Specialist health clinics: FGM was first identified in the UK before the 1985 legislation was enacted, when Somali and Sudanese refugees attended hospital in labour with Type-III FGM—a development for which health professionals were initially unprepared. The first specialist service for FGM-affected women was the African Well Woman Clinic, established in 1993 by FORWARD and Northwick Park Hospital. The clinic also established protocols for care that are still in use today, and provided the template for 25 such clinics across the UK, serving women and girls with all types of FGM.
All-Party Parliamentary Group on FGM: All-Party Parliamentary Groups (APPG) are informal cross-party groups that have no official status within the UK Parliament, but which are run by and for Members of the Commons and Lords. The first APPG on FGM was launched in 2011 (with Equality Now as the Secretariat), with the purpose of raising awareness of the problems caused by FGM in the UK and globally. The first-ever parliamentary hearing on FGM was organised in 2000 by the APPG on Population, Development and Reproductive Health, which recommended a review of the UK law.
National Society for the Prevention of Cruelty to Children (NSPCC) helpline: in June 2013 the NSPCC launched an FGM helpline. Information gathered from calls to the helpline will help police and child protection agencies take action against those planning to subject girls to FGM.
Girl Summit: The 2014 Girl Summit hosted by the Prime Minister focused on child marriage and FGM and was led by the UK Department for International Development (DfID) and UNICEF. The Summit provided a platform for policymakers and other key stakeholders to define action plans to address FGM and child marriage, and to make public pledges of monetary support for their implementation. DfID has since been allocated £35 million to tackle FGM in Africa.
University College London Hospital (UCLH) clinic: The first specialist FGM service for under-18s suspected to have had or be at risk of FGM was opened in UCLH in 2014. The clinic assesses if FGM has occurred, provides follow-up intervention to assess if other girls in the family are at risk and offers a counselling service. Members of clinic staff work in close liaison with the police, social care and local community groups, preparing documentation for and attending court hearings. By the end of 2015 the clinic had had 38 referrals, of which 18 involved FGM.
Over the past five years an increasing number of young people have become advocates and campaigners against FGM, encouraged by projects such as Integrate Bristol, Youth for Change and Young People Speak Out. The result has been to change the discourse on FGM in the UK, especially among young people from affected communities.
Community advocates and champions
The emergence of survivors as campaigners, advocates and community role models has also increased significantly over recent years, compelling communities to reflect on their views, values and practices. Many survivors have professional qualifications, which they use in their interventions and activism. However, these pioneering women bear an exceptional burden in their willingness to speak out: it is important that as the fight against FGM moves forward, structures are put in place to support them individually and in their work.
Communities tackling change
The Tackling FGM Initiative is a £2.8-million intervention founded in 2012 and funded by Trust for London, the Esmée Fairbairn Foundation, Rosa, the UK Fund for Women and Girls and Comic Relief. The initiative has been at forefront of preventive community action against FGM, funding 14 organisations through its main grants programme and a further 39 through small grants. The Initiative has also published Communities Tackling FGM in the UK a Best Practice Guide for (Khalifa & Brown, 2016).
Local Authority integrated approaches to tackling FGM
Other integrated models on tackling FGM include the Bristol FGM Safeguarding Group, a multi-agency collaboration delivering a holistic response to FGM, centred on key communities. The Bristol Model on FGM includes key statutory agencies from health, education, police and social care, along with the voluntary sector, young people and other organisations. Strategies include youth empowerment, women’s leadership and community engagement, policy action and a delivery group (to support wider actions with key agencies).
The Harmful Practices Pilot launched in 2014 is a pan-London project organised by the Department for Education and the Mayor of London’s Office for Policing and Crime, which seeks to introduce systemic models of change working with health, social care and communities to prevent and address FGM. Individual London authorities have launched community projects to address FGM, including the Boroughs of Tower Hamlets, Newham, Waltham Forrest, Kensington and Chelsea, Hounslow and Westminster.
The increase in anti-FGM grassroots/user-led organisations reflect a rising community commitment to take charge of the anti-FGM movement in their own communities—a major development in terms of sustaining changes in attitudes and behaviour in relation to FGM.
Working in schools
Innovative initiatives aimed at working with and in schools (including primary schools) have had excellent results with regard to safeguarding. Projects include training of school staff and student awareness-raising sessions, aimed at educating and empowering students to take action to protect themselves and others from FGM. The FORWARD schools programme has developed structured lesson plans, teacher-training modules and accredited resources.
Men speak out
Engaging men is a highly constructive means of enabling and requiring men to be accountable for the role they have played in the persistence of FGM and the new role they can play to end it. NGOs such as FORWARD in London, the Alliance of Cohesion and Racial Equality (ACRE) in Reading, Community Info Source in Glasgow and the Bolton Solidarity Community Association have made significant advances towards helping men break their silence on FGM. A number of local authorities have also instigated small-scale initiatives, employing men to work with men. These include the boroughs of Tower Hamlets, Waltham Forest, Kensington and Chelsea and Westminster. These initiatives are very new and their effectiveness has yet to be evaluated. However, early signs are encouraging, helping to reframe the issue of FGM as everybody’s business.
Provision of Specialist Services
As mentioned previously, there are currently 25 clinics (sometimes described as African Well Women Clinics) providing health services to FGM-affected girls and women (usually Type III) including advice, de-infibulation and related counselling. However, these clinics tend to be overrepresented in London and the south of the country. Given the ‘dispersal policy’ aimed at relocating migrants, including FGM-affected communities, all over the country, there is an increasing need for quality FGM-specialist services outside the capital.
There has recently been increased interest in the mental-health support services required by FGM-affected girls and women. In February 2016, the Minister for Public Health stated that the government was “working with professionals, campaigners and survivors to plan how to deliver and embed these services in the health system” as part of activities marking the week of action of zero tolerance to FGM day.
There are currently only a few counselling, therapeutic and support services available for FGM-affected women, most provided by NGOs such as Ashiana, the Dahlia Project, FORWARD, IKWRO and the Women and Girls Network, among others. A service for under-18 girls (and boys) is run by the UCHL FGM clinic. However, services for boys and young men are in general virtually non-existent.