The All Party Parliamentary Group (APPG) on FGM comprises more than 50 MPs and peers, representing all the main political parties. It has worked with both governmental and non-governmental organisations to raise awareness of the issue in the UK and abroad. Following a round table meeting in September 2012, which I attended along with prosecutors, police officers, government departments, child protection specialists and medical professionals, the UK Director of Public Prosecutions, Keir Starmer QC, published an action plan on tackling FGM in November 2012.
In addition to this, a new 'Health Passport' was launched by the Home Office in late November 2012. This is a document, which outlines UK laws on FGM, designed to fit into the back of a girl's passport or to be carried by parents who want to protect their daughter from extended family members. If convicted of failing to do so, parents, who are not yet citizens, could lose the right to remain in the UK.
Educational and legislative efforts to eliminate FGM are two sides of the same coin. Alongside attempts to strengthen existing legislation, renewed focus on education about FGM is also urgently required to protect the fundamental human rights of all children 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" (WHO, 2012). Efforts to eliminate FGM have been ongoing in the UK since the early 1980s, when it was first raised as an issue which affects not only girls and women in Africa, but also citizens and residents of the UK. In the years following the implementation of the Prohibition of Female Genital Circumcision Act (1985), work has predominantly focused on raising awareness among affected communities. However, major obstacles continue to exist, which block the flow of information to the families who need it, while child safeguarding issues continue to exist, which cannot be dealt with effectively through dialogue alone with those community members who support the practice.
We are encouraged by the progress which has been made over the past thirty years in relation to addressing FGM. Levels of awareness of it as a health and human rights issue have increased steadily in practicing communities. The foundation of 17 NHS specialist clinics, which promote access to obstetric and gynaecological care for women, was a major step forward. These are particularly important for those women who have undergone 'infibulations', the most radical form of FGM, where the external genitals are stitched up and the vulva is almost entirely closed over. The Female Genital Mutilation Act (2003), introduced by Ann Clwyd, strengthened earlier legislation and makes it a criminal offence for a UK national or permanent resident to excise, infibulate or otherwise mutilate the whole or any part of a girl's labia major, labia minora or clitoris, or to aid, abet, counsel or procure another to do so, whether in the UK or elsewhere (the extra territoriality clause).
However, despite sustained efforts to discourage it, FGM continues to be practised on girls in the UK. An estimated 24,000 girls in England and Wales alone are at risk of undergoing FGM, but the real number is likely to be significantly higher than this. UK-based parents who are determined to have their daughter mutilated frequently take them abroad to have the procedure done. They rarely fear prosecution on their return. A common expression is that 'the UK does not have the guts to prosecute anybody in relation to FGM'. This is a major frustration for community outreach education workers from affected communities.
The most common type of FGM is partial or total clitoridectomy and although several justifications continue to be put forward for FGM, the main underlining reason for it is to suppress the natural sexuality of the girl and to boost the family's 'honour'.
FGM is irreversible and aside from the trauma experienced by girls and the potential long term psycho-sexual health risks associated with these mutilations, it is a clear violation of the fundamental human rights of the girl involved. Most importantly, it fulfils the World Health Organisation definition of child abuse, which includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development or dignity. Within this broad definition, five subtypes can be distinguished: physical abuse; sexual abuse; neglect and negligent treatment; emotional abuse; and exploitation. It could be argued that FGM relates to most, if not all of these subtypes.
The parallels between FGM and other forms of child abuse are blatantly evident. In all instances, children experience confusion, guilt, fear and anxiety. In almost all cases, the child victim has a close relationship with the perpetrator of the crime - an adult (usually a parent or family member in the case of FGM), who holds significant physical and emotional power over them. The child who undergoes FGM is silenced and any sense of entitlement to her natural sexuality is removed forever.
Key challenges to the lack of prosecutions in the UK are the young age of those involved and the fact that FGM is a hidden practice within families and affected communities. In the UK, cases largely rely on victims who are frequently under the age of 10, to come forward and provide evidence. For obvious reasons, these girls are not able to defend themselves in this way. Like other forms of culturally-sanctioned abuse of women, family and community members tend to intimidate any older girls who wish to speak out against the issue. The victims of FGM are therefore at the mercy of frontline professionals, particularly in health and education (FGM typically occurs during the primary school period), to report suspected cases. Therein lies the problem.
Authorities are often reluctant to intervene in FGM cases because of the perception that it is a traditional or cultural practice, which is approved by the practising community and in which the legal system should not intervene. This faulty thought process often leads to inappropriate responses by professionals. The notion exists too that parents who mutilate their girls 'love' their daughters and should not be prosecuted. If traditional practice existed, where a child's finger was amputated - or an eye removed, medical and education professions would not hesitate to report the crime, while authorities would react instantly by protecting the girl involved and arresting the perpetrators. However, instead of feeling accountable, professionals often fear the implications of getting involved in what is often believed to be a 'family matter'. This is a counter-productive situation, which puts girls at severe risk, but which also creates a difficult barrier to potential prosecution, which is reliant on the irrefutable evidence of suspected cases by independent professionals.
The government multi-agency practice guidelines, issued in 2011, clearly confirm that FGM is child abuse and a form of violence against women and girls and should therefore be dealt with as part of existing child and adult protection structures, policies and procedures. Medical professionals should remain constantly alert to signs of FGM and feel safe when reporting any suspected cases. Educators should be aware too of missed classes, evidence of physical or emotional pain and feel responsible for - but also supported in - their efforts to report this abuse. Meanwhile, social workers, the police force and the legal profession should be educated in the need to deal sensitively, but also responsibly, with any reports of suspected FGM. If we are to eliminate FGM for the next generation of girls, the time to change our way of thinking is now.
While parents, guardians, educators, childminders, medical professionals and those other members of society who encounter minors on a regular basis are particularly well-situated to do so, we are all responsible for reporting to the relevant authorities any information which relates to potential cases of FGM. Through undertaking communal responsibility and accountability for the well-being of our children, we can help to break down the barriers which proponents of FGM rely on for its continued survival. The safeguarding of children is not optional. The collective assumption of our responsibility and accountability in protecting them is both a social and legal necessity.
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