Understanding Harmful Cultural Practices: A Q&A With Dr. Nazar Shabila

How do you combat a harmful practice that is both culturally accepted and a threat to public health? Nazar Shabila, a lecturer and public health researcher at Hawler Medical University in Erbil, the capital of Kurdistan in northern Iraq, has been talking to activists, lawmakers, healthcare professionals, religious leaders, women, and men, in order to understand attitudes toward the practice of female genital mutilation, which impacts an estimated 200 million women in over 30 countries. 

Tell us about your research for The Enhancing Life Project -- what, recently, have you been focused on? 

I am trying to understand the roots of female genital mutilation (FGM) in the Kurdistan region, where it is widely practiced, unlike in the other areas of Iraq. I am trying to understand why it is usually linked to social norms, cultural traditions, and in many instances, indirectly to religion. Very recently, I was mainly working with religious leaders to understand their perspectives on FGM, if they support it or not, and if they are talking to the people about their views. I've also been talking to men about their perspective. In the past, I talked to health professionals, women, men, and religious leaders. For my next steps, I'll be talking to civil society activists and lawmakers to understand their experience in fighting or trying to ban this practice in Kurdistan region. 

Did any of the groups that you talked to have responses that surprised you? 

One of these aspects is the sensitivity of the issue — so many people don't like to talk about this subject, especially men and religious leaders. There is also generally a poor awareness of this problem: many people do not know that it's so commonly practiced, many people do not know the adverse effects of the practice, and many people think that it's useful in some respects. 

Since this is largely a problem of awareness, what educational policies and awareness campaigns have you encountered? 

Most of the efforts have been through the mass media, but the mass media cannot reach all the people. The practice occurs mainly in the rural areas, where they have no such access to the mass media, so what people are thinking is that the awareness should happen through the community level first. For example, teachers and religious leaders at the community level have to talk to the people in rural areas. There's also a lack of awareness among religious leaders themselves, and among the health professionals, so it's a bit surprising that the issue has not been integrated into school curricula. It would be good if it were integrated into the curriculum, if it were studied in nursing school and midwifery school, for example, and for religious leaders and scholars. Because they directly interact with the victims, or with the mothers that are subjecting their daughters to the practice, they could then advise these people in the future.  

Based on your research, are there any specific policies that you think could be particularly helpful moving forward? 

We already have a law, which is unfortunately not very well enforced. So, what we need is increased awareness and enforcement of the law that we have. The policy issue is also to integrate the subject in the educational curricula of specific groups as well, so people can become more aware of the topic and they can take a leading role in prohibiting it in the future.  

Have you been teaching an Enhancing Life Studies course in conjunction with your research? 

I have developed two courses—one was supposed to be taught in October, but it has been delayed until February, so in February, I will have a course on women's health, with the principles of enhancing life integrated into it. From March to May, I'll have another course, an Introduction to Social Medicine, that will include a lot of principles of enhancing life, as well. 

Who will your students be for these courses, and what will you have them do? 

For the course on women's health, it will be for faculty, staff, and postgraduate students, so it's a kind of capacity-building workshop. It will be mainly through lectures, but I hope that it will be very interesting, because it will be talking about a lot of, not only the physical health, but also the cultural and social aspects of women's health. We will focus specifically on the Kurdish society, with special focus on traditional, harmful practices, and how the community can move into the future, and improve the health of women. So, there will be a lot of discussions, and hopefully we will come up with some suggestions and recommendations as well—not only lectures. 

What, if anything, are you most hoping that your colleagues come away from the course knowing about FGM? 

I hope that my colleagues and students will become more aware of this problem that exists in our community, and that they understand what are the roots of the problem, as well as why it's linked to social norms in the community, and to the religion as well. Hopefully they will, in the future, more actively work on this specific issue, through research and also through preventative programs, since many of them will be working in the public health and family health fields. Hopefully they will take the issue seriously. 

Read Dr. Shabila's blog post here.