FGM Report

Dr S K Sethi
City LSCB -June 2015

Why us? Why now?

All procedures which involve
the partial or total removal of the external genitalia or
injury to the female genital organs whether for
cultural
or
any other non-therapeutic reasons

The World Health Organisation

What is FGM?
2
4
 types
• I – circumcision – removal of clitoris

• II – Excision – I + removal of Minora

• III – Infibulation – I + II + Majora

• IV – Piercing, chemicals, burns – everything

else
 Identification and Intervention
There are 3 circumstances

1. Child at risk

2. Child has been abused through FGM

3. Mother has undergone FGM

 Why is FGM carried out?
• Religion is NOT a basis for FGM
• Cultural identity – A tribal initiation into
adulthood
• Gender Identity – Moving from girl to
woman – enhancing femininity
• Sexual control – believed to reduce the
woman’s desire for sex and therefore the
possibility of sex outside marriage
• Hygiene/cleanliness – unmutilated women
are regarded as unclean and not allowed to
handle food or water
 How is FGM carried out?
• Varies from community to community
– generally by an elder woman in the community
using non-sterile, blunt instruments without
anaesthetic

• UK
– girls are taken on “holiday” to become a woman
– Communities are believed to have their own
practitioners here

• Some doctors will do this under anaesthetic

 Indications that FGM may be
about to take place…..
• The family come from a community that is known to
practise FGM

• Parents state they will take the child out of the

country for a prolonged period

• A child may talk about a long holiday to a country

where the practice is prevalent

• A child may confide that she is to have a “special

procedure” or celebration
Indications that FGM may have
already taken place…..
• A child may spend long periods of time away from the
classroom during the day with bladder or menstrual problems

• Prolonged absences from School plus a noticeable

behaviour change

• The child requiring to be excused from physical exercise

without the support of their GP
 Communities at Risk
29 practising countries in particular

• Somalia – 98%
• Sierra Leone – 90%
• Ethiopia - 90%
• Sudan – 91%
• In Middle East – Egypt – 97%
 Health Consequences
Short term

• Haemorrhage
• Severe pain & shock
• Urine retention
• Infection including tetanus & HIV
• Injury to adjacent tissue
• Fracture or dislocation to limbs as a result
of restraint
 Health Consequences
Long-Term
• Difficulty with passing urine & chronic urinary
tract infections which can lead to renal
problems or renal failure
• Difficulties with menstruation
• Acute & chronic pelvic infections which can
lead to infertility
• Sexual dysfunction/Psychological/Flashbacks
• Complications during pregnancy
• Chronic scar formations
 What do I do?
• You must inform your designated child
protection Advisor

• They must make a referral to the Local

Authority Children’s Social Care

• Holistic – child and Think Family

• Legal parameters – March 2004.

Why do we need to Safeguard Girls and Women
from FGM ?

FGM is recognised internationally as a violation of the

human rights of girls and women.

FGM constitutes child abuse and causes physical,

psychological and sexual harm which is life long.

FGM is performed on a child who is unable to resist or

give informed consent

FGM is illegal in the UK.