Saturday, 25 January 2014

Female genital mutilation and clinicians

Awareness of FGM and its consequences should be increased amongst staff working in all service areas as women who have undergone the procedure are likely to present in a range of services.

  • Training should be specifically focused to the subject of FGM. The training encountered so far appears to have been adjunct to training in other areas, such as child protection. As a result little time is dedicated to the topic. Training should provide a background to FGM, with information about the reasons for the practice and the contexts within which it occurs as well as raising awareness of the range of views that may be present in communities/families. It should highlight the range of ways in which FGM can impact upon a woman‟s life and encourage professionals to take a holistic approach to working with clients. Furthermore, training should help professionals to feel confident in sensitively raising the topic of FGM with clients and explore ways of talking about it.


  • In order to address the training needs described above a formal training package is needed. This should involve service users and circumcised women in its development. The importance of this can be seen in the current research where women have provided invaluable information about how professionals can provide better services for women who have experienced this practice.


  • Professionals working with women who have experienced FGM should be offered support in managing their personal responses to the stories they hear within their clinical work. Awareness amongst those who supervise others is therefore crucial. This further highlights the need for all clinicians to be informed about FGM, not only those who might be working directly with the issue.


  • Clinical psychologists should involve themselves in working with communities within which FGM is commonly practiced. This work should aim to reduce barriers to psychological therapy through increasing knowledge about what services are available, by addressing issues of stigma associated with seeking help from mental health professionals and by ensuring that the language needs of clients are met.


  • Whilst the current research only interviewed English speaking participants training interpreters about FGM would be important as many women who have undergone the procedure would require an interpreter during clinical sessions.


  • Clinical psychologists using interpreters with clients referred for FGM related difficulties should consider the gender of interpreters and their cultural background and consider the impact this might have on the client. They should also brief and debrief interpreters prior to and following sessions and consider that the interpreter themselves might have undergone FGM.

FGM needs tackling on all levels and at the end of the day we all want the same-to end this evil practice.

Thursday, 23 January 2014

The Psychological impacts of female genital mutilation

There is need for careful exploration of the emotional and psychological impact of FGM and that the lack of this might be associated with cultural prohibition, whereby women are forbidden from discussing concerns regarding their sexuality.


Despite the lack of data related to the psychological impact of female circumcision, psychosomatic and mental health problems have been observed. These include mood and thought disturbances, sleeplessness, recurring nightmares, loss of appetite and panic attacks. Further researches shows emotional trauma, depression, anxiety, psychosis, fear of sexual relations, chronic irritability, hallucinations and post traumatic stress disorder (PTSD)


Some women reported that symptoms of PTSD became apparent immediately following the procedure whilst others experienced psychological symptoms at various stages throughout their life.

Lockhat conducted qualitative interviews and focus groups with women who had undergone FGM. She found that less than one tenth of women were experiencing “current PTSD” that is ongoing symptoms at a clinical level, and over a quarter were suffering from “lifetime PTSD” (clinical levels of PTSD experienced at some point during their lifetime). Predictors of psychological trauma were reported to be women’s appraisal of their experience (negative appraisals were associated with trauma) and how they felt they had coped with the experience of circumcision (e.g. what coping strategies they had employed).


It has been suggested that not being circumcised in certain communities can have a greater psychological impact than the trauma caused by circumcision itself, often as a result of the stigma and potential to be ostracised.

Female genital Mutilation has massive psychological impacts on the victims and the sad part is these women might never have professional help.

Tuesday, 14 January 2014

Ways to help end female genital mutilation: simple but effective

There is a lot of assumption by professionals involved in dealing with female genital mutilation. In my view, the difficult goal of raising awareness and changing mind sets, should begin by working from bottom to top not vice versa. With FGM, people need to get involved with communities and gain trust before anything else. This then will enable people to feel comfortable to walk in or contact the NHS / CPS, the police or any other source of help that they might need.

Furthermore professionals can sometimes forget that FGM is a broad subject and an understanding of one aspect of it does not solve the problem. In-depth understanding of people and their beliefs is crucial and working to this fit in with our campaign is what will bring about real change.

Working with the community

Community leaders, religious leaders, church elders from FGM practising communities will play a key role in changing mindsets. People do not want to feel as if they are being attacked and are likely to”stone wall” apparent interference. Few victims, I think, would have the confidence or even the desire to walk into their local NHS centre and say they were mutilated , particularly given they will have been misled into believing that the practise is a necessary part of their culture, rather than plain abuse.

Educating Frontliners

Educating the victims and making them aware of what it is we are trying to stop( Schools and Teacher training for example. There are still some teachers who are unclear about FGM, and would presumably find it difficult to identify a child that might be at risk, or has been taken for cutting/mutilation)


Raising Awareness

Raising awareness is the starting point. More grass root work needs to be done with communities.
This could be done by:

  • Using the local radio stations
  • Different womens discussion groups and talks
  • Sharing information with different members of the communities
  • Visiting schools (sex education and talk about FGM)
  • Plays, dramatising(visual is better than reading)
  • Local news and television

  • Teachers, the police and other frontline staff
The ending female genital mutilation war has to be fought on all fronts.

