Manchester Safeguarding Boards

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1 Manchester Safeguarding Boards Female Genital Mutilation (FGM) Practice Guidance This document should be informed by the statutory guidance on FGM and other relevant MSB and agency policies and procedures, such as an operational guide for practitioners, with pathways through services and referral criteria. Date of publication: April 2017 Ratified by MSAB/MSCB Board: Copyright & reproduction: MSB and partners Review by: March 2018 Document Owner: MSB

2 1. FGM Affected Communities Greater Manchester is part of the Home Office Asylum Seekers Dispersal Programme, and also the Gateway Protection Programme which offers a settlement route to 750 refugees each year, contributing to the growth of arrival populations, including those from Africa. Many of these newly arrived populations are from FGM affected countries, across Africa. In the Greater Manchester area, Manchester City has the highest population of FGM affected communities, closely followed by Salford, Bolton and Rochdale. Wigan and Bury have lower populations of affected communities; while Oldham and Trafford have a growing population of communities that practise FGM. Generally, communities mainly at risk include Kenyans, Somalis, Sudanese, Sierra Leoneans, Egyptians, Nigerians and Eritreans. Over the last 10 years there has been a steady increase in the number of African migrants to the UK. In Greater Manchester, there are an estimated 45,300 Black African people, twothirds of whom were born abroad. Population statistics, according to country of birth, list Nigeria as having the highest number (10,236) accounting for 0.4% of the Greater Manchester population. There has also been a steady increase in the Kurdish community (from Iran and Iraq) due to the ongoing conflict in those areas. The Map in figure 2, published by UNICEF in 2016 shows the percentage prevalence of FGM across Africa. However, the map is not an exhaustive survey and prevalence within any country may vary according to ethnicity, geographical area and other cultural factors. Other sources record significant FGM prevalence in Malaysia, Indonesia, Saudi Arabia, Jordan, (Kurdish) Iraq, Syria, Oman, United Arab Emirates and Qatar. When assessing FGM risk, in respect of a specific family, both maternal and paternal backgrounds must be considered and professionals should be conscious of the influence of extended families and communities with regard to FGM. Figure 1: FGM prevalence in Greater Manchester (AFRUCA: 2015) Country of Origin FGM Prevalence (UNICEF) Type of FGM Burundi Unknown IV Eritrea 89% I,II,III Ethiopia 74% I,II,III,IV Guinea Bissau 50% I, II, III Kenya 27% I,II,III Nigeria 27% I,II,III,IV Rwanda Unknown IV Sierra Leone 88% I,II, III Somalia 98% I,II,III Sudan 88% I,II,III Uganda 1% I,II,IV Zimbabwe Unknown IV Page 1 of 19 msb fgm practice guidance final april 2017

3 Figure 2 :( UNICEF: 2016) Key facts (Ref: World Health Organisation) Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. The procedure has no health benefits for girls and women. Procedures can cause severe bleeding and problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of newborn deaths. More than 200 million girls and women alive today have been cut in 30 countries in Africa, the Middle East and Asia where FGM is concentrated. FGM is mostly carried out on young girls between infancy and age 15. FGM is a violation of the human rights of girls and women. Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. Page 2 of 19 msb fgm practice guidance final april 2017

4 The practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirth. In many settings, health care providers perform FGM due to the erroneous belief that the procedure is safer when medicalised. WHO strongly urges health professionals not to perform such procedures. FGM is recognised internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person's rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death. Procedures Female genital mutilation is classified into 4 major types: (World Health Organisation) Type 1: Often referred to as clitoridectomy, this is the partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals), and in very rare cases, only the prepuce (the fold of skin surrounding the clitoris). Type 2: Often referred to as excision, this is the partial or total removal of the clitoris and the labia minora (the inner folds of the vulva), with or without excision of the labia majora (the outer folds of skin of the vulva). Type 3: Often referred to as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoris (clitoridectomy). Type 4: This includes all other harmful procedures to the female genitalia for nonmedical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area. This practice guidance is to be used by professionals or agencies should there be a concern about the risk of FGM to a female child or where there has been a disclosure of FGM made. This practice guidance also provides details of support services to safeguard women at risk of FGM and to support women who have undergone FGM. Refer to Flowchart below - Stage 1: FGM Concerns Raised Page 3 of 19 msb fgm practice guidance final april 2017

