FGM in Scotland: Issues and challenges Dignity Alert and Research Forum
DARF at a glance DARF is a non-governmental voluntary organisation formed to raise awareness about FGM and forced child marriages in Scotland. DARF promotes action to bring about positive social change and aims to enhance health, wellbeing and dignity of girls and women in Scotland and Eastern Africa
What we do In Scotland Create awareness Mobilise communities and engage young people Provide training, advice & information Undertake research Undertake policy advocacy & campaigns Raise fund for African initiatives In Africa Promote and provoke dialogue Support community based initiatives to bring about change
Female Genital Mutilation Female Genital Cutting or Female Circumcision refer to all procedures which involve the partial or total removal of the external genitalia or other injury to the female genital organs for non-medical reasons. WHO
Types of FGM Type I: Type II: Type III: Type IV: Partial or total removal of the clitoris and or the prepuce (Clitoridectomy) Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (Excision) Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (Infibulation) All other harmful procedures to the female genitalia for non-medical purposes, for example pricking, piercing, incision or scraping and cauterization.
Types of FGM
How is FGM carried out? It varies from community to community but generally by an elder woman in the community designated for the task or traditional birth attendants in a non-sterile environment and without anaesthetic using unclean sharp instruments such as razor blades scissors kitchen knives and even pieces of broken glass
Cutting instruments are frequently used on several girls in succession increasing the risk of infection transmission of viruses including HIV Increasing use of health professionals (trained midwives and even physicians) to avoid the health complications UK girls are taken on holiday to have FGM FGM practicing communities in the UK also have their own practitioners here
Prevalence 3 million women and girls are mutilated annually About 140 million African and Middle Eastern countries are affected
Females of African origin living in the UK Kenya 18,518 32% Somalia 15,272 98% Nigeria 6,925 9% Sierra Leone 5,963 94% Egypt 3,592 97% Sudan 2,879 90% Ethiopia 2,807 82% Eritrea 2,545 89% Tanzania 2,102 18% Ghana 1,340 5% (FOWARD 2007)
Why is it an issue in Scotland? As the number of immigrants, asylum seekers and refugees increases in Scotland so does the number of young women entering Scotland from FGM practising cultures has increased dramatically.
Who is at risk in Scotland? Women and girls from practising communities living in Scotland and UK Any girl born to a mother who has already undergone FGM who is between 0-18 years old
Immediate health consequences Extreme pain and excessive bleeding Septicaemia Transmission of infection and diseases from reused cutting equipment In some cases FGM may result in severe haemorrhaging and death Permanent disfiguration of genitalia Shock
Long term health effects FGM leads to short term and long term health complications, particularly sexual and reproductive health. Bleeding (due to repeated de-infibulations/infections) Problems with passing urine Recurrent urinary tract infections Abscesses (due to infected cysts/ abscesses) Keloid formation Fistulae (vesico/ recto vaginal) Difficulties in menstruation
Many women are not aware or fail to make the links to the health effects of FGM Sexual dysfunction/ genital phobia Infertility and miscarriages Infants of mothers with extensive form of FGM at increased risk of dying at birth Problems in ante natal care and difficulties with health care e.g. smears, foetal monitoring, getting a clean sample Psychological trauma
Difficulty conceiving (or even having sex) Abuse from frustrated husbands The majority remembered their experiences of FGM, providing detailed accounts Post traumatic stress disorders including sexual problems, depression and anxiety
Why? Social-cultural context of FGM Culture, tradition it is what we do Social acceptance To ensure marriageability, economic imperatives Chastity, fidelity, honour To suppress female sexuality (before and during marriage)
Purity To clean/purify women (uncircumcised women portrayed as dirty ) Cultural identity The tradition of FGM is older and more important than the concerns of any individual Gender identity and expectations of what is a good woman, sexually not demandingmakes women calm. FGM confers status & credibility
Religion viewed as religious obligation-a good Muslim/ Coptic Christian/ Ethiopian Jew Aesthetics and hygiene the vulva in its natural state is considered unattractive and unclean To make sex more pleasurable for men Uphold the patriarchy
FGM Who decides? Mothers under huge pressure from older female relatives back home and some older women in the UK Women fear female relatives will circumcise daughters against their will back home Mothers have to be highly motivated and assertive to resist ongoing pressure Seen to be women s business father escapes pressure to circumcise daughter Women who decide not to circumcise their daughters may face ongoing internal doubts especially if they plan to return to original country Families may fake daughter s circumcision to avoid pressure Men are as involved - preparation, funding, coercion
FGM is a human rights issue FGM violates a number of human rights principles, norms and standards, including equality and non-discrimination on the basis of sex, it Violates Convention on Elimination of All Forms of Discrimination Against Women (CEDAW) Negates the Convention on the Rights of the Child-right to equality and to freedom from mental and physical violence Interferes with the right to attain the highest standard of sexual & reproductive health Affects the right to be free from torture or cruel and inhuman or degrading treatment- (results in severe pain)
Law and FGM in Scotland The 1985 Prohibition of Female Circumcision Act made the practice of FGM in the UK a criminal offence. The Prohibition of Female Genital Mutilation (Scotland) Act 2005 made revisions: It provides definition of FGM It is an offence to excise, infibulate or otherwise mutilate the whole or any part of the labia majora, labia minora, clitoris, prepuce or vagina of another person.
