1. Valentine Nkoyo Director, Mojatu Foundation BA Hons, MBA
Understanding Female Genital Mutilation
#NottsEndFGM, #EndFGM

2. Our main work strands Media Education/training
Community engagement & integration
Health promotion
-FGM, mental health, HIV, cancer, diabetes
Sickle cells disease etc

3. Key learning objective
Understanding FGM, statistics, reasons it’s practiced and the impact on individuals
Understanding the law and our responsibilities
Tackling FGM confidently and sensitively
Working with survivors and affected communities
How professionals can get involved
Work in the community and it’s importance

4. Note…
There is no easy way to talk about FGM – although there is no attempt to shock in this presentation, you may find some of the content difficult and may feel upset
Look after yourself - If you need to take a break please do
Our fous is safeguarding children and young people

5. What is Female Genital Mutilation?
‘FGM is a procedure where the female genital organs are injured or changed and there is no medical reason for this.
It is frequently a very traumatic and violent act for the victim and can cause harm in many ways.’
Multi-agency statutory guidance on FGM – HM Government 2016
Female Genital Cutting?
Female Circumcision?
Other ethnic names eg Sunna, bondo, Ibiugwu

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Get participants to name the parts – urethra, labia minora and majora, clitoris, vagina.
Knowing the ‘un-cut’ female genitalia is the foundation upon which we can build knowledge and understanding.
Cards can be given out.

7. Types of FGM
Type 1 – Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris).
Type 2 – Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are the ‘lips’ that surround the vagina).

8. Types of FGM…
Type 3 – Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris.
Type 4 – Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.
Multi-agency statutory guidance on FGM HM Government 2016

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10. Impact on girls and women
PHYSICAL
Complications in pregnancy and childbirth
Difficulties in menstruation
Bleeding/hemorrhaging
Sexual dysfunction
Severe pain and shock
Infection/urine retention
Cysts and abscesses
Psychological damage including PTSD
Death
EVERY WOMAN EXPERIENCE IS DIFFERENCE!
EMOTIONAL & PSYCHOLOGICAL
Trauma
Betrayal
Feelings of fear around sex or intimacy
Anxious
Angry
Ashamed
Defensive
Pride
A sense of belonging
Might not know how they feel
EVERY WOMAN EXPERIENCE IS DIFFERENCE!

11. FGM prevalence?

12. International, National & local Statistics
Estimated that up to 200 million women and girls worldwide have undergone FGM (UNICEF 2016)
Age varies but manly carried out between 5 and 8 yrs
Estimated 103,000 women aged and approximately 24,000 women aged 50 + who have migrated to England and Wales are living with the consequences of FGM
Approximately 10,000 girls aged under 15 who have migrated to England and Wales are likely to have undergone FGM.
Multi-agency statutory guidance on FGM HM Government 2016
In Nottingham, about 85 new cases were recorded through NHS in 2016/17- Tip of the iceberg?

13. WHY?

14. The UK law
FGM is illegal in England and Wales under the:- Female Genital Mutilation Act 2003
illegal to perform FGM (unless for medical reasons, eg. cancer)
illegal to assist a girl to carry out FGM
illegal to assist a non-UK person or UK resident to carry out FGM outside the UK on a UK national or permanent UK resident.
Max 14 years Imprisonment

15. The UK law……
The Serious Crimes Act 2015 amended the 2003 act to also include:
-An offence of failing to protect a girl from the risk of FGM (person who is responsible for the girl at the time the FGM occurred)
-Lifelong anonymity for survivors
-FGM Protection Order - can be used to protect girls at risk.
-A mandatory reporting duty (U18) for regulated profession eg teacher, healthcare, social care… use 101 non emergency crime number

16. Potential Risk Factors
A girl born to a woman who has been subjected to FGM
Any girl who has a sister or cousin has already undergone FGM
A girl whose father comes from an affected community
Belief that FGM is integral to cultural/religious identity.
Strong levels of influence and involvement of elders in family life
Limited level of integration within UK community

