As evidenced in the readings on social determinants of health, there are numerous factors that may affect and impact the health status of certain individuals. In studying FGM/C in Somalia, I think what has the most impact is the social gradient/economic factor. As is widely realized, Somalia is still a very economically disadvantaged country and has yet to have a central authority after the war. “An entire generation is growing up without experiencing stability and security, basic human rights, and economic prosperity (Hansen, et al. 2018). This poses a serious health threat to those living in Somalia. According to WHO, “people further down the social ladder usually run at least twice the risk of serious illness and premature death as those near the top” (WHO, 2003). As we can easily imagine a situation like this in our country and instantly think of an economically disadvantaged, underserved area in the vicinity of our hometown, it may be more difficult to grasp the implications of the majority of an entire country having this extreme disadvantage.
A huge problem is lack of health services in general. In a recent article from 2017, it’s explained that, “there is no doubt that the quality of life of people from all walks of life have been affected; nevertheless, the extent of damage has been enormous among the vulnerable sections of the community.The estimates from the nation suggest that only one-fifth of the women have an access to skilled birth attendant at times of childbirth, while 94% of women do not have access to modern contraceptive methods” (Shrivastava, 2017). This is just one of the many surprising and devastating statistics coming from the status of health care in Somalia.
We’ve read and learned a lot about FGM/C this week, specifically on the different types. While, in the lecture video, it was mentioned that Type 1, which involves a small prick of the clitoris, is quite common – that is not necessarily the case in Somalia. From my research over the past weeks of class, Type 3 (or infibulation) is the most common in Somalia. Infibulation is also the most severe and can be very life threatening. If there is a serious lack in access to a skilled birth attendant, you can only imagine the lack of medical personnel present or available for FGM/C practices. Although there is a serious lack of data, it has been found that numerous young girls develop infections and many will die from blood loss as a result of the practice. In these cases, it is often impossible for the girls’ family to get them the medical attention they need. If Somalia were able to have a stable government, and eventually a stable economy, they could have the economic means to improve the access to health professionals and medical care that many of their people are in desperate need of.
Hansen, et al. “Somalia: A Political Economy Analysis.” All Institutions, Institute of Electrical and Electronics Engineers (IEEE), 22 June 2018, brage.bibsys.no/xmlui/handle/11250/2502618.
Shrivastava SR, Shrivastava PS, Ramasamy J. Training and deploying midwives to reduce the incidence of maternal deaths in Somalia. Ann Trop Med Public Health 2017;10:801-2
Wilkinson, Richard, and Michael Marmot. “Social Determinants of Health: The Solid Facts.” Anthropology MSU, World Health Organization, 2003, anthropology.msu.edu/anp270-us18/files/2015/05/Soc-Determs-of-Hlth-the-solid-facts-WHO-2003.pdf.