Aware of the difficulties faced by women at different steps of their life, the medical and health care team of the hospital of Saint-Denis, France decided to create a unique place to offer counselling to women victims of violence and female genital mutilation (FGM). In the French department of Seine-Saint-Denis, 16% of the patients that come to the hospital’s maternity (Maternité Angélique du Coudray du Centre Hospitalier de Saint-Denis) undergone FGM. Extreme insecurity is experienced mostly by migrant women, women in difficult administrative situations and women with no social and familial tie. Creating a unique place between city and hospital and fostering synergies between existing structures, appears to an appropriate solutions to meet the needs identified by patients and doctors. Surgery, psychological support, speaking groups and long-term following were discussed to guarantee the best organisation. Permanent legal assistance and caring programme focused on psycho-trauma will be implemented. Three surgeons, two midwives and one nurse are ready to proceed.
The project's specific objectives are to :
The construction of the Women's House will start in 2014 on a bare land belonging to the hospital of Saint-Denis on the site of Delafontaine.
On 8 March 2014, International Women’s Day, the Kering Foundation together with Elle and Raja Foundations – which also support the project – attended to the laying of the foundational stone of the “Maison des femmes” with Catherine Vauconsant, director of the hospital, and Ghada Hatem, head of obstetric service.
Read the full interview of Ghada Hatem by Catherine Robin, published by Elle France in its 5 December 2014 issue
GHADA HATEM-GANTZER, THE DR HOUSE OF WOMEN
Dr. Ghada Hatem-Gantzer, a gynaecologist and Head of the Delafontaine Maternity Ward in Saint Denis is fighting to open a Women's House, a safe house where vulnerable patients would be able to find shelter, medical care and a friendly ear.
Russian icons, African statues, feminist posters... In Dr. Ghada Hatem-Gantzer's office, the whole world is present, just like at the Delafontaine Hospital in Saint Denis where she works. The "International Hospital" as she calls it, with a joking nod to the American Hospital in Neuilly-sur-Seine, the very sociological antithesis of the 93 Département's "capital city"! From the Grandes Gueules ("Loud Mouths") social movement (when she worked at the militant maternity ward of Les Bluets) to the Grande Muette ("Great Mute", the French nickname for the Army) when she worked at the Bégin Military Hospital, she is now Head of a mega-maternity ward that welcomes around 4,000 births a year. Among the mothers-to-be, many are vulnerable women, victims of abuse and genital mutilation. With support from the Elle Foundation, it is for their sake that this OG-GYN has decided to build a Women's House on the hospital’s last vacant lot. The first stone was laid on 8 March. Since then, the building is still awaiting full financing. Dr. Ghada Hatem-Gantzer spends her days between providing medical care to her patients and her new fund-raising mission. An intense but customary pace for this down-to-earth, lion-haired and contagiously enthusiastic woman.
ELLE. How did you arrive in France?
Ghada Hatem-Gantzer. I was born in Lebanon and studied at the French High School in Beirut. When I was 18, I wanted to study medicine, but my country was at war and France had withdrawn its support to the local Faculty of Medicine. I am deeply Francophone and Francophile. When I arrived in Paris, I felt at home.
ELLE. What drove you to study medicine?
Ghada Hatem-Gantzer. For a long time, I hesitated between Architecture, Social Sciences and Medicine. The latter won, because I saw myself more in the role of a caregiver. Barber-shop psychologists might see a link there with my personal history, my country at war, but personally I don't really make that connection. An internship in a maternity ward convinced me to become an OB-GYN. Perhaps because in this specialism, everything usually ends well. It's medicine, surgery, psychology and people care all wrapped up into one. Birth is a crucial time during which family histories collide and human relations are very rich.
ELLE. Is working at the Saint Denis Hospital a coincidence or a militant choice?
