Proposition 54K1799

Projet de loi relative à la lutte contre les actes de violence perpétrés au nom de la culture, de la coutume, de la religion, de la tradition ou du prétendu "honneur", y compris les mutilations génitales.

General information ¶

Authors

CD&V Nahima Lanjri, Nathalie Muylle, Els Van Hoof
MR Benoît Piedboeuf
N-VA Valerie Van Peel
Open Vld Ine Somers

Submission date

April 27, 2016

Official page

Visit

Status

Adopted

Requirement

Simple

Subjects

professional secret doctor medical data sexual violence sexual mutilation criminal law

Voting ¶

Voted to adopt

Groen CD&V Vooruit Ecolo LE PS | SP ∉ Open Vld N-VA MR PVDA | PTB PP VB

Party dissidents ¶

• Fabienne Winckel (PS | SP) abstained from voting.

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Discussion ¶

May 31, 2018 | Plenary session (Chamber of representatives)

Full source

I refer to the written report, Mr. Speaker.

I am very pleased that today we are able to vote on the bill on genital mutilation. Today we can make a crucial step forward in the fight against genital mutilation, a horrible practice that is in line with our norms and values of equality between men and women. I am also very pleased that we unanimously approved the proposal in the Committee on Public Health. I look forward to a similar support later in the plenary session. As Parliament, we are sending a very important signal.

Dear colleagues, how do we do that? How do we stop a horrible but deeply rooted cultural practice? We do this by focusing on prevention and protection as well as repression. I think we need to move on all these fronts here in Belgium.

I am convinced that my bill and the proposal for a resolution will allow us to take significant steps to substantially change the situation of the numerous victims of genital mutilation.

Torture does not tolerate taboo. In 2008, the United Nations recognized genital mutilation as torture. It is a form of sexual violence. It is a terrible expression of a worldview in which women must be submissive and in which women are not allowed to have sexual pleasure but only to be there to serve their husbands.

An estimated 200 million girls and women worldwide have suffered genital mutilation. Most of the victims of genital mutilation, more than 90 million, are found in Africa. But even in Belgium it is not a ver-van-ons-bedshow, because the practice was imported to Belgium.

A recent study by the Institute and the FOD Public Health shows that the figures in Belgium have tripled in ten years. In Belgium, there are more than 70,500 women from countries where female genital mutilation is practiced. Approximately 17 000 of them have already been circumcised and more than 8 000 are at risk of becoming victims of genital mutilation. These are alarming figures. Behind those figures and statistics are always people, girls and women, who are going through that horrible experience.

Following the bill, a woman from Mali sought to contact me. She had fled with her four-year-old daughter. She was pregnant, had already had two miscarriages and suffered a lot of pain. Her biggest fear was that her child would be the victim of the same practice. Even here in Belgium, as in Mali, pressure is being placed to continue the practice. We must not abandon those women.

The bill that is being discussed here today will boost the struggle in two ways. First, we provide for the mandatory registration of genital mutilation in the hospital file. It is important to detect and record genital mutilation as early as possible. This enables victims to receive better and faster guidance and treatment, as doctors and nursing staff are alerted faster. Today, they are still looking away carelessly, but at that point they will be obliged to see what kind of genital mutilation occurred and from which region the victims come from. At that time, the hospitals are expected to provide assistance.

With the registration in the hospital dossier, we can gather much better data and better map the problem of genital mutilation. The numbers already mentioned are estimates and extrapolations, but through the recording we can finally measure and know. We choose to have the registration in the first place in the hospital, because the vast majority of births, in which the problem of genital mutilation is clearly depicted, still take place in the hospital today.

Often after childbirth, doctors are also asked about reinfibulation. The reference centers for genital mutilation in Gent and Brussels also work through the hospital file. With the bill, we want to anchor the registration and extend it to all hospitals.

Another important step with which we raise the fight against genital mutilation in the bill, is the extension of the right of reporting by professional practitioners. Today, the professional practitioner can only report genital mutilation if it is a minor. But also adult women become victims of circumcision or re-circumcision. That is why we extend the right of reporting to all women, not only minors but also women of major age.

That is important. If a woman gets a child, it is common in some countries of origin that the woman is re-seated. Testimonials show that doctors and gynecologists who work in Belgium have also received questions to switch to reinfibulation.

