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FGM – Are we serious ?


The number of those of all ages with Female Genital Mutilation in the UK has increased almost threefold to 170,000 over the past ten years according to the Times.

See  I was so shocked – This has to Stop

This article is so important but, as it is only available on a subscription, I reproduce most of it at the bottom of this post.

Recently, a Dr Dharmasena, registrar in obstetrics and gynaecology, became the first prosecution brought in the UK since FGM was criminalised in 1985. He was found innocent.

 

Even a conservative estimate is that there are 6,000 cases of FGM a year in this country.

 

http://www.bbc.co.uk/news/uk-30886077

 

We are not taking FGM attacks on our children at all seriously…

 

And this is perplexing.  It seems axiomatic that if social workers knew that a young, white female was to be mutilated by their family in this way, then that that child would instantly be taken into care, and probably so would all the other children of these, seen to be, dangerous parents.

And yet, it is said that at least 17 UK children a day suffer this practice.

 

Should we not extend our legal protection to all our children?

 

I risk being painted Daily Mail-ish, but I do feel we must draw a line in the sand.

And I do not feel this is a do-gooder attack on a particular section like as last century’s wholesale state abduction of Maori children in Australia.
I propose temporary but robust supplementary regulations.
(By ‘temporary’ I follow my Liberal maxim that, the default should be that the relevant proposed change in the law should be temporary – have a ‘sunset clause’ of a generation, say, – 25 years).

I do believe that this horrific cultural tradition will wither in the face of education as developing countries begin to lose their fear of the sexual side of women. There are worthy initiatives by the international community to chip away at the practice
see Lynne Featherstone’s £25 million to help in this. http://www.newstatesman.com/politics/2014/02/we-cannot-end-fgm-uk-without-ending-it-africa

But here, as above, there is a pressing need not to be overwhelmed by the numbers but to take a robust set of actions to protect our young girls.

 

For those entering the UK

There are more than 30 countries of origin, where FGM forms some part of the culture for some.
(See
http://en.wikipedia.org/wiki/Prevalence_of_female_genital_mutilation_by_country)

 

I propose:

 

  1. As part of the embarkation card completion, every family entering the country from those countries has handed to them written confirmation that FGM is illegal in this country and that even arranging for FGM to be carried out abroad is illegal since 2003.
    Signing the disembarkation card confirms the receipt of leaflet.
  2. Also on the leaflet there is confirmation of the teachings of well-known religious scholars of Islam and Christianity (hopefully) condemnation of the practice or at least confirmation that nowhere in the Qur’an (or its Hadith interpretations) is there support for FGM. http://en.wikipedia.org/wiki/Religious_views_on_female_genital_mutilation.Nor that in the Bible it is mentioned.
  3. Lastly, that if FGM is discovered in any female children a Place of Safety Order will be sought – and they will lose that child, and this, along any other female children of their family.They should be left in no doubt that this country’s Family Courts hold the reasonable assumption that the discovery of FGM means that parents must have arranged the procedure, or failed to prevent it – and that under this country’s laws, this makes them unfit parents.
  1. The formal signing by the parents, above identified, of an Agreement that they are aware that FGM is unlawful, and
  2. Regular confirmation reminders by post in appropriate language that this is the case.

Vulnerable children now in the UK

Vulnerable children born in this country whose parents are from the identified group of FGM countries are readily identified by hospitals health visitors, nurseries and primary school teachers.

And there are a host of charities to tackle the procedure including Project Azure, the Dahlia Project, but although there are these resources available, inner-city primary school teachers tell me there is no formal training to help them identify potential or actual FGM victims.

 

Whilst I agree that it is essential to stop FGM abroad it is also essential we stop the practice in its tracks in the UK.

 

I propose:

 

  1. The same amount of money given by the Government to FGM prevention abroad (£25 million) is given directed to funding resources for charities here to contact each and every potential FGM family and to seek to re-educate them.
  2. Re-educate social workers away from their reluctance to interfere in ‘cultural’ matters which is reported as allowing this dreadful physical and emotional abuse to be ignored.
  3. Begin to take children into care from families of FGM victims and the other female children of the family.A few well publicised examples of this will surely be sufficient to warn families contemplating this practice.

