LangTurbo - Learn Languages Faster

of this impact on the victims so in this program we'll be talking walking our listeners through the

various ways fdm impacts the life of its victims so just one sec let me okay great

now okay so yeah so to help us actually make sense all of this today we have to

Now okay, so yeah, to help us actually make sense of all this today, we have to.

guess with me in this call i have dr helene margaret koudijs i'm not sure that the correct

Guess with me in this call I have Dr. Helene Margaret Koudijs, I'm not sure that's correct.

pronunciation very good yeah who is the senior advisor project lead and my medical doctor of

Pronunciation very good yeah who is the senior advisor project lead and my medical doctor of

global health and tropical at faro correct you're gonna tell us a bit about faro so we

Global health and tropical at Faro, correct? You're going to tell us a bit about Faro, so we...

had hardly no one

had hardly anyone

first does you know i'm waiting about that and then uh we also have in the call

First, do you know I'm waiting for that, and then, uh, we also have it in the call.

this our miss aminata baa who is a social worker and an fgm uh health advocate working

This is our Miss Aminata Baa, who is a social worker and an FGM health advocate working.

with the nh nhs in in the uk she's also an ambassador with the end fgm eu network

With the NHS in the UK, she is also an ambassador for the End FGM EU network.

while she's

terwijl ze is

supporting other ng o's and violence against women and girls so on this note i would like to

supporting other NGOs and violence against women and girls, so on this note I would like to

welcome you ladies thank you very much yeah thank you i want to share a few things about yourself

Welcome, ladies. Thank you very much. Yeah, thank you. I want to share a few things about yourself.

a few details with our viewers and listeners that maybe i didn't mention feel please feel free to do

A few details with our viewers and listeners that I may not have mentioned, feel free to do so.

so before we proceed shall i go first yeah you go first okay perfect so yeah so my name is helene

So before we proceed, should I go first? Yeah, you go first. Okay, perfect. So yeah, my name is Helene.

um i'm indeed working for faros but i'm a medical doctor and i worked quite extensively

Um, I’m indeed working for Faros, but I’m a medical doctor and I’ve worked quite extensively.

from 2018 to 2022 in first ethiopia and then cheryl leone um mostly in projects also related

From 2018 to 2022 in first Ethiopia and then Cheryl Leone um mostly in projects also related.

to women's health yeah so that's actually how i got acquainted with the topic which

to women's health yeah so that's actually how I got acquainted with the topic which

is very close to my heart and that's also how i moved to faros i don't know if this is the time

is very close to my heart and that's also how I moved to Faros I don't know if this is the time

to say something about faros yes yes please yeah okay i will so um faros is uh the dutch

and national expertise center on health equity which sounds very difficult but we basically

focus on unnecessary and unfair differences in health or health disparities for specific groups

meaning we focus on making healthcare accessible basically for everyone whether you're

born in the netherlands or whether you're a migrant whether you are highly educated or

born in the Netherlands or whether you are a migrant whether you are highly educated or

hardly educated everyone should have the same access to healthcare and also the same outcome

Barely educated, everyone should have the same access to healthcare and also the same outcome.

and related to fgm we are the national focal point for fgm which means that we do a lot of

And related to FGM, we are the national focal point for FGM, which means that we do a lot of

advice and also connecting different stakeholders healthcare providers so that women and who

survived fgm are getting the care they need in the netherlands right right how does your work

Survivors of FGM are getting the care they need in the Netherlands, right? How does your work?

i mean compared with the what the cricket does uh or is there an overlap

I mean compared to what the cricket does, uh, or is there an overlap?

who does

your work compare with or overlap with kkd

Does your work compare with or overlap with KKD?

oh yeah so safe hey day has um which is basically the public health service in the netherlands

Oh yeah, so safe, hey. Day has um, which is basically the public health service in the Netherlands.

so they have a very important role in public health services meaning they also offer like

for instance a care for women who have undergone ftm so they sort of link them to um but it's very

much from an health promotion perspective whereas faros is sort of taking the helicopter view and

much from a health promotion perspective whereas faros is sort of taking the helicopter view and

and connecting all the dots but because we also have medical expertise

in-house we can also sometimes give specific advice um to healthcare providers who are not used to

In-house, we can also sometimes give specific advice to healthcare providers who are not used to.

um seeing women or um helping women who have undergone fgac okay awesome thank you so very much

Um, seeing women or um, helping women who have undergone FGAC. Okay, awesome, thank you so very much.

all right mr minetta you may go next you can tell us a bit more about yourself if you wish

All right Mr. Minetta, you may go next. You can tell us a bit more about yourself if you wish.

if you so wish yeah um thank you so much for having us today so my name is amina tas useva

If you so wish, yes, um, thank you so much for having us today. My name is Amina Tas Useva.

I'm joining you from London UK today. I am a social worker, a children and family social worker.

Ik ben vandaag bij jullie vanuit Londen, VK. Ik ben een sociaal werker, een sociaal werker voor kinderen en gezinnen.

I'm no longer working for the NHS as a health advocate, but I was working with them for the past two years, maybe more,

Ik werk niet meer voor de NHS als gezondheidsadvocaat, maar ik heb de afgelopen twee jaar, misschien langer, met hen gewerkt.

within one of the clinics that support women who have undergone the practice of FGM.

Also, in addition to being a senior ambassador to the NFGM EU, I'm also one of the co-presidents, a board member of the network.

The issue of FGM is dear to my heart. I come from a country, I think we are the second, which is Guinea-Conakry in terms of prevalence after Somalia.

I'm pleased to be here today. Thank you.

Ik ben blij hier vandaag te zijn. Dank u.

Awesome. I do hope that after this the two of you will connect. Never know, you might do something together.