Likewise, many women who wish to marry at a later age and have not been circumcised are asked, from the family, to undergo a circumcision first, before marriage. The choice they have then is actually none: after all, it is the choice between either being marginalized or undergoing the circumcision. That relevant threat can be ⁇ with the proposal, which can make a substantial difference for those girls and women.

It is a right of the professional; it is not a duty. It is the doctor himself who decides whether he or she will exercise that right or not. The doctor may report this to the Procurator of the King. He may, in turn, forward such facts to the Family Justice Centers, to the correctional court or to the family court or he may, as noted in Minister Geens’s address letter, go into conversation with the family and submit a signed declaration that they will no longer undergo genital mutilation of their children.

As you can see from the approved amendments to the bill, the aspect of extending the right of reporting was mainly updated. We have obtained the advice of very many organizations and have also followed the recommendations of, among others, the Institute for Equality of Women and Men and the State Council. In the amended version, we would like to extend the right of reporting of professionals to all crimes identified, as listed in Article 458bis of the Criminal Code.

These include, among other things, female genital mutilation and crimes committed because of cultural motives, customs, traditions, religion or so-called honor. In this way, we bring our legislation in line with the Istanbul Convention, which stipulates that each Member State must ensure that a professional or a healthcare provider can breach his professional secrets when honour-related violence occurs.

We have taken great account of the various recommendations. We have done what is necessary to reach a proposal today.

I am grateful for your support in bringing the bill to a good end. I think we are now taking important steps in the fight against this horrible mutilation of women.

For me it is not only a political struggle, but also a struggle as a women’s rights activist, a struggle that I will continue after my political struggle in Belgium and in Africa.

I think we should be grateful for being able to fight this struggle together in Parliament. It is about torture. The draft resolution also refers to this. Women are marginalized if they do not undergo genital mutilation. It is therefore good that organisations such as GAMS and Intact, as also mentioned in the draft resolution, engage in the fight against genital mutilation. The text calls for continued steps in the right direction. It is therefore welcome that government policy is supported across party boundaries.

Thanks to an update and amendments, the draft resolution also takes into account, for example, the notification code of Secretary of State Demir and the circular letter of the Minister of Justice on honour-related violence. The text also supports the establishment of two rescue centres, in Gent and in Brussels.

Every step towards a world without women-friendly practices is crucial. Therefore, it is good that we continue to fight for it together, the majority and the opposition, the government and the Parliament.

Mr. President, Mr. Van Hoof, I thank you for this presentation and for taking the initiative with this proposal.

I think most of it has already been said. The bill was approved unanimously, so everyone here knows what it is about. It is a horrible crime against women and often very young girls, with lifelong consequences.

This law proposal can ensure that every act here comes to light. This is where it begins. I wonder if the hallucinating figures that we have today are true, and if a compulsory registration will not prove that they are a little higher. The fact that this has also been taken into account is also for me the reason why I absolutely support this proposal. We need to start out as much as possible.

Colleague Van Hoof, the second element was indeed a discussion about professional secrecy. This is a discussion that I have repeatedly held in other files. There is always, rightly, a lot of discussion about professional secrecy. I understand why. I think that is still a very important data for a relationship between a healthcare provider or a social worker and a patient. That is undoubtedly so, but I also maintain, also in this dossier, that professional secrecy has never been intended to be absolute. Fortunately, we all quickly agreed on this. There have always been exceptions. I think one of the first ones to get into it was child abuse, because it is about victims who cannot defend their rights themselves. I am afraid that in this case it is the same reasoning, that the victims in question are caught in a net and that it is also here to demonstrate that it is better that the professional secret can be broken.

This is where we landed. I have already said in the committee that I personally believe that the proposal should have gone even a step further and that we should have introduced an obligation to speak, so that every healthcare provider who encounters genetic mutilation, i.e. torture, is obliged to report this to the prosecutor’s office.

But well, I assume that the interpretation of this right will make the good care providers we have in this country realize that it should feel like a kind of duty for them.

My party will definitely support this bill. State Secretary Zuhal Demir has also been fighting against genital mutilation for a long time, along with her colleague Geens. They have developed this action plan with notification codes for doctors. Professional secrecy was a huge obstacle. I think this legislative amendment is a good answer.

I can find myself 100% in what the speaker says. We will, of course, also support this bill. I have been asking questions about this issue for years. I think everyone shares these concerns. This bill is definitely a step in the right direction.