5 Stage 1 FGM Concerns Raised 1. FGM Practising Community Mother a victim of FGM Female child under Professional speaks to family (See guidance) Family state no intention of FGM for children (Including pressure from community) 3. Mandatory Report to Police Direct observation of FGM in child or Disclosure of FGM by a child under Possible FGM indicators in child Other additional evidence of FGM (or intention for FGM) Concerns raised about family s intentions/attitudes or capacity to protect children from community pressure Follow agency procedures for recording FGM. Liaise with other agencies as appropriate 5. Referral to Children s Services Page 4 of 19 msb fgm practice guidance final april 2017

6 2. Risk Assessment (Prior to making a referral to Children s Services) Refer to Flowchart above - Stage 1: FGM Concerns Raised If your agency has guidance, you should follow it. If not, the following guidance notes can be used. If FGM is identified in either the mother or paternal extended family and there is a female child, the parents (both mother and father if applicable) should be spoken to by the safeguarding lead, or relevant person in your organisation. Professionals should ensure that, in consultations with women and girls, the environment is safe and private and that their approach is sensitive and non-judgemental. Professional interpreters must be used, if necessary. Consideration should be given to the gender of the interpreter when making the request. Family members or friends should never be used as interpreters. The term FGM may not be familiar to families and can be a barrier to open communication, due to the connotations of mutilation. A list of words for FGM in various languages is contained in Appendix 1. The word cut or cutting is often used with families as a less formal term, however some forms of FGM do not involve cutting; such as cauterisation, pricking, or stretching of the labia. It may, therefore be necessary to first establish with the family a shared term of reference. Questions for parents: What is your understanding of FGM? Has your daughter had FGM? Will your daughter have FGM in the future? Would your husband, family or community allow/want your daughter to have it? If any of these risk factors are identified professionals will need to consider what action to take. If unsure whether the level of risk requires referral at this point, professionals should discuss with their named/designated safeguarding lead. Alternatively professionals can use the consultation line within the MASH. Once a decision as been made that a referral to Children s Services, is appropriate. The referral should contain as much relevant information as possible (see section 4 on mandatory reporting to the police and section 5). You should also consider discussing the concerns with the family. However, be alert that doing so may increase the risk to the child, for example of being removed from the country. Parents should normally be informed when a referral is made, unless it is felt that it could place a child, another person or professional at risk of immediate harm. The purpose of the conversation with parents is twofold; firstly, to risk assess regarding FGM for the child(ren); and secondly to ensure that the family fully understand the health consequences and the legal consequences of FGM. Page 5 of 19 msb fgm practice guidance final april 2017