Awesome. I do hope that after this the two of you will connect. You never know, you might do something together.

Yeah, I think we already through the network, isn't it? Faros is part of the NFGM EU network.

Yeah, I think we're already through the network, aren't we? Faros is part of the NFGM EU network.

Yeah, definitely. Awesome. Okay, so let's just get started.

Yeah, zeker. Geweldig. Oké, laten we gewoon beginnen.

So like I probably hinted you, it appears that there isn't much research available regarding the psychological, social and the social impact of FGM.

So as I probably hinted to you, it appears that there isn't much research available regarding the psychological, social, and the social impact of FGM.

Which kind of surprised me when I was trying to do a little research on that.

Het verraste me een beetje toen ik daar wat onderzoek naar probeerde te doen.

I don't know whether you agree or not. I don't know what your take will be on that position.

Ik weet niet of je het ermee eens bent of niet. Ik weet niet wat je mening zal zijn over die positie.

Yeah, so maybe Aminata want to go first?

Yeah, so maybe Aminata wants to go first?

Yeah, it's not, to me really, it's not surprising. You make me smile because when it comes to FGM in general, this is a topic that has been said again and again.

It's really surprising. Yeah, it's not surprising to me. You make me smile because when it comes to FGM in general, this is a topic that has been said again and again.

And one of the campaigns, one of the advocacy that goes around with organisation working in the area is that we need more data, we need more research, we need really that work to be done.

And one of the campaigns, one of the advocacies that circulates among organizations working in this area is that we need more data, we need more research, we really need that work to be done.

And I've seen, I think there was this agenda with the joint project UNICEF and UNFPA.

I think they coming together.

I think they're coming together.

It was I think last year where they have this.

I think it was last year when they had this.

where they have this agenda draft to encourage research in the area so it is a good news but

waar ze deze agenda-ontwerp hebben om onderzoek op dit gebied aan te moedigen, dus het is goed nieuws maar

it's not a surprise i did my um on the personal level really my two dissertation my first degree

It's not a surprise I did my master's on a personal level, really my two dissertations for my first degree.

and my masters one was on fgm two different focus area but it was very very difficult to find

and my master's one was on FGM, two different focus areas, but it was very, very difficult to find.

you know uh material uh peer-reviewed articles yeah there are some there are some in the medical

side i would say that talk about the health impact or the the physical health impact

Side I would say that talk about the health impact or the physical health impact.

of fgm what is ft fgm the different type etc but anything to do with the psychological

of fgm what is ft fgm the different types etc but anything to do with the psychological

the mental health for instance um the research of mental health and fgm is quite

The mental health, for instance, um, the research on mental health and FGM is quite

uh limited and even the impact on i would say the different programs the organization working

uh limited and even the impact on I would say the different programs the organization is working on

around fgm the lived experience of women and families or communities yes all that is quite

Around FGM, the lived experience of women and families or communities, yes, all that is quite.

limited so it's not surprising yeah but in terms of the reasons really why this is what it is

it can be many really maybe lack of interest i would say yeah in terms of fund in terms of

It can be many really, maybe lack of interest I would say, yeah, in terms of funding in terms of.

decision makers as well um who fund research projects in this area maybe ethical issues as

decision makers as well as those who fund research projects in this area, perhaps ethical issues as

well uh to conduct uh some good research in the area you know i'll i'll uh elaine add some keyword

Well, uh, to conduct uh some good research in the area, you know, I'll uh, Elaine, add some keywords.

no no i think i have to agree with everything you said i think it's a very difficult topic to

No no, I think I have to agree with everything you said; I think it's a very difficult topic to.

research and i think in general it already starts with that there is a problem with what we call

research and I think in general it already starts with the fact that there is a problem with what we call

fgm which is basically how often does it happen and how many women does it affect

FGM, which is basically how often it happens and how many women it affects.

in the netherlands where i'm from now or in europe in general so these studies on numbers

in the Netherlands where I'm from now or in Europe in general so these studies on numbers

so purely numbers they have been done um but there there's always a big uncertainty in them because

um i mean part of it is done based on a scientific calculations rather than

Um, ik bedoel dat een deel ervan is gedaan op basis van wetenschappelijke berekeningen in plaats van

actually seeing all these women and i think that is also related to some um issues with this topic so

Actually seeing all these women, and I think that is also related to some issues with this topic.

like you said it's felt as a bit of a niche here which i don't think is necessarily fair but

zoals je zei, wordt het hier als een beetje een niche ervaren, wat ik niet noodzakelijkerwijs eerlijk vind, maar

because it doesn't affect a huge group like in cheryl leone where i worked or uh guinea-conakry

because it doesn't affect a huge group like in Cheryl Leone where I worked or uh Guinea-Conakry.

where you from like it affects so many um women here it's seen as a minority group already in

Where are you from? It affects so many, um, women here; it's already seen as a minority group.

general that is affected by it which is one then of course there is shyness to address the topic

and i think that comes both from providers as well as from patients so there's really a mismatch also

And I think that comes from both providers and patients, so there is really a mismatch as well.

in terms of how we address it um and i think um i mean in yeah people are also just not really

In terms of how we address it, um, and I think, um, I mean, yeah, people are also just not really.

um linking yet because there's a lack of knowledge also among healthcare providers if i look at my

I'm linking yet because there's a lack of knowledge also among healthcare providers if I look at my.

own training that people also don't really associate certain aspects for instance to

own training that people also don't really associate certain aspects with, for instance, to

the practice of fgm which makes it even harder so i think the fact that we don't really know

the practice of FGM which makes it even harder so I think the fact that we don't really know

um who all the affected population is

um wie de getroffen bevolking allemaal is

not a hot topic so you want to say for funders researchers etc plus a lack of knowledge together

