We must all take responsibility to end FGM, by Professor Janice Rymer, King’s College London.
Female Genital Mutilation (FGM), is defined by the World Health Organisation as all procedures involving partial or total removal of the external female genitalia or injury to the female genital organs for non-therapeutic reasons.
More than 130 million girls and women alive today have been cut in the 29 countries in Africa and the Middle East where FGM is concentrated. There have also been reports of FGM occurring in Asia. If current trends continue, as many as 30 million girls are at risk of being cut before their 15th birthday.
Closer to home, it is estimated that 66,000 women living in England and Wales in 2001 had undergone FGM and over 23,000 under the age of 15, from African communities, were at risk of or may have undergone FGM. There is currently a new study updating this prevalence study and the Department of Health is compiling data on the incidence in hospitals, GP surgeries and mental health units.
To date there has not been a single conviction for the perpetrators of FGM despite specific legislation passed in 1985. Additionally, it is illegal to take a British National or permanent resident abroad for FGM or to help someone to do this. Over the last year, there have been a range of policy developments that will better safeguard and care for children and women in the UK. We know that the Police and Crown Prosecution Service are trying to secure a prosecution to demonstrate that the UK is serious about ending FGM.
The reasons behind the practice are complex and based on culture and tradition and we need to understand these in order to communicate sensitively with victims. However, the long-term physical and emotional consequences for the victims mean that health and social care professionals all have a duty of care to end FGM.
As part of the present government’s FGM programme, mandatory reporting was introduced in the UK. The timely reporting and recording of all known cases is crucial in the continuing effort to prevent and ultimately eradicate FGM in the UK.
Education and training are key to raising awareness among health professionals. This has to begin at undergraduate level in medical school. Similarly, trainees and doctors need to ensure that they have the appropriate knowledge and skills to deal with all cases should a woman present with signs of FGM. Health Education England’s e-learning modules on FGM are now live. We would urge all NHS professionals to have a look.
All clinicians must be aware of the law and the relevant statutory and professional guidance on FGM. The RCOG is currently updating its clinical guideline and we would encourage all Members, Fellows and trainees and other maternity colleagues to read them when these are published. More importantly, trusts need to implement them so that women can get the best care and support that is available.