7 Consider risk to any other female child(ren) in the immediate or extended family. Provide parents with material on the health and legal implications of FGM. Liaise closely with other involved professionals: Midwife, GP, Health Visitor, School Nurse, FGM specialist organisations etc. If the answer to the above questions does not indicate a risk to a child then: an Early Help Assessment should be considered if support needs are identified, but a Children s Services referral is not needed at this point. If the mother has undergone FGM needs will need to be considered and this may include support around her health. Information should be shared with the child s record-holder (school nurse/health visitor) and GP. 3. Mandatory Reporting A mandatory reporting duty for FGM was introduced via the Serious Crime Act The duty requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM, in under 18 year-olds, to the police. Known cases are those where either a girl informs the person that an act of FGM however described has been carried out on her, or where the person observes physical signs on a girl appearing to show that an act of FGM has been carried out and the person has no reason to believe that the act was, or was part of, a surgical operation within section 1(2) (a) or (b) of the FGM Act The report to the police must be made within one month of the disclosure / observation and can be made by phoning the police on 101 and must be made by the professional who heard the disclosure or made the observation. However, the working expectation is that the report should be made by the close of the next working day. The duty to report does not breach any confidentiality requirement or other restriction on disclosure which might otherwise apply. Professionals will need to record the decisions they have made, and inform local safeguarding leads in their organisation of action taken. Professionals will also need to discuss the report and what it means and what action the family can expect to follow at the appropriate time. The duty does not apply in relation to at risk or suspected cases or over 18s. However, professionals must follow appropriate safeguarding procedures whenever they identify safeguarding concerns around FGM or, indeed, any other form of abuse. In addition, the duty does not apply if a professional can identify that another individual working in the same profession has previously made a report to the police in connection with the same act of FGM. In summary, there are two circumstances which require mandatory reporting to the police: A disclosure is made by the child that she has been a victim of FGM. Physical signs which indicate FGM are observed by the professional. Page 6 of 19 msb fgm practice guidance final april 2017

8 Although not mandated by legislation, it would be best practice to make a report to the police if: A third party discloses that a child has been, or is likely to be, a victim of FGM. A child discloses that they believe that they are likely to be a victim of FGM. An adult who is unable to protect themselves is likely to be a victim of FGM. A referral to Children s Services should be made in addition to the report to the police. 4. FGM Indicators Indicators that FGM may have taken place: Prolonged absence from school - behaviour changes on return Frequent or prolonged visits to the toilet Difficulty sitting still, walking, or standing Complaining of pain between legs Something done to me I m not allowed to talk about A special thing when we were on holiday A girl may ask for help but may not be explicit about the problem due to fear or embarrassment Emotional/ psychological needs identified: withdrawal/ depression, anger, posttraumatic stress symptoms Refusing to participate in P.E Recurrent urinary tract infections Complaints of abdominal pain. Some of these indicators may not indicate FGM on their own, however when viewed together may represent sufficient evidence to warrant further assessment. Please note that this is not an exhaustive list. 5. Referral to Children s Services The referral should include as much detail regarding the evidence of FGM as possible. If a disclosure has been made, record the exact wording or as close as is possible; the circumstances under which the disclosure took place; and who took the disclosure. If the referral is based on observation of signs of FGM, then include details of the observations; the circumstances under which they were made; and the job role of the person making the observations. Page 7 of 19 msb fgm practice guidance final april 2017

9 If the referral is based on indicators of FGM, then include as much detail as possible about the indicators such as: when observed, by whom, how frequently, when it started. Other information which should be included in the referral is the: Ethnicity of both parents Country of origin of both parents Language spoken How long the family has been resident in the UK and what is their immigration status Address and contact details Names and dates of birth of all household members (if known) School details (if known) Precise details of the disclosure, or of statements by parents Any relevant health information Details of girls within extended family (if known). Refer to Flowchart below - Stage 2: FGM Referral Received by Children s Services Page 8 of 19 msb fgm practice guidance final april 2017

10 Stage 2 FGM Referral Received by Children s Services 6. MASH MASH ENQUIRY Allocated SW becomes aware of FGM on an open case Recorded as information only 7. No identified FGM Risk 6. Single Agency checks Early Help Hub 11. Referral to SARC for CP Medical (A referral to an FGM service must be made prior to referral to SARC) Evidence that FGM has occurred 8. Other support needs identified Evidence of FGM Risk 9. Strategy Meeting Non-immediate Risk 10. Child & Family Assessment Assessment for psychological support Emergency Protection Order FGM Protection Order Initial Child Protection Conference Child in Need Planning Direct work with family by the Guardian Project or FGM org. No Further Action/Step Down Page 9 of 19 msb fgm practice guidance final april 2017

