On International Women's Health Day: A reminder to fight the injustice of oppression

There are significant shortcomings in the care and support of migrant and refugee women, particularly in dealing with violent experiences during medical treatment. A conversation with Douha Nasser: Those affected, health guide and clerk at AOK Plus in Leipzig.

Women with refugee and migration experience are affected by far-reaching health problems. Racist and sexist structures make access to health care more difficult and cause psychological stress. Douha Nasser has experienced these challenges herself. After fleeing Syria 9 years ago, she became seriously ill in Germany. Despite experiences of discrimination during the treatments, she decided to devote her new vitality to supporting other affected people. This is how she got a job with the health insurance company and volunteered as a health guide, where she accompanies people with a migration background to appointments.

When accompanying women with a migration background, she notices above all that there is too little cultural sensitivity in the areas of women's health, i.e. in often very delicate contexts. Instead, there are often language barriers, a lack of information, time pressure and insufficient awareness of cultural differences. Upskilling medical staff on religious and ethnic diversity is slow and there is a lack of first language counseling. All of this has a negative effect on treatments and therapeutic success. "Culture-sensitive services in a multilingual medical practice are of great importance to ensure that patients are treated appropriately and feel respected and understood", according to Nasser.

Because examinations in women's health in particular are associated with negative emotions such as shame and fear for many refugee women. Sexual self-determination rights continue to be taboo in many societies around the world, with the female body being reduced to reproduction only. Gynecological care and reproductive health are therefore new to many women because they simply do not have access to them in their home countries. According to Douha Nassar, this access to reproductive health care becomes all the more important here, “including contraceptives, safe abortion options, and prenatal and postnatal care services.” In order to reduce the shame of speaking about these topics, empathy and enlightenment are needed on both sides. Women need to be informed about their own health so they can make treatment decisions, she said.

This is the only way to prevent violent experiences for refugee and migrant women. We particularly criticize the lack of knowledge on the part of health workers in dealing with women affected by female genital mutilation (FGMC). Female genital mutilation is a recognized reason for flight; It is estimated that more than 100.000 people are affected in Germany alone. This violation of human rights, practiced worldwide, is therefore a reality for many women. It must not be that those affected have to fear stigmatization and treatment errors because of negligent knowledge - or do not even make use of examinations. In addition, they often do not understand purely linguistically what is happening around them and on their bodies. If there is no mutual understanding and understanding in such vulnerable situations understandable explanation are confusion,  Communication and treatment abort as well as fear are the result. Nasser calls for comprehensive training of doctors so that they can treat women in a way that is attuned to these (cultural) specific needs.

We demand the unconditional implementation of the human right to medical care for ALL women! We finally demand protected spaces in which intercultural sensitization, advice at eye level and educational work are reality and normality.

A non-violent life for women and their rights to self-determination must also – and in particular – be enforced in hospitals and medical practices.

Denn: “We should remember on this day of action that promoting women's health is an important step towards creating a more just and inclusive world. Women need access to affordable and quality health care, regardless of their social status, residency status, race, sexual orientation or geographic location"Said Nasser.

[1] https://www.frauenrechte.de/images/aktuelles/2022/FGM/2022_Dunkelzifferscha%CC%88tzung_final.pdf

[1] https://www.bmz.de/de/themen/frauenrechte-und-gender/gewalt-gegen-frauen-und-maedchen/fgm-weibliche-genitalverstuemmelung