01/12/2014 12:37 GMT | Updated 31/01/2015 05:59 GMT

Egypt's Worrying Trend Towards Medicalising FGM

With the first ever prosecutions underway in the United Kingdom and Guinea-Bissau, an increased focus on strengthening the law in Kenya, and a rare conviction in Uganda, positive moves are being made in various locations to implement laws which ban female genital mutilation (FGM).

Under this increasingly optimistic backdrop, last Thursday's verdict in the case of Soheir al-Batea, a 13-year-old Egyptian girl who died after undergoing FGM in the Daqahliya Governorate, north-east of Cairo, was particularly disappointing.  Both Soheir's father and the doctor who carried out the mutilation were acquitted, despite the fact that a medical examiner's report, endorsed by Egypt's general attorney, confirmed that FGM had taken place.  The judge, who was appointed to the case only recently, seemed to discount this unbiased expert evidence and instead acquitted both men through writing in a court ledger.

Egypt has had a tumultuous past in terms of its battle to eliminate FGM.  In 2006, its two most senior Islamic clerics stated that FGM has no basis in religion.  Following this, in 2007, the country's medical professionals were banned from performing FGM, after a 12-year-old girl died.  It was this ban, backed by legislation introduced in 2008, that was used to prosecute Soheir's father and doctor in a very similar scenario, six years later.  Even with good laws in place, justice can continue to be evasive.  If laws are not implemented properly and the judicial system is not transparent, girls such as Soheir will continue to fall through the cracks.

According to Unicef, more than 27.2million Egyptian women and girls have been affected by FGM.  This represents 91% of the female population and is the biggest number for any one nationality.  Out of an estimated 100-140million affected by FGM globally, at least one in five is from Egypt.  While figures for younger women and adolescent girls seem to be decreasing slowly, this abuse continues to have broad national support from various quarters - including from professionals who are supposed to have a duty of care.

Unfortunately, as well as prevalence, Egypt also leads the world in terms of one of the biggest risks to the global anti-FGM movement - that of the increasing trend towards its medicalisation, which fundamentally contradicts WHO guidelines.  Incredibly, a 2012 academic document by Egyptian doctor Mohamed Kandil in 'F1000 Research', a peer-reviewed scientific journal, suggests there is "insufficient evidence to support the claims" that FGM Type 1 is harmful, when performed by medical practitioners.

Unicef suggests that 77% of the FGM which happens in Egypt is carried out by doctors or other medical professionals - an increase of over 100% since 1995.  Despite leading the way globally in terms of falls in prevalence, Kenya is also experiencing an increase in the medicalisation of FGM, while Indonesia has yet to fully ban it, although that country recently revoked its shocking 2010 regulation, which allowed medical professionals to legally perform FGM.  In 2010 too, Equality Now succeeded in reversing a decision by American Academy of Pediatrics (AAP) to endorse Type IV FGM, when it suggested changes in the law to allow for a "ritual nick" or pricking of the clitoral skin.

All efforts to permit or make FGM supposedly "safer" conceal the severe violence it represents and hide its lifelong and life-threatening physical, emotional and psychological consequences.  Soheir's death tragically highlights FGM as an extreme violation of the human rights of girls and women with serious health risks, regardless of whether it is performed on her inside or outside a medical establishment.

Without strong messages from the Egyptian government, such as proper implementation of the law and swift punishment for the perpetrators, FGM may become more acceptable, with women's rights increasingly taking a back seat at all levels.  Part of the solution too is ensuring that health care providers are given comprehensive education and training on the health and human rights implications of FGM.

This week, we are working with local lawyers at the Centre for Egyptian Women's Legal Assistance (CEWLA) to ensure that Soheir gets justice at last - justice for one girl, but hopefully setting a precedent to help ensure that countless others are protected.  Egypt needs to decide which direction it would now like to take. 

Equality Now is working on the Soheir al-Batea case as part of its Adolescent Girls' Legal Defense Fund (AGLDF), created to help rectify the unique and devastating human rights abuses suffered by girls during adolescence.  The AGLDF supports and publicises strategically selected legal cases, diversified to represent the most common and significant human rights abuses of adolescent girls.