4.6.2 Shairon Fray
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4.6.2 AWHN Conference 6 2010 Chancellor 6: The Education Program on Female Genital Mutilation (NSW FGM). Myths and misconceptions and all the other things I don’t know!.
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4.6.2 Shairon Fray
- 1. The Education Program on FemaleThe Education Program on Female Genital Mutilation (Genital Mutilation (NSW FGM)NSW FGM) Myths and misconceptionsMyths and misconceptions and all theand all the other things I don’t know!.other things I don’t know!.
- 2. Dispelling the mythsDispelling the myths Scenario OneScenario One Fatma and Saadia are friendsFatma and Saadia are friends and talkingand talking
- 3. Women’s Health ProgramWomen’s Health Program ““The Women’s Health and Traditions in a New Society.”The Women’s Health and Traditions in a New Society.” Facilitated by Bilingual Community Workers (BCWs) from theFacilitated by Bilingual Community Workers (BCWs) from the same cultural and linguistic background.same cultural and linguistic background.
- 6. Cultural Days held in 2008 & 2009Cultural Days held in 2008 & 2009 Egyptian WomenEgyptian Women’’ss Cultural DayCultural Day Kurdish WomenKurdish Women’’ss Cultural DayCultural Day Sierra Leone andSierra Leone and Liberian WomenLiberian Women’’ss Cultural DayCultural Day Ethiopian and EritreanEthiopian and Eritrean WomenWomen’’s Cultural Days Cultural Day Sudanese WomenSudanese Women’’ss Cultural DayCultural Day
- 7. Dispelling the mythsDispelling the myths Scenario 2Scenario 2 Linda and Sam are two midwifesLinda and Sam are two midwifes talking about an in-service onetalking about an in-service one attendedattended
- 8. Prevalence of FGM in AfricaPrevalence of FGM in Africa
- 10. Dispelling the mythsDispelling the myths Scenario 3Scenario 3 Mr Awad has come to see his localMr Awad has come to see his local General Practitioner about a healthGeneral Practitioner about a health problemproblem
- 11. International women’sInternational women’s Health ConferenceHealth Conference May 2010May 2010 The NSW Education Program onThe NSW Education Program on Female Genital MutilationFemale Genital Mutilation The Education Program on FemaleThe Education Program on Female Genital Mutilation (Genital Mutilation (NSW FGM)NSW FGM) Principles of the ProgramPrinciples of the Program Program StructureProgram Structure
- 12. AchievementsAchievements Professional trainingProfessional training Clinical pathwaysClinical pathways
- 13. Men’s ForumMen’s Forum Media CampaignMedia Campaign Rural OutreachRural Outreach StrategyStrategy
- 14. ChallengesChallenges Evaluation of the whole programEvaluation of the whole program FGM/clinical standards for all stateFGM/clinical standards for all state hospitalshospitals Engaging the ImamsEngaging the Imams
- 15. Thank You
Editor's Notes
- Introduce Shairon and Linda There are many myths and misconceptions around the issue of female genital mutilation which can cause women and their families to be stereotyped and stigmatised. This paper will dispel these myths by illustrating the work the NSW FGM program is engaged in. We will do this though the use of case studies and role play. We would like to acknowledge all the workers in the FGM team and commend the amazing work of our bilingual health workers from the many FGM practicing communities who are the backbone of this program but sadly could not be here today. Change slide
- Fatma and Saadia ‘Fatma What is it with you? I came twice to visit you in the last several of weeks but you were not home. What’s keeping you so busy?” Change slide
- Fatma: I was attending a program on women’s health. “A bilingual Community worker that speaks my language presented a program for 3 hours every week. There were 11 sessions. We had a very good time.” “Every week we discussed and shared information on a different topic.” We got a certificate of attendance at the end. Saadia: “So what did you learn about? “ Change slide
- Linda: We learnt about the NSW Health Services and how to take care of our selves to be healthy. I learnt that there are different circumcisions and they all are harmful to women. It’s a myth that its a requirement in either Islam or the Christian faith. There is also a law in NSW that bans female circumcision. Even if the girl is taken out of Australia it is against the law to circumcise her. Did you know that even in a lot of African countries now there are laws against female circumcision. Shairon: I wish I had attended with you. Do they have any other programs? Change slide
- Linda: Yes, they also held a Zero Tolerance day. 100 women from 10 countries attended. They held two conference for men on women’s health. All the presenters were men. The Third Secretary from the Egyptian Consul spoke about how the Egyptian government is working to stop FGM in Egypt, Two doctors and two community workers presented information about the harmful effects of female circumcision not only on the woman but the whole family..Its a myth that only women suffer. Everyone suffers. They even had an Imam and priest who spoke about how Islam or Christianity actually do not call for female circumcision. The men were very eager to take an active role to stop female circumcision. Shairon: Wow, That must have been a good session. Linda: Yes, and in November they had the “International Day of the Child “ They spoke about child protection law and how we as parent can take action to protect our daughters. Many men came also and heard the information on how they as fathers need to prepare to protect their daughters if family members overseas pressure them to circumcise their daughters. Shairon: How can they stop FGM when it is such a cultural tradition? Turn to next slide
- Linda: This year they had 6 cultural days. There was dancing, singing and fashion parades. We can enjoy our culture and our good traditions, but we must stop the harmful traditions that hurt us and our children. We were able to speak and share our opinions around FGM and the Laws against it. Some of the younger ladies came and they wanted to get information around the Human rights of Women and children. Did you know some ladies said they had contacted their sisters and relatives back home and pressured them not to circumcise their daughters. So you see we can bring about change back home too. We all have to take action to stop this practice from continuing. Shairon: This program sounds so empowering for women. End Next slide
- Oh Linda it was such a shame you were not able to come along to the midwifery FGM in-servce we had the other day. The things I learnt plus there were things I thought I knew and was I wrong. The misconceptions I have held all this. Linda: “Such as” Myths to dispell: I was shocked to know that 130 million women are affected by one form of FGM across the globe. Change Slide