Not a hot topic, so you want to say for funders, researchers, etc., plus a lack of knowledge combined.

makes it um quite difficult to get evidence and it also affects us in our work at files because

makes it quite difficult to gather evidence and it also affects us in our work on cases because

we always would like to give you know like evidence-based advice if possible but a lot

We always want to provide you with evidence-based advice if possible, but a lot.

of the evidence is actually very low and they call it low level quality just because it hasn't been

studied extensively enough

do you think this situation is going to remain as it's always it's likely to to

Do you think this situation is going to remain as it always has? It's likely to.

change uh because if there is a need may everyone then there's a need for this kind of

Change uh because if there is a need, then there’s a need for this kind of.

information but the data is not there you think there's going to be attention focused on this at

some point in time i think i mean that's definitely what nfpm europe is focusing on a lot it's also

At some point in time, I think I mean that's definitely what NFPM Europe is focusing on a lot, it's also.

are doing but i mean that's also for instance why we are spending a lot of time like trying to get

are doing but I mean that's also for instance why we are spending a lot of time like trying to get

and other harmful traditional practices

en andere schadelijke traditionele praktijken

in training

programs for medical professionals

et cetera, trying to

raise awareness among the women affected

raise awareness among the affected women

so like to sort of

you know, get it on the agenda

you know, put it on the agenda

but it's definitely a process

maar het is zeker een proces

I mean it has proven not to be

Ik bedoel dat het niet is gebleken.

super easy, otherwise it would have been

solved by now

opgelost tegen nu

ok, we'll just keep our fingers crossed

Okay, we’ll just keep our fingers crossed.

and going forward hoping that

en in de toekomst hopend dat

it will get to where it must

It will get to where it must.

get to, so then

based on your years

of work and experience

on FGM, would you like to share

yeah, I think you've shared your perspective

Ja, ik denk dat je jouw perspectief hebt gedeeld.

generally on this, but

I would like us to

maybe take those three areas

and kind of

en soort van

deep dive a little bit

dive in a little bit

ok, so let's talk about

oké, laten we het hebben over

the psychological

consequences of FGM

based on your practice

op basis van uw praktijk

your experience

you know, encounter with people

can you maybe

mention some of the

psychological consequences or impact that you

psychologische gevolgen of impact die jij

have noticed on people

I think that would be nice to share with our viewers

I think that would be nice to share with our viewers.

and listeners, because

en luisteraars, omdat

some people have totally no idea

sommige mensen hebben totaal geen idee

and when you mention FGM because

it's a taboo topic, so some people

are kind of shocked sometimes when you raise

the issue, you know, but

they need to know

what it is and what is really happening

so they can be able to

empathize more

yeah, no, definitely

ja, nee, zeker weten

go ahead

oh, sorry

so in terms of

psychological effects

psychologische effecten

I think what I've heard more than

have frequently

are for instance people

having fear or

anxiety disorder

depression

related to FGM

also of course

some women can experience post-traumatic

Some women can experience post-traumatic

stress syndrom

stress syndrome

or having reliving

moments where they

rethink about what happened

in the past

and I mean I told you a lot of my work

and I mean I told you a lot about my work

also before but also now at Faros

is focused on women's health

is gericht op de gezondheid van vrouwen

so like the negative

consequences on

sexuality but also related

to like sexual reproductive health

issues such as delivery

like I mean delivery itself can be very

Like I mean, delivery itself can be very

traumatic for women

who have undergone FGM

because things are happening

omdat er dingen gebeuren

in that area which is already so sensitive

for women

let alone if

laat staan als

you survived the practice

of FGM

yes, yes, yes

Aminata, you want to just ask some

Aminata, do you just want to ask some?

yeah, I think

ja, ik denk

really Eliane has

touched everything

in that area really

and it's important to really emphasize

the psychological impact because

they are as severe

as the physical impact as well

as well as the physical impact

and are you struggling

to hear me? Sorry

and now we can hear you

we can hear you

we kunnen je horen

okay

Okay

so I was saying the psychological

So I was saying the psychological

impact as severe

as the physical

you know impact as well

so it's really important

so it’s really important

to talk about it

women affected by FGM I think one of the

what I have seen in my work

and in my personal experience

is that burden of

not even being able

to talk about it

having that

hebben dat

psychological burden

and that mental health

buried inside you

for years and years

and not being able to share with anyone

en niet met iemand kunnen delen

because

it's not recognized

het is niet erkend

and it's not understood

it's something very

het is iets heel

very very very powerful

and for women who

been to the different

to the clinic where I was working

to seek counselling

to seek counseling

most of it like

Dr. Eliane said is linked to

Dr. Eliane said it is linked to

that

psychological consequences like

psychological consequences such as

the problem they are encountering

in their relationship

in intimacy

that developing you know the anxiety

That developing, you know the anxiety.

of being alone with a man

the depression with that

you know the fear of being touched

you know

so it's quite important

to consider

all these things but also to consider

I think the journey of the

survivors the women

because everyone will experience their own

psychological impact

differently at different stages

anders op verschillende momenten

in their lives you know

in hun leven weet je

so yeah

that's important to recognize

dat is belangrijk om te erkennen

yeah so Eliane

so yeah

how do you

try to help people who have been impacted

psychologically by this

psychologisch hierdoor

this experience

how to kind of bring some

relief or some sort of healing

to people who have this kind of

had this kind of experience

how do you take care of them

well I mean first of all let me say

Well, I mean first of all let me say

I'm not a psychologist or psychiatrist

Ik ben geen psycholoog of psychiater.

