Female Genital Mutilation

Jane Ellison Excerpts

Thursday 5th July 2012 Commons Chamber

[Jane Ellison (Battersea) (Con)]

Thank you, Mr Deputy Speaker, for giving me the opportunity to speak again on this important and topical issue. The Under-Secretary of State for the Home Department, my hon. Friend the Member for Hornsey and Wood Green (Lynne Featherstone) and I have been here before on a Thursday evening.

In April this year, a Birmingham dentist, Dr Omar Addow, told undercover reporters from The Sunday Times that female genital mutilation was

“not allowed in this country”.

He also said:

“These are very private and secret things...It must be confidential but I think it’s better you go to Africa...I can give you some medication...I can help you.”

The same report quoted Mohammed Sahib, an alternative medicine practitioner from Barking, east London, offering to carry out FGM on a 10-year-old girl for just £750. The actions described by those men are illegal under this country’s law, as the House will know. Under the Female Genital Mutilation Act 2003, which built on the Prohibition of Female Circumcision Act 1985, it is illegal to take girls abroad for FGM or to facilitate that process in any way. The 2003 Act extended extraterritorial protection to all UK residents and citizens. However, it seems that those legal protections are still being flouted and thousands of young British girls every year face the prospect of becoming victims of a serious and violent form of child abuse.

I am glad that the dentist, Dr Addow, and the doctor who referred the reporters to him, Dr Mao-Aweys, were arrested and that their respective professional bodies are investigating the matter. As an aside, though, I would question why it took a newspaper to expose that activity. Why was it not on the police’s radar, or that of local health officials? Or is it the case of “where there’s a will, there’s a way”? I will return to the key role that must be played by front-line professionals later in my speech.

Members will be aware of my interest in female genital mutilation and of the all-party parliamentary group on the issue, which I chair. I am grateful to the many Members who have taken an interest in the subject over the past year. I have spoken before about this barbaric practice still being carried out across the world and I believe that it is still being practised on girls who live in this country.

The World Health Organisation defines FGM as any

“procedure that intentionally alters or causes injury to the female genital organs for non-medical reasons.”

The WHO and the United Nations also recognise FGM as a human rights violation. I will not go into great detail about the devastating effects of FGM—I have covered those subjects before—but it results in girls, usually under the age of 10, facing a lifetime of pain and many significant physical and mental health problems. Today, I want to focus on those girls who are most at risk of being taken overseas in the long summer holidays by their families to have FGM inflicted on them—the theory being that the holiday break gives the girls time to “heal” before returning to school in September.

There are many who downplay the issue or deny that FGM is a problem in the UK, and trying to eradicate a practice that is shrouded in such secrecy and to establish the evidence base for one’s arguments is, by definition, difficult. However, I believe that some girls in the UK are at risk of suffering FGM, and I would like to offer the House some facts from which that conclusion can reasonably be drawn.

The last comprehensive study into FGM prevalence in the UK was carried out in 2007, and was itself extrapolated from the 2001 census figures based on settlement in the UK from FGM-practising regions of the world, such as east Africa. That study has become the main source of statistics for debate on FGM in the UK ever since. Although we need a fresh comprehensive study, it should be noted that the Forward study has been peer-reviewed in the past six months by a panel of European experts and its methodology remains robust. The study’s figures also received an update in the report on harmful cultural practices, “The Missing Link”, commissioned by the Greater London authority last November.

We cannot precisely determine the persistence of FGM as a cultural practice in the communities that have resettled in the UK. Some reports have found a falling away of the practice, while others have found an aggressive re-commitment to it among diaspora communities. However, we know from freedom of information figures obtained by media organisations last year that the number of women seeking treatment for FGM has increased in recent years. The London Evening Standard reported that, in 2010, 442 women in 11 London NHS trusts sought treatment for FGM and related complications, often associated with pregnancy and childbirth—a 30% increase on 2007. This would suggest that, even if—and it is a very big if—the percentage of girls and women having had FGM is falling in the UK, the increased volume of migration from practising countries and regions would still mean that there is a net increase in the number of women and girls with, or at risk of, FGM. This is of particular concern as the UK has seen significant migration from Somalia, where World Health Organisation estimates put FGM percentage prevalence in the high 90s, and where the most extreme form of FGM is widely practised. I highlight Somalia for a reason: Puntland, a large region in north-east Somalia, has recently passed a law that indemnifies families who inflict sunna-type FGM on their girls, even if the girls die as a result.

