Features

Female Genital Mutilation - Warning signs

Sometimes female genital mutilation is carried out on very young girls. With changes to safeguarding law, Charlotte Goddard asks what practitioners must do

Earlier this year, a two-year-old thought to be at risk of being subjected to female genital mutilation (FGM) was taken from her home in England to Guinea, west Africa. Following a police investigation, a family court in London made an FGM protection order and arrangements were made to get the girl out of Guinea. In another case, a protection order was issued after the mother of a baby girl in Staffordshire asked a doctor if there were any examples of people being caught after subjecting their daughters to FGM.

‘It is important that people don’t see this as a problem higher up the age range,’ says midwife Celia Jeffries, head of the National FGM Centre. ‘In Malaysia and Indonesia, for example, the cutting might take place in the first 40 days of a baby’s life.’ The centre is a partnership between Barnardo’s and the Local Government Association, providing training for educational professionals and for multi-agency teams.

FGM, also known as ‘female circumcision’ or ‘cutting’, has been illegal in the UK since 1985 and is viewed as child abuse. Since July 2015, anyone can apply to the court for an FGM protection order if they are concerned a child is at risk, and a statutory duty to report known cases of FGM in under-18s to the police using the 101 line came into force in October 2015.

LIMITS TO EXPERTISE

Early years practitioners are well-placed to spot warning signs. ‘Young children tend to talk about things to their key worker or childminder,’ says Rosalind Jerram, FGM project manager at charity Manor Gardens. ‘Also early years workers may change nappies and carry out potty training, so they are the people who may hear about FGM or think they see it has happened.’

However, there are limits – an early years practitioner does not have the expertise to examine a child to confirm FGM has taken place. ‘It is important [practitioners] are not put in a position where they have to decide whether this is FGM,’ Ms Jerram says. ‘But if they have a feeling something is not right, it is equally important they have the confidence to take it further.’

Between April 2015 and March 2016, there were 5,702 new cases of FGM in England. While most girls were between the ages of five and nine, 341 were aged one to four, and 235 were under one. The duty to report known cases – where a child has told a professional they have been cut, or the professional has seen that FGM has taken place – covers regulated social workers, health professionals and teachers, but when it comes to early years there is some confusion over exactly who is subject to the legal requirement.

‘The situation is more complex in early years settings, as it depends upon the ages of the children being taught, and whether they meet the definition of “pupils”,’ says a DfE spokesman. ‘We recommend that anyone working as a teacher in any early years setting considered a school should consider themselves to be within the scope of the duty and report any known cases of FGM to the police.’ Childminders are not covered by the duty, he says.

However, most early years work includes some element of teaching, and settings that would not consider themselves to be schools nevertheless employ early years teachers. ‘There needs to be clarification around whom the statutory duty applies to,’ says Ms Jerram.

Whether staff are covered by the statutory duty or not, good practice would require them to report concerns. ‘Even staff outside the scope of the duty should report any concerns that a girl may have undergone, or be at risk of, FGM, using their setting’s safeguarding procedures,’ says the DfE spokesperson.

‘If in doubt, report – you are not going to get it wrong,’ says Ms Jeffries. ‘If you are confused about whether the mandatory reporting applies to you, do it anyway, but also make sure your safeguarding duty is being covered. Do not report to the police and then be satisfied that is the safeguarding duty discharged.’

In order to report, practitioners must have some idea of what FGM is and how to spot it. ‘The problem is finding the funding to train staff,’ explains Ms Jerram. ‘It is not mandatory for all people who have to report FGM to have training.’

TRAINING

Manor Gardens was previously funded to deliver its two-hour FGM workshops to professionals, but now only has funding to target parents and communities, so early years settings such as children’s centres and nurseries must now pay for the workshops themselves.

In some parts of the UK, such as Newham and Waltham Forest, local authorities fund FGM training for early years professionals, but in other areas this is not the case. ‘There is a real need for local authorities to fund training in this area,’ says Ms Jerram.

SSS CPD Training and Assessment offers an FGM e-learning package for early years settings. Sam Preston, director of training, tells Nursery World, ‘The course covers the four different types of FGM, indicators of risk, the health consequences, such as difficulty in passing urine, and all the latest legislation, such as statutory reporting and the FGM protection orders. We look at how legislation translates into everyday practice in a nursery or other setting.’

Indicators that a child is at risk can include family members who have experienced FGM, and talk of ‘special trips’ abroad. ‘If a child suddenly says, “I am not going to be at nursery next week because I am going to have a special party with my grandma in her country”, if you have had training about FGM you might ask, ‘What is that special party?”,’ says Ms Jerram.

PRECONCEPTIONS

Hibo Wardere, who was forced to undergo FGM as a six-year-old child in Somalia, now goes into schools in Waltham Forest to talk to students about FGM. She also delivers training to anyone working with children, including childminders. She says that practitioners have false preconceptions about who might be affected by FGM. ‘Some people make the mistake of thinking it is associated with a particular area of religion,’ says Ms Wardere. ‘It is not just an African issue, nor is it a religious practice – it can affect Christians, Muslims and Jews.’

‘Some people think they shouldn’t report concerns because this is another culture and they don’t want to upset anyone,’ says Ms Jerram. ‘But if a child came in with a cut on their leg and no explanation, they would be asked what has happened. We work in partnership with a specialist FGM midwife to train children’s centre and nursery staff, and we have someone from a practising community to go with her and talk about their own perspective.’

‘It is really important that early years workers are able to talk to parents about their concerns,’ says Ms Jeffries. ‘It is hard to open up that conversation without looking like you are profiling them, and training should help empower practitioners to ask relevant questions.’

Ms Preston believes that e-learning allows settings to ensure that all staff are fully trained. ‘The model of getting everyone together risks missing people out if someone is off sick or there are new starters,’ she says.

Early years workers also need to be aware that the way FGM is practised is changing, driven by the desire to go under the radar. ‘Children who might have been cut later are now being cut earlier, and vice versa,’ says Ms Jeffries. ‘And what communities might consider “lesser” forms of FGM, such as cutting around the clitoris hood or burning the clitoris, are being practised because they think that is not so identifiable.’

Despite the legislation, there have not been any prosecutions for FGM in the UK, though there were 60 applications, and 46 orders, made for FGM Protection Orders to the end of March 2016. ‘We are looking at a slow movement to the first prosecution, but upholding the first prosecution will show the community there is a seriousness about prosecuting and keeping children safe,’ says Ms Jeffries. ‘The only way to get there is to ensure professionals are fully aware of their duty to report.’

www.ssscpd.co.uk/fgm