I wish I also was

I wish I also was.

but there is a lot that I can leave to other professionals

but I think it really starts with

maar ik denk dat het echt begint met

you know like

the healthcare provider being aware

that these effects

occur because of FGM

and also

acknowledging it and being open

and also sometimes when you see

en soms wanneer je ziet

that women are affected

to sort of break the taboo

om een soort taboe te doorbreken

a little bit so if I'm able to

een beetje dus als ik het kan

talk about it and

step over that shyness

and talk

openly and give women space

also to ventilate their thoughts

because like Aminata said they can be different

in different stages of their life

in verschillende fasen van hun leven

and also in different situations

en ook in verschillende situaties

I think that by itself

I think that by itself.

we see a lot

I recognize a lot that women feel relieved

I recognize a lot that women feel relieved.

when they feel acknowledged

and also

en ook

how do you say it

accepted in a way

op een manier geaccepteerd

and also that they feel accepted that

this is actually true

I think that is very important

I think that is very important.

whether you're a medical doctor

a social worker

or wherever you work to sort of yeah

acknowledge

and give space

and give them literally the physical space

to address how they feel

yes yes yes

but have you like

maar heb je zoals

come across women

have you come across women

who are in this phase of their lives

and struggling really

en echt worstelen

to come to terms

with what has happened to them

met wat er met hen is gebeurd

and to still get on with their lives

and to still continue with their lives

have you come across a number of women

who are dealing with this

this phase of their lives

have you experienced FGM

yeah definitely

ja zeker

for instance I'm 32 myself

so women in my age category

are often busy with babies

and thinking about how they see their lives

for instance not only as a partner

for example not only as a partner

or as a wife

or als een vrouw

but also as a mother

maar ook als moeder

so I've seen cases also

so I've seen cases too

where women are really you know

also struggling with the fact

and also the fear

en ook de angst

of having undergone FGM

to get pregnant

or like also child delivery

or like also childbirth

and what that could mean

en wat dat zou kunnen betekenen

not only like I mean as I said physically

but also for their mental health and well being

maar ook voor hun mentale gezondheid en welzijn

and whether they are

whether they feel they are capable

like well capable like

if they are in a well enough

if they are in a good enough

mental state to deal with that

mental state to cope with that

because it affects so much

omdat het zoveel beïnvloedt

also their fear

and how they look at

basically very human

things like

dingen zoals

relationships

relaties

pregnancy

and becoming a mother

en moeder worden

wow

I would like to add to that really

I would really like to add to that.

I have encountered

many young women

who are at the age of getting married

who are of marrying age

and who has undergone

the type 3 of FGM

type 3 of FGM

so they come and seek

counselling

counseling

and then therapy first

en dan eerst therapie

and then they go through the surgery

en dan ondergaan ze de operatie

yes

before the wedding

voor het huwelijk

and all that

en dat alles

so it's quite a journey

and it's quite a difficult period of time

so most of them are in their twenties

you know

or late teenage years

and they are starting the process

you know

to getting ready

for the big day

so it's humbling

I would say for me

Ik zou zeggen voor mij

it was really humbling

het was echt nederig

to work alongside these women

and to accompany them in that journey

en hen te begeleiden in die reis

but it's also

maar het is ook

really gets to me

suddenly

when I see this

wanneer ik dit zie

and when I know that

en wanneer ik dat weet

all the burden

alle last

the fears

the anxiety

de angst

they are carrying

ze dragen

for their big day

voor hun grote dag

which is supposed to be a happy moment

you know a happy day

but they are this

maar ze zijn dit

you know all that is covered

and fear and etc

so it's really

FGM is a silent

I would say

Ik zou zeggen.

killer

I think I would say it

I think I would say it.

because we don't imagine

omdat we ons niet voorstellen

we don't realise how much survivors

we don't realize how much survivors

women affected by this practice

suffers

but we have also

but we also have

I have also unconscious partners

I also have unconscious partners.

really which is

that come to the clinic

to support their wife

so booking the appointment

which is also very positive

to see

so yeah

I think that's the hope

I think that's the hope.

you know

it's a positive thing that we should

It's a positive thing that we should.

capitalise on

capitalize on

and work on

en werk aan

and continue to raise the awareness

and continue to raise awareness

really and join the forces

to end this practice

From both of you

Van jullie beiden

you come from Guinea

and you were in Sierra Leone

how is the campaign

to stop this harmful practice

I mean how well is it being received

I mean how well is it being received.

and can we

see

can we really see

the practice like

diminishing

I mean is it getting down to the

I mean, is it getting down to the

grassroots

what would you say about that

What would you say about that?

I think for me

I really struggled

Ik had het echt moeilijk.

so I have Ethiopia as an example

So I have Ethiopia as an example.

and then I worked in Sierra Leone

in Sierra Leone

there is no law against FGM

which I found so difficult

to understand and to deal with

but that didn't mean

maar dat betekende niet

that I didn't see

improvements

like for instance

I worked in a hospital

I worked in a hospital.

I had a lot of staff

I had a lot of staff.

educated women

opgeleide vrouwen

none of them

geen van beiden

had their child undergo

their daughters undergo FGM

so there was definitely a lot happening there

they are also much more open

and vocal about that

en daar openhartig over zijn

they also want the practice to end

but then we did a lot of outrage

but then we expressed a lot of outrage

to rural communities

and if you are really in a rural community

social norms

tend to be a lot more important

than what is happening in the bigger world

than what is happening in the larger world

so like

also young patients

but also in our delivery room

maar ook in onze bezorgkamer

I still saw a very very very

high number of women

being affected

so I think concluding

in the urbanizing

community

and the women

that are getting education

that are receiving education

you see really

you really see

that there is a big change happening

I think also

I think so too.

the Kenyan advocate

the Kenyan lawyer

has spoken about the importance

of education also to end FGM

as a practice

but I think if you are in rural communities

maar ik denk dat als je in plattelandsgemeenschappen bent

in some African countries

in sommige Afrikaanse landen

social norms still keep it

sociale normen houden het nog steeds in stand

in fact the practice

in feite de praktijk

unfortunately

yeah

I totally agree

I totally agree.

