Female genital mutilation (FGM) is a harmful practice that affects 200 million women and girls alive today. While there has been a steady decline in FGM prevalence, still, an estimated 3 million girls and women are at risk of undergoing FGM every year. FGM has no health benefits, but one in four girls and women have experienced FGM performed by health workers. This points toward an alarming trend in the medicalization of this human rights violation.
We sat down with Catherine Meng’anyi, a nurse in Kenya, to hear about her work to end FGM. Through her efforts, she has reached more than 25,000 people from her community by advocating against FGM in a culturally sensitive way. She has rescued more than 200 girls from FGM and early marriage. Catherine has worked under Kenya’s Ministry of Health closely with the World Health Organization (WHO) in adapting materials used to end FGM and applies the WHO’s person-centred approaches to FGM prevention and care. She holds a Bachelor of Science in Nursing and is currently undertaking a Masters in Field Epidemiology and Laboratory Training Program.
Q: What brought you to ending FGM?
I am a survivor of FGM. When I was 12, my parents, who are well-educated, decided to go along with our culture and community, but chose to have a healthcare provider perform the cut. I knew the provider very well and it took me many years to let go of the harm she caused and to forgive her. She had every reason not to cut me, but she did.
When I underwent the cut, I was outside near my home, surrounded by relatives and people who knew me. I was covered with cloths and there were loud noises of celebration. I felt agitated and confused wondering what was going to happen next and if I would bleed to death. From the day I was cut, I carried pain, stigma and emotional, psychological trauma. The pain is always there.
For a long time, all I could think about was how I should raise my voice and prevent others from going through the same trauma. I have younger sisters, and I felt I needed to do something to protect them. From the age of 15, I spoke up to my family, telling my parents that my sisters should not undergo the cut. It worked. From there I spoke to close relatives. Then, when I finished school, I took the opportunity to speak up in my local community against the providers who are still practicing the cut in secret. I was still not strong enough to share my own story, but I stood up for what I knew was right.
Q: As a health worker, how have you managed to rescue hundreds of girls from FGM and early marriage?
My strength has been in building a network of people I can call when I need help. When I am stuck or I identify a girl who needs assistance, I always have somebody just the click of a button away. As a nurse in Kenya I work closely with the Department of Children’s Services and the police in case there's a girl who has been subjected to early marriage or other forms of gender-based violence. FGM has been illegal in Kenya since 2011, and so collaborating with the police has been very key.
In addition to the network of people with the government who are working to stop gender-based violence, I've always wanted to build up a network of survivors of women who underwent FGM and need support. Finding the strength to speak about your experience helps others say no; it helps end the practice.
Q: There is a growing call for men to help stop FGM. What do we need men to do?
It is important for men to stand up and say these cultural norms do not make sense. The practice of FGM is causing harm to their own children, their own sisters and mothers. We need men to embrace women who have not undergone the cut, to advocate and say they will marry women who have not had the cut. Many young men are coming out and saying no to FGM, so we need to strengthen these networks of men so that they are a team, a collective voice that other men hear.
Q: What is your advice to health workers? What can they do in their clinics and at community level?
People come to health workers for FGM, thinking that it’s much better than the traditional way, but FGM is a harmful tradition irrespective of how it’s done. It has been key to empower community health volunteers as role models in their communities who say no to FGM. We have them organize forums for girls to have a conversation about the dangers of FGM and early marriage.
I believe person-centered communication is the very best approach when trying to change a person’s values. Often it starts with value clarification for providers themselves to help them understand that what they thought was correct, like FGM, is actually wrong and harmful. Usually once someone understands the dangers of something, it's easy to change their mind.
I have always believed that having a conversation and understanding where a person is coming from is important. When a patient comes in for services, we, as health workers, need to start up a conversation about female genital mutilation and address the issue. Having this conversation also means getting solutions from the community themselves. That is the only way we are going to end FGM and early marriage.
The World Health Organization (WHO) uses a public health approach to FGM and works to ensure that girls and women living with FGM receive quality medical care and counselling, as well to develop evidence and advocacy tools to support efforts to prevent FGM.