Aissa Edon is an FGM (female genital mutilation) specialist midwife and former Community Midwife Team Leader at the Hillingdon Hospital Foundation NHS (National Health Service) Trust. She currently works for Medecins Sans Frontiers. She is a Mary Seacole Scholar and founder and director of the FGM Hope Clinic, which grew out of her passion to end female genital mutilation. Here she is interviewed by Terri Murray.
Terri: Can you tell us a bit about the aims of the project you undertook as a Mary Seacole Scholar?
Aissa Edon: It was to understand the needs of survivors of FGM and their partners in terms of psychological and pyschosexual support in Britain’s NHS system. So it was a service evaluation to hear the voices of the practicing community and people who have undergone female genital mutilation and to see how the NHS can improve their services and answer the needs of care.
Terri: It’s pretty cool that your project included partners. Is it an angle that has been looked at much before?
Aissa Edon: No it wasn’t really looked at before because FGM is often seen as a women’s issue. I do believe that it is a community issue. That was why I wanted to look at the place of the partner. Also, if you look at the origins of the practice, it was done for men, and most of the time it was by men, so I think we need to go back to the origin of the problem and make sure we include everybody impacted to eradicate the practice and find a solution. I also wanted to understand how FGM can impact [male partners] because in my studies, when I did the literature research, there was a little information about the impact on female survivors, but I haven’t seen anything on the how men and partners of FGM survivors are affected.
Terri: A lot of FGM survivors I’ve met have said that this is actually a form of child abuse, even if it is culturally acceptable and conventional. What is the psychological impact of that?
Aissa Edon: If you look at the practicing communities, talking about the psychological needs or the psychosexual needs is not something very ‘usual’ in these communities, so obviously it is a long process. The impact is still there, and we in the practicing communities feel it, but it is difficult to talk about the impact of the trauma. So it is difficult even to just scratch the surface, but I think it is really important that we try because the healing should not only be physical; it should also be for the whole well-being of the person, mental and social as well.
Terri: What recommendations did you make as a result of your research?
Aissa Edon: The recommendations are in different sectors, because they all came from what I was told in the ten focus groups: five with men and five with females. It was their experiences and their recommendations to be fair, not really mine. First of all, they wanted education to be provided to the front-line caregivers, and that means to ensure that it is part of the teaching curriculum for doctors and health care providers. They also talked about the need for education about FGM, so that teachers in schools have this in the curriculum, as well as social services and police. So the first step was education. They were very keen on that.
In terms of care provision, they wanted to have holistic care. That meant that they wanted to have standardised care, to make sure that wherever they live, they will have the same quality of care and a global care. They also wanted to work in partnership with the healthcare provider to make sure it is individual care, so that they have a say in their treatment, a voice and a plan where they have a consultation for their care. And they want to be seen not just as individuals but also as couples, with couple care so that partners of females who have undergone female genital mutilation could be included.
They also wanted to look at FGM care in a ‘global view’. They understand that in the UK it is an illegal practice and there is a lot of education and prevention, but they feel like it should not stop at the UK border but should be a global thing. They felt there should be the same approach in their countries of origin, where FGM was originally practiced. They also expressed a desire for the healthcare professional to go there and not only stick to the UK and do things here.
Terri: You’ve worked in this area for a long time and gained lots of experience. Were there any big surprises in your research findings?
Aissa Edon: For me it was really to have the voices of the partners of FGM survivors. That’s not something I’m used to hearing. I’ve been very touched and shocked also how big the impact of FGM is on these men, and how devastating and harmful FGM is for them. That’s something we need to understand because it may be the way we will stop the practice, if we have more men coming forward and fighting against female genital mutilation. It is affecting the women in terms of their physical well-being; it is affecting her obstetric history or sexual history and also her relationship. For men, who are not living the harm of FGM physically, they do feel a very huge impact emotionally and psychologically and that needs to be known. The relationship and sexual intimacy issues FGM causes with their wives was something male respondents talked about a lot.
Terri: What insights or advice can you offer to health care professionals who want to be better equipped to handle FGM?
Aissa Edon: It’s about having good training and also having a gentle, respectful approach, and a non-judgemental approach. It is also really important to make sure you are treating the patient and the family respectfully. Knowing what you’re talking about and how to approach things in a sensitive manner, and sometimes we don’t always have the words or attitude to say things, but fortunately the Mary Seacole Awards allowed me to also meet others who are working on the issue. One of the other Mary Seacole Award Scholars, Joanne McEwen, developed an App called Let’s Talk FGM, which teaches healthcare professionals how to talk about FGM in a simple manner. This is a really helpful tool you can download for iPad. It allows patients and professionals to give and receive information about FGM.
Worldwide, 200 million girls undergo FGM, and one in three women experience sexual or physical violence.
Terri: During your many years working to eradicate FGM, what was your most proud moment or achievement?
Aissa Edon: That’s a difficult question. I think when I will be the most proud is when FGM will be eradicated, so I’m not done yet. Every milestone… uh, I’m not really a very proud person anyway, but I’m waiting for the end of FGM and I will make sure everything I’m doing until then is for this goal.
Terri: One of the big problems in combating female genital mutilation seems to be that Western Europeans feel it would be an imposition on other cultures to criticise practices that are non-Western. We can easily be perceived as ‘superior’ or engaged in ‘cultural imperialism’ if we criticise the practice.
Aissa Edon: I don’t think we need to look at it this way. I prefer to look at it as a human rights violation. We need to recognise it as the cause of health complications and mental health issues, as well as other problems. It is not knocking on peoples’ doors and saying “you’ve done wrong”. It’s looking at the effects. For example, urinary problems or obstetric problems that exist because of female genital mutilation. Some pregnant women with FGM can’t have a normal vaginal delivery. That’s because of female genital mutilation. The fact that when you have sex it is so painful that you scream your head off: that’s because you had female genital mutilation. That’s fact. That’s not judgemental. It’s not saying that you’ve done wrong. It’s just telling the facts, showing the facts, and nobody can deny facts. Facts are the way to move forward, and by this means people will understand why this practice should be stopped. There is nothing judgemental in facts.
Terri: What’s next for you in your personal journey?
Aissa Edon: For me it is about carrying on what I’m doing. Then too, I still want to make sure that restorative surgery will be offered in the UK. I would like FGM to end in one generation, and if it can be in my generation that will be great. That’s the goal.