I think in Guinea, Conakry

I think in Guinea, Conakry.

it looks like the same really

in the capital

which is Conakry

we have a lot of active

I would say young people

I zou zeggen jongeren.

really campaigning

echt campagne voeren

going around

in social media

and doing a powerful

job

about raising awareness

but also stopping the practice

maar ook het beëindigen van de praktijk

but when you go down

maar als je naar beneden gaat

in villages

I would say in rural communities

Ik zou zeggen in plattelands gemeenschappen.

the story is different

unfortunately

but there have been changes

I would say in Guinea

Ik zou zeggen in Guinee.

and once again

en nogmaals

in terms of data collection

and research we are behind

we still come up

on the global map

as the second with

90 something percent

Ninety something percent

but that has gone down

or 80 something percent

or 80 iets procent

in terms of prevalence

but that has gone down

there are some

like local organizations

but also international NGOs

that recognize that

dat erkennen dat

there have been changes

but it's slow

maar het is langzaam

you know

because we have the other issue now

omdat we nu het andere probleem hebben

that

some families as well

sommige families ook

who doesn't want to engage in FGM

because it's so

omdat het zo is

strong and rooted

within the society

they don't want to do it openly

so they will not come and say

okay I'm not doing it anymore

okay ik doe het niet meer

still maybe there can be ceremonies

in families

but all the girls are not

maar niet alle meisjes zijn dat

undergoing the practice anymore

no longer undergoing the practice

so here again another challenge

in terms of research

and collecting data

en gegevens verzamelen

so yeah

okay awesome

okay geweldig

well let's touch on

the social consequences

of

for those who have undergone

the social impact

you might say for those who have undergone

the practice

it might be related to the psychological

het kan te maken hebben met het psychologische

as we've spoken but perhaps

as we try to deep dive

we might perhaps highlight more

the social impact

of FGM

on the victims you know

about the victims you know

look at that

kijk daar eens

any of you can go first

yeah

it's interesting

het is interessant

because when you are

omdat wanneer je bent

within a country

for instance or growing up

within a country or a community

which is

practicing FGM

I would say the social impact can be quite

positive for you because you are

part of that

circle I would say

I would say circle.

where you feel like

waar je je goed voelt

you are privileged

you have now

a sense of

you have this sense of belonging

of the community

it's like part of a rite of passage

het is als een onderdeel van een ritueel van passage

that is

you've come of age

sort of

kind of

something like that

iets dergelijks

yeah so you are respected

you are considered more of a woman

so once again it may depend

on the communities

or

different parts of the world

but

definitely for Guinea

definitief voor Guinee

you have that identity now

that is established

you have that sense of respect

and belonging

en toebehoren

so but

in contrast when I look at

in the European context for instance

if

we are

we zijn

like if you are from

a practicing community in Europe

een praktiserende gemeenschap in Europa

you are part of the minority

and you can feel really

and you can really feel

really different

and ask yourself

en vraag jezelf

why is this happening to me

waarom gebeurt dit met mij

I don't understand

Ik begrijp het niet.

you can feel

isolated

and

if you decide by chance

if you decide that you want to

fight against the practice

you can be ostracized and you can be

rejected as well

from your own community

and then you know there is this

racism, stigma

stereotypes that comes with it as well

stereotypes that come with it as well

you become

ordered because

you are different

you come with your different

practices and traditions within

communities that are

completely have different rules

different norms

etcetera etcetera yeah so the cost

etcetera etcetera ja dus de kosten

can be quite high

I would say depending

I would say depending.

on where the context

where we are

waar we zijn

so like within a

social setting

sociale omgeving

how would other women

recognize or identify

another who has undergone FGM

another who has undergone female genital mutilation

I mean and to the extent that

Ik bedoel en voor zover dat

in a social

it can be impacted

excluded or discriminated

against or something like that

tegen of iets dergelijks

how would they know that a fellow woman

has undergone FGM

that's interesting it's assumed that everyone

dat is interessant, er wordt aangenomen dat iedereen

like everyone from my community

is assumed that they are going to

undergo FGM you know

so like I was saying

you know so

because of that even if

omdat dat zelfs als

your family decides now

they are a bit progressive

they are not carrying

ze dragen niet

those conservatives ideas anymore

those conservative ideas anymore

they have to hide it

they cannot openly

and say we are not practicing FGM anymore

and say we are no longer practicing FGM

and we still have that

issue that challenge you know

so today there are families

in Guinea who are not practicing

FGM but they are not

FGM maar ze zijn het niet

going to say it openly

it's assumed and when it happens

het wordt verondersteld en wanneer het gebeurt

as well is a ceremony so everyone

knows in the

in the area so it's not done

in de buurt, dus het is niet gedaan

quietly now it will be

done quietly because there is a law

gedaan in stilte omdat er een wet is

people are trying to hide from it

they can do it at a younger age

but in certain communities

maar in bepaalde gemeenschappen

in Guinea for instance

it's done openly during holidays

It's done openly during holidays.

you see

you see young girls walking the roads

although there is a law you know

the way they are dressed

the way they carry themselves

you know that they are in that moment

where they are going through

waar ze doorgaan

the practice

the ceremonies and all that

so it's done openly I would say

So it's done openly, I would say.