11 6. Referral Received and Triage Information should be sought on each subject child(ren) from all involved organisations, including: School Nursery GP Health Visitor Midwife. This can be done as a single agency enquiry or a MASH enquiry. The decision will be made by the MASH team manager. Whichever enquiry process is used, information must be sought from partner agencies in order to create a holistic assessment of the risk of FGM. Voice of the Child A referral to the Guardian Project should be made to enable them to meet with girls, young women and families to discuss FGM and provide support with assessing risk and needs. 7. Information Only If the enquiries carried out produce satisfactory explanations of the concerns raised in the referral and there is no evidence of FGM, the referral can be recorded for information only and closed. In all cases where the family are from an FGM affected community or mother was subjected to FGM and the child is female, a professional should speak with the parents as in section 2. The purpose of the conversation is twofold: firstly to risk assess regarding FGM for the child(ren); and secondly to ensure that the family fully understand the health consequences and the legal consequences of FGM. If the conversation has been held with a suitable professional, prior to referral and no further evidence of risk has been identified from multi-agency enquiries carried out in the MASH, the referral can be closed as information only. Support is available to young adults and women affected by FGM and at this point support services available should be explained and offered to her. 8. Support needs identified In some cases, other support needs may be identified through the multi-agency enquiries, but no evidence of risk of FGM identified. In this situation, the referral should be sent to the Early Help Hub and an appropriate support provision should be identified for the family. Page 10 of 19 msb fgm practice guidance final april 2017

12 Research has shown that children s services assessments sometimes overlook the father. It is important that the father s views should be sought and the influence and role of the wider paternal and maternal extended families included. 9. Strategy meeting If it is believed or known that a girl has undergone FGM, or if evidence is found that a girl is at risk of FGM, a Strategy Meeting must be held as soon as practicable (and in any case within two working days). Examples of evidence of FGM risk include: Disclosure by the child that a special ceremony / party is going to be held for her or similar narrative, indicative of FGM Disclosure by a friend of the child or other person that FGM has or will take place A cluster of FGM indicators (see section 4) Travel plans by the family (either abroad or within the UK in conjunction with other evidence of intention to carry out FGM). The purpose of the meeting is to discuss the implications for the child and the coordination of the criminal investigation. It is recommended that FGM services are invited to attend the initial strategy meeting so they can provide clarity on how FGM is performed within various communities and they can carry out additional work with the family and children if needed. This is a resource that is commissioned for this purpose and freely available to professionals. A second Strategy Meeting should take place within ten working days of the initial referral. A joint assessment should be carried out between the police and children services. The strategy meeting should clarify the roles of the involved agencies and the scope of the investigation (i.e. which children are at risk). The responsibility of the police is to investigate any possible crimes and to prevent any future crimes from taking place. The responsibility of Children s Services is to make a holistic assessment and to identify and meet any support needs for the child and family. The assessment should cover the three domains of the assessment framework: the needs of the child; the capacity of the parents to meet the needs and role of the extended family / community in providing support; or as potential risk factors in regard to FGM. Police should work with other agencies to obtain relevant support and guidance for the victim. Where relevant they can work with other professionals to prevent FGM by educating parents/carers about the legislation relating to FGM and possible consequences. Police staff working with children - if a girl is at risk of undergoing or has already undergone FGM, the duty inspector must be made aware and support should be sought from the Public Page 11 of 19 msb fgm practice guidance final april 2017

