Dani Garavelli: How best to stamp out FGM?

Kenyan teenage Maasai girls in Kilgoris, 220 kilometres north-west of the capital Nairobi. Picture: Getty

WITH the summer holidays now under way in Scotland, the airports are swamped with families heading off on their summer breaks. For many this is likely to involve a fortnight lying on a beach in Italy or Spain.

For those who hail from abroad, and who have made Scotland their home, it may mean a trip back to their country of origin. Such sojourns allow young people to connect with their heritage. Such trips conjure up idyllic images of children escaping the Scottish rain to spend a summer eating mangoes barefoot in the shade of exotic trees. But for a proportion of those whose families come from countries in Africa and the Middle  East, could the reality be very different?

Charities working with immigrant populations believe every year some girls are taken from Scotland and other parts of the UK to undergo female genital mutilation – a brutal cutting of the vagina for cultural rather than health reasons which can have devastating physical and psychological impact.

Women who have experienced FGM – women like Fatou Baldeh, who is originally from the Gambia, but now runs the Dignity Alert and Research Forum in Edinburgh – describe being blindfolded and tied down before being cut with crude, unsterilised equipment such as knives, pieces of glass or razor blades, and with no anaesthetic.

The immediate effects of FGM, believed to have been performed on 130 million women worldwide, include shock, bleeding, infections and difficulty urinating; the long-term effects include menstrual problems, kidney problems and infertility.

Charities who work with ethnic minorities believe some girls from the UK, whose parents were born in countries such as Djibouti, Somalia and Egypt where FGM is prevalent, undergo the procedure in the UK at organised “parties” where someone is flown in to cut a group of people at the same time. But others are taken back to their parents’ homeland.

Performing FGM on a resident of the UK is against the law whether it takes place here or abroad, but it is easier to arrange in countries where it is accepted practice and the summer break allows a longer recovery period, making it less likely suspicions will be aroused on their return.

Concern about FGM in the UK, and the lack of action to tackle it, has been mounting for several years as the country has seen an influx of immigrants from the 28 countries, mostly in Africa and the Middle East, where FGM is practised.

In those countries, the ritual, which may involve the removal of the clitoris, the cutting off of the labia and/or the sewing up of the vaginal opening, leaving only a small hole for urinating, is linked to deeply-entrenched concepts of social acceptance, family honour and the preservation of virginity.

Last week, Keith Vaz claimed there could be as many as 170,000 victims of this form of child abuse in the UK alone and branded the failure to address the problem as a “national scandal”. He was speaking after the publication of the home affairs select committee on FGM, which also highlighted the lack of support for victims who were cut in their own countries before moving here.

Comparisons have been made with France, which carries out routine physical examinations on very young girls and has seen 100 prosecutions in connection with FGM. So far, despite political pressure, only one prosecution has been brought south of the Border and, though around 15 referrals have been made to Police Scotland, none has been passed to the procurator-fiscal.

In the past 18 months, however, the Scottish Government has made FGM a priority. According to the 2011 census, 2,403 girls were born to women from FGM-practising countries between 1997 and 2011, while the number of residents born in Africa has doubled since 2001, suggesting many young girls could be at risk.

Groups such as the Women’s Support Project are working to raise awareness of FGM among health visitors, social workers and midwives, and equip them with skills to deal with women who come to them seeking help or advice and Equalities Secretary Shona Robison has written to all head teachers in Scotland calling on them to train staff and parents to recognise the warning signs of FGM, which include long periods spent in the toilet and once-a-month absences.

Police Scotland has been focusing on the issue, training police officers at Edinburgh Airport to be on the look-out for possible FGM-related trips, putting NSPCC posters on FGM up in airport toilets and formulating a national action plan.

“Police Scotland will investigate thoroughly and professionally any report or information received about child abuse, including FGM no matter the passage of time or status of the perpetrator,” says Assistant Chief Constable Malcolm Graham.

Even so, addressing the problem of FGM in those living in Scotland is far from straightforward. For a start, while third sector organisations insist there is anecdotal evidence of girls who live here undergoing the FGM, no such case has ever come to the attention of the police or the NHS.

In the past, cultural sensitivities led the authorities to shy away from tackling FGM, which was often referred to as female circumcision and treated more as a religious ritual than an act of violence.

Its prevalence and barbarity may also have been played down because it didn’t fit the traditional feminist narrative of violence inflicted on women by men (many of those arranging FGM are women who have been cut themselves). Community pressures are such that victims are often too scared to come forward, while charities are reluctant to publicise their work in case it puts the women involved at greater risk, making it difficult to gauge the scale of the problem.