wow

it's a deeply rooted

cultural belief that

you know it's hard to kill

I should say

I think it's very much

I think it's very much.

dependent on the social norms

like Aminata said

it really depends on the social norms

It really depends on the social norms.

of the context you are in basically

how you are received

and also how you perceive yourself

en ook hoe je jezelf waarneemt

basically

yeah

I know some of the culture

Ik ken een deel van de cultuur.

traditions, beliefs, norms

tradities, overtuigingen, normen

they don't die easily

I mean

Ik bedoel

we carry them for generations

and it can be a problem

and I think it's really

like what Aminata said

zoals Aminata zei

it really depends also

it really depends too

who is your peer group then

so who do you relate to

So, who do you relate to?

like for instance we hear from women in the Netherlands

that decide to opt out

so that they themselves

or their children, their daughters

do not undergo FGM

they can feel protected

because of the Dutch general context

vanwege de Nederlandse algemene context

where FGM is seen as child abuse

waar FGM wordt gezien als kindermisbruik

which it is

but if they look at the specific context

of the Malian community in the Netherlands

you can still feel very much

like you might be

zoals je misschien bent

risking being an outcast

or being rejected

of afgewezen te worden

or sent off

from your community

uit jouw gemeenschap

so you also really see women struggling with that

So you really see women struggling with that too.

and

one lady has to be the first one

but we also have a lot of

maar we hebben ook veel van

key persons

sort of survivors

that we work with at VAROS

who say if they are the first one

who says they are the first one

then it goes so so hard

then it goes so, so hard

like it has such big

dire consequences for them

also to sort of say

I don't want this practice anymore

I don't want this practice anymore.

and then it only becomes easier

and then it only gets easier

when more women sort of

also say they opt out

because then there comes

a new community forms

with new norms forms

with new norms shapes

where you feel safe in

but like rejecting

maar zoals afwijzen

what the community around you feels

is really really difficult

yes

so for

those

Guineans or Somalians

and the rest that are living

and the rest who are living

in the west

are they

zijn ze

I'm sure they do have some kind of

Ik weet zeker dat ze op de een of andere manier hebben.

modified version of

the rites of passage

for the young girls

I want to presume

I want to assume.

that they don't

do they have

some sort of activities

that celebrate

the passage of the young girls

into adulthood

in de volwassenheid

how is it now

I just wanted to have an idea

I just wanted to have an idea.

I mean

you mean here

in the west

no

nothing I'm aware of

niets waar ik me van bewust ben

I know

Ik weet het.

at least nothing that is

generalized I would say

I would say generalized.

within the community

there are some families now

they celebrate

they go out to celebrate

period time for instance

you know puberty

both for boys but also for girls

you know and

we have they have also

some

sommige

like working groups

or you know clubs for the girls

for young girls where they talk about

they educate they talk about

the culture

you know what is good about our culture

You know what is good about our culture.

what is bad about

I mean less good about it I would say

I would say less good about it.

but nothing

maar niets

really

echt

that is that stand out

I would say as FGM

that is followed by everyone

you know I've seen I think

in outside

Europe in

countries where

the prevalence is high

they're trying to replace it

they're trying to

ze proberen te

replace the cutting by

vervang de snede door

you know

do the ceremony

perform the ceremony

but don't do the cutting

maar doe het snijden niet

trying to encourage that

and there are some communities

in West Africa

who are taking part into that

who are taking part in that

you know

that's more progressive

dat is meer progressief

to reform

the

ceremony so that

ceremonie zodat

they take out the harmful part of it

they remove the harmful part of it

you know what I'm saying

there is a sense and a meaning

to having this kind of ceremonies

om dit soort ceremonieën te hebben

where you know a child passes from

where you know a child passes through

puberty to adulthood or whatever

puberteit tot volwassenheid of wat dan ook

and then so it's nice to

en dan is het fijn om te

maintain that but to take away

the harmful part of it I think that

The harmful part of it, I think, is that

hopefully

hopelijk

the transformation you know

completely is done

for the different cultures we have

yeah

yes

okay awesome let's now

dig deep into the sexual

dig diep in de seksualiteit

impact now we know already that

impact now we already know that

there are difficulties and

complications associated with the

complicaties geassocieerd met de

you know

the FGM

when it comes to the sexual

terrain you know yeah

you mentioned some of those during

the discussion of the

psychological part of it

psychological aspect of it

but maybe you can

maar misschien kun jij

perhaps throw more light

perhaps shed more light

if you wish on

the sexual impact

of FGM

on the lives of these women

maybe you can I think it would be nice

Maybe you can, I think it would be nice.

to do some

get some more detailed insight

into how it impacts their lives

hoe het hun leven beïnvloedt

yeah

so I think I mean that's already

So I think I mean that's already.

mentioned a very important

topic which is related to basically

topic dat in feite gerelateerd is aan

sort of the physical aspect

of sex so for women who have

undergone type 3

underwent type 3

which is the type

where sort of the

waar een soort van de

labia of the women are

the labia of the women are

sewn together so there is a very small opening

for urine and

there is often not physically

possible to

have very

yeah exactly

ja precies

which makes it very makes that

part very difficult but then

part zeer moeilijk maar dan

how sexuality is perceived

is also something entirely different

which relates to a lot more

factors so of course there is

a lot of research that says that

and also I've heard it a lot that

women say like I have pain

all the time like I cannot have sex

without having pain

even if my husband is very nice to me

even if we

you know like we take the time

you know, like we take the time

it's still always painful

het is nog steeds altijd pijnlijk

but there is also women I mean

but there are also women I mean

sex means a lot of things to a lot of

Sex means a lot of things to a lot of people.

different people so there is also

women who say

has something different

there is women who do get orgasms

There are women who do have orgasms.