I wanted to take a step into what colleague Van Peel said, namely that she personally wanted to go a step further by making the right of speech an obligation of speech. My group shares that opinion. We have therefore amended the bill in that sense so that it is no longer optional for doctors to inform the Procurator of the King because this still ⁇ ins an escape route that should not exist for such terrible phenomena.

I fully agree with the opinion. I hope that Ms. Van Peel will therefore support our amendment in the vote.

I would like to respond to this one more time. I fully support this morally. Unfortunately, the State Council is not fully involved in the consideration. That is why we have a right of speech. However, I expect that healthcare providers will see this as a duty now that the opportunity is created.

According to UNICEF’s latest figures, 200 million women and girls worldwide have already undergone a form of genital mutilation, a violent act that generates infections, diseases, complications during childbirth and sometimes results in death. It is a cruel act that also inflicts persistent moral suffering on women who are victims of it.

Despite international conventions that prohibit these harmful practices, they remain widespread, mainly in Africa. Our country, like other Western countries that welcome populations affected by these practices, is facing both the problem of preventing the risks of mutilation, and the treatment of the consequences of these mutilations on women’s health.

The study of the prevalence of female genital mutilation in Belgium, conducted by the Institute of Tropical Medicine in 2014, also drew a disturbing finding. It was estimated that more than 13,000 excised women and girls lived in Belgium and that 4,000 little girls were still considered " at risk". According to a more recent study from 2016, conducted by the Institute for Gender Equality, these figures have increased. These excised women would be more than 17,000 and more than 8,000 are at risk.

While Belgium has legally condemned these mutilations since 2001, providing imprisonment penalties for anyone who has practiced, facilitated or favored any form of mutilation of a woman’s genital organs, with or without her consent, very few cases have been registered to date with the judicial authorities of our country.

Between 2009 and 2013, only 14 cases were registered with the prosecutor’s office. I am therefore looking forward to seeing these two texts come, both Mrs Van Hoof’s bill and our resolution proposal. I look forward to seeing these texts on our banks today. I would like to thank all the colleagues of the Health Committee and its Chairperson, who have agreed to carry out constructive work as part of this indispensable struggle against genital mutilation.

It is true that many things have already been done in our country to come to help the victims. I think in particular of the establishment of two medical centers for the care and reconstruction of excised women, namely CeMAViE (Medical Centre for Assistance to Victims of Excision) and the Multidisciplinary Centrum Genitale Mutilatie which advise, prescribe and coordinate appropriate care. It is also true that these centers were established thanks to the then minister, Mrs. Laurette Onkelinx, who fought a lot for this cause. I also think of the awareness and training sessions organized by the SPF Public Health since 2012 in various hospitals in the country.

Today, through this resolution, we would like to remind you how much work is still needed in various fields to prevent these mutilations and to best help women who are victims of them. Today I would like to highlight the important work that is done daily in our country by field organizations such as GAMS or Intact, organizations that need to continue to support financially so that they can continue to carry out their mission.

Our resolution proposal also tends to further strengthen our policy on combating mutilation across various axes. I will cite a few of them.

1 of 1. Awareness, guidance and support of relevant communities.

2 of 2. Information and permanent training for professionals in contact with those victims or at risk.

3 of 3. The implementation of the 2015-2019 National Action Plan to combat all forms of gender-based violence with – and this is primary – an evaluation of the specific measures that are aimed at and that allow to combat female genital mutilation.

4 of 4. The designation of reference persons, in particular within hospitals and with police and judicial services.

5 of 5. The need to continue working with the Regions and Communities to establish a system for the identification and recording of cases of mutilation, so that reliable and comparable annual data can be available.

6 is The need to advocate, within the framework of our bilateral diplomatic relations, with third countries concerned by this problem for the implementation of legislation prohibiting female genital mutilation.

In conclusion, as studies show, female genital mutilation is still a sad reality today, in many countries including ours, which is no exception. It is therefore our duty to continue to act to ensure that these mutilations are no longer invisible and that affected women and girls benefit from adequate prevention and protection. I thank you for your attention.

The problem of female genital mutilation is ⁇ serious. Indeed, they violate a number of principles to which we are attached: physical integrity, gender equality, the rejection of medieval practices. These mutilations are the inheritance of a religious conception that no longer corresponds to modern morals and behaviors and whose physical and psychological consequences are condemned.

