Working together to end FGM Edited slide presentation. For - - PowerPoint PPT Presentation

Female Genital Mutilation

Working together to end FGM

Edited slide presentation. For information on training contact:- valentine@mojatu.com Claire.Trott@nottinghamcity.gov.uk

Key Learning Objectives

• To inform participants what is meant by the term

FGM and how it can impact on individuals and communities

• To raise awareness of indicators and risk factors

in the context of our safeguarding and legal responsibilities

• To raise confidence in appropriately

approaching this subject

• There is no easy way to talk about FGM –

although there is no attempt to shock in this presentation, you may find some of the content difficult and may feel upset

• Look after yourself - If you need to take a break

please do

• Our focus is safeguarding children and young

people

• Ground rules:- respect, responsibility,

appropriate language, confidentiality (unless safeguarding concerns) …

What is Female Genital Mutilation?

‘FGM is a procedure where the female genital organs are injured or changed and there is no medical reason for this. It is frequently a very traumatic and violent act for the victim and can cause harm in many ways.’

Multi-agency statutory guidance on FGM – HM Government 2016

Female Circumcision? Female Genital Cutting?

Other names within communities

Ibiugwu, Omobirin, Kutahiri Wasichana, Gudiniin, Kurua, Khitan, Tahoor, Mekhnishab, Megrez, Niaka, Sunna, Bondo, Khifad

FGM is the mutilation of the labia majora, labia minora or clitoris.

Types of FGM

• Type 1 – Clitoridectomy: partial or total

removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).

• Type 2 – Excision: partial or total removal of

the clitoris and the labia minora, with or without excision of the labia majora (the labia are the ‘lips’ that surround the vagina).

Types of FGM

• Type 3 – Infibulation: narrowing of the vaginal
• pening through the creation of a covering seal.

The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.

• Type 4 – Other: all other harmful procedures to

the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.

Multi-agency statutory guidance on FGM HM Government 2016

Prevalence

Percentage of girls and women aged 15-49 who have undergone FGM in Africa, the Middle East, and Indonesia

Senegal 25 Gambia 75 Guinea- Bissau 45 Guinea 97 Sierra Leone 90 Liberia 50 Cote d’lvoire 38 Bukina Faso 76 Ghanna 4 Togo 5 Benin 9

% of 0-11yrs Indonesia 49 < 10 10-20 20-50 51-80 > 80 No data

UNICEF global databases 2016

International and National Statistics

• Estimated that up to 200 million women and girls

worldwide have undergone FGM (UNICEF 2016)

• Age varies but manly carried out between 5 and 8 yrs
• Estimated 103,000 women aged 15-49 and

approximately 24,000 women aged 50 + who have migrated to England and Wales are living with the consequences of FGM

• Approximately 10,000 girls aged under 15 who have

migrated to England and Wales are likely to have undergone FGM.

Multi-agency statutory guidance on FGM HM Government 2016

Regional/Local data

• Nottingham City ranks 9th in terms of highest

prevalence rates outside of London (2nd after Leicester City in the East Midlands region)

• The FGM prevalence dataset - 849 newly identified

individuals with FGM within the Midlands and East area between Sept 14 and March 15 (Health Scrutiny Committee report Dec 2015)

• NCH NHS Trust see between 100-200 women a year

(2014 freedom of information request)

• Between 2005-2013, an estimated 408 girls were born

to women with FGM (2.09% of all girls born to women in Nottingham).

Why?

Psuedo religious reasons Belief: more hygienic Suitable for marriage Belief:

stops female promiscuity

Family honour

Community belonging

Rite of passage

Aesthetically desirable

Fear: you don’t Fear: Myths of what happens if you don’t

Potential Risk Factors

• Any girl born to a woman who has been

subjected to FGM

• Any girl who has a sister or cousin has already

undergone FGM

• A girl whose father comes from a practicing

community

• Belief that FGM is integral to cultural/religious

identity.

• Strong levels influence and involvement of elders

in family life

• Limited level of integration within UK community

Potential Risk Factors

• Family is not engaging with professionals (health,

education or other)

• Family is already know to social care in relation to
• ther safeguarding issues
• Limited access to information about FGM effects
• r UK law
• A girl whose parent/family member expresses

concern that FGM maybe carried out

• A girl withdrawn from PSHE at school may be at

risk as a result of her parents wishing to keep her uninformed about her body and rights

Possible Signs and Indicators

FGM may be about to take place:

• Unexpectedly absent from school
• Female family elder visiting from

country of origin

• You hear reference to FGM in

conversation

• Talk about a ‘special procedure’ or that

she is going to ‘become a woman’.

• A girl may request help
• Parents state that they or a relative will

take the child out of the country for a prolonged period.