there is women who do

there are women who do

have pleasure

have fun

in sex it's a very

In sex, it's very

wide spectrum basically

broad spectrum basically

of

yeah

yes

how FGM affects you

but

I think like even more than

FGM itself

is already a taboo

sex in FGM is a

ginormous taboo

which makes it also really difficult

which also makes it really difficult

for a lot of people to talk about it

and I think it's such a shame

because there is also a lot to be won

because there is also a lot to be gained

here yes

absolutely yeah

absoluut ja

Evelette what would you

Evelette, what would you?

what would be your take on

yeah I think

ja ik denk

she is on point and

I think it's the same really

Ik denk dat het eigenlijk hetzelfde is.

most of women who have

most of the women who have

I have encountered at the clinic

I have encountered at the clinic.

come in because of lack

come in due to lack

lack of

desire or lack of

pleasure during intercourse

plezier tijdens de geslachtsgemeenschap

there is a term for it

in medical I can't remember

In medical, I can't remember.

I start with G

three

there you go

so yeah

it's not a laughable matter

it's not a laughing matter

but it's really

maar het is echt

it's really

het is echt

difficult because

that's part of

dat maakt deel uit van

you know

the daily lives and

you know

being married and having

or being with a man

having a partner

and you cannot

you know

leave your sexuality at the fullest

leave your sexuality at its fullest

it's really

het is echt

it's really tragic

het is echt tragisch

yeah it's tragic so

ja, het is zo tragisch

this is most of the women here

dit zijn de meeste vrouwen hier

I have encountered is that

and like I think Dr. Helen said

en zoals ik denk dat Dr. Helen zei

is really depending on

is echt afhankelijk van

the FGM

you had the type of FGM you had

you will have different consequences

and it will affect you

en het zal je beïnvloeden

differently but

yeah sexually

ja seksueel

I think the main

this is the main reason FGM is

taking place is really to affect

that particular

really

echt

sensitivity of the

woman in all that so

most of women will

most women will

a good number would say

women will have

vrouwen zullen hebben

some consequences around that

some consequences surrounding that

where there is no feeling

waar geen gevoel is

no desire

and you can imagine what does that mean

and you can imagine what that means

really

echt

in their lives

in hun leven

yeah

ja

also you know like you say

it really affects also being a woman

it really affects being a woman too

a lot which is what I hear a lot

I also heard it from friends in Sierra Leone

I also heard it from friends in Sierra Leone.

who had undergone the tradition themselves

that they also said

that they really felt

which I think is so so sad

which I think is so, so sad

like they felt that they were less of a woman

because of specifically this aspect

omdat specifiek dit aspect

and I disagree wholeheartedly

en ik ben het daar helemaal mee oneens

but

talking to them you see

where they are coming from

waar ze vandaan komen

because it's so yeah

omdat het zo is, ja

very sad

yes yes yes

yeah you know

ja, je weet wel

I just wish

Ik wens gewoon

I could give back to this woman

I could give back to this woman.

whatever they took away from them

wat ze ook van hen hebben afgenomen

but there is

maar er is

along the line

we met a doctor

a surgeon here

een chirurg hier

was then in Amstelveen

and he had a practice

en hij had een praktijk

where

waar

we heard that he did

what is called a reconstruction

and he said

I don't know if you can tell us

I don't know if you can tell us.

how effective

hoe effectief

how reassuring

hoe geruststellend

how comforting

hoe troostend

that sort of procedure can be

for women who have been

maybe who had less type 3

type 3 FGM

and they want to undergo reconstruction

I mean to what extent does it restore

I mean to what extent does it restore.

their confidence

hun vertrouwen

their dignity

hun waardigheid

their sense of well being and all that

hun gevoel van welzijn en al dat soort dingen

yeah so I think first of all

yeah, so I think first of all

I want to mention of course

I want to mention of course.

that what has been taken away

that which has been taken away

is not something you can replace

is niet iets wat je kunt vervangen

but of course

like in terms of sensitive tissue

zoals in termen van gevoelig weefsel

around the women's

private parts

there is a lot still there

there is still a lot there

also after FGM

so when they are doing reconstructive surgery

so when they are performing reconstructive surgery

they are basically removing a lot of the scar tissue

They are basically removing a lot of the scar tissue.

sensitive tissue

sensitieve weefsel

more to the surface

so that women can have

their private parts

look more

like they would have

zoals ze zouden hebben

before the practice

etcetera

so in the Netherlands

there are some different rules

and regulations in Europe

in some countries this is already done

in sommige landen is dit al gedaan

like for different indications

in the Netherlands currently

it is mostly done for

people who have physical complaints

but not so much for psychological

or sexual consequences

but they are researching

maar ze zijn aan het onderzoeken

whether it could also be done

for people who experience

sexual problems

or psychological problems

after FGM

I think

it is

for a group of women

it can be

potentially very helpful

if only because they feel

als het alleen maar is omdat ze zich voelen

they are getting

ze krijgen

some form of rehabilitation

but I think for another group of women

maar ik denk voor een andere groep vrouwen

also having a

sexologist who is

culturally sensitive

and used to working with women

who have undergone this practice

can also be a good solution

or having a good psychotherapist

to talk about their fears

or their trauma

or their depression

of their depression

that came from this

so I think

it is very women specific

It is very specific to women.

and women dependent

whether a reconstructive surgery

or a sexologist consultation

or a psychologist

or maybe physiotherapist consultation

is the best solution

is de beste oplossing

so I think it all comes down to

basically patient centered

basically patient-centered

and case specific care

en gevalspecifieke zorg

yeah yeah yeah

well half a loaf

or half a bread

or half a loaf

is better than nothing

so there is something like that

that can at least help towards the healing

or restoration

I think it is better than nothing at all

Ik denk dat het beter is dan helemaal niets.

that is some good news I would say

That is some good news I would say.

