Female Genital Mutilation

Case 23

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Intimate partner violence in Nigeria

Objectives

  1. Intimate partner violence can lead to any form even life threatening injuries

 

Narrative case

A twenty-two year old single woman had a child out of wedlock and was living with her parents. One day she went to visit the father of her child; he inflicted an injury on her vulva with a sharp object. The girl did not tell anyone though her mother noticed that her gait had changed. She collapsed at home in a pool of blood.

She was immediately taken to hospital and transfused with one unit of whole blood, as blood products were not available at the centre. A detailed history obtained at this point revealed that she was beaten up by the father of her child who also inflicted an injury on her four days prior to presentation. She did not tell her parents about the injury but her mother noticed she has been sad and unable to walk properly. Her mother inquired if there was any problem and she did not receive any reasonable answer.

She is a single mother resulting from an unwanted pregnancy while she was a teenager and she is not married to the man. She decided to have the baby although the father of the child wanted an abortion. She visits the man while she and her child reside with her parents. Her parents are responsible for her upkeep and that of her child. She was discharged home on the four days later and her father paid her hospital bills.

 

Learning points:

  1. Sometimes much probing has to be done as most women who experience violence from an intimate partner conceal it especially in developing countries for fear of loss of the partner.
  2. Cultural norms and beliefs may play a role in intimate partner violence as some cultures see violence of a woman by her husband as a result of disobedience on the part of the woman. Therefore the women might feel guilty and do not want to tell anyone about the incident because they might fear further punishment.
  3. There should be a high index of suspicion of intimate partner violence in any woman presenting with injuries in the external female genitalia not caused by delivery, and accidents.

Case 21

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Case study from Kenya on FGM and cultural practices which violate girls’ rights

Objective:

To show how cultural practices violate the rights of girls.

Narrative Case:

The UN convention on the rights of children define this group as those aged under 18 years. One ethnic grouping in Kenya honours the rites of passage for adolescent boys by unfortunately violating the rights of girls.

Mwandi is fifteen years old. She has known since she started her menses at the age of 12 years that she was destined for something special. Her mother kept a close eye on her and did not allow her to spend nights away from home at her friend’s houses like other girls. Early one morning her mother woke her up and after she had bathed, dressed her up nicely and took her to a strange hut in the nearby village where she was told to lie on a bed and keep her legs open[1].  Before she could scream, she felt a sharp excruciating pain down below after which she felt the sting of some herbal preparations [2]. She was told to keep her legs together. That was the beginning of the end of her childhood. Two weeks later when it had all healed up her mother gave her some special fragrant herbs to bathe with and told her she had to be good as she was going to bring honour to their family.

Later she learnt that ‘warrior’ boys are confined in a camp for various rites. Tradition and culture means girl children are circumcised and given to ‘warriors’ as sexual companions.There was no protection offered against sexually transmitted infections when she developed sores and was later told at the clinic that she was HIV positive [3]. Treatment consisted of herbs that her mother procured from a medicine man [4].

If girls get pregnant, because these relationships are outside marriage, the mother of the girl has to find a way of aborting the foetus. This is done by crushing the head of the foetus against the girl’s pelvis.  Mwandi was brought to the clinic by an aunt who visited the village and noticed the severe pain and extreme bleeding (menorrhagia) she was having [5,6].

 

Learning Points:

[1] Perpetrators are primary caregivers, parents, teachers and close relatives in Kenya and many other countries where culture and tradition are the predominant reason for a large number of practices that are harmful and violent, especially to girls.

[2] Female genital mutilation is believed to help control sexual urge in young girls and keep them chaste. The same tradition and culture is however throwing these virgin girls at young men to whom they are not married.

[3] There is no sex education of either young men or the young women to protect them against sexually transmitted infections (STIs) or pregnancies.

[4] There is a lack of healthcare available for those who get STIs.

[5] Women doctors must be aware of these practices and use every available opportunity to educate their patients on the dangers of these practices and the continued violations of the rights of children especially girls.

[6] Women doctors need to work with community opinion leaders to offer education on the effects and outcomes of these harmful practices.

 

Bibliography

  1. Mohamed  FJ. Does Kenya have the courage to lead on women’s rights in Africa? The Guardian April 21 2014. Available at : http://www.theguardian.com/global-development/poverty-matters/2014/apr/21/kenya-courage-lead-africa-womens-rights [Accessed 28th August 2015]
  2. Munyao WL.  Gender Issues Affecting the Girl Child in Kenya International Journal of Humanities and Social Science 2013; 3(4): 125-9. Available at: http://www.ijhssnet.com/journals/Vol_3_No_4_Special_Issue_February_2013/13.pdf [Accessed 28th August 2015]
  1. Queens University Belfast. Children’ rights resources. Available at http://www.qub.ac.uk/research-centres/CentreforChildrensRights/ChildrensRights-BasedResearch/ChildrensRightsResources [Accessed 28th August 2015]
  1.  Armstrong S. In Kenya, a Victory for Girls and Rights. The New York Times June 4 2013. Available at: http://www.nytimes.com/2013/06/05/opinion/global/in-kenya-a-victory-for-girls-and-rights.html?_r=0  [Accessed 28th August 2015]