As the International day against female genital mutilation (Mgf), ActionAid launches an urgent appeal for Italy to apply decisive measures to prevent and combat this specific form of gender violence and to protect the human rights of girls and women most at risk or who have already suffered this harmful practice. According to available estimates, in 2019 there were 87,600 women carriers of FGM in our country, of which 7,600 were minors, while there were around five thousand girls at risk, mainly coming from Egypt and Nigeria. However, these numbers do not reflect the actual diffusion of the phenomenon since it is a practice that is still little known and recognized.
For many years, an Italian law (no. 7/2006) has prohibited female genital mutilation, at the same time establishing the implementation of a series of prevention and assistance measures in favor of the victims under the responsibility of various ministries and the Regions. However, there are many critical issues recorded. First of all, the lack of training of those who, in the social, health, educational and legal sectors, come into contact with girls and women at risk or already subject to FGM; the limited involvement of practicing communities; reduced access to healthcare and medical services, especially for the reconstruction and regeneration of genital tissues.
“To guarantee all the necessary support to those who have undergone female genital mutilation, it is essential that institutions at national and regional level take action to improve the policies and procedures currently available”, we read in a note from ActionAid. «The national health system must recognize the physical and psychological consequences resulting from FGM, providing for their inclusion in the list of essential levels of assistance (Lea) for chronic pathologies and allowing the exemption of the co-pay. Furthermore, access to care must also be guaranteed for women and girls without healthcare through specific STP (Foreign Temporarily Present) coding or equivalent qualifications, depending on their legal status.”
According to ActionAid, it is necessary to establish «special codes of Homogeneous grouping of diagnoses (Drg – Diagnosis-related group) for the functional, sensorial and anatomical surgical reconstruction of the vulva and its tissue regeneration. The Regions can also play a fundamental role in promoting the right to full sexual and reproductive health of women carrying FGM and ensuring, at the same time, adequate financial reimbursement to hospitals in the event of intervention».
«The international scientific community agrees in stating that, in women who have undergone mutilation and who request it, simple deinfibulation is often insufficient to treat chronic symptoms related to the practice“, points out Barbara Grijuela, surgeon, specialist in obstetrics and gynecology at the Asst “Santi Paolo e Carlo” in Milan. «There are many reconstruction techniques that can be proposed, but none have a specific DRG coding and adequate reimbursement for the procedure. This implies that reparative and regenerative surgery codes created for other pathologies are used, with the risk that the coding is inappropriate and therefore the procedure is not adequately reimbursed.”
At the same time It would be necessary, at a regional level, to create specialized multidisciplinary units that use resources already present in the area, integrating duly trained linguistic-cultural mediators and plastic surgery specialists. This opportunity arises from a proposal from Italian society of plastic, reconstructive-regenerative and aesthetic surgery – Sicpre which, thanks to associates such as the plastic surgeon Massimiliano Brambilla, is very active on the front of female genital mutilation. Not only: greater transparency is necessary regarding the application of law no. 7/2006. At present, in fact, there are no periodic reports available on preventive measures, support services and National toll-free number 800.300.558 and on the planned information and training initiatives, to which the Budget Law annually allocates dedicated resources”, we read further in the ActionAid note. «The future national plan against male violence against women, in synergy with regional anti-violence plans, must also include structured and continuous research, awareness-raising, information and training actions».
“Still too often female genital mutilation is considered a distant phenomenon that does not concern us“, he claims Aisha Ba, community trainer for ActionAid Italia. «And yet I am a form of violence present in many Italian territoriesmade invisible by the lack of attention of the institutions and the inadequate knowledge of those who, in various professional capacities, may come into contact with girls and women who could be affected by this harmful practice. To make visible a very serious violation of human rights and, above all, prevent and combat it, it is necessary for both central and local institutions to implement a long-term multi-agency strategy. The latter, among others, must include adequately funded and regularly implemented activities aimed at practicing communities and key actors in the educational, health, social and legal sectors to equip them with specific knowledge and operational and coordination tools that allow the emergence , sending and taking charge of potential or actual cases of FGM in the various territories of the country. In this context, community trainer and linguistic-cultural mediators must have a central role because we are essential bridges between cultures that facilitate access to services, truly allowing us to combat FGM in Italy.”
ActionAid works to put an end to female genital mutilation through the direct involvement of the communities most at risk, thanks to the fundamental role of community trainers, specially trained professional figures belonging to the communities affected by this practice. After “After”, a European project born in 2016 and implemented in Italy and other European countries to monitor public policies and raise awareness among communities, since 2020 ActionAid has continued to work on the topic with projects financed by European Commission – come “Chain” e “Join our Chain”. Central to this is the creation of local multi-agency networks capable of identifying potential or actual cases of FGM, so as to provide prompt and adequate assistance to girls and adult women. Social services, health facilities, schools, law enforcement agencies, judiciary, territorial commissions for the recognition of international protection, third sector bodies, are the main actors that ActionAid has involved in the development of an intervention chain model in Milan and Rome .
Credits: photo Ian Kiragu on Unsplash