Reconstruction surgery can offer life afresh to women who have been subjected to genital mutilation. A study published in The Lancet says such surgery can make it possible not only to reduce the pain such women live with but also restore the lost sensations. It advocates that more plastic surgeons be trained in the procedure. The study comes at a time when voices are being raised in India against female genital mutilation (FGM) in the Bohra Muslim community. The World Health Organisation (WHO) has declared the practice as having no health benefits,only harm. Islamic scholars suggest there could be up to 1 million women who have been subjected to FGM in India. There is,however,little awareness among surgeons of either the procedure or its reversal though they say that by the sound of it,it should not be a difficult surgery to perform. Dr Ajay Haryani,a consultant plastic surgeon at Mumbais Nanavati Hospital Bohra Muslims are mainly concentrated in Maharashtra and Gujarat said: That (possibility of reconstruction after FGM) would depend on which parts of the female genitalia are mutilated. There is little information we have on this practice. An online petition was recently addressed to Bohra high priest Dr Syedna Mohammad Burhanuddin,reportedly by an activist in Mumbai,calling for an end to the practice,known as khatna. According to WHOs definition of FGM,it involves all procedures that involve partial or total removal of the external female genitalia,or other injury to the female genital organs for non-medical reasons. The Lancet study cites surgeries by doctors from three hospitals in France,led by Dr Beatrice Cuzin of the urology department at Lyons Edouard Herriot University Hospital,on 2,938 women aged 18 or above over an 11-year period till 2009. Reconstruction broadly involved four steps. The skin covering the stump was resected to reveal the clitoris. The suspensory ligament was then sectioned to mobilise the stump,the scar tissue was removed from the exposed portion and the glans was brought into a normal position. As per answers to a questionnaire given out before the surgery,99 per cent of the women who opted for the surgery did so to get back their identity while 81 per cent said they want an improved sex life. Of the 840 patients who came back for follow-up,821 reported an easing of their pain,and by one year,51 per cent of them reported a more rewarding sex life. FGM is practised as a means of ensuring female purity by prevention of illicit sexual relations. WHO labels it a violation of human rights of women and children and associates it with recurrent bladder and urinary tract infections,cysts,infertility and increased risk of childbirth complications and neonatal deaths. Islamic Scholar Asghar Ali Engineer,a Bohra Muslim himself,says there is no religious sanction for reconstruction after FGM but many women in the community are beginning to talk about it now. However it is very hush hush,both the mutilation and the reconstruction. Seventy-five per cent women in the community undergo the procedure,so there would be about 1-1.2 million women in India alone who have undergone FGM, says Engineer. Dr Mahesh Mangal,chairman of plastic surgery at Sir Ganga Ram Hospital,said: I have not come across any case of female genital mutilation. However,reconstruction should not be difficult to do.
