The topic of this study was Female Genital Mutilation, a crime against human rights and a severe problem in parts of Africa. Laws against FGM have had limited effect and nurses are faced with many opportunities to inspire behavioral changes in individuals, making the aim of this study to explore Ghana’s nursing students’ knowledge of and attitudes towards female genital mutilation. Data was collected at the Atibie Midwifery and Nursing Training School located in central Ghana. It was a descriptive non-experimental empirical study carried out by collecting quantitative data with questionnaires. Data was registered and analyzed manually. The outcome of this study indicated that nursing students at Atibie Midwifery and Nursing Training School in Ghana have a fairly high knowledge of FGM and FGM-related complications. Further, the students seem to have very mixed attitudes towards FGM, the majority being a negative attitude towards the practice. Although, a small part of the study population does have a more traditional point of view.

<p>When professionals meet people from other cultures, there are some problematic issues that may appear, especially when considering human rights. Every individual has the right to live as they choose, and have the right to their own culture and traditions even if they have immigrated to another country. Female genital mutilation is a tradition that violates human rights. In this study we will look at what conflicts of values that professionals can have while meeting clients who have been mutilated. We have made qualitative interviews with four professionals working in a small town in Sweden in an area where many immigrants live. Professionals who meet people that have been genital mutilated have to balance respect for the individual with official restrictions and law. Knowledge about other countries and cultures can be important in the meeting between the professional and the client. Many conflicts of values appear and in this study we lift some of these conflicts.</p>

Magister Legum - LLM / This thesis sets out to examine the practice of Female Genital Mutilation/Cutting (FGM/C) in Somalia and its impact on women. The political instability in Somalia provides an opportunity for the increase of all forms of violations of human rights. The prevalence of FGM/C in Somalia has been declared as the highest in the World, but the Somali Government has not taken any steps to address the problem. This study was motivated by the dire situation of women in Somalia. Women suffer from gender inequality in the sense that societal practices – and norms dictate that women’s sexuality be controlled with a view to suppressing their sexual desires. In this way; their rights are violated. Infibulation and sunna performed on women come with immediate and late complications including death, infection, sexual dysfunction, and exposure to HIV infection. Somalia is one of the African countries where women’s rights are almost non-existent. As Dirie notes: ‘if genital mutilation were a problem affecting men, the matter would long be settled.’ International human rights instruments help this study to investigate whether customary practices such as FGM/C are harmful to Somali women and children and whether they constitute violence against women. This practice prevents women from enjoying fundamental rights as recognized by international human rights standards. It is universally known that FGM/C constitutes a violation against women and girls’ rights because they are forced to embrace the practice. Consequently, several rights are violated such as the right to equality, the rights to freedom from all forms of torture and cruel, inhumane and degrading treatment, the right to freedom from harmful customary practices, the rights of the child, and the right to health. The persistent practice of FGM/C is mainly a result of the absence of specific legislation proscribing it as well as the political instability that creates an environment conductive to the wanton violation of the rights of citizens. A recent Somali provisional constitution has recognised FGM/C as a violation of children’s rights but the law is not enforced.Infibulation and sunna are part of Somali culture. That is why attempts to eradicate the practice create a dilemma for the authorities. This has invariably placed Universalists and cultural relativists on a collision course. Ensuing government inaction has resulted in numerous reservations being made to stall the adoption of certain instruments of human rights law such as the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of the Child (CRC). This is because cultural relativists do not consider FGM/C as a violation, but as an expression and fulfilment of Somalis’ culture as provided for in the Universal Declaration of Human Rights (UDHR) of 1948. As argued by Packer, human dignity and life represent universal values for everyone; even if FGM/C is a part of culture, certain limitations must be implemented to preserve people’s fundamental rights. This thesis agrees with the stance that FGM/C violates women’s health. This is due to the absence of proper legislation in Somalia, inadequate literacy and the collapse of the political system. Recommendations include the proposal that legal strategies to eradicate FGM/C must be accompanied by broad policies and grassroots programmes such as educational activities to explain to people the risks of this practice and how communities can remedy it without affecting their cultural tenets.

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