1. Female Genital Mutilation Summer is for Fun……. Not for Pain

2. What is FGM ? 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

3. Types of FGM Type 1 - removal of the clitoral hood with or without the removal of the clitoris Type 2 - removal of the clitoris and partial or total removal of the vaginal lips Type 3 - removal of the clitoris, vaginal lips and the stitching of the vagina, leaving a 1- 2cm opening Type 4 - piercing the clitoris, cauterisation, cutting the vagina, inserting corrosive substances

4. Who is at risk? 2 million girls around the world every year are mutilated Mainly African and Middle Eastern countries and alarmingly now in the immigrant population of Europe, America and Australia It is estimated that as many as 20,000 girls are at risk of FGM within the UK every year Any girl is at risk – usually between 4-14

6. Female Genital Cutting Areas of Practice - TYPE II Type II involves the partial or entire removal of the clitoris, as well as the scraping off of the labia majora and labia minora. Return to Introduction

7. Communities at Risk 28 practising countries in Africa Djibouti – 98% Somalia – 97% Sierra Leone – 90% Ethiopia - 79.9% Sudan – 90% Guinea – 98.6% In Middle East – Egypt – 97%

8. How is FGM carried out? Varies from community to community but 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 in the UK are believed to have their own practitioners here Some doctors will do this under anaesthetic

9. 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 womans 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

10. 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

11. 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

12. Human Rights Female Genital Mutilation is a fundamental human rights issue with adverse health and social implications… (it) violates the rights of girls and women to bodily integrity and results in perpetuating gender inequality UK All Parliamentary Group on Population Development and Reproductive Health (2000 )

13. Female Genital Mutilation Act 2003 Offence to commit FGM Offence to aid, abet, counsel or procure a girl to commit FGM Offence for someone in the UK to aid, abet, counsel or procure FGM outside of UK that is carried out by a person who isnt a UK national or resident Any act done outside UK by UK National or resident

14. 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

15. 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

16. What do I do? You must inform your designated child protection Advisor They must make a referral to the Local Authority Childrens Social Care

17. Female Genital Mutilation Summer is for Fun……Not for Pain The school summer holidays are a time when it is known that girls are taken out of the country to undergo FGM Report any concerns. Child protection is everyones responsibility FGM is a serious crime and can be fatal

18. Female Genital Mutilation CHILD ABUSE INVESTIGATION COMMAND Project AZURE Information Line: 020 7161 2888 scd5mailbox-azure@met.police.uk