Med Student Sheds Light On Controversial Practice

Released on 06.12.2017

In her first year of medical school, Reem Abdalla volunteered at a student-run Global Health Conference focusing on women’s health.  For the event, she was assigned to research and design a workshop on female genital mutilation (FGM) – the partial or total removal of external female genitalia for non-medical reasons.  It was then she learned of the prevalence of the practice in Egypt, a country she calls home.

“When I was doing research on FGM, I found that it was very common in Egypt which shocked me,” said Abdalla, who will begin her final year of medical school this fall. “I had never heard about it, and so I felt led to do more research and write about it to educate others, especially as a Muslim-American-Arab girl in healthcare.”

Armed with the information she gained from her research, Abdalla wrote an academic essay that was published recently in The Pharos, the Alpha Omega Alpha Honor Society’s quarterly journal. The publication contains scholarly essays on nontechnical medical subjects, including medical history, ethics and medical-related literature.

Though she was born in Chicago, Abdalla’s family is from Egypt, a country where more than 90 percent of women are estimated to have been circumcised. The World Health Organization estimates that more than 200 million girls and women living in Africa, the Middle East and Asia have experienced female genital mutilation – a practice recognized internationally as a violation of human rights.  According to WHO research, in some countries FGM is an important religious, cultural or social tradition, for others it’s a way of ensuring cleanliness for girls and is believed to promote chastity.

In her article, Abdalla explores the origins of FGM, the cultural and socioeconomic factors associated with the practice and suggests ways to eliminate mutilation through education.

“The point of the article is to bring awareness, to educate families about the negative effects and risks associated with the practice,” Abdalla said, noting that many women die during or after the procedure from infections or from childbirth complications later on.

“There are women who don’t want this for themselves or their daughters, and so I want them to know that there is help, that there are organizations that help women escape forced FGM.”

Abdalla believes it’s also important to educate men who refuse to marry uncircumcised women.

“That’s one of the main reasons women get circumcised, because they are considered pure and able to remain faithful to their husband.  So educating men is even more important,” she said.

Her urge to research and write about the topic was supported by Dr. Judy Simms-Cendan, associate professor of obstetrics and gynecology at the College of Medicine. An adolescent gynecologist, Dr. Simms-Cendan has practiced in parts of Africa where the practice is prevalent.

“Having worked globally, this is something I was familiar with, but it’s not talked about much in the developed world,” Dr. Simms-Cendan said, echoing the need for more awareness of the practice, particularly among U.S. physicians.

“Practicing in a multinational country, physicians need to be aware of this procedure and the areas where it’s endemic,” Dr. Simms-Cendan added.  “Doctors may have to treat women and girls who have had this procedure, and it’s important they are not treated in any way that can be judgmental.”

While the practice is illegal in the U.S., Dr. Simms-Cendan noted that this does not deter parents from sending their girls to their home countries to get it done or approaching American physicians to have the procedure performed on their daughters.

The Centers for Disease Control has reported that approximately 513,000 women and girls in the United States were at risk for FGM in 2012, more than three times higher than an earlier estimate, based on 1990 data.  The CDC estimates that the increase is a result of the rapid growth in the number of immigrants from countries that conduct the practice who are now living in the U.S.

“For those reasons, we need to educate physicians so they understand where this thought process comes from,” Dr. Simms-Cendan said, “to know how to educate families why it’s not necessary and be able to advocate for their patients.”

Abdalla said she has received positive feedback on her article from healthcare providers who support her move to promote awareness.

“After the article, I got emails from readers from around the country telling me about their first-hand experience with FGM when they worked in Ethiopia, Egypt and Kenya.”

Abdalla plans to continue her research and publish more articles to build awareness.

“I just signed up as a volunteer and was placed to design the FGM workshop,” she said. “I didn’t choose it; it chose me without me actually looking for it. So I felt like it was a responsibility for me to write this.”

Abdalla’s article can be read in full here.

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