Mwanri Lillian, Gatwiri Glory Joy
Discipline of Public Health, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Level 2, Health Sciences Building, Registry Road, Bedford Park, South Australia, 5042, Australia.
School of Arts & Social Sciences, Southern Cross University, Gold Coast Campus, Gold Coast, Australia.
Reprod Health. 2017 Mar 14;14(1):38. doi: 10.1186/s12978-017-0300-y.
It is well acknowledged that Female Genital Mutilation/Cutting (FGM/C/C) leads to medical, psychological and sociocultural sequels. Over 200 million cases of FGM/C exist globally, and in Kenya alone, a total of 12,418,000 (28%) of women have undergone FGM/C, making the practice not only a significant national, but also a global health catastrophe. FGM/C is rooted in patriarchal and traditional cultures as a communal experience signifying a transition from girlhood to womanhood. The conversations surrounding FGM/C have been complicated by the involvement of women themselves in perpetuating the practice.
A qualitative inquiry employing face-to-face, one-on-one, in-depth semi-structured interviews was used in a study that included 30 women living with obstetric fistulas in Kenya. Using the Social Network Framework and a feminist analysis we present stories of Kenyan women who had developed obstetric fistulas following prolonged and obstructed childbirth.
Of the 30 participants, three women reported that health care workers informed them that FGM/C was one of the contributing factors to their prolonged and obstructed childbirth. They reported serious obstetric complications including: the development of obstetric fistulas, lowered libido, poor quality of life and maternal and child health outcomes, including death. Fistula and subsequent loss of bodily functionalities such as uncontrollable leakage of body wastes, was reported by the women to result in rejection by spouses, families, friends and communities. Rejection further led to depression, loss of work, increased sense of apathy, lowered self-esteem and image, as well as loss of identity and communal sociocultural cohesion.
FGM/C is practised in traditional, patriarchal communities across Africa. Although the practice aims to bind community members and to celebrate a rite of passage; it may lead to harmful health and social consequences. Some women with fistula report their fistula was caused by FGM/C. Concerted efforts which embrace feminist understandings of society, as well as multi-sectoral, multidisciplinary and community development approaches need to be employed to address FGM/C, and to possibly reduce cases of obstetric fistulas in Kenya and beyond. Both government and non-government organisations need to be involved in making legislative, gender sensitive policies that protect women from FGM/C. In addition, the policy makers need to be in the front line to improve the lives of women who endured the consequences of FGM/C.
人们普遍认识到，女性生殖器切割会导致医学、心理和社会文化方面的后遗症。全球存在超过2亿例女性生殖器切割案例，仅在肯尼亚，就有总计1241.8万名（28%）女性接受了女性生殖器切割，这使得这种做法不仅成为该国一个重大问题，也是一场全球健康灾难。女性生殖器切割植根于父权制和传统文化，是一种集体经历，标志着从少女到成年女性的转变。围绕女性生殖器切割的讨论因女性自身参与使这种做法延续下去而变得复杂。
在一项研究中，采用了定性研究方法，通过面对面、一对一、深入的半结构化访谈，对肯尼亚30名患有产科瘘的女性进行了研究。我们运用社会网络框架和女性主义分析方法，呈现了肯尼亚女性在经历长时间难产和分娩梗阻后患上产科瘘的故事。
在30名参与者中，有三名女性报告称，医护人员告知她们女性生殖器切割是导致她们长时间难产和分娩梗阻的因素之一。她们报告了严重的产科并发症，包括：产科瘘的形成、性欲降低、生活质量差以及母婴健康问题，包括死亡。这些女性表示，瘘以及随后身体功能丧失，如身体排泄物无法控制地泄漏，导致她们被配偶、家人、朋友和社区排斥。排斥进一步导致抑郁、失业、冷漠感增加、自尊和形象下降，以及身份认同和社区社会文化凝聚力丧失。
女性生殖器切割在非洲各地传统的父权制社区中存在。尽管这种做法旨在凝聚社区成员并庆祝一种过渡仪式，但它可能会导致有害的健康和社会后果。一些患有瘘的女性报告称，她们的瘘是由女性生殖器切割引起的。需要采取协调一致的努力，运用对社会有女性主义理解的方法，以及多部门、多学科和社区发展方法来解决女性生殖器切割问题，并有可能减少肯尼亚及其他地区的产科瘘病例。政府和非政府组织都需要参与制定对性别问题敏感的立法政策，以保护女性免受女性生殖器切割之害。此外，政策制定者需要站在前列改善那些承受女性生殖器切割后果的女性的生活。