13 Protection Investigation Unit where the victim resides or in their absence the CID. Relevant safeguards should be put in place immediately in order to prevent any risk of harm to the child. Risk to any other children should be considered and acted upon immediately. The investigation should be dealt with as a child safeguarding investigation. If any officer believes that the girl could be at immediate risk of significant harm, they should consider the use of police powers of protection under section 46 of the Children Act If it is suspected that FGM has already occurred, a medical examination should be conducted by a qualified doctor trained in identifying FGM. This will be achieved by completing the FGM Referral form for St Mary s Sexual Assault Referral Centre (SARC); see section Child and Family Assessment (CAFA) If evidence from the referral and from enquiries carried out in the MASH indicate that there is some risk of FGM, but no evidence of immediate risk, or that FGM has already taken place, a Child and Family Assessment (CAFA) should be carried out to assess the risks and explore interventions and measures to protect the child. The CAFA should be holistic and follow the Assessment Framework. The role of wider family and community is significant with respect to FGM risk. The views of the community and of community elders may place considerable pressure on families to carry out FGM, even if they are personally against it. Areas to consider when assessing current and future risk of FGM include: The family s level of economic independence Stability of housing / accommodation situation How recently the family arrived in the UK Relationship with community elders Relationship with maternal and paternal extended families Level of support the family receive from community or extended family (e.g. childcare, financial support / loans, support with immigration issues, employment). Communicating with and understanding the cultural background of families may be a challenge for workers. The Guardian Project will work with services and with families to carry out direct work in respect of attitudes and responses to FGM. The Guardian Project will produce a report following the direct work addressing levels of engagement, understanding of the health and legal issues, community pressures and overall attitude towards FGM. In Manchester AFRUCA and NESTAC offer specialist FGM services. The Guardian Project is a joint project between AFRUCA and NESTAC. Page 12 of 19 msb fgm practice guidance final april 2017

14 The benefits of this work are multiple: providing valuable information to inform assessment; aiding families to better understand the lifelong consequences of FGM; and supporting parents to withstand pressure to carry out FGM from extended families and communities. If at any point during the assessment, evidence of immediate risk, or of prior FGM, comes to light, a review strategy meeting with the police must be convened. 11. Child Protection Medical Examination If there is evidence which indicates that FGM may have already occurred, a referral for a Child Protection Medical Examination should be made to the Sexual Assault Referral Centre (SARC, on the SARC FGM Referral Form. A referral should also be made to the Guardian project to ensure the child is fully aware of the reason behind the medical and their needs are heard and met (see Guardian Project page 14). The purpose of the referral should be made clear. Reasons for an examination can be some or all the following: To verify whether or not FGM has taken place To assess whether there are any physical, medical needs which need treatment To assess whether there are any psychological needs as a result of FGM, such as PTSD To gather forensic evidence to assist a prosecution under the FGM Act Emergency Protection Order (EPO) An EPO should be used only in situations where there is compelling evidence that FGM is likely to be carried out in the immediate future and no other options for effectively safeguarding the child(ren) are available. FGM Protection Order (FGMPO) A FGMPO is a less intrusive intervention which might contain prohibitions, restrictions or other requirements for the purposes of protecting a victim or potential victim of FGM. This could include, for example, provisions to surrender a person s passport or any other travel document; and not to enter into any arrangements, in the UK or abroad, for FGM to be performed on the person to be protected. Either the police or Children s Services can apply to the court for the order. Children s Services, as the lead agency on safeguarding, should normally make the application. Families can apply to the court for leave to make an application for an FGMPO. There have been cases where parents have made successful applications for FGMPO to assist them in resisting pressure from extended family members that are pressuring them to allow FGM to be performed on their daughters. Child Protection Plan (CPP) In situations where no immediate risk of FGM is identified, but professionals have serious concerns about the family s ability to protect the child(ren) from FGM, it may be appropriate to go to an Initial Child Protection Conference (ICPC) and present evidence that a CPP is Page 13 of 19 msb fgm practice guidance final april 2017