Saturday, 11 January 2014

The dilemma female genital mutilation among victims

Female genital mutilation makes a permanent mark on the victims, physically, mentally, sexually and psychologically. In most cases (Type 1 and 11 as well as infibulations) the girls are taken away to be mutilated without knowing. The practice, done in secrecy does not leave any of the victims free to talk to others. All they are told is, “This is what a woman has to endure. You have to do this because every woman does it’’. Victims are given no choice but swear to secrecy before and after the procedure. In my case I only got to hear people talk about female circumcision in high school. It was clear that female genital mutilation and talking about it was going to cause grief. A few girls had not gone through the procedure and the rest had. Those who had not done the procedure felt as if they had destroyed their lives and chances of getting married. It seemed as if they would be feeling ostracised for the rest of their lives since not having gone through circumcision was regarded as a failure and would result in the girls not securing a husband. It has to be remembered that in many African communities marriage is one of the most important things in a woman’s life. Failure to secure a husband has always been considered to bring shame to families. For the girls there is pressure is every where- from the family, society and friends. The pressure and trauma resulting from this led to some of the girls loosing their self esteem. There were divisions as those who had had the procedure felt like the heroines. This was just a pressure uncalled for and made some girls stay away from normal day to day activities. Shame and being made to feel inferior also affected some of the girls. Being one of those girls I was not sure I had done the right thing. I had ignored my grandmother‘s call for me to pull my clitoris.

The point I am making is that sometimes in communities and households, the pressure to do what everyone else is doing can be huge. People get scared of being shunned and would always want to be part of a group.

However with FGM it should not be so. FGM is child and women abuse and should not be seen as a social identification. It is a shame that some older women in some parts of Africa have had to be infibulated well into adulthood because an aunt or mother in law felt it was wrong not to have done it.


Saturday, 4 January 2014

Female Genital Mutilation: The fight carries on!

In Africa, where FGM is most common, there is disagreement about the best approach to curtail the practice. Some countries have attempted community-based education as the best long-term strategy.


 In Senegal, where Parliament banned FGM in January 1999, there are mixed feelings. Some communities were beginning to make inroads with a health education campaign, then the national law criminalized up to 2 million citizens and Kenya recognized the ritual aspect of FGM and developed an alternative rite of passage for girls of circumcision age.


In the Tharaka Nithi district of Kenya, new festivals have been organized for the months of August through December, when circumcision would usually be performed. During a week of seclusion, girls in the alternative program are educated on a wide range of subjects, including personal hygiene, relationships, dating and courtship, and marriage.


The program also covers topics such as peer pressure, male and female reproductive anatomy, menstruation, conception and prevention of pregnancy, the consequences of teen pregnancy, sexually transmitted diseases, HIV and AIDS, and ways to prevent exposure. Positive aspects of tribal culture are taught, such as self esteem, decision making, and respect for elders.


Tanzania adopted a program for initiation without mutilation in 1998. Girls age 10 to 13 receive instruction in domestic chores, midwifery, hygiene, sex and pregnancy over a two-week period. For the initiation ritual, the girls are beautifully dressed and participate in a ceremony where they demonstrate their readiness to receive instructions in womanhood. The whole village joins in drumming, singing, dancing and feasting to celebrate the new phase of the girls' development. The Inter-African Committee urged all African countries to develop initiation without mutilation.


A few physicians and circumcisers have been indicted for performing FGM in Ghana and Egypt, usually in cases where the young woman has bled to death, but prosecutions are very rare. In Guinea, the penalty for FGM is death, but the sentence has never been applied. Many Africans are unaware of the health risks and aid workers see a focus on health education as the best avenue for change.


Many cultures that accept FGM are Islamic, and Islam has been seen as being tied to FGM because of its insistence on virginity before marriage, a practice which circumcision is supposed to insure. However, this common belief has been challenged by Islamic scholars. Other faiths that have supported FGM include Coptic Christianity as practiced in Egypt; Orthodox and Ethiopian Jews; and the Falashas, a group of Ethiopians Jews who live in Israel.

An estimated 137 million women in at least 28 African countries have undergone circumcision. Africans point out that most circumcisers are women. The Centers for Disease Control estimates that 168,000 females in the United States are at risk for having FGM performed. The CDC places the highest risk on African immigrant women living in large metropolitan areas. This is a worldwide disaster and we all ought to be involved in the fight.


Female genital mutilation is laden with many intercultural taboos. When African leaders were fighting against British colonialism during the 1980s, the male leaders defended FGM as a private matter and accused feminists who opposed FGM of "cultural imperialism." However, some African women who desire change counter that "culture is not torture." Africans point to Western practices such as bulimia, anorexia, liposuction, silicone breast implants, repeated facelifts-all in pursuit of idealized feminine beauty-and ask how Westerners can sit in judgment of Africans.

However the fact remains there is no need to mutilate girls and women. FGM has no medical value but only destroys lives. The fight against this horrific practice will carry on until the battle is won.