• A girl may talk about a long holiday to

her country of origin or another country where the practice is prevalent

• Parents seeking to withdraw their

children from learning about FGM

FGM may already have taken place:

• Difficulty walking, sitting or standing
• Spending a long time in the toilet
• Urinary, menstrual or stomach problems
• Prolonged or repeated absences from

school

• Noticeable behaviour change
• Requests to be excused from

PE/swimming

• Girl or family member tell someone or

ask for help

• May talk about pain or discomfort

between her legs

• Increased emotional/psychological

needs

Impact on health

On Health

• Urine retention – leading to UTIs
• Complications in pregnancy and

childbirth

• Difficulties in menstruation
• Bleeding/hemorrhaging
• Sexual dysfunction
• Severe pain and shock
• Infection
• Fracture
• Cysts and abscesses
• Psychological damage including

PTSD

• Death

Emotion / Psychologically

• Trauma
• Betrayal
• Loss
• Feelings of fear around sex or

intimacy

• Confused
• Anxious
• Angry
• Ashamed
• Defensive
• Proud
• A sense of belonging
• Might not know how they feel

• FGM has been illegal since 1985 (Prohibition of Female

Circumcision Act 1985; Female Genital Mutilation Act 2003)

• Illegal to take British nationals or UK residents abroad for

FGM (whether it’s legal in that country or not)

• Illegal to aid, abet, counsel or procure the carrying out of

FGM in UK or abroad

• It’s now under the Serious Crime Act 2015
• It is mandatory for all regulated professionals (teacher,

healthcare, social care) to report any cases involving girls under 18 should they discover that FGM has been carried- Use 101, the non-emergency crime number

What does the law say?

Refugee Women Voices on FGM

https://www.youtube.com/watch?v=JwepmsCr1bw

Working with our communities Mojatu Foundation work

• Community engagement

events and sports

• Community magazine, radio

and TV presentations

• Talks/presentations
• End FGM logo
• Research collaborations
• Partnership with CCFSB

(Jan 2015).

• First City of Zero

Tolerance with Sheriff!

• Mojatu Foundation in

Parliament!

• Community FGM Steering

Group (formed in March 2014)

• Survivors’ club- Support for

survivors

• Cultural events and

information sessions

• Conferences, workshops and

Training

• Film viewings, Interfaith

discussions

• Community Champions

project

Safeguarding

• FGM is a serious child protection concern

(Significant Harm threshold)

• We have a responsibility to respond and protect
• Follow multi-agency statutory guidance/your

services safeguarding procedures/LSB Procedures http://nottinghamshirescb.proceduresonline.com/p _fem_gen_mutil.html

• Check FGM is included in policies/procedures

Mandatory reporting duty FGM Protection Orders

• If a person in a regulated profession (teacher,

healthcare, social care) discovers that FGM has been carried out on a girl U18 they are required to inform the police

• Use 101, the non-emergency crime number
• FGMPO – a civil order (application by person to be

protected, ‘relevant third party’, ‘any other person’.

Safeguarding through Working Together

• No single professional can have a full picture of

an individual’s needs and circumstances

• Multi-Agency and Victim-centred approach

needed

• ‘Cultural sensitivity must not get in the way of

tackling FGM but communicating about it in the wrong way can undermine and damage efforts’

• The safety and welfare of the child is paramount
• We should actively seek and support ways to

reduce prevalence – working with community

• rganisations and advocates

Why training and education is needed in schools?

• Duty to safeguard
• Provide appropriate care and support to those

affected

• May have heard of FGM but may be

unsure/confused

• Gives an opportunity for pupils to understand

what abuse is and develop the confidence to speak about it

• Safeguards others
• Pupils are the next generation
• Part of Ofsted inspection Framework

Engaging Young people……

https://www.youtube.com/watch?v=45CTI5A3COU

How can you help?

• Moral duty of care- Support

those at risk and survivors and report any serious concerns immediately

• Encourage awareness raising

in your institution through posters, leaflets etc.

• Engage and build trust with

parents/community members

• Talk about it to others in your

profession and share knowledge

• Donate/fundraise/volunteer to

support organisations tackling FGM IT IS EVERYBODY’S RESPONSIBILITY!

Important contacts/resources

Concerned or need to refer???

• Follow your institution’s

safeguarding procedures to ensure concerns are dealt with ASAP

• Liaise with local social services for

safeguarding

• NSPCC – helpline dedicated to

FGM that is anonymous and open 24/7, you can call them on: 0800 028 3550

• Urgent matters ring 999

immediately

• Refer survivors to community

groups like Mojatu Foundation for further support.

• UK FGM clinics

http://www.forwarduk.or g.uk/wp- content/uploads/2014/1 2/Specialist-Clinic- Services-Listing-10-12- 14.pdf

• Multi-agency practice

guidelines- https://www.gov.uk/gov ernment/uploads/syste m/uploads/attachment_ data/file/512906/Multi_A gency_Statutory_Guida nce_on_FGM__- _FINAL.pdf

Further Information and Support

• FGM e-Learning
• https://www.gov.uk/government/publications/female-

genital-mutilation-resource-pack/female-genital- mutilation-resource-pack#effective-practice-and- resources Schools

• The PSHE Advisory Service

Claire.Trott@nottinghamcity.gov.uk www.character-uk.org

• Advanced Designated Safeguarding Leads (ADSLs)
• The Mojatu Foundation

www.mojatufoundation.org

Further Information and Support

• www.forwarduk.org.uk
• http://integratebristol.org.uk
• www.nscpcc.org.uk
• www.thegirlgeneration.org
• http://28toomany.org
• www.dofeve.org (Daughters of Eve)

The FGM Board’s adopted logo