17. Potential Risk Factors…..
Family is not engaging with professionals (health, education or other)
Family is already know to social care in relation to other safeguarding issues
Limited access to information about FGM effects or UK law
A girl whose parent/family member expresses concern that FGM maybe carried out
A girl withdrawn from PSHE at school may be at risk as a result of her parents wishing to keep her uninformed about her body and rights

19. Safeguarding
FGM is a serious child protection concern (Significant Harm threshold)
We have a multi-agency responsibility to respond and protect
Follow multi-agency statutory guidance/your services safeguarding procedures
Check FGM is included in policies/procedures

20. Some tips for professionals
Care of affected girl/woman- primary concern
Be non-judgemental and prioritise safeguarding
Ensure there is appropriate time and environment to listen
Be aware of specific circumstances of the individual- complexities
Do not be afraid to ask about FGM- use appropriate and sensitive language
Beware some women might not know they have FGM
Show respect and compassion
Be aware of other services available for referral including community and peer support
Ogo

21. Examples of starting a discussion…
“I can see in your notes from the obstetrician or midwife that you have been cut. Could you tell me a bit more about this?”
“I know that (some) women in your country have been cut. How do you feel about this? Could you tell me a bit more?”
“You have talked about your cutting and the traditions in your country. Is there anything else you want to tell me about this?”
“How do you, and how does your partner, feel about female genital cutting? How do the people around you feel about this? Are you still in touch with relatives in your country? How do they feel about it? At what age is it usually performed?
Ogo

23. Our Mojatu FGM Work Community Steering Group- since March 2014
Awareness raising and community engagement
Survivors/ family support….links with SS
Training-Community, Education, health etc
Research
Resource development and publications
Consultancy
Advocacy-Zero tolerance & influencing policy

24. Zero Tolerance to FGM Journey
Survivors and community members engagement
Lobbying followed by motion at full council house
Nottingham in Parliament- National event
Bratislava- WFWPI
Vienna- United Nations
Kenya- Development of a National Strategic plan(Forced marriage and FGM)
Maasai Cricket Warriors tour

26. Key achievements
More survivors, families and community members coming forward- KEY
Our community engagement & involvement
Recognition & interest beyond Nottingham- other cities, WFWPI, UN, Kenya UN
Publications
Resource development
Partnership development- Social services
Partnership implementation of Zero Tolerance pledge- on the agenda
End FGM Logo

27. How you can get involved with Mojatu Foundation
Adopt a tree
Advertise and share stories in our magazines
Awareness raising through your networks and promote our work
Book for a training session
Volunteer
Fundraise to support our work
Purchase our Clit warriors/Change Makers/No Abuse T-shirts

28. Curriculum Approaches
‘It is up to schools, colleges and universities to decided exactly how they address FGM, taking account of the numbers of pupils from relevant communities. They can, however, create an ‘open’ and supportive environment by raising awareness thorough learning in SRE within PSHE’ Home Office FGM Resource Pack.
Suggestions for curriculum resources
NSPCC PANTS campaign
FGM lesson to go with Christopher Winter Project
Skills Ladder
Bristol Integrate
FORWARD Schools Pack
FGM session PSHE Association Website
SEE MORE ON THE MULTI-AGENCY GUIDELINES DOCUMENT

29. Important contacts/resources
UK FGM clinics
Multi-agency practice guidelines-
Concerned or need to refer
Refer survivors and families to community groups like Mojatu Foundation for further support , referrals and engagement.
NSPCC – helpline dedicated to FGM that is anonymous and open 24/7, you can call them on:
Liaise with local social services for safeguarding issues
Urgent matters if FGM just happened or about to happen ring 999 immediately
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30. Contacts and more information
Talk to us TODAY!
Websites:
and
Tel & M: /
&
Facebook: Valentine Nkoyo and
Mojatu Foundation