Over the last year, I have attended conferences held by health practitioners, including midwives, gynaecologists and obstetricians who have illustrated that more women were presenting for childbirth with FGM, many of them then asking to be reinfibulated—that effectively means sewn back up—or coming in for the birth of a later child, with clear evidence of reinfibulation after the birth of their earlier children. This does not support any conclusion that there is a rapid rate of abandonment of this practice in the UK, and these women’s daughters should be considered at risk.

Although, regrettably, there have been no prosecutions for FGM-related crimes in the UK in the last 25 years, people have been successfully prosecuted and convicted in other comparable European countries, most of which have significantly smaller communities from FGM-practising regions than the UK.

In the light of the evidence I have presented, I hope the House will agree it is reasonable to conclude that a substantial number of young girls living in Britain today are at risk of becoming victims of FGM. I will focus my remaining comments on what more we can do to reduce that risk.

I want to be clear—I have said this before—that this is not about picking on one culture or another. Just as we celebrate cultural diversity in our country, however, we cannot shy away from difficult issues because of cultural sensitivities. Proper regard for people’s cultural heritage has become warped by over-sensitivity, and harmful cultural practices have not always been challenged as strongly as they should have been. The feedback from health professionals at the conferences I have attended is that they do feel constrained and they worry about deterring patients from presenting. Some teachers I have spoken to, although charged with safeguarding these children, were completely ignorant of FGM and some admitted their guidelines were, at best, embryonic. Most conversations with front-line professionals quickly come round to cultural sensitivity.

Even a recent detailed report on the Somali community in a particular London borough did not contain a single mention of FGM, or even an allusion to it, despite the fact that it is probably the most serious health issue faced by women in the British Somali community. The authors said that community leaders were very sensitive about the issue and did not want it mentioned. This is an oft-repeated pattern, and it will continue as long as we—politicians are the worst offenders here—continue to address issues affecting women and children in minority communities via their community leaders who are overwhelmingly male and often very socially conservative.

We have to ask ourselves what we care about more—the sensitivities of community leaders or the health and well-being of our children? And they are our children. We do not affirm their equality in our country by denying them the protection of our laws and the excellent safeguarding guidelines that exist but are not routinely implemented.

I have mentioned the last comprehensive study into FGM prevalence by Forward. Although still robust, it needs updating, and in my Adjournment debate speech last November, I asked the Minister to consider funding a national study into FGM prevalence. I commend her and thank her for funding, and therefore making possible, the two-day preparatory research workshop co-ordinated by Equality Now. I know she is considering its findings. Although many of the recommendations relate to other Departments—in particular, the Department of Health—I hope she will commit to work with colleagues to respond positively to the workshop.

I am also very pleased to see that the Home Office has worked with the Southall Black Sisters to produce the excellent “Three steps to escaping violence against women and girls” guide, which includes FGM. Will the Minister tell us how this is being used, how wide is its distribution and whether it has been sent to local education authorities and/or head teachers by the Department for Education? The chief medical officer wrote to all GPs and other health professionals in May this year with some excellent guidance on treating FGM and protecting at-risk girls. I feel that something similar is needed for schools.

Helping parents to protect their own children is also important. Work done by the charity Forward in 2009 found that some women from at-risk communities were reluctant to cut their daughters and felt that the pressure to do so had diminished in the UK. One reason that was identified was that those women no longer had to deal with pressure from extended family members, particularly grandmothers. That is especially relevant in the context of tonight’s debate about girls who risk being taken abroad for the long summer holidays, where they and their parents may be exposed to such family pressure for extended periods.

The parents who do not want to cut need to be supported in resisting the pressure to inflict FGM on their young daughters. Simple measures such as the “health passport” which was introduced in the Netherlands last year, and whose introduction is being considered here, could go a long way towards empowering parents to stand up to family pressure. Can the Minister update the House on any progress towards the introduction of a “health passport” for England and Wales before the school summer holidays? If that cannot be done this year, I hope that it will definitely be done next year.

I understand that the Minister met a delegation of young people in Bristol yesterday to talk about what could be done about FGM. Can she also update the House on their views about the best way in which they feel they can safeguard their own health? No doubt she will join me in commending the work of the Bristol safeguarding children board and that of key professionals such as Nurse Jacalyn Mathers, who have done excellent work to tackle FGM. Much can be learnt from the work in Bristol across many Departments, and I am sure that the Minister will have details of their action plan. The Mayor of London’s Office for Policing and Crime is also developing a pilot initiative, which the all-party group will follow with great interest.