Such practices should not be considered acceptable on the grounds that they are the result of a cultural difference and it is important that such behaviors cannot be reasonably accommodated. Due to the migratory phenomena and in order for our country to meet its international obligations in the fight against mutilation, more attention must be paid to this. It is therefore proposed, on the one hand, to reform the regulation on professional secrecy and, on the other hand, to make mandatory the registration of mutilations in the hospital file. We are signing it.

The Minister of Justice, the College of Prosecutors General and the Justice Committee agreed on the bill. At the same time, the Grouping of French Language Obstetric Gynecologists of Belgium has already, in July 2016, subscribed to the principle. The Order of Doctors, it is true, has given a more subtle opinion on the matter, in particular due to professional secrecy. However, it was recalled that the proposal aims at a right of speech and not an obligation, as is the case in other countries.

Many initiatives have already been taken in our country: the National Action Plan 2015 - 2019, the medical centers, of which my colleague recalled the action for taking care of excised women. The proposal for a resolution mentioned in the next point of our agenda refers to these points. We support the various texts proposed today. These are additional steps in the fight against genital mutilation. They are important.

We must and must continue to develop an ambitious policy to combat all forms of gender-based violence, based in particular on the Convention of the Council of Europe.

The MR Group will ⁇ enthusiastically support this proposal of our colleague, co-signed by all groups and unanimously adopted by the committee. I thank you.

Mr. Speaker, colleagues, let it be clear, for my group, genital mutilation is a horrible crime, whether it concerns girls or women but also boys, if it is not a medical necessary intervention.

Genital mutilation is an attack on the physical integrity of sometimes very young children. This is something we want to fight with all means.

In our country there are more than 17 000 women and girls who have been circumcised. More than 8,500 are at risk of being circumcised. These are figures from the Institute for Equality of Women and Men.

A few months ago, even the rumor went out that women’s circumcision would also happen in our own country, under our nose. A number of cities have been mentioned in this context. Fortunately, this has not yet been confirmed. I hope it remains with rumors.

However, it proves that we need to be extremely alert and that we need to take a number of concrete measures to intensify the fight against genital mutilation and to improve some existing measures. That is what is done in this bill and this resolution, quite rightly.

The proposal contains a number of measures that directly address the problem. The resolution sets out a number of lines that allow us to further improve the implementation of a preventive and, above all, a tightening policy in the future.

For those who are not yet clear, our group will also approve these two points with full conviction.

The floor is yielded to Ms. Gerkens.

Mr. Speaker, an interesting work could take place in the Public Health Committee from the resolution proposal of Mrs. Winckel et consorts and the bill proposal of Mrs. Van Hoof et consorts. These two texts are indeed necessary to help us fight genital mutilation, which physically and psychologically damages – including in Belgium – too many little girls, young girls and women.

The discussions were long. We asked for opinions on the bill, not on its part “integration in the medical record of the mutilated person” – even if it is important – but on the possibility for care providers to break their professional secret. Such measures should be taken with all the necessary caution. The text that we have adopted grants this right. Similarly, it confirms the notion of violence against women because of the traditions of honor crimes.

These clarifications will allow care providers to report these facts. However, it is important to maintain their ability to appreciate and evaluate, for the time necessary, in the best way to preserve the relationship of trust. It is absolutely necessary that people who are or could be subjected to such mutilation – because their surroundings are likely to impose it on them – can confide and explain what is likely to happen to them and that measures can be taken without finding themselves in a situation of family exclusion or repatriation to their country because they could not have been really helped.

It is because this text has become balanced that we have supported this integration into article 458bis of the Criminal Code.

With regard to the resolution, it was interesting to adopt recommendations supplementing the bill to resume it in a more global context that should mobilize us all within our cross- and shared competencies, but also within our federal competencies, in particular to evaluate the arrangements in place, such as the National Action Plan to combat all forms of gender-based violence 2015-2019, which is expiring. It is also worth paying attention to the medical centers that operate by asking about the difficulties encountered and the improvements they wish to see bring. In addition, it is necessary to make the point with them in order to obtain information about the people who attend these centres, how, with what difficulties and with what capacity of expression.

