What is FGM?
Female Genital Mutilation includes all procedures that intentionally alter or cause injury to female genital organs for non-medical purposes. There are 4 main procedures which are outlined on the World Health Organisation website. FGM is also known as Female Circumcision or Female Cutting, although other colloquial names can be applied such as ‘sunna’ and ‘tahara’.
The procedure is concentrated in North African such as Egypt, Sudan, Somalia and a smaller number of Middle Eastern countries such as Saudi Arabia; immigration from these countries across Europe means that FGM takes place in the UK within certain communities. The procedure occurs both within the UK and where a woman or child is taken out of the country; there are increasing cases of FGM being carried out by health care providers, although for non-medical reasons.
FGM is most commonly carried out between infancy and the age of 15. The procedure is carried out for a number of reasons consistent with cultural beliefs, but offers no benefits and a number of health risks. These include:
- Intense pain and/or haemorrhage that can lead to shock during and after the procedure as well as anaemia;
- Risk of blood borne viruses if the same instruments are used for a number of procedures;
- Wound infection, including tetanus
- Urine retention from swelling and/or blockage of the urethra;
- Injury to adjacent tissues;
- Fracture or dislocation as a result of restraint;
- Damage to other organs;
- Complications during birth;
The free FGM e-learning course has been updated.
The course now includes information on the changes to the law introduced through the Serious Crime Act 2015,
updated prevalence data, the NHS England enhanced dataset, and new guidance for UK Visas and Immigration.
To access the course, go to www.fgmelearning.co.uk
FGM Support from AFRUCA
AFRUCA’s new therapy service provides emotional well-being support for African children affected by FGM in Greater Manchester; the service aims to Bridge the gap to specialist mental health services by providing support to those both at risk or under pressure to have the procedure, and for those where the procedure has already taken place.
AFRUCA, in partnership with NESTAC, are now offering the Guardian Project; this is a pilot project coordinating support for girls up to age 21 who are the victims of or at risk of FGM. The Guardian Project is available to provide advice, support and guidance for all professionals across Greater Manchester. For more information, please see the leaflet below, which can be displayed in your workplace.
Guidance and Reporting
On the 31st October 2015, a new professional duty came into place making it mandatory for all professionals to report ‘known’ cases of FGM in under 18sto the police.
The Department for Health have released a number of guidance documents, below, for Health Professionals:
- Quick guidance – a 2-page summary of the duty including a process flowchart
- A Poster for health organisations to display about the duty
- Video interviews with Vanessa Lodge, NHS E National FGM Prevention lead
- An information leaflet for patients and their families which professionals can use to help when discussing making a report to the police.
HM Government have also issued comprehensive Multi-agency practice guidelines, which provide detailed guidance for Children’s Social Care, Schools, the Police and Health, guidelines for good practice, preventative measures and how to identify risk, as well as legal implications. The guidance can be found here.
Professional concerns around suspected cases of FGM, or beliefs that a child may be at risk of FGM should always be reported. Pages 17-21 of the Department of Education guidance provides a checklist if you believe a person to be at risk, including specific factors to consider in the case of a child.
Greater Manchester Guidance
Up-to-date guidance for professionals can be found on the Tri-x website in the Greater Manchester Safeguarding Procedures.