Even within immigrant communities there are differing views on the extent to which girls born in the UK are victims. Baldeh recently told the Scottish Parliament’s equal opportunities committee: “We know that women from practising communities – some women – do still support the practice of FGM.”

But novelist Nadifa Mohamed, who was brought up by Somalian parents in the UK, believes the majority of Somalis who settle here abandon the custom because the societal pressures no longer exist and there’s no established network of cutters.

“It is a mystery,” says Jan Macleod of the Women’s Support Project. “On the one hand, no doctor or A&E has had a child present who has been recently cut and there have been no referrals to the police which have been passed on to the procurator-fiscal. But on the other, if you look at the length of tradition associated with FGM and the importance that is still put on it in certain countries then common sense tells you that some girls whose parents come from those countries must be at risk.”

DCI Norrie Conway of Police Scotland’s national public protection unit agrees there is an intelligence gap across the country. “But we have done a bit of scoping round education in Scotland – we know there are large pockets of [people from the relevant countries] in Glasgow, Edinburgh, Aberdeen and Dundee,” he says. “When you look at the prevalence of FGM in their home nations, and then you realise there have been just 15 referrals to the police in a year, it is reasonable to say there must more of this going on.”

If we accept the prevalence of FGM in some cultures – in Egypt more than 90 per cent of girls are cut – means it is highly likely it is being carried out on girls in the UK, then what should we be doing about it?

Last week, Vaz said more of those deemed to be at risk should be placed on child protection orders and suggested failure to report FGM could be made a criminal offence. The Metropolitan Police Commissioner, Sir Bernard Hogan-Howe, and MP Diane Abbott are among those who have already called for the UK to introduce mandatory medical examinations for young girls. And a coalition of health bodies, trade unions and Equality Now recently produced an intercollegiate report which recommended better information-gathering and holding front-line professionals accountable.

Many of these suggestions seem to take their lead from France. It has no specific laws on FGM but has been bringing prosecutions against parents and cutters under its existing laws on grievous bodily harm and violence against children since the late 1970s. There has been a steady trickle of cases – 100 prosecutions in 29 trials over 34 years.

The success of lawyer Linda Weil-Curiel in bringing cases to court has led the UK to be condemned as a “soft touch”. But while successful court cases make it clear to immigrants from FMG-practising countries that the practice won’t be tolerated here, the knowledge that those involved might be prosecuted may discourage people from coming forward while the targeting of specific immigrant groups can be stigmatising.

In Scotland, it seems, a greater emphasis is being placed on awareness-raising, training and grass-roots community work. In particular, efforts are being directed at encouraging midwives to ask, routinely whether a patient has undergone FGM.

“I remember about 10 years ago when it was first suggested to health workers that they routinely ask about domestic abuse, they said, ‘why us?’” says Macleod. “Now they are clear domestic abuse is a health issue. We need to get the same point on FGM. This is not a personal habit, this is a very serious health issue.”

The Scottish Refugee Council has been commissioned to carry out more research into which areas are likely to be high-risk and the most effective interventions, while Police Scotland is working with health, education and third sector organisations to encourage closer co-operation.

Conway recognises this is a potential sticking point; some organisations are wary about handing on information out of concern for the women who have placed their trust in them.

Conway believes too much emphasis can be placed on prosecutions. None of the 15 referrals received by Police Scotland made it to court, he says, because, in each case, the risk of FGM was averted through early intervention. “There is a lot of shouting about the lack of prosecutions – but there’s a lot happening behind the scenes to intervene and prevent FGM, which is a positive,” he says.

Overall, anti-FGM campaigners seem to believe the long-term battle against the procedure is more likely to be won by changing attitudes than by targeting individuals (though any individuals suspected of organising or carrying out FGM will be investigated).

“We’re at a stage where we have practising communities in this country and we have grass-roots organisations such as ourselves who are engaging on the ground-level to try to raise awareness of the issue and the fact it’s illegal,” says Anela Anwar, head of projects at Roshni, a charity working with ethnic minorities across Scotland.

“We are trying to win hearts and minds and get communities to move away from a practice that’s been around thousands of years so it’s not going to happen overnight.”

She believes progress is being made, but that much more can still be done. “We need front-line staff to have an increased awareness of the issues and we need a multi-agency specialist team, involving police, social work and health, and a clear referral route,” she says. “I think that is what is missing. That is what is needed if a real impact is to be made.”

Twitter: @DaniGaravelli1