15 necessary to ensure the child(ren) is safeguarded while further assessment and work is done with the family to address the risk in the long term. A CPP can only ever be a short-term solution. Work should be done with the family to strengthen their capacity to protect the child(ren) in the long term. The success of the work will determine future plans for the child(ren) to ensure their long term protection. This work should be done in conjunction with community based FGM services that can support with this work. (See Guardian Project) Child in Need Planning (CiN Planning) If the presenting issue for the family is FGM and there are no other concerns, CiN planning is unlikely to be the best response. However, if there are other concerns which need to be addressed in addition to FGM risk, a period of CiN planning may be appropriate while work is done to address long term FGM risk. The Guardian Project The Guardian Project is a new service across Greater Manchester aiming to safeguard and support girls and young women affected by FGM. The Guardian Project provides a free service across Greater Manchester and is available 5 days a week. This is a joint project between NESTAC and AFRUCA. The Guardian Project services include: Support with FGM cases, including attending strategy meetings and joint family visits Meeting with girls, young women and families to discuss FGM and support with assessing risk and needs Providing advice and guidance for professionals who have concerns about a girl Coordinating care and support for girls and young women affected by or at risk of FGM. Direct work from AFRUCA AFRUCA, Africans Unite Against Child Abuse, is a national charity promoting the rights and welfare of African children in the UK. AFRUCA has its Head Office in London; a Centre for African Children and Families in Manchester; and projects working with families and communities across the country and delivers peer mentor schemes, wellbeing programme and research. Direct work from NESTAC NESTAC, New Step for African Communities, is a Greater Manchester (Rochdale) based charity and delivers projects in Manchester such as the FGM advocates programme, Wellbeing programme with SOS clinics in St Marys and the Kath Locke centre and delivers a schools educational programme with FORWARD the national FGM charity. Step down plan - No Further Action (NFA) If the CAFA forms a view that there is no significant risk of FGM and no additional support needs to address, the case can be closed with No Further Action. In this case a child in need meeting should be held and all partner agencies in collaboration with the child and family should agree to a step down multi agency plan. This plan should consider ongoing risk Page 14 of 19 msb fgm practice guidance final april 2017

16 management and review by universal services to safeguard female children and young people from FGM throughout childhood. Education and universal health services (GP, school nurse and health visitor) should always be updated on the risk of FGM prior to social care case closure. If the mother has been identified as having FGM then support services should be explained and offered even if there is no risk to female children (see Guardian Project). Page 15 of 19 msb fgm practice guidance final april 2017

17 APPENDIX ONE: TERMS USED FOR FGM IN OTHER LANGUAGES Country Term for FGM Language Chad the Ngama Sara sub Bagne group Gadja Gambia Niaka Kuyungo Musolula Karoola Mandinka Guinea-Bissau Fanadu di Mindjer Kriolu Egypt Thara Khitan Khifad Arabic Ethiopia Megrez Amharic Ethiopia Absum Harrari Eritrea Mekhnishab Tigregna Iran Xatna Farsi Kenya Nigeria Nigeria Kutairi Kutairi was ichana Ibi Ugwu Didabe fun omobirin Ila kiko fun omorbirin Swahili Igbo Yoruba Sierra Leone Sunna Soussou Sierra Leone Bondo Temenee Sierra Leone Bondo / Sondo Mendee Sierra Leone Bondo Mandinka Sierra Leone Bondo Limba Somalia Sudan Gudiniin Halalays Qodiin Khifad Tahoor Somali Arabic Turkey Kadin Sunneti Turkish Page 16 of 19 msb fgm practice guidance final april 2017

