In one of our first blog posts, we lamented the decision of an Egyptian court to acquit the perpetrator of the botched circumcision that lead to the death of 13-year old Suhair al-Bata’a. How could an entire judicial system overlook the death of a minor, and by so doing, uphold a tradition that it had outlawed on the basis of another minor’s death? How could it fail to implement any sanctions when 700 USD had cost the life of a child? In a reversal of fortunes however, the Egyptian courts conducted a retrial of both the doctor and the father of Suhair who had been responsible for the chain of events that led to her demise.
The court convicted Dr. Raslan Fadl of manslaughter and sentenced him to two years in prison for the offence and three months for performing the genital surgery. His clinic will be closed for a year. Suhair’s father was handed a three-month suspended sentence. Advocates against FGM/C in Egypt and around the world are hailing this development as an important stride in the campaign against the practice, especially in a country that has a prevalence rate of 91.1%. Indeed, the earlier acquittal raised questions about the effectiveness of instituting legislation against the practice. However, national laws against FGM were not encouraged as the only intervention for curbing FGM, but as an attendant to the ongoing efforts of discouraging the practice.
Another FGM/C trial is now ongoing in the UK, where Dr Dhanuson Dharmasena has been accused of performing a reinfibulation in 2012. Reinfibulation is “the practice of re-suturing and thereby creating an infibulation following a procedure in which the infibulation has been partially or fully opened, most commonly to facilitate childbirth” (WHO 2010). In this case, Dr. Dharmasena did not leave the infibulation open as has been recommended as best practice during post delivery care for women who have undergone FGM. Reinfibulating one’s patient not only constitutes an offence under the UK 2003 Female Genital Mutilation Act, but it also leads to additional physical and psychological trauma for the woman. It amounts to performing FGM/C all over again. According to Dr. Dharmasena, he was unaware that his actions counted as an offence under the law. He maintains that he was simply following the wishes of patient. While we are yet to see what the UK will conclude on this case, we can consider what this case reveals about the state of healthcare and its relationship to FGM/C.
Healthcare providers need to be educated on FGM/C. In today’s world, and especially in countries where a significant number of the population practice FGM/C, doctors cannot afford to remain ignorant about FGM/C. Indeed, such ignorance can only lead to substandard and insensitive care for pregnant women who are circumcised. Countries need to develop and fully implement training protocols on pre and post-delivery care for women who have undergone FGM/C. Such care should be done within an atmosphere that fosters respect for the pregnant mother, while explaining why a reinfibulation will not be performed i.e it may lead to physical, psychosexual and obstetric complications. Individuals trust their lives to doctors, and doctors should never abuse this trust, whether for financial gain or out of ignorance.