Nawal Nour: The MacArthur Genius Is Training Healthcare Providers to Work with African Women Who've Undergone Female Genital Circumcision

Article excerpt

Why did you decide to open the African Women's Health Center in Boston? When I was doing my ob/gyn residency at Brigham and Women's Hospital, I gradually developed a practice for African women who have circumcision ... I grew up in Sudan where circumcision was very common. The African women felt comfortable with me because I saw female circumcision as a matter of fact. Then, I approached the leaders of the Brigham and Women's Hospital [to see] if they were interested in formalizing an African center where we would be focusing on women who had genital cutting and also reproductive health in general of refugee women of African descent.

Was there any resistance to opening the center? When we opened it up. no one showed up for several months ... it was a bit of a puzzling moment. Then around that time, I realized the community thought that I was financially benefiting by opening up the clinic. I had to go back into the community to say I'm a salaried position. If you'd like to come see me, great, but I'm going to see anyone who comes to see me. I intended to provide a service that was specifically for them, but there was suspicion in the community.

Was this suspicion something that came from their experience in the United States or from their homelands?

I think it's both. The Somali community has come from war zones. It is very rare that people do something good because they would like to do something good for them. had to work very hard to establish trust to get them to understand that it's pure recognition that there is a need in the community and my job is to fulfill the need. And that I'm being selfish in that it gives me pleasure to fulfill the need; not [that] there is any other ulterior motive.

The other portion is that in the United States, it gets very difficult for immigrants and refugees to settle here and feel welcome.

Where are your patients from? The majority live in Boston, but I do have women who travel from very far away ... some come from Texas and California. I try to prevent that, so I do a lot of counseling on the phone. The goal is to train other physicians and not to have patients travel from afar. Most are immigrants [and] refugees who don't have much funding, can't afford the finances or the time to come see me.

And that also goes back to training the residents. Most graduate and leave Boston. For about 10 years, I've created a network of physicians who know and are comfortable taking care of women who have been circumcised.

What are the most common misconceptions healthcare providers have about women who've been circumcised? …