Credit: UN Photo/Rick Bajornas
The World Health Organization (WHO) has released a new report to help medical practitioners engage in a human-rights-based approach toward managing and treating health complications associated with or caused by female genital mutilation (FGM). See World Health Organization, WHO Guidelines on the Management of Health Complications from Female Genital Mutilation (2016). The guidelines identify the human rights implications of FGM, including on the right to the attainment of the highest standard of health. See id. at 5. Recognizing that an estimated 200 million women worldwide have undergone FGM and citing a lack of awareness of its negative health consequences by the international medical community, the guidelines provide recommendations on methods for treating the negative health impacts of FGM and address best practices for avoiding further human rights violations in those treatments.
With this report, the WHO highlights the important role of trained health professionals in mitigating and remedying violations of international human rights standards that result from FGM and in guaranteeing the protection of the right to health, which includes providing adequate health care services to victims of human rights abuses. See id. 7. The report, therefore, seeks to establish standards to be used by the international medical community to ensure that efforts to eradicate the practice, particularly the elimination of the performance of FGM by medical practitioners, and to provide care for women living with FGM are carried out with consideration for women’s human rights at their core. See id. at viii.
Human Rights Implications
The report is the latest development in decades of efforts by the international community to end the practice of female genital mutilation. In 2008, the WHO published an inter-agency statement calling for the worldwide elimination of FGM, and in December 2012 the United Nations General Assembly adopted a resolution on the elimination of female genital mutilation that also called on States to provide competent medical care and other services to women and girls who have undergone FGM. See World Health Organization, Female genital mutilation (FGM) and harmful practices.
Fueled by an array of sociocultural factors that vary by region, ethnic group, or community, FGM still continues in nearly 30 countries worldwide, and the resulting health and human rights implications are worsened by the existing gap in medical training on its immediate and long-term health consequences. See World Health Organization, WHO Guidelines on the Management of Health Complications from Female Genital Mutilation, 10-11; United Nations Children’s Fund, Female Genital Mutilation/Cutting: A statistical overview and exploration of the dynamics of change (2016), 2. Therefore, the new guidelines seek to provide health care professionals with rights-based standardized procedures for treating women who have undergone FGM and to serve as a resource for medical training programs in both the countries where FGM is common, as well as countries which host growing diaspora communities of people who have migrated from regions where FGM is widespread. See World Health Organization, WHO Guidelines on the Management of Health Complications from Female Genital Mutilation, 11.
The guide contains a comprehensive summary of relevant protections and safeguards against FGM contained in international and regional human rights instruments. See id. at 5-8, 9. The WHO states that female genital mutilation violates the rights to life and personal integrity; freedom from violence; freedom from torture, inhuman, or degrading treatment; equality and non-discrimination on the basis of sex; the rights of the child; and, in particular, the right to the highest attainable standard of health. See id. at 9.
The WHO recognizes the State as the ultimate duty-bearer in safeguarding human rights and emphasizes the responsibility of State governments to respect, fulfill, and protect women’s human rights, including the right to health, through such measures as the provision of an adequate healthcare system, appropriate policies aimed at preventing and eliminating FGM, and support services for victims. See id. at 7.
The report, however, indicates that while States ultimately have the duty and obligation to ensure the right to the highest attainable standard of health and the eradication of FGM, medical professionals can contribute to protecting human rights, including the right to health, through the effective treatment of FGM-related health problems. See id. at 7-8.
Of particular focus is the obligation of medical practitioners to avoid engaging in the medicalization of FGM, whereby families turn to medical professionals to facilitate the act in order to minimize health complications. In this regard, the WHO builds on a 2010 report it compiled in collaboration with other UN organizations and health care professional bodies, national governments, and non-governmental organizations and asserts that medical professionals have a duty to refuse to perform the procedure in order to avoid and oppose perpetrating the violations inherent in FGM. See id. at 10. See also World Health Organization, Global Strategy to Stop Health-Care Providers from Performing Female Genital Mutilation (2010).
WHO Guidance
The report concludes with three guiding principles and several recommendations and best practice statements. See World Health Organization, Female genital mutilation (FGM) and harmful practices, ix. The guiding principles state that first, survivors of FGM should receive quality health care; second, stakeholders should work towards the elimination of FGM; and third, the medicalization of FGM is unacceptable as a violation of medical ethics. See id. The recommendations provide for when deinfibulation – reversing type III FGM – should be used to prevent and treat certain health complications, including those that arise during pregnancy and childbirth; address treatment for mental health disorders, such as post-traumatic stress disorder; female sexual health counseling; and the spread of information and education for girls and women living with FGM. See id. at x, 16-32. Paired with the recommendations are best practice statements indicating how health care professionals can best support the particular needs of women who have undergone the procedure as well as spread education and information that may advance abandonment of FGM. See id.
Additional Information
In addition to past reports and statements released by the World Health Organization, these guidelines build on calls from United Nations entities for the worldwide elimination of female genital mutilation. For instance, in November 2014 the UN Committee on the Elimination of All Forms of Discrimination against Women (CEDAW Committee) and the UN Committee on the Rights of the Child (CRC) published a joint general comment recognizing female genital mutilation as a violent act of sex-discrimination and asserting the duty of States to work toward the realization of women’s rights, including the right to be free from acts of violence such as female genital mutilation. See CEDAW Committee and CRC, Joint General Recommendation/General Comment No. 31 of the Committee on the Elimination of Discrimination against Women and No. 18 of the Committee on the Rights of the Child on harmful practices (2014), paras. 7, 19.
For more information on women’s human rights, visit the IJRC Online Resource Hub.