I think women

sorry to bump in

sorry to interrupt

having that choice

het hebben van die keuze

that service available

for women and they can choose

to use it or not

I think that must be

Ik denk dat dat moet zijn.

encouraged to be there

aanmoedigen om daar te zijn

definitely

is that something that

is dat iets dat

either of you ladies have come across

in the line of your work

in the course of your work

which maybe touch you

which may touch you

so deeply about

these three areas we have spoken about

the psychological the social

and the sexual

maybe a recollection of something you have

maybe a memory of something you have

experienced or seen or heard

maybe touch you deeply

on this topic you want to share

yeah so

ja dus

feel free

voel je vrij

along the cut of your work

or you experienced something or heard something

either you experienced something or you heard something

that maybe touched you deeply

that may have touched you deeply

you want to share

it is difficult

what you are asking

because I think everything

omdat ik denk aan alles

is touching and emotional

is aangrijpend en emotioneel

in this work

in dit werk

you know

there was no moment

that I go to that

clinic or I go into this

family or I do a workshop

where I don't feel

waar ik me niet voel

like okay

maybe I have taken part of someone

or I have left part of me

there you know

there have been moments where

you cry internally

with the women that you see

you know

and just

remembering like women

herinneren zoals vrouwen

coming in I would say

ik zou zeggen binnenkomen

everything yeah every moment

alles ja elk moment

is difficult I would say it touches you

but seeing women

maar vrouwen zien

coming and seeking support

that's very very courageous

dat is heel erg moedig

and brave of them

but seeing them desperately seeking

but seeing them desperately searching

for reparation

you know

and wanting that piece

of them that was taken

years ago to come back

that's difficult

dat is moeilijk

that's really difficult

dat is echt moeilijk

especially

in the UK context for instance

we

the NHS

the national healthcare system

doesn't provide surgery

for women

you know like

reconstructive surgery they do

surgery for women who have

undergone the part

the type 3 FGM

that's the application it's called

dat is de applicatie die het heet

but for reparation

maar voor schadevergoeding

they don't do surgery like that

They don't perform surgery like that.

so having to

so moeten

interview and receive

interview en ontvangen

women who are seeking specifically

that reparation and then

they have to be turned down

zij moeten worden afgewezen

and looking at their face

you know that's something

je weet dat dat iets is

that stays with you

you know so yeah

that's what is coming to my mind

dat is wat in mijn opkomt

but there's more really

but there's really more

every soul

iedere ziel

every woman

you meet in this line of job

you meet in this line of work

you remember them

yeah

ja

I have two cases

I have two cases.

I think that really inspired me

I think that really inspired me.

to work more on this topic

so the first one was when I was training

So the first one was when I was training.

as a doctor

for my specialization program

and I was working in the delivery rooms

en ik werkte in de kraamkamers

and there was a girl very young

from Eritrea

van Eritrea

and she had undergone a type 3 FGM

and she was terrified

for delivery

voor levering

she had probably been raped

and she came to deliver

and she had been

so she had undergone type 3 FGM

she was in the delivery room

She was in the delivery room.

and she was terrified

but

all the healthcare providers

alle zorgverleners

were in that room sort of looking at her

like she was some sort of

zoals ze een soort van was

having a look at her private parts

I think there were 10 women

I think there were 10 women.

between her legs

looking at her

kijkend naar haar

like she was some sort of

bizarre creature

not communicating with her

and I thought oh my god

en ik dacht oh mijn god

we have to do this better

how is this possible

this is a few years ago

but it really inspired me

I think we need to train

I think we need to train.

our healthcare providers and our health team

because this is not right

omdat dit niet juist is

women deserve good care

Women deserve good care.

you shouldn't be feeling

je zou je niet moeten voelen

as an outcast in that setting

you should be getting culturally appropriate

care by people who care about you

and really

for me it inspired me

to work further on this topic

to continue working on this topic

so that was one

and then there was one experience

in Sierra Leone

so this was in the Netherlands

and in Sierra Leone

en in Sierra Leone

I had a really nice medical doctor

I had a really nice medical doctor.

from Sierra Leone

uit Sierra Leone

who was under me

and she called me at some point

and she told me Helene

you have to come to the hospital

You have to come to the hospital.

so I asked what's going on

her name is Asenatu

so I went there and she said

Helene I saw a woman with a clitoris

Helene, I saw a woman with a clitoris.

she has not been cut

imagine she has not been cut

but she was

maar ze was

so happy to see

an uncut woman

but she was also so sad

maar ze was ook zo verdrietig

for herself

voor zichzelf

because she's like

omdat ze zoals

I wish I was that girl

I wish I were that girl.

and how amazing

en hoe geweldig

so she was complimenting the family

and asking where are you from

en vragen waar je vandaan komt

how does it work

how amazing that she is

hoe geweldig dat ze is

already adult age

she's not been cut

ze is niet geknipt

we have been busy with this topic

and I'm sure you have learned a lot

from these two ladies

and we would

hopefully we would have them back

hopelijk zouden we ze terug hebben

some other time

hopefully on a related topic or something

Hopefully on a related topic or something.

but we certainly have enjoyed you both

but we certainly have enjoyed both of you

and I want to thank you so much for your time

en ik wil je heel erg bedanken voor je tijd

and we will keep you posted

and we will keep you updated

on what happens from here on

so thank you so very much

and I want to wish you a lovely evening

you too thank you so much

thank you

Thank you.

Psychological, Social & Sexual Impact of FGM