18 APPENDIX TWO: FGM Support Services in Manchester AFRUCA Centre for Children and Families Phoenix Mill, 20 Piercy Street, Ancoats, Manchester M4 7HY or or call: Fax: Nestac or or call: Registered office: NESTAC Charity, 237 Newstead, Rochdale, OL12 6RQ. Tel: , Mob: UK Registered Charity No Support Our Sisters (SOS) (NESTAC) Support Our Sisters (SOS) project is dedicated to engaging FGM/C communities, using a holistic approach, to positively change and improve life chances for young girls and women who went through FGM/C and those at risk of FGM/C. SOS services include: SOS CLINICS (Psychosocial Support Services) This is a confidential service which provides a transcultural therapeutic service to women who have undergone FGM/C and to those who are at risk: Women only Group Therapy One to One cultural counselling Support to families of FGM sufferer Health and Wellbeing activities Referral and signposting to relevant agencies Referral to specialist services for de-infibulation (reversal of Type III FGM) or other examinations Advice and assistance regarding social needs. Bilingual staff and volunteers available. Self referrals and referrals from voluntary and statutory agencies are welcome. SOS EDUCATION Service to increase insight and understanding of FGM/C for lay community members and professionals who are likely to come into contact with women who have, or are likely to be exposed to the practice: FGM Awareness Training (Half day programme) FGM Awareness Training (Full day programme) Introduction to basic cultural counselling skills on FGM (2 full day programme) FGM Peer Mentor Counselling Training (3 full day programme) Internship / Research and Policy Development / Publications e.g. New Step for African Community. SOS Community Engagement Initiative Our Voice, Our Future Empowers young girls and women of the FGM/C practising communities to renounce the practice and prevent abuse: Become an FGM/C Community Ambassador Become an FGM/C Community Youth Advocate Page 17 of 19 msb fgm practice guidance final april 2017

19 APPENDIX TWO: FGM Support Services in Manchester Raise awareness and campaign against FGM/C Provide advice, support and guidance on FGM/C Contribute to policy development Raise awareness of school staffs and educate children on FGM/C Hold awareness events to tackle FGM/C. All my life I ve tried to think of a reason for my circumcision. If I could think of a reason, then perhaps I would be able to accept what they ve done to me. But I ve never been able to find one. And the more I ve thought about it, the angrier I ve got. Waris Dirie (model, author and human rights activist) New Step for African Community FOR MORE INFORMATION SOS Project is committed to providing a high quality service to its clients, and to actively empower young girls and women at risk of the practice, and those who have undergone FGM/C. Clinics are based across Greater Manchester: Rochdale Group Therapy / One to One Clinic NESTAC Community Centre 237 Newstead, Rochdale, OL12 6RQ Salford One to One Clinic Asylum Seeker Mental Health Consultation Service Lance Burn Health Centre Churchill Way, Salford, M6 5QX City Centre St Mary s Hospital / Antenatal Clinic One to One Clinic Oxford Road, Manchester, M13 9WL Manchester The Kath Locke Centre Group Therapy 123 Moss Lane East, Manchester, M15 5DD The Guardian project To access the service: guardian.project@outlook.com Phone: Page 18 of 19 msb fgm practice guidance final april 2017

20 APPENDIX THREE: Statutory guidance and online training To learn more about recognising and responding to this safeguarding issue see the Government FGM web pages below: FGM Factsheet (Home Office) National Multi Agency Guidelines (Home Office) FGM Resource Pack (Home Office) There is also an e-learning course which is useful for anyone who is interested in gaining an overview of FGM, particularly frontline staff in healthcare, police, border force and children's social care. Health Education England (HEE), in partnership with a number of key stakeholders (March 2015), have launched an e-learning resource which is designed to raise greater awareness and help support healthcare professionals when working with women and girls who are victims of female genital mutilation (FGM). Supported by the Department of Health s FGM Prevention team, the e-learning resource focuses on issues related to health, legal status and referral pathways. The sessions are knowledge based and will provide practical support to healthcare professionals facing challenges such as how to approach a conversation about FGM with patients. The new support package includes documents that support the introduction of the duty. They include: a poster explaining what the duty means for healthcare professionals guidance on what healthcare professionals should do if they think a child has had or is at risk of FGM a training package to introduce the duty to healthcare professionals a leaflet explaining the duty to patients. You can also visit the NHS Choices website to see Vanessa Lodge (National FGM Prevention Lead) and Juliet Albert (Specialist FGM Midwife) discuss what the new duty means for professionals. Page 19 of 19 msb fgm practice guidance final april 2017