- It does not happen in only Africa. Its happens in over 42 countries around the world. 28 in Africa. I never realised how complex this issue is and how intertwined it is with culture and traditions. Its important we understand this practice in its cultural context. Countries affected (pp of world map comes up) Many countries have laws now. Linda: Did they talk about how women suffer? Change slide
- Health effects Many health problems both long and short. But not all women suffer in the same way. It depends on the degree of circumcision the woman has had. Some women who have had the most extensive form of FGM can still have a fulfilling sex life, but not all. What we need to do now in our wards is to develop best practice models of care and Develop clinical policies and guidelines Are you interested in helping me? Of course, I am that sounds like a good idea. Finish Change slide
- Shairon: Dr. “Good morning Mr Awad, sorry to keep you waiting. What can I do for you today?” Linda : Mr Awad: “Good morning Doctor. Actually I am here on a very difficult and sensitive issue.” “My wife and I are going through many problems. You see according to our culture she was circumcised as a child of eight, and we are finding she is in much pain when we try to sleep together.” “We have been married for nearly two years now, but she has not fallen pregnant.” “I feel that we are not really having a normal sexual relationship. I know that some of the men from our community say they had similar difficulties in the beginning of their marriages, but we seem to be having more difficulties than the normal. “ Shairon Dr. “Sometimes the circumcision is very tightly sewn and the only way is to deinfibulate, which means that we surgically have to open and widen the opening. Some women who are circumcised do have difficulties with sexual intercourse. Often people think all women suffer but this is a myth For those that do suffer we can help them if that is what they choose. This procedure has medical Item No. and a Dr can perform this procedure in hospital at no cost to you or your wife, as it is covered by Medicare.” Linda Mr Awad:” But I think it is more than just the physical. My wife is also very sensitive to me being close to her. When I ask her she says she gets flash backs of the day she was held down to be circumcised. I want her to know that I do not want to hurt her. But I don’t know how to help her.” Shairon Dr. “There are several specialists who can help you and your wife, as she discusses and speaks to you both, as a couple and individually about these issues.” I will need to examine your wife first and then refer her to a Specialist Gynaecologist and she may have to be deinfibulated. I can also refer you both to a counsellor who will need to know about the circumcision. After that I think we can also look at why your wife is not falling Pregnant. It might be just because of the tight circumcision and complications that causes. Linda Mr Awad: “Thank you Dr. I am sure my wife will be happy to come with me, as we both love each other, and want our marriage to work.” This tradition is a bad thing. We must find a way to stop this from continuing. Shairon Dr: By the way, there is also a Men’s Advisory group that are working towards stopping this traditional practice. If you want to contact them, you can call the NSW Education Program on FGM, and they can get you in contact with some of the men. Finish Change slide
- We hope that these scenarios have dispeled some of the myths around the issue of FGM. The NSW Program is a state wide funded program and each other state in Australia the programs are set up and managed quite differently. Principles The Program is based on the principles of community development, and the belief that community empowerment is at the core of community capacity building. The strategies developed empower the communities to build their capacities towards prevention of the practice. The Program maintains that the practicing communities, who are the custodians of the practice, can best achieve prevention of FGM. Program Structure The program has two main arms. Professional Education and Training Community Education Program Change slide
- Professional Education and Training The Professional Education Program targets counselors, youth workers, health services, relevant government and non-government education, welfare workers and police. Training offered covers clinical case management and counseling responses to FGM in order to equip workers to provide care in a sensitive non-judgmental manner to women and girls affected by FGM. Clinical Pathways The NSW Education program has developed referral pathways in collaboration within SWAHS for FGM affected women eg: uro-gynaecologists / psychologist. This means: Change slide
- Men’s forum: The men’s forum, began when the women who have attended our “Women’s Health and Traditions in a New Society” advised us that the men needed to come on board. As the decision makers and protectors of their families, they needed to understand the effects that FGM had on the women. Ten men were elected from the first men’s conference on Women’s health to be a part of the forum and the NSW men’s advisory group. The group meets every quarter to discuss strategies of working with men from each of the target communities and to participate in the functions and programs run with the different communities. Organized the Human Rights Training for the men to understand how the FGM Law was embedded in the Charter of Human Rights Media Campaign: 2 scenarios were developed, translated, recorded and broadcast on community radio in 3 different languages before the long school holidays. The aim of the campaign is to inform community members of the harmful effects of FGM and the NSW Legislation against FGM. It encourages parents to take a stand in protecting their daughters from the practice of FGM while on holidays abroad. Rural Outreach Strategy: As the NSW Education Program on FGM is a state wide program, the program has taken the Women’s Health and Traditions in a New Society to areas where women from Communities affected by FGM have been settled: Coffs Harbour New Castle Wagga Wagga Orange
- Sydney West Area Health Service (SWAHS) is to undertake an evaluation of the program of work conducted by The NSW Education Program on Female Genital Mutilation (NSW FGM) from 2001 – 2009. This will be commencing very soon and this will give us the opportunity to see what has and hasn’t worked and what we have achieved. Plus provide us with some directions for the future. Following this the NSW Health dept has committed to developing clinical management standards and guidelines for childbearing women affected by FGM which will be rolled across all public hospitals across the state in order that we provide consistent high level quality care to all women affected by FGM.