Female genital and sexual mutilation

PROGRESS REPORT 2002: CBPB EDUCATION CAMPAIGN TO STOP FGM

BY: FRAN P. HOSKEN / WOMEN'S INTERNATIONAL NETWORK

THE CHILDBIRTH PICTURE BOOK (CBPB) HEALTH EDUCATION CAMPAIGN STARTED IN 1982 WIN NEWS ANNUAL REPORT WITH 2002 LETTERS FROM CBPB USERS

BACKGROUND:

The Childbirth Picture Book Program was started by WIN NEWS to help implement the Recommendations of the ground-breaking 1979 Seminar in Khartoum, Sudan on Traditional Practices Affecting the Health of Women and Children sponsored by the World Health Organization Regional Office in Alexandria, Egypt: Female Genital Mutilation (FGM) was the main topic of this official meeting to which Health Departments from 9 African countries sent delegations.

Two of the four Recommendations specifically cite education:

- "Intensification of general education of the public, including health education at all levels with special emphasis on the dangers and the undesirability of FGM; and

- Intensification of education programmes for traditional birth attendants, midwives, healers and other practitioners of traditional medicine, to demonstrate the harmful effects of FGM. . ."

As editor of WIN NEWS I was invited due to my research on FGM published in international health and medical journals and participated as temporary advisor and member of the Secretariat. My research paper "A Global Review of FGM" introduced the discussion of this subject.

The Recommendations of this seminar continue to serve as main guidelines for preventive activities and programs to eradicate FGM all over Africa. They were adopted and amplified by the Inter-African Committee (IAC) on Traditional Practices Affecting the Health of Women and Children which was organized in 1984 at a conference in Dakar to follow-up on the Khartoum Seminar. By now the IAC has affiliates in 26 African Countries. (IAC c/o ACW, P.O. Box 3001, Addis Ababa, Ethiopia and 145 rue de Lausanne, CH-1202 Geneva, Switzerland, Liaison Office).

After the Seminar I researched teaching materials on reproduction to implement the Recommendations on health education: but nothing was available that could be used to explain the process of childbearing in simple, straightforward ways that could be understood regardless of language or literacy and to show the damage done by FGM. It became evident that specific educational materials would have to be developed.

Together with a medical artist Marcia L. Williams, a midwife and other health advisors the Childbirth Picture Books and their Additions to Prevent Excision and Infibulation were developed page by page over nearly a year. A "prototype" was printed first in loose-leaf form in English and French and widely circulatred in 1980/81 in Africa and worldwide to health departments, international health and family planning organizations to UNICEF, UNFPA, WHO field offices, to midwives, physicians and nurses for comments and advice. The cross-cultural drawings - "teaching pictures" - are understood everywhere. The Additions to prevent Excision and Infibulation were approved by African midwives and gynecologists The biologically accurate pictures make the message clear by presenting the information in a straightforward way that readers and non-readers can understand.

PRINTING OF THE CHILDBIRTH BIRTH PICTURE BOOK (CBPB) AND TRANSLATIONS

The first books were printed in 1982: The Basic Childbirth Picture Book and the Universal Childbirth Picture Book in English, French and Spanish with Additions to Prevent Excision and Infibulation in English and French. The Arabic translation was added in 1984 made by request of the population program of the Egyptian Health Ministry who had 10,000 copies printed. The Somali translation includes Infibulation and was made in 1993 by a group of Somali women immigrants in Canada: the Health Ministry of Canada immediately ordered 2,000 copies.

At present WIN NEWS distributes:

- The Basic CBPB: English with the Text under each picture (for personal reading)

- The Universal CBPB: English / French / Spanish / Arabic / Somali (for teaching)

- Addition to Prevent Excision: English/French/Arabic

- Addition to Prevent Infibulation: English/French/Arabic

- Nutrition Supplement: English/French/Spanish.

Coordinated with the CBPBs are: Flip Charts, (English / French) 4x the size of a book and Color Slides. Each book consists of 5 sections: Pictures, Text, Discussion Guide, Glossary and Resource List.

A community-based approach is needed to improve the health of childbearing women and to teach about prevention of FGM. Showing the damaging results of FGM - as the Additions on Excision and Infibulation of the Childbirth Picture Books do - is convincing. First, the natural process of reproduction is explained, as it is still shrouded in secrecy and myths. The books explain with drawings the whole process from conception to birth, demonstrating that the genital organs of a woman are well made for childbirth and cannot be cut or excised without endangering mother and baby.

This message has been accepted in all local communities in Africa where the CBPBs have been distributed, so the thousands of letters WIN NEWS has received over the years show. They also show that people in local communities are eager to change and to teach in their communities