Will the Minister join me in encouraging MPs with at-risk girls in their constituencies to ask the right questions in the next few weeks when they visit schools? They should ask head teachers, as I have, whether their staff know the signs to look out for, and are clear about what to do if they suspect that a girl is at risk. Health and education professionals must be alert to indicators that FGM may be about to happen. Those include talk of and requests for extended holidays, preparations for so-called special ceremonies, and requests for travel vaccinations or anti-malarial medication. The British Medical Journal recently carried helpful guidance to doctors on the subject.

Has the Minister had any conversations with other Departments about the heightened risk of FGM at this time of year? For example, has she had—or could she have—any discussions with the Foreign and Commonwealth Office’s excellent forced marriage unit, with a view to learning from its experience of safeguarding UK minors overseas?

In February this year, the Minister assured me during Women and Equalities questions that she would undertake to ensure that UK border staff read the safeguarding guidelines. Perhaps she can update us on whether that has happened. While on the subject of borders, may I commend the work of the charity Children and Families Across Borders, and ask the Minister to consider the comprehensive plan that it has prepared to identify and track at-risk girls? It is too late for that to be done this year, but the project could make a big difference in the future.

Let me quote again from the article which was published in The Sunday Times in April:

“‘It is not possible, we cannot do that’, one man said. ‘The only advice I can give you, if you can, if possible, take your sister or your daughter to another country that allows… it’s no problem... You know in this country you have to fight for... your cultures. They don’t like your cultures.’”

Well, Mr Deputy Speaker, FGM is not culture; it is child abuse. We must stand firm on that point and match our words with action, and I very much hope that further action will result from this debate. We must work together to put additional practical barriers in the way of those who, this summer, are planning to blight the life of a child with a blade. If we can save only one little girl from that fate, the House will have spent its time well this evening.

--- Later in debate ---

[Lynne Featherstone]

It is a bit late to be taking new steps before our schools break for the summer, but I will get out whatever messages are possible in whatever way I can.

Home Office staff will attend a conference in Nairobi this month, training consular staff—who are the first responders to forced marriage and FGM cases—in how to respond effectively to reported cases abroad. A year on from launching the FGM multi-agency practice guidelines, we are continuing to challenge and tackle this appalling crime.

Additionally, the Department of Health continues to ensure that health professionals are able to respond to women and girls at risk, and it has focused on communications, which will extend throughout the summer period. A short film about FGM will be launched for the NHS Choices website. The film will be available to the public and is aimed at raising awareness among families, young girls and all professionals who may come into contact with girls and families who may be at risk.

In May, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), who has responsibility for public health, wrote to the royal colleges and NHS agencies, encouraging them to raise awareness of FGM among professionals. It is shocking that many of them still do not know enough about it, even though so much information is available. The Health Department’s chief medical officer and director of nursing, with the support of the royal colleges, wrote to health professionals drawing their attention to FGM and the multi-agency practice guidelines.

My hon. Friend the Member for Battersea raised the issue of Puntland, Somalia. The recent legislation on FGM in Puntland needs to be understood in the context of a broader ongoing political and constitutional process—however frustrating that is—which means that it would not be helpful for us to challenge it at this time. A number of key players in Puntland are working towards the abandonment of FGM, although I acknowledge what my hon. Friend said about that not being successful.

[Jane Ellison]

I am well aware that the British Government made significant efforts before this legislation was passed, and that this issue was raised at the Somalia conference. I just wanted to highlight why girls from that region in particular might be at risk, as the culture is still very prevalent there.

[Lynne Featherstone]

I think I must have misunderstood my hon. Friend’s point. We have been working there, and a number of key players in Puntland are working towards making progress as well, including the President himself, religious leaders and UN agencies. I have recently begun to question our work with leaders in communities and countries where such practices are so embedded, however. The Somalia FGM taskforce, of which the UK is an active and vocal member, is of the view that working to support these individuals, and working with the diaspora, is the best approach to supporting the abandonment of the practice.

I am pleased to be able to say that there are encouraging developments on the international stage. During my visit to Ethiopia in April, I met Dr Bogaletch, a founder of KMG—Kembatta Women’s Self-Help Centre. She has worked in Ethiopia since 1997, with the goal of creating an environment where the rights of women are recognised. It has managed to mobilise communities to review long-held beliefs critically and honestly, allowing the communities themselves to question the practice and empower individuals to ignite change. I met her recently when she came over to this country, and she is going to supply us with the tools and the pathway—the route that she uses in communities. Her work is very interesting. I do not know whether it is directly transferable to the diaspora here, but there may be something in it. Although we are trying to make progress with prosecutions, progress is agonisingly slow, so we should leave no stone unturned.

