Dr David Richmond, RCOG President, writes…
Picture this: You are travelling home in a crowded train late on a Friday afternoon and come across a newspaper article that sends you choking with indignation over something that is happening several thousand miles away. Short of spilling your coffee and muttering to yourself, what else can you do?
That was how I felt two weeks ago when I came across the story about a pregnant Sudanese mother and doctor who was sentenced to death for apostasy.
You would think that such stories are isolated incidences but in the last week, we have seen more grave news of the maltreatment of women. We have heard of a pregnant woman who was stoned to death in front of the courts in Pakistan by an angry mob and the horrific gang rape and hanging of two Indian teenagers in rural India.
How can these acts of barbarity happen in our modern, progressive society? This issue was discussed at our recent College Council meeting over the weekend.
Violence Against Women and Girls (VAWG) has a complex aetiology and there are many interconnected problems that need to be understood and confronted in order to root out this evil. At its rotten core are misogyny, oppression and ignorance.
The examples above occurred in under-resourced settings but in the developed world, women who are victims of violence often have other problems such as psychological trauma suffered during childhood and substance misuse and abuse. With increasing immigration into the UK, there are also other social problems such as female genital mutilation (FGM), child marriage and honour-based violence, which we as a society are only just beginning to become aware of.
For healthcare professionals, we have to deal with the consequences of actions arising from VAWG that are beyond our control – teenage pregnancy, fistula, STIs and HIV, preterm birth, to name a few. We see the links between cause and effect and yet, very often, we do not feel it is our place to speak out.
There are several reasons for this – it may be because we have a busy clinic and haven’t much time to spend on each patient, it may be because we don’t know how or with which agency to contact or it may be down to ignorance of our role and responsibilities.
The RCOG’s position, and that of many doctors, has always been to be culturally-sensitive and not to cause offence towards the women we serve and their families. We are very aware of the potential for the misinterpretation of good intentions and we have also been too careful over not interfering in private matters. There is a fine balance to be struck between doing what is right for the vulnerable and being accused of paternalism.
There is recognition by Council that we, as a profession, have a duty to speak out on behalf of women. Sometimes, a direct and unequivocal response is needed to help prevent cruel and inhumane practice. We are beginning to acknowledge that human rights principles must be embedded into women’s health and the curricula of medical training. This empowerment agenda will strike at the heart of gender politics and deeply entrenched social norms, firstly through better educational opportunities for girls and then through better employment prospects for women. The benefits are obvious.
We know that there is now a surge in global opinion against any form of violence on women. The 12th of July is the UN’s UNiTE campaign to end violence against women. Closer to home, the Foreign and Commonwealth Office and the Department for International Development are organising a Global Summit to end sexual violence in conflict on 10-13 June in London. A Declaration has been drafted that will call on all countries to end the use of rape as a weapon of war.
Leadership is needed to drive forward this global agenda and we can achieve much more if we work collectively to uphold the human rights of women. This is what we did with regard to the plight of Ms Meriam Ibrahim, the Sudanese mother mentioned at the start of this blog post.
Together with colleagues from the International Federation of Gynecology and Obstetrics (FIGO), the American College of Obstetricians and Gynecologists (ACOG), the Society of Obstetricians and Gynaecologists of Canada (SOGC) and British Medical Association (BMA), we wrote individually to the respective heads of state to urge action at the highest levels. No doubt we added our voice to many others.
In the UK, all three leaders of the political parties have condemned the treatment of Ms Ibrahim and have urged the Sudanese government to repeal her death sentence. Latest reports are that she will be released but these rumours still need to translate into action and I have written only this morning to our Prime Minister to continue the pressure at the highest levels. We shall continue the good fight.