It is an offense for a UK nationals or permanent resident to carry out or aid and abet female genital mutilation in the UK and abroad The maximum penalty for FGM has increased to 14 years imprisonment. It also allows a court to refer the victim and any child in the same household to the reporter to the children s panel
Challenges and issues Specific criminal laws do not necessarily result in prosecution Effective implementation is hindered by problems in detention and reporting of cases and lack of sufficient evidence to take a case to court This prevents effective protection of girls at risk
Challenges and issues Lack of skills and knowledge of FGM among key agencies Lack of reliable data to support policies and initiatives for women and young girls living with FGM Lack of awareness of available health services Linguistic and cultural barriers for women and girls leading to exclusion and reticence to make use of health services No coherent guidance or plans on FGM in Scotland Lack of clarity around FGM as grounds for asylum
Challenges and issues The age at which girls undergo FGM varies enormously according to the community. The procedure may be carried out when the girl is newborn, during childhood, adolescence, at marriage or during the first pregnancy. In the majority of cases FGM takes place between the ages of 5-8 and therefore girls within that age bracket are at a higher risk
Risk factors indicators of at risk The parents come from a community that practises FGM and live with extended family Older female members of the immediate family or extended family having undergone FGM; Parents indicate taking the child away for a prolonged period; A child may talk about a long holiday to a country where the practise is prevalent Frequent trips to the country of origin An older sibling has already undergone FGM A child may confide that she is to have a special procedure or a celebration Low level of integration into UK society
Indications of FGM in girls A girl may spend long periods away from the classroom, bladder or menstrual problems Prolonged absences from School and a noticeable behaviour change The child requiring to be excused from physical exercise, swimming etc. Truancy, running away from home Moved school after long holidays etc.
Child protection If you suspect that any girl is at risk of being subjected to any form of FGM, take action to report it immediately. To protect a girl from FGM you can take any of the following actions: Ring your local Social Services Department Ring your local Police Child Protection Unit Do not let labels of 'tradition' 'culture' 'religion' or a fear of being called a 'racist' stop you from taking action to protect girls at risk of FGM, it is a violation of human rights!
Protection responses Where a child is thought to be at risk of FGM, practitioners should be alert to the need to act Quickly If a referral is received concerning one child, consideration must be given to whether siblings or other girls in that community are at similar risk. Professionals should be alert to the fact that any one of the girl children amongst these could be identified as being at risk of FGM and will then need to be responded to as a child in need or a child in need of protection
Case reporting FGM constitutes child abuse and causes physical, psychological and sexual harm which can be severely disabling Police have a statutory responsibility to safeguard children from being abused through FGM There are three circumstances relating to FGM which require identification and intervention Where a child is at risk of FGM; Where a child has been abused through FGM; Where a prospective / new mother has undergone FGM
Responding to the child Being sensitive to the fact that the child will be loyal to their parents; Giving the child time to talk; Getting accurate information about the urgency of the situation, if the child is at risk of being subjected to the procedure; Giving the message that the child can come back to you again;
Arranging for an interpreter if this is necessary; Creating an opportunity for the child to disclose, seeing the child on their own; Using simple language and asking straight forward questions; Using terminology that the child will understand (e.g. the child is unlikely to view the procedure as abusive)
Making legislation effective Individuals and agencies that are able to detect cases, such as health professionals, teachers, police and social workers should be informed and, trained to be able to identify girls at risk or performed cases of FGM To provide appropriate protection mechanisms To prevent future parents from subjecting their daughters to FGM (Preventative measures) It is important to recognise the social pressure to conform to tradition that often lies at the core of the practice (community based intervention in changing attitudes is vital)
The way forward Informed and trained professionals (such as police, teachers, social workers) in place the police force should put this high on its agenda Initiate a Task Force with various stakeholders to speed up the prevention and implementation measures as well as monitoring and evaluation Work with specialised stakeholders to prepare FGM Resource Pack in Scotland Launch a special website and FGM helpline in Scotland
Contact us Dignity Alert and Research Forum UN House 4 Hunters Square Edinburgh EH1 1QW 0758 343 4602 dignityalert@hotmail.co.uk www.darf.org.uk