What I want to highlight today is the incredible social change that young people themselves are driving forward. My hon. Friend mentioned the young women from Bristol, I believe.

[Jane Ellison]

indicated assent.

[Lynne Featherstone]

Yesterday, I had the pleasure of meeting a group of inspiring young women who are working on projects run by Daughters of Eve and Integrate Bristol, speaking out against FGM. They are dedicated girls, and with the support of Home Office funding have written a stage play that tackles FGM. They are using poetry to address FGM, which is quite clever because it is less head-on and does not arouse the anger that they face in some other contexts. They are leading peer-mentoring workshops to educate others about FGM, and they are preparing to deliver a national conference. Their innovation, passion and dedication to educate others demonstrate the power of community activity. They are not scared to stand up as women and speak out to protect others. Such qualities and action are vital to ensure a safer future for the next generation, and their work is truly inspirational. Of all the people I have met during discussions about tackling FGM, those young women were particularly inspiring. If they are a sign of things to come—if only we could clone them or multiply them—change will come. They are the agents of change and offer great hope that we can move forward.

In the next few months I intend to organise a round-table meeting to understand what methods are working and what more we need to do. I want to have a very open discussion with some of our key partners in the work on FGM. Have we, for example, been taking the right approach in asking leaders in communities that practise FGM to be the agents of change themselves? As someone recently pointed out to me, would we ask rapists what to do about rape? We have to temper such views with a recognition that we do need to work with communities. At this round table, I want to take a very fresh look with all our key partners, such as social workers and the police. I will focus the meeting on how we create a step change in approach in order to engage communities in the UK. We need this now in order to progress the good work being done across the country.

My hon. Friend works tirelessly on this issue, I am putting a lot of effort into it, and Members on both sides of the House take it seriously. Progress is good but slow, given the size of the population where this practice is prevalent.

My hon. Friend raised the issue of updating the evidence base in the UK. Learning from international development was not the only commitment I made to this House in November. I am also committed to looking at updating the statistical and quantitative evidence base. My hon. Friend made the powerful point that the records are outdated, even if the methodology is still robust. As she mentioned, the Home Office funded the organisation Equality Now to carry out a small methodological workshop. I have just received the final report from Equality Now, and I would like to take this opportunity to thank it for all its work. I have noted the recommendations, which my hon. Friend has said she supports, and I have asked officials to convene a meeting with Equality Now to ensure the findings are fully discussed with the Home Office, colleagues across government and other interested organisations.

My hon. Friend asked me about the leaflets produced by the Home Office and Southall Black Sisters in February. The leaflet was translated into 12 languages and has been distributed to more than 30 embassies in the UK and to asylum screening units for women and girls claiming asylum in the UK. The document can also be found on the Home Office website and we are happy to speak to the Department for Education to try to ensure that LEAs and education professionals are aware of the document.

In November, I also committed to look at the use of the document used in Holland.

[Jane Ellison]

I just want to emphasise that I do not think that the message is getting through to teachers.

[Lynne Featherstone]

I am grateful to my hon. Friend and I could not agree with her more. I have some idea how we might approach the subject and I am happy to talk to the Department for Education. Schools are the right place to deal with this and at the moment the message is not getting through.

My hon. Friend mentioned the health passport, which is an information leaflet about the legislation relating to FGM for use by families and girls when they travel abroad. After careful research, I am pleased to announce that we will develop something similar and test it within the next year.

[Jane Ellison]

Hear, hear.

[Lynne Featherstone]

I congratulate my hon. Friend, as she is the one who brought up the idea.

In the UK, we propose that the document, which we will call a “Declaration against FGM”, will state that FGM is a criminal offence, including when a British citizen is outside the UK, and what the penalties are for anyone found committing or aiding the offence. Additionally, it will include important advice and contact details for help and support. We hope that it will be an additional tool for families and girls who travel abroad that will clearly state the UK position. It will also complement the refresher training being given to consular staff over the summer and all consular staff will be aware of it.

Once again, I thank my hon. Friend for securing the debate and for her continued determination to bring the subject to people’s attention.

Question put and agreed to.