Female genital mutilation (FGM), also called female genital cutting, involves the partial or total removal of external female genitalia or another injury to the female genital organs for non-medical reasons . FGM is usually performed with a blade or a shard of glass by an elderly person or a midwife with limited training and often in unsanitary conditions . FGM is associated with various health consequences and even death. The practice can result in pain, bleeding, infection, and urinating problems as immediate health consequences. Chronic infections, cysts, chronic pain, birth complications, and sexual and emotional suffering are examples of long-term consequences of FGM [2–4].
FGM is a common practice in Iraqi Kurdistan, an independent region in northern Iraq that includes the three provinces of Erbil, Suleimaniya, and Duhok. In the early 2010s, the prevalence was found to be 40%, varying by geographic location and governorate from 4% in Dohuk to 58% in Erbil.
FGM/C provides no health benefits and causes serious immediate and long-term physical, psychological and sexual harm, including chronic pain, recurrent urinary and vaginal infections, post-traumatic stress, and severe pain during sexual intercourse . The immediate effects of FGM (significant pain and heavy bleeding) recur and are often exacerbated during and after childbirth, especially in women with type III FGM . Girls and women who are living with FGM shared the difficulties they had physically with childbirth, enjoying sexual relations, with menstruation, but also the many emotional difficulties . The negative effects of FGM also affect men, many complain of their wives being unable to enjoy sex and the strain this puts on a marriage .
The girls and women who live with FGM need care and protection, especially in a crisis-stricken country like Iraq, which is facing various problems where Where due to cultural and religious diversity social problems are high and varied in nature [13-15]. The girls and women who live with FGM have the right to live a life without pain and health, to live without stress, to enjoy sex, ensure physical, psychological, and sexual health will lead to care and protection. Mental health and sexual health are also two of the major aspects similar to physical care and protection. Therefore, the need to promote and practice knowledge and skill-based psychosexual care to girls and women who live with FGM is essential.
In the current study, an 18 days TOT workshop was conducted for the social workers working with FGM victims through the NGOs at Iraqi Kurdistan and reach out to social workers in these towns and villages to discuss and give them tools on how to live with the emotional and physical consequences of FGM. The module was divided into six sections: Understanding female genital mutilation (FGM) and FGM in Iraqi Kurdistan, communicating with girls & women living with FGM, Immediate & short-term physical complications arising from FGM, Mental health & FGM, Sexual health & FGM and Additional considerations for work with girls and women living with FGM. The module was divided into six sections: (1) Understanding female genital mutilation (FGM) and FGM in Iraqi Kurdistan, (2) Communicating with girls & women living with FGM, (3) Immediate & short-term physical complications arising from FGM, (4) Mental health & FGM, (5) Sexual health & FGM and (6) Additional considerations for work with girls and women living with FGM. These models look at the care of girls & women living with FGM by addressing their issues at individual, family, and community levels towards making it a clinical care and support model. The current training focused on understanding and addressing issues of FGM victims at the individual level through physical and psychosexual care for FGM victims, rehabilitation intervention, and promoting intervention through clinical care programs and referral programs.