David Cameron recently spoke out about female genital mutilation. Appearing before the Liaison Select Committee in January 2014, the Prime Minister said; “This is an absolutely unacceptable practice. It is illegal for anyone in the UK, no matter what their background or culture or anything else, it is illegal. Full stop, end of story.” Female genital mutilation is not a religious rite of passage that deserves preservation in a multi-cultural society. It is a criminal act of violent child abuse, whereby a young girl’s genitalia is cut with scissors, a razor, a knife or other blade, and stitched or sewn up – usually with no anaesthetic or antiseptic treatment. It causes extreme and severe physical and emotional pain, leaving a victim with lifelong health consequences; such as infertility, complications during pregnancy and childbirth, menstrual problems, the inability to urinate, kidney damage or failure, haemorrhaging and can even cause death.
Despite this, FGM continues to be practised for a range of reasons; to eliminate sexual desire; male approval; family honour; social acceptance; and to prevent a girl from having sexual intercourse before marriage by rendering it too painful to do so. It is an outrageous form of social control that is extremely harmful to a girl’s health, contravenes basic human rights and needs to be eradicated, particularly given that the majority of cases occur to young girls who are between 5 and 8. Yet, due to the nature of FGM and the fact that it takes place in minority communities, many people are too scared to question the practice for fear of appearing intolerant of minority cultures. Instead they prefer to turn away, avoid the awkward conversation and carry on with their daily lives.
The figures are stark: 125 million women around the world are victims of FGM, and in some African countries up to 98% of the female population have been cut. Though FGM is a serious global issue, the question must be asked: how can our country work to eradicate FGM globally, when it is still being practised right here in the UK?
FGM was made illegal in the UK in 1985. In 2003, the law was tightened making it illegal for FGM to be performed anywhere on UK nationals or permanent residents – closing the legal loophole in the 1985 legislation that had enabled relatives to take girls out of the UK for FGM procedures. Despite FGM being illegal for nearly three decades, there has not been a single prosecution, even though 66,000 women live with the consequences of FGM and 24,000 more are estimated to be at risk in the UK.
Lack of awareness
Years have gone by with little serious government commitment to eliminate FGM. The legislation was a vital step, but without efforts to raise awareness alongside it, FGM has remained a taboo subject. Most importantly, the attitudes of those who carry out FGM have not changed. Even today, there is still a lack of awareness within practising communities that FGM is even a criminal act. Without engagement to educate and change attitudes, it is clear that this centuries-old practice will continue. Until we work with communities to improve understanding of both the health consequences and the criminal consequences of practising FGM, nothing will improve.
The more people who make the effort to understand FGM, the more progress can be made. A recent Channel 4 documentary by campaigner Leyla Hussein, ‘The Cruel Cut’, brought FGM to a mass audience. I am sure that if everyone reading this blog took an hour out of their evening to watch the programme, they would be shocked to realise exactly how abhorrent FGM is. The documentary itself showed a group of young men from practising communities who initially spoke in support of FGM. Once they were shown demonstrations of the actual procedure, many walked out unable to cope with witnessing the violence, describing it as ‘torture’.
Training
In a recent YouGov survey, four out of five teachers said they had not received child protection training about girls at risk. In another survey conducted by the Wales FGM Forum, 69% of medical professionals, social workers, police and charity workers said they were ‘very unconfident’ in protecting children from the practice, and 58.8% said they received no training in their current role. It is clear that the government has to improve the training given to professionals coming into regular contact with victims of FGM, those still experiencing health problems as a result, and those who are at risk of undergoing the procedure.
Underreporting
There are two ways in which FGM will be reported; either by victims and members of practising communities who are experiencing FGM first hand or by professionals coming into contact with victims and those at risk. The former method is problematic: reporting FGM will often mean the victim reports the involvement of their parents or relatives. Though relatives may not carry out the procedure themselves, they will have assisted in arranging a ‘cutter’ to travel to the UK and as a result victims will fear coming forward out of loyalty, or from social pressure from communities to stay silent. In a recent article, experts Dexter Dias, Felicity Gerry and Hilary Burrage highlighted how the burden of policing FGM must not rest on victims, and that there are steps we can take to encourage reporting – for example, to make special measures explicitly applicable to FGM cases, and for the CPS to immediately declare this as their approach. Another suggestion was for sentencing guidelines to emphasise the availability of significantly reduced sentences for former cutters or parents who co-operate with the authorities.