 
Then, their parents must admit in writing when, where, and by whom the mutilation took place if they wish to avoid arrest and criminal investigation.
This signed evidence against any identified UK doctor said to have carried out the operation, on its own, may not be enough to form a successful prosecution, but arrest and criminal investigation is always frightening – and the BMA will be informed.
And their card will be marked…
I leave it to readers to judge whether this would frighten off Doctors from this bizarre practice.

Warn those parents that there will be a mandatory, yearly, medical examinations of their female children to detect FGM.
Any FGM found, will be reported, as well as entered on a central database.
This, of course, is racial profiling and can attract objections of being a violation of human rights, the right to family life etc.
However, there are 170,000 reasons why we should ignore such arguments to meet quickly this disgraceful failure to protect our young girls.

Non-medical people, identified as having done this to a youngster, again may avoid prosecution without willing witnesses.  However, an arrest should be made and them being warned that they could certainly face imprisonment, as well as their ending up being the future cause of a child being removed from its parents.

 

  1. That all these discovered post-FGM children automatically go onto an at-risk register.
    And the parents warned formally that future FGM imposed on any of their intact daughters, will inevitably will trigger a POS order, an arrest, imprisonment and the children being removed.
  2. The mandatory attendance at suitable parenting courses run by their racial group.
    Or face a Family Court with powers make orders to effect this.
    This, if no there is not sufficient evidence to bring a charge in the Criminal Courts.
  3. And lastly, but blindingly obviously, the mandatory examination of any potential-FGM vulnerable female, before being allowed to visit abroad, possibly at the airport, and then after their return, to discover if FGM has occurred while away.

All this may seem harsh and illiberal to some.
And there will certainly be some families who are wrongfully targeted – in fact, it is known that families in the past have fled some of the 30-odd sub-Saharan and Middle Eastern countries where this practice is found.

 

However, I do feel that just a few well-publicised examples of children taken into care to protect them from FGM, and news that they were eventually adopted out, and lost forever to their misguided, dangerous parents,  will have a dramatic effect on those others holding that this evil procedure is can be carried out in the UK.

 

And I for one would rather pay the extra taxes needed to cover a massive, temporary influx of children into Care than have another 170,000 children suffer this cruel, dangerous, humiliating, misguided procedure.

It will take determined action on behalf of Society, but are we serious about putting a stop to this cruelty to our children, or are we not?

 

The Times Article – “I was so shocked – This has to Stop

FGM has been documented in 28 African countries, including Djibouti, Eritrea, Sudan, Somalia and Egypt – as well as in countries in the Middle East such as Yemen, Oman, Kuwait, Brunei and areas of Iraq and Iran

The number of FGM survivors in England and Wales has increased almost threefold to 170,000 over the past decade

There has not been a single prosecution brought in Britain since GM was criminalised in 1985

The law was updated in 2003, making it also illegal to arrange for a child to be taken overseas to be cut

Campaigners believe 24,000 girls under the age of 11 are under risk

Unicef says there are 125 million women and girls alive today worldwide who have suffered FGM

“Miriam” is a Somali-born woman living in the UK who fell victim to female genital mutilation Times photographer, Susannah Ireland

  • Dr Phoebe Abe, a doctor at the Yiewsley Health Centre and campaigner to raise awareness about Female Genital Mutilation

    Dr Phoebe Abe, a doctor at the Yiewsley Health Centre and campaigner to raise awareness about Female Genital Mutilation Times photographer, Susannah Ireland

Lucy Bannerman
Published at 12:01AM, January 25 2014

Dr Phoebe Abe began to notice the pattern about a year ago. A beautiful young woman walked into her consulting room and, after listing a litany of medical complaints, paused, then asked in a whisper: “Doctor, can you give my clitoris back?”

The woman confided that, as a child, she had had the most severe type of female genital mutilation.

“I was so shocked. What do you say? I had to pretend to type into the computer,” Dr Abe remembers.

After that meeting, Dr Abe started to ask discreet questions of any woman of African or Middle Eastern origin who presented symptoms such as back pain, mobility and bladder problems, or urine infections, and tallied them on her calendar. At first, she counted two a week. Then, as word spread among immigrant communities, and more women travelled to see her, it rose to five.

