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French Team’s Post-FGM Holistic Services Include Surgery

ENGLISH Mart 31, 2016
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Fanta, a 27-year-old nursing assistant, says she had the surgery because she wanted to be “like other women” and have the chance at feeling “sexually active and satisfied.”

She spoke to Women’s eNews in a hospital room just a few hours after reconstructive surgery to repair the effects of female genital mutilation, or FGM. To safeguard her privacy she asked that her real name not be used.

Fanta lives in Viroflay, a community in the Île-de-France in north-central France. She underwent FGM as an infant in Bamako, a city in her native Mali, where FGM is common.

Fatama has suffered the painful consequences of FGM but says she does not blame her mother who was just 17 at the time.

Taking on a Taboo

In Mali, Fanta says, people are not free to speak about FGM, that the topic is taboo.

But here in her room at the Inter-Communal Hospital Centre of Poissy-Saint-Germain-en-Laye, a public hospital, in Yvelines, in the Île-de-France region, she does comment on what she thinks sustains the practice.

“Some are doing it because they say that the clitoris will be long and not beautiful to look at without FGM,” she says. “Some say it’s because of religion and some others because it is tradition.”

In her own view, the point of the custom is to decrease women’s pleasure.

Since 2003, the cost of post-FGM reconstructive surgery like hers has been covered by the French public health system.

Female genital mutilation is the practice of partially or totally removing the external female genitalia or otherwise injuring the female genital organs as a customary requirement for marriage. It is associated with a series of health risks and consequences, according to a 2008 statement by the World Health Organization.

Addressing the Emotional Trauma

In addition to pain and bleeding, FGM is associated with such long-term consequences as chronic pain, infections, decreased sexual enjoyment and post-traumatic stress disorder.

At the Reproductive Health Institute, or Institut en Santé Génésique, located in Yvelines and founded in 2014, all those issues are addressed, not just the surgery.

“Now instead of a simple operation, we have a complete multidisciplinary patient care approach that works better because we treat the whole mutilation with its emotional, social and psychologic impact,” Dr. Pierre Foldes said in an interview in his office at the institute that was conducted in French and translated.

“What we need to know,” Foldes says, “is that these women are for most of them not only victims of FGM but also forced marriages and less visible violence.”

Foldes, 63, Fanta’s surgeon, is a former doctor with Médecins du Monde, or Doctors of the World, an international humanitarian organization providing medical care to people who have been afflicted by war or natural disaster.

Foldes first encountered the traumatic effects of FGM, or excision as some call it, 30 years ago while he was working as a humanitarian doctor in Burkina Faso in West Africa.

From there he went on to become part of a team who developed a surgical technique to restore the clitoris after FGM.

Today that team is one of very few in the world performing this operation.

In addition to performing this surgery at the Inter-Communal Hospital Centre of Poissy-Saint-Germain-en-Laye, a public facility, Foldes also performs it at the nearby private  Saint – Germain Clinic .

Women seeking post-FGM treatment come from all social strata, says Isabelle Valentin, a psychologist volunteer at the Reproductive Health Institute who counsels women who have undergone genital cutting.

For all their differences, Valentin says the decision to have reconstructive surgery is equally important in a very basic way for each woman.

“They’re going to discover an organ they have never known, or barely knew if they underwent cutting at a young age,” she says.

“When the patients come here, they feel incomplete, they feel something is missing,” Valentin adds. “Most of the time they feel pain and they suffer when delivering their children.”

Since the institute opened two years ago Valentin has met about a hundred survivors of excision and has been studying their posttraumatic symptoms.

When FGM occurs at an older age girls have particularly horrible memories, Valentin says. “But in all cases, their bodies remember this trauma.”

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