On Friday 17th August, two Londoners were charged with carrying out female genital mutilation (FGM) on a three-year-old girl. It is just the third prosecution of its kind in UK history, a country where an estimated 137,000 girls and women live with FGM and a further 144,000 are at risk.
“What is increasingly clear is that FGM is now a global issue,” said Jacinta Muteshi-Strachan, project director on FGM research at the Population Council. “We’re finding it present in North America, Africa, Europe, and in Asia.” Governments in the global north are facing a problem that is routinely cast as unique to the global south.
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Only 10 of the EU’s 28 member states have specific laws criminalising FGM. While campaigns like the EU-wide End FGM project have raised awareness of the practice, national policy in the global north remains uneven. Pockets of excellent prevention work aren’t spreading, and best practice isn’t always being shared.
So where should policymakers look next to prevent FGM? Here are three possible approaches.
Putting the law to work
In 1985, Britain criminalised FGM within its shores, expanding the law in 2003 to cover all British citizens who are sent abroad to be cut. But in more than thirty years of the ban, none of the three prosecutions on the grounds of FGM has resulted in a conviction.
That isn’t true of other countries, however. “France is often held up as an example of where some very serious criminal sanctions were enacted thanks to successful prosecutions,” said Helen Baillot of the Scottish Refugee Council. One such case was in 1991, when a cutter was jailed for five years following a landmark trial.
France has jailed around 100 people in a series of high-profile cases since criminalising the practice in 1983. Researchers say that France has prosecuted FGM cases more vigorously than other European countries, and that high-level political will lets police officers and prosecutors investigate and charge potential perpetrators.
But it has also relied on other systemic differences. Prosecutions have been aided by mandatory screening of all girls under the age of 6 who attend maternal and child health centres in France, with a clear referral system to appropriate support services and police where girls have been cut.
The law, having been the subject of media attention and high profile cases, has had a symbolic effect beyond individual convictions, said Baillot. “It sent a message that this is a serious crime, which seems to have had a preventative effect.”
A scoping review of European best practice, conducted in 2014, emphasised the importance of having clear and connected referral systems in place. The Netherlands’ approach was identified as one of the most robust on the continent.
The Ketenaapak (“Chain Approach”), developed in the 2000s, takes a multi-disciplinary partnership-based approach to preventing FGM. It builds links between police forces, social services medical practitioners and communities.
It is based on a five-step guideline for professionals that are in contact with girls who could be FGM survivors. The Chain Approach involves knowing when to refer, how to refer, and to whom — only in the final stages is the survivor referred either to social services or the police.
Some 20 child and family abuse reporting centres cover the country, and each has an FGM specialist on staff responsible for safeguarding measures, risk assessments and — crucially — engaging with community figures in cases where girls are at risk.
The designers of Ketenaapak consulted figures from communities most affected by FGM when coming up with the approach. They recruited some of these people to make home visits to families that are at risk. The participatory nature of the research is not yet standard practice in all countries’ referral systems, but the scoping review suggested that it is vital to the success of the Dutch system.
Watering the roots
A growing consensus in the academic literature suggests that eradicating FGM depends upon having the communities which practise it buy in to prevention efforts. That applies both in countries where it has traditionally been practised, and in the global north.
Grassroots initiatives are in no short supply. In Britain, Integrate UK sends young people into schools to talk about racism and integration, including FGM.
The charity seeks to raise awareness among women at risk, but also among the whole school community, through school visits, social media campaigns, music and video.
“You need to work with everyone,” said Lisa Zimmerman, Director of Integrate UK. That means teaching women and girls their rights and the health implications of FGM. It means engaging boys and men as agents of prevention. And it means helping teachers have the knowledge to know what to do and who to refer to where girls are at risk.
But community initiatives don’t operate in a vacuum: sustainable, long-term funding from governments is integral to sustainably changing community attitudes, she added.
Back to basics
Recent work by the European Institute for Gender Equality into FGM in Europe is promising, but countries still need to prioritise the issue and approach it on two overarching principles, experts say.
The first is that FGM sits on a continuum of other forms of violence against women and girls and should be treated as such. “The biggest mistake is to ‘other’ FGM — it’s part of a bigger picture and you won’t address FGM unless you address the underlying issues of gender inequality and violence,” said Zimmerman.
The second is that FGM is everyone’s problem. What grassroots initiatives, the chain approach, and legislative actions point to is that prevention work should happen at all levels of society, by family members, doctors, nurses, social workers, teachers and anyone else.
That means embedding knowledge from top to bottom.
The aim is ambitious, but things are looking up. Lisa Zimmerman, commenting on the UK’s approach since 2010, expressed optimism: “In the last ten years, there has been a huge, huge change in the way we approach and prioritise FGM,” she said, “and it’s important to acknowledge the progress as well as the challenges that remain.” — Edward Siddons
(Picture credit: Flickr/DfID)