Remarks by M.F.Fathalla
IPPF, London, 24 November 2009

After serving in my developing country, and then moving in the international field, I came to realize that women in different countries have more in common than what meets the eye.

They all had or are still having an uphill struggle to claim their God-given rights. Basic to these rights is that girls are given a chance. Unfortunately, in many parts of the world, they are still not given a chance.

Where does giving girls a chance begin?

It begins in the first place by giving the girl a chance to be born. The practice of sex selective abortion of the female foetus has been spreading widely, particularly in East and South East Asia. I deplore that my profession and our own scientific advances have been an accomplice in this practice, resulting in a skewed sex ratio at birth, that is beginning to have unprecedented social repercussions.  

Where next are girls to be given a chance?

The girl child is to be given an equal chance to her brother for survival and healthy growth and development. Son preference and discrimination against the girl child still prevail in many societies.

Health of the adult builds on the health of the child. Contrary to what some people may think, the female of the species is the stronger biological sex.

This biological advantage of being born a female can be reversed by the social disadvantage of being a female. In many countries, infant and child mortality are more among females, contrary to the biological expectation. 

Is this decreased natality and increased mortality of girls a small public health problem?

Absolutely not.

They result in a sizeable global deficit of females in the world. The Nobel Laureate, Amartya Sen, back in the 1990’s rang a bell, by estimating that more than one hundred million females are missing in the world. This finding was later confirmed by other demographic researchers, with even higher estimates for the missing females. 

Where next the girl child should be given a chance?

Girls should be given the chance to have their God- given sexual rights, by not mutilating their genitalia. The World Health Organization estimates that more than three million girls are having their genitalia cut each year. The harmful traditional practice is now not limited to countries in Africa, where it has been endemic. With international migration, it is spreading beyond geographical borders. 

Where should the girl child be given a chance next?

Girls in the majority of developing countries are still not given the same chance for education as their brothers.

This denies them the potential of a productive career, and leaves them only with one choice in life, a reproductive career, and exposes them to tyranny of excessive childbearing.

Education empowers.

Uneducated girls are left powerless, and powerlessness of women is a serious health hazard. 

The girl child now becomes an adolescent. What chance should be given, and what chances is she still denied?

The girl adolescent should be empowered to say NO to unwanted sex and to say NO to forced early marriage.

And when she has sex, she needs to be given the chance to protect herself from infections, sexually transmitted from her intimate partner, including HIV infection. And she needs also to be empowered to regulate and control her fertility.

And when she becomes a mother too early, literally a child giving birth to a child, she needs to be given the chance of the extra medical care needed to save her health and life.

She runs a higher risk of a maternal death. She may be better off as dead, if she develops a serious complication such as a vesico-vaginal fistula (an opening between the urinary bladder and the vagina), resulting in complete urinary incontinence. 

How different it would be if girls are given a chance?

How different it would be for the girls’ own lives?

How different it would be for their communities and countries?

There is no question that investment in girls to have their full and free potential is one of the best socio-economic investments in terms of yield and high return. 

But why are girls not given the chance, and how can they be given a chance?

One of the uses of government is that we have a body we can always blame for things we are not happy about.

But in this particular issue, we have to acknowledge that that there is a limit for what governments can do.

Governments are good at enacting laws and introducing regulations. They can also be good if they provide services.

But when it comes to social behaviour and cultural social norms, governments are not credible preachers, at least the governments I know best. 

So, what do we need to give girls a chance to give us a better world?

We need action, where the action is: at the community level.

It is civil society, and not government, who can be the agents for change.

They can make the change from within, by understanding people, respecting people, and working with people, pursuing culturally sensitive approaches.   

In this context, I can say that IPPF Member Associations have a comparative advantage.

They have been around for a long time, they have a track record, and they enjoy the trust of the communities in which they work.

In addition, they have the back up of IPPF, to give a collective voice for the issues they grapple with, and also to provide an opportunity for mutual learning between countries. 

Is there anything limiting the capacity of IPPF Member Association from doing more to give girls a chance?

The answer is Yes. It is the “R” word: resources. 

Let me end on a positive and optimistic note.

I have lived long enough to see how much progress has been made, and is still being made. Thirty years ago, I served as Dean of the Medical School in Assiut, in poor Upper Egypt.

I remember at the time that several of my girl students told me that they were the first girls who dared to leave their villages, to be educated in the city away from their homes.

Now, girl students are a norm in our provincial university, and generally do better than boys.

It makes me happy to see these girls given the chance that was denied to their mothers, and to have a world of choices opening for them.