Bioethics. 2012 Oct;26(8):ii-iii. doi: 10.1111/j.1467-8519.2012.02010.x.
Europe debates circumcision…and what about the child’s best interest?
No abstract is available for this article.
Article first published online: 8 NOV 2012. DOI: 10.1002/hast.86. Nov-Dec 2012 42(6):3
Culture and Cutting
The two provocative essays in this issue of the Hastings Center Report should stimulate debate not only about female genital cutting, fetal dexamethasone, and clitoral reduction surgery, but also about our fierce commitment to particular cultural norms about the body. Under what conditions may adults irreversibly modify a child’s body because they think the change is in her best interest? Certainly, parents who opt for female genital cutting or for surgical reduction of an enlarged clitoris in a girl with congenital adrenal hyperplasia want to make choices that will contribute to their child’s potential happiness. If cutting in Africa—or mitigating CAH symptoms here—upholds a girl’s gender identity, which will translate into a fulfilled life as an adult, some argue that a parent’s refusal to abide by social prescriptions does the child a serious disservice
Explore (NY). 2010 Jul-Aug;6(4):220.
Statement on female genital mutilation from the staff of Explore.
Dossey L, Kligler B, Radin D, Sierpina V, Fenton M, Horrigan B, Schwartz SA.
…. An estimated 100 to 140 million girls and women worldwide are currently living with the consequences of female genital mutilation (FGM), according to the World Health Organization. Sometimes called female circumcision, FGM includes procedures that intentionally alter, injure, or partially or totally remove the external female genitalia for nonmedical reasons. These procedures include but are not limited to clitorectomy, partial or total excision of the labia, and infibulation. They are usually carried out on girls between infancy and age 15 years. They confer no health benefits but can cause severe bleeding, infection, death, anxiety, fear, pain, urinary problems, and later, childbirth complications. Although FGM is internationally recognized as a violation of the human rights of girls and women, it persists widely in many African, Middle Eastern, and Asian…
Reprod Health. 2010 Aug 18;7:21.
Strengthening the emergency healthcare system for mothers and children in The Gambia.
Cole-Ceesay R, Cherian M, Sonko A, Shivute N, Cham M, Davis M, Fatty F, Wieteska S, Baro M, Watson D, Phillips B, Macdonald R, Hayden B, Southall D.
Head Office, Maternal and Childhealth Advocacy International (MCAI), Conway Chambers, 83 Derby Rd, Nottingham NG1 5BB, UK. firstname.lastname@example.org.
ABSTRACT: A system to improve the management of emergencies during pregnancy, childbirth, infancy and childhood in a region of The Gambia (Brikama) with a population of approximately 250,000 has been developed.This was accomplished through formal partnership between the Gambian Ministry of Health, the World Health Organisation, Maternal Childhealth Advocacy International and the Advanced Life Support Group.Since October 2006, the hospital in Brikama has been renovated and equipped and more efficiently provided with emergency medicines. An emergency ambulance service now links the community with the hospital through a mobile telephone system. Health professionals from community to hospital have been trained in obstetric, neonatal and paediatric emergency management using skills’ based education. The programme was evaluated in log books detailing individual resuscitations and by external assessment.The hospital now has constant water and electricity, a functioning operating theatre and emergency room; the maternity unit and children’s wards have better emergency equipment and there is a more reliable supply of oxygen and emergency drugs, including misoprostol (for treating post partum haemorrhage) and magnesium sulphate (for severe pre-eclampsia). There is also a blood transfusion service.Countrywide, 217 doctors, nurses, and midwives have undergone accredited training in the provision of emergency maternal, newborn and child care, including for major trauma. 33 have received additional education through Generic Instructor Courses and 15 have reached full instructor status. 83 Traditional Birth Attendants and 48 Village Health Workers have been trained in the recognition and initial management of emergencies, including resuscitation of the newborn. Eleven and ten nurses underwent training in peri-operative nursing and anaesthetics respectively, to address the acute shortage required for emergency Caesarean section.Between May 2007 and March 2010, 109 patients, mostly pregnant mothers, were stabilised and transported to hospital by the new emergency ambulance service.293 resuscitation attempts were documented in personal logbooks.A sustainable system for better managing emergencies has been established and is helping to negate the main obstacle impeding progress: the country’s lack of available trained medical and nursing staff. However, insufficient attention was paid to improving staff morale and accommodation representing significant failings of the programme.