“Now I see around one every day. Yesterday, I saw three,” she says.

In the past 12 months, she has identified 53 women out of a total of 5,104 female patients at her surgery in West Drayton, Greater London, who have had their genitals butchered and, in many cases, had their vaginas sewn up almost completely. Five of them are under 15. One woman in her 30s walks with a stick. Others are on kidney dialysis, while another has had to have a kidney transplant.

“It is the back pain! These are young women and they can barely walk from recurrent infections.”

Most importantly, she says, she doesn’t let any of them leave her consulting room without finding out how many daughters they have and recording how many other female relatives may also be at risk.

Dr Abe, a feisty mother of five from Uganda with 26 years experience as a GP in the UK, says she feels like she is fighting the battle alone. She believes there is a spectre sitting in doctors’ waiting rooms, but no one wants to know. Her frustration is palpable.

“Nobody else is coding it. I am the only one counting. We GPs should all be taking proper medical histories, asking questions, just like we were taught to at medical school. Investigate, treat and manage.”

She adds that most of her female genital mutilation (FGM) patients have made repeated visits to other surgeries before coming to her. They didn’t volunteer the information and the health professionals didn’t ask. Many of them didn’t even make the connection between their symptoms and the childhood trauma bestowed upon them by their own relatives in a warped bid to make them more eligible for marriage, mark their passage into womanhood or simply prevent them straying off in search of sexual pleasure.

Dr Abe claims that many of her patients even went through complicated pregnancies, and endured difficult labours at NHS hospitals, without FGM being discussed.

“They are handed their baby girls and off they go, without any follow-up.”

It has become an increasing cause of embarrassment that, despite having had legislation criminalising FGM for almost 30 years, not a single prosecution has ever been brought in the UK.

Dr Abe warns that unless GPs and other health professionals follow her proactive approach, perpetrators will continue to go unpunished. She puts it even more bluntly: how can progress ever be made if nobody is counting?

The doctor records cases in files on her desktop, and writes notes in red biro for her colleagues, when new ones come in. Her oldest FGM patient is 72. Her youngest is 9. She still describes with horror the worst case she ever saw — a 36-year-old woman from Somalia.

“The urine and faeces didn’t know which way to go. She had so many fistulas she was leaking everywhere.” She throws up her hands in exasperation. “This has got to stop.”

A recent report by the New Culture Forum estimated that the number of women and girls suffering FGM has increased almost threefold to 170,000 over the past decade. Freedom of information requests found that, though hospitals were dealing with thousands of victims, they were failing to record cases or refer them to the authorities.

There is no specific hospital code to record cases of FGM, which means that hospitals are variously recording cases as anything from “assault with sharp object” to “open wound”.

This invisibility extends to GP surgeries. A code does exist for FGM but it is down to doctors’ discretion when to use it.

It is thanks to the support of her colleagues at the Yiewsley Health Centre that Dr Abe has managed to identify as many cases as she has, she says.

However, resistance among the wider medical profession has driven her to despair. She recalled a meeting with a specialist urogynaecologist at a major London hospital. “I was so excited. I thought I’d found someone who could help.” The specialist told her politely that FGM was too uncommon to be a top public health priority. “I came home and cried,” she says.

The NHS can ill afford to miss these cases, she argues — intervention saves another generation of little girls from needing medical treatment for the rest of their lives.

A spokeswoman for the Royal College of General Practitioners says it is working with the Royal Colleges of Midwives, Obstetricians and Gynaecologists to produce further guidance for health professionals.

Professor Amanda Howe, vice-chairwoman of the RCGP, says: “Good clinical practice dictates that GPs code all medical encounters as best they can. However, clinical coding frameworks are complex and set independently of the RCGP. These must be designed to reflect the problems that patients present, as accurately as possible.”

Progress is being made, albeit slowly.

Campaigners celebrated one step forward yesterday, when their e-petition calling for a national strategy to tackle FGM gained more than 100,000 signatures, and consideration for a parliamentary debate.

Meanwhile, Dr Abe urges fellow doctors to follow her example: “When you see women from any of these countries [where FGM occurs], take their medical history, gain their confidence, talk to them. And don’t forget to ask at the end: ‘Have you been cut?’”

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