Gambia takes on as National Program UAB project to abolish FGM

The Government of the Republic of The Gambia has decided to create a National Programme based on the "Initiation without Mutilation" project (Iniciació sense mutilació), directed by UAB researcher Adriana Kaplan, financed by Fundació "la Caixa", and managed by the Institute of Primary Care Research IDIAP Jordi Gol and the NGO Wassu Gambia Kafo. The project aims to eliminate the genital lesions created by these traditional rituals by proposing alternative methods which prevent physical mutilations but continue to respect the tradition. Researchers thus proposed a circular approach between Gambia and Spain to train health professionals of both countries in this area and to raise the population's awareness of the problems posed by such mutilations.

More than 130 million women in the world have been victims to some type of genital mutilation (FGM) and it is estimated that every year over three million girls are at risk of becoming victims of this initiation ritual. According to a 2005 census, more than 3600 women in Catalonia had been victims of some type of FGM and over 2000 girls were at risk of becoming victims of this practice in the next few years. To combat this problem, in 1989 researcher Adriana Kaplan began a research line on sexual and reproductive health among immigrant populations with fieldworks in Gambia and Spain.

Now Dr Kaplan has achieved one of the most important goals of her work, which is the acceptance of the Initiation without Mutilation project by the Gambian government and the creation of a National Programme under the Health Ministry's Department of State for Health & Social Welfare. The exceptional relevance of achieving this goal becomes apparent if one takes into account that only ten years before the Gambian government had prohibited any type of awareness-raising activity related to female genital mutilations as a response to the aggressiveness of some NGOs towards this issue.

The project consists in applied research, training, material designs and proposed methodologies, and aims to implement a pioneering strategy in Gambia and Spain that would solve the problem of FGM in both countries. The strategy is based on awareness-raising and prevention and on increasing the decision-making power of women so that they and their communities can adapt alternative proposals which do not include mutilations. This implies proposing and promoting substitute models for the rite of passage which would not include genital mutilation but at the same time would continue to be functional and culturally acceptable.

One of the project's highlights will be the creation of an FGM Observatory which has already published interesting data on this issue. According to data from the Observatory's past survey, out of the 185 sub-Saharan immigrants belonging to the Primary Care Centre of the city of Mataró (CAP del Maresme) 58 per cent of the women do not consider that FGM causes health problems, 74 per cent think Spanish laws only penalise cases of FGM practiced in Spain (parents who allow FGM to be practised on their children in their home country are also given prison sentences), 57 per cent welcome the alternative ritual proposed by UAB researchers, and 88 per cent of women and 71 per cent of men are against FGM. With regard to health professionals in Catalonia, the survey of 516 people reveals that only eight per cent of participants had adequate knowledge of what FGM is and of the types of mutilations practised.

The Gambia-Spain circular approach (to be carried out mainly in Catalonia given the large Gambian communities residing here) will make it possible to use the synergies created with Gambian immigrants in their role as opinion generators and models in their home country. Due to the growing demographic weight of the Gambian community in Spain it is possible that conflict situations related to female genital mutilations could become a common problem in the near future.

In Gambia, this project is being coordinated by the Faculty of Medicine and Health Sciences of the University of Gambia with the collaboration of UAB. The faculty will be in charge of training the country's public health professionals. For Adriana Kaplan, the project's research director: "This means that the knowledge transfer will take place and remain in Gambia, which guarantees its sustainability whereas itinerant training has proven to have little impact on the population. Thanks to the government's participation we have a solid project, a historical milestone which will lead to the training of health professionals all over the country." Dr Kaplan states that "although there are sanctions, this problem must be solved with social, religious and cultural transformations based on the respect towards their traditional rituals, but offering alternatives that do not involve mutilations."

When asked about the international projection of the project, Dr Kaplan affirms that "the learnings and conclusions from this project can pave the way for the application of this strategy in other populations with rites of passage containing similar initiation rituals, which in this case would include the rest of Western Africa".

FGM can be practised on girls shortly after their birth up until their pre-adolescent years, but always before they begin to menstruate. The injuries caused by these mutilations can worsen the health of the girls or even cause their death, while they perpetrate gender inequality, discrimination and a systematic violation of the rights of these women.

Adriana Kaplan is professor of the UAB Department of Social and Cultural Anthropology and scientific director of the Interdisciplinary Group for the Prevention and Research of Harmful Traditional Practices (GIPE/PTP). The project is financed by the International Cooperation sector of Fundació "la Caixa" and managed by the Institute of Primary Care Research IDIAP Jordi Gol and the NGO Wassu Gambia Kafo.

The GIPE/PTP is a research group certified by Universitat Autònoma de Barcelona and linked to the UAB Department of Social and Cultural Anthropology. It is made up of several professionals from the Primary Healthcare field working with immigrants in general and with FGM in particular. In the past few years, members of the group have been on various research trips to Senegal and Gambia to learn first hand of the population's situation, the reasons for their emigration and specifically the factors related to female genital mutilation. The group also offers training workshops on FGM for primary care professionals. For more information: http://mgf.uab.es

The Primary Care Research IDIAP Jordi Gol is one of the first institutes devoted to this type of healthcare research in Spain. For more information: www.idiapjgol.org

Since its creation in 1997 the Obra Social "la Caixa", through its international cooperation programme, collaborates in actions promoting the social and economic improvement of developing countries. This commitment is based on the support of local and international, innovative and quality social justice initiatives which promote local participation and focus on the most vulnerable societies. Through a holistic approach the Foundation gives support to projects promoting sustainable economic and production activities, micro credits, initiatives to improve living conditions and infrastructures, programmes in community organisation, Just Commerce, training, education, health, human rights, and support for actions in sudden or prolonged emergencies. These initiatives are carried out with the collaboration of development NGOs (DNGO) and other Spanish cooperation agencies, organisations, institutes and private entities.

Until now the International Cooperation programme of "la Caixa" has helped finance 371 projects in 58 countries with over 43 million euros.

Wassu Gambia Kafo is a non-governmental organisation present in Catalonia and Gambia. It was created by health professionals taking part in cooperation projects and living in Gambia. Its main objectives are the promotion and dissemination of cooperation projects working towards the development of Gambia.