The Royal College of Midwives recently found that a third of midwives have previously cared for patients who have undergone FGM. Many more doctors and nurses as well as social workers, teachers, the police and other professionals will clearly be coming into contact with victims, those at risk and their families on a regular basis. Yet the multi-agency practice guidelines for FGM, though important, are ‘designed to be educative and provide advice’ only – not mandatory. Campaigners suggest that the guidelines are becoming increasingly ignored. Improved training will help in enabling professionals to identify and support those at risk, but to ensure reporting increases we should consider introducing a legal obligation on professionals to report to police and social services.
Enforcement
Although recent statements from the CPS have suggested that an FGM prosecution is ‘imminent’, we have yet to see one reach court. Not only does this mean criminals are walking free, but this perpetuates the problem because there is zero deterrent effect. With a stronger approach to both awareness and reporting, better enforcement should soon follow. Keir Starmer, former DPP, highlighted the importance of a prosecution, not necessarily for FGM alone but for a related offence such as child neglect – so we can demonstrate that the UK is taking FGM seriously as a criminal act. It is appalling that three decades have gone by and no one has yet been brought to justice. It’s time to enforce the law.
Government commitments
Last week saw wider coverage of FGM than ever before on the UN’s International Zero Tolerance on FGM Day. The Government published a Declaration outlining their commitment to tackling FGM through future initiatives including:
- A new Home Office Community Engagement Initiative – a fund for voluntary sector organisations to bid and carry out community engagement work aimed at raising awareness;
- The Department for Education taking forward major reforms of child protection processes and social work education in order to protect children from all forms of abuse;
- The Ministry of Justice will seek views on how a civil prevention order might work alongside criminal legislation.
The NHS has also announced the introduction of official codes for FGM enabling medical professionals to log details of wounds inflicted on each victim on the hospital database, in order to publish a national measure of the number of victims treated by the NHS for FGM later this year.
These pledges are positive and show how FGM is finally starting to get the attention it deserves. But this is only the start of a long term agenda for all relevant agencies and their government departments to end FGM in the UK.
The future for FGM
So what more could be done to tackle FGM?
End Female Genital Mutilation Unit: The problems addressed in this piece highlight a major flaw in the government’s agenda to date: there is no single individual or body driving the government’s commitment to end FGM. The recent Declaration has 7 signatures, each from separate government departments and agencies. Though a multi-agency approach is key, until we have a national lead on ending FGM to oversee the work being carried out, only limited progress can be made. This could be undertaken by a body similar to the Foreign Office and Home Office Forced Marriage Unit, which operates both inside the UK and overseas and provides an extensive outreach and training programme.
Multi-agency approach: The introduction of Police and Crime Commissioners provide a unique opportunity to drive a local multi-agency approach. PCCs must take responsibility by using their position to oversee action in their area, not only by the police but all relevant organisations. Agencies must begin to collect and share data about FGM with one another, or else the lack of communication will prevent those at risk from receiving the treatment or support needed.
Engagement with practising communities: Engagement is the key to ending FGM. Until we change attitudes of those who practise FGM, change will be slow or non existent. Front line police and voluntary organisations must be given the support and resources to reach out to the practising communities, educate them about the consequences of FGM, and improve the process of identifying those at risk. Schools should introduce regular educational sessions with the families of children they believe to be at risk. The dedicated funding from the Community Engagement Initiative is welcome, but we need continuing commitments to enable organisations to progress their work long-term.
Mandatory guidelines and reporting: Advisory guidelines have failed to make any real difference in the way in which agencies deal with FGM. We need to give medical staff, teachers and social workers the confidence to ask the difficult questions – providing better, regular training than simply a hand out of non-mandatory guidelines. The government must consider introducing mandatory reporting of FGM, bearing in mind the unlikelihood of children reporting their own families.
Prepare for prosecutions: Special measures must become explicitly applicable to cases of FGM, and the CPS must publicise this with immediate effect. Sentencing must be reviewed to consider shortening sentences for those who have co-operated with the police in bringing others involved in FGM to justice. Civil orders preventing FGM should be welcomed, perhaps to prohibit mutilation where there is clear evidence of risk as campaigners have suggested. They have proved successful in other areas such as domestic violence. Surely though, until the criminal legislation starts to come into effect, we should not focus our efforts on yet more legislation.
With prosecutions imminent and a policy agenda finally taking shape, the UK’s commitment to eradicating FGM has improved drastically in the last year. However, as the school summer holidays draw near – when FGM procedures are commonly arranged – the government should significantly increase its efforts to eliminate FGM, not just with words, but actions.