Ghada Hatem-Gantzer. In Paris, after a brief period at Saint-Vincent-de-Paul Hospital, I joined the Bluets maternity where I discovered Fernand Lamaze's work, one of the creators of painless childbirth through psychoprophylaxis. He was the first doctor to tell women: "It is your decision to play an active role in birth." That wasn't commonplace at the time. He taught us this revolutionary idea that a patient who knows what is going to happen to her is less afraid. He also popularized birth preparation and fought for it to be reimbursed by Social Security. Finally, he supported the idea that everyone has a role to play in a birth, from the midwife to the person who cleans the room. After ten years there, I left for the Bégin Military Hospital in Saint-Mandé. From one extreme to the other, from “commies” to soldiers without going through basic training or shaving my head! In this hospital, my personal victory was to establish the practice of abortions (IVG), which many thought would be impossible. I also created an infertility treatment unit. A few years later, the Head of the Saint Denis maternity ward, who was getting ready to retire, contacted me. I thought it might be a nice end-of-career project: the maternity was being rebuilt and I had embarked on a Master's in medical management... I dropped my bike, my favourite means of transportation, and I threw myself into this new adventure.
ELLE. What are the specific features of this hospital?
Ghada Hatem-Gantzer. People who go through this institution come from over a hundred different countries, many experience extreme social problems. This diversity is a wonder, but when you only see women who speak poor French, who have no clue whatsoever with regard to the concerns of parenthood, the role of a father, what being treated well means, it doesn't particularly encourage you to develop new projects. They're happy with what we give them. Yet the concept of "birth planning" for example that emerged in the past twenty years is also an opportunity to create a dialogue, to address personal issues, such as genital mutilation.
ELLE. You opened a reconstructive surgery unit specifically for excised women. Did the women ask for it?
Ghada Hatem-Gantzer. Women who have suffered genital mutilation account for 14 to 16% of the 4,000 women who give birth here every year. So we asked ourselves what we could do for them. Three surgeons went to train with Dr. Pierre Foldes, the reconstructive surgery guru. We set up a medical consultation office that includes midwives, a psycho-trauma psychologist, and a gyno-sexologist... Not every woman asks to be "repaired" and we must respect their wishes, while also helping them acknowledge what they are victims of. They need us to explain, to understand why they are the way they are and what options they have.
ELLE. Since this unit already exists, why open a Women's House now?
Ghada Hatem-Gantzer. Welcoming mutilated women is not its sole purpose. It is a dedicated space that will provide shelter, consultation, prevention and guidance for all women who are struggling, whether they are experiencing an unwanted pregnancy, domestic violence, forced marriage or, of course, excision. The Family Planning unit is cramped in our maternity ward, uncomfortably stuck at the end of a hallway and yet many people go there. We do 1,000 abortions every year at Delafontaine. I was looking for a new location to move Family Planning, but there was no available space left in the hospital. We needed to build a new place, but since the maternity ward had just been refurbished, there was no money left. So with support from Gisèle Halimi, I went in search of funding from local authorities and foundations such as ELLE or Kering. Today, we are finally making progress. We are waiting for a pending regional aid and hoping for support from the Pièces Jaunes initiative (national "small change" collection).
ELLE. You were talking about Family Planning... Forty years after the Law on Abortion was voted, is this right in jeopardy?
Ghada Hatem-Gantzer. Abortion has lost its great historical activists. This right has become commonplace. Less enthusiasm and support towards it is felt today. However, the Government is on the supportive side. The ARS [Regional Health Agency] has implemented the Frida plan [facilitating the reduction of inequalities in access to abortion] in particular to reduce waiting times and avoid the closure of abortion units during holiday periods. At Saint Denis, everyone is ok about doing abortions, but nobody fights to do them! Nowadays, young doctors have a more technical approach and a less militant vision of this matter. Abortions have to be done, so they do them. Period. We need to stay vigilant, as the example of Spain has shown us recently.
Picture: ©Bertrand Guay/AFP