‘’I realized that my thighs has been pulled wide apart, and that each of my lower limbs were being held as far away from each other as possible, gripped by steel fingers that never relinquished their pressure. I felt that the rasping knife or blade was heading straight down towards my throat.

Then suddenly, the knife metallic edge seem to drop between my thighs and these, cut a piece of flesh from my body. I screamed with pain despite the tight hand held over my mouth, for the pain was not just a pain, it was like a searing flame through the whole of my body’’

Davis .A.Y Women, culture and politics 1994.

All procedure which involves partial or total removal of the external genitalia or injury to the female genital organs whether for cultural or any other non therapeutic reasons.

World Health Organisation.

TYPE I Clitoridectomy Removal of the

clitoral hood with or without the removal of the clitoris

TYPE II Excision Removal of the

clitoris and partial or total removal of the vaginal lips (Libia minora)

TYPE III Infibulation

Complete removal of the clitoris, vaginal lips (labia minora) and stitching of the vaginal, leaving a 1-2 cm opening

TYPE IV

Piecing the clitoris, cauterisation, cutting the vagina, inserting corrosive substance

2.8 million girls around the world every year are mutilated.

Over 8 million have experienced type III which is most common in Djibouti, Eritrea, Egypt, Ethiopia, Somalia and Sudan.

Mainly African and Middle Eastern countries and alarmingly now in the immigrant population of :-

Europe America and Australia

Any girl is at risk- usually between Infancy -15yrs

28 practicing countries in particular

Somalia & Egypt- 98%

Sudan – 91%

Sierra Leone- 90%

Ethiopia & Eritrea 90%

• The origin of FGM/FC is not well known but according to history it can be traced back centuries.

• It is also believed to have originated in ancient Egypt.

• The justification often given for FGM/FC are:• Hygiene and Cleanliness• Family honor• Enhancing fertility• Increasing sexual pleasure for the male• Custom and tradition

›Preservation of virginity/chastity›Social acceptance especially for marriage›Sense of belonging or fear of social exclusion›Gender identity›Religion.

• Hemorrhage• Severe pain & shock• Urine retention• Infection including tetanus & HIV• Injury to adjacent tissue • Fracture or dislocation to limbs as a

result of restraint

• Difficulty with passing urine & chronic urinary tract infections which can lead to renal problems or renal failure

• Difficulties with menstruation• Acute & chronic pelvic infection which can

lead to infertility• Sexual dysfunction/

Psychological/Flashbacks• Complication during pregnancy • Chronic scar formations.

The family come from a community that is known to practice 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 practice is prevalent

A child may confide that she is to have a ‘’special procedure’’ or celebration

Be aware and informed Be sensitive and not superior Assessing individuals needs Informing and explaining Involving partners and families Involving and informing other care

professionals Providing continuing support

FGM/FC internationally recognized as a violation to human rights of girls and women.

Deep rooted inequality between sexes, and an extreme form of discrimination against women.

It is also a violation of the rights of children, person’s health, security and physical integrity.

In addition, the right to be free from torture and cruelty, inhuman and degrading treatment and above all the right to life ( some procedures results to death)

WHO: UNICEF: female genital

mutilation/cutting: a statistical overview and exploration of the dynamics of change 2013