The designation of a reference person in hospitals, in the police, in the magistrates is obviously more than necessary, given the delicate approach to these unacceptable violence and those victims who are in a difficult situation. Therefore, we need trained staff who can really help all stakeholders.

All these aspects are addressed in the text of the resolution, not to mention the collaborations to be strengthened with associations such as GAMS and Intact, associations that should not be forgotten on the budgetary level. Indeed, although it is said that these are indispensable intermediaries with whom it is necessary to work, if they are not granted the budgetary resources to engage the necessary personnel, these associations will find themselves unable to fulfill their mission. This would be catastrophic because they are known and benefit from the trust of the women and girls concerned.

These are, Mr. Speaker, dear colleagues, the elements for which Ecolo-Groen voted in favor of both the bill and the resolution.

We will, of course, support the main principles of these proposals. This is a serious and serious problem. It is therefore important to support women who, more than others, are in a very vulnerable situation.

The first priority for these women, these young women or adolescents, is to have medical and psychological care. They must also receive legal and social assistance. Today, it is important to note that there is still some progress to be made in the field so that the various departments can take on a specific and special care, in addition to their already very large workload.

I therefore plead with the majority and with the government that, beyond these texts, the Minister of Health can truly enroll the issue of the fight against female genital mutilation in an ad hoc interministerial conference. The federal authorities are not the only authorities concerned; the federal authorities are also responsible. Different ministries could work together, within their respective competences, to try to remove the weak links in the overall handling of the problem of female genital mutilation.

I have two reservations on this matter. The first is the way in which you proceeded to amend Article 458bis of the Criminal Code concerning the lifting of medical secrecy. Different stakeholders in the associative sector, including the GAMS, the Ordre des médecins, certain actors of justice and the College of Prosecutors-General were in favour of ⁇ ining Article 458bis of the Criminal Code, as it is today.

In fact, the vulnerability of women, violence including sexual violence as well as the problem of minors are already directly referred to in the existing article 458bis. In addition, there is a certain form of inconsistency, since the circular of the College of Prosecutors General as it exists for this subject does not take up the same denomination as the one inscribed in this bill. This is even more problematic since the College of Prosecutors General had specified that the violence related to honour was even wider than what you decided to be included in article 458bis of the Criminal Code. In the end, it could exclude from its scope specific situations. I think we shouldn’t have touched it.

I advocate that the Minister of Justice ask the College of Prosecutors General to adapt the circular in order to establish coherence between the different texts.

It also seems to me essential to emphasize that it is extremely important to ensure that women do not lack so much confidence in caregivers and doctors that they will no longer consult. I heard colleagues calling for an obligation of reporting on the part of doctors. I remind you that doctors are not investigators and that if you transform Article 458bis on the lifting of professional secrecy as an obligation to lift it, in the end, these vulnerable and raped women will no longer have an interest in seeing a doctor. Any judicialization will not allow progress in favor of the women concerned.

Regarding the registration in the hospital medical record, I would like to remind my colleagues that this is just an element. This will not allow, on the contrary, to have information that follows the patient. This also raises questions about data confidentiality. It is delicate.

Despite these points of attention, which might have had to be addressed otherwise, we will support these texts. This is an important social issue for these vulnerable women.

Mr. Speaker, dear colleagues, I welcome the initiative taken by the authors of both texts to remind that in our country, ⁇ beyond what could be conceived, the practice of female genital mutilation has unfortunately reached many victims. In addition, it is known that it is young girls who, before the age of five, are exposed to this type of risk or even to this act of barbarism.

I would like to congratulate the work carried out for many years by a number of personalities from the medical world, the associative world, the political world. I think singularly of my colleague Fatoumata Sidibe who, in the Brussels Parliament, has advanced the awareness of this reality in the very heart of our country. She is not the only one and I welcome the work done by all those officials who aim to remind us that we cannot remain silent and passive in the face of this scandalous practice.

The texts offer new opportunities for professionals to act and better inform the families most exposed to this risk. Let us not hide it, the work will still be long because, for some families, too impregnated with what they believe to be a tradition, a cultural fact or, more seriously, the acceptance of a form of submission, it must be repeated to them that there is also a stretched hand that will allow them to take another step in respecting the dignity and the protection of their children.

Thank you to those who took the initiative of these proposals. This must mobilize us more than ever because there is simply the conviction that we must have that this type of practice will one day be definitively eradicated in our country to be in others too.