1. Inform and provide evidence
A clear worldwide agreement is required for effective measures against FGM: ‘Female Genital Mutilation is a crime! We do not tolerate it anywhere!’ The United Nations should pass a resolution in the name of all of their member states – and ensure that the public will be informed so that no one can claim that they were unaware of the practice of FGM.
2. Laws without loopholes – strict enforcement
Female Genital Mutilation is actually either directly or indirectly prohibited in many countries. So far orderly investigations on a wider scale have only taken place in France. The NHS in the United Kingdom has now mandatory reporting of FGM by Doctors, midwives and nurses.
a) FGM must be classified as a crime and it needs to be defined precisely – so that there are no more doubts on what is considered a genital mutilation and what not.
b) FGM must be prosecuted consequentially – regardless of the offender’s citizenship regardless of the victim’s citizenship regardless of the place where the crime took place. Anybody in the world must be held responsible under all circumstances for the genital mutilation of a girl.
c) Every suspicion of genital mutilation must lead to obligatory (!) criminal investigations.
d) A gynaecological examination of a possible victim and her sisters must become a compulsory part of investigations – regardless of the consent of their parents.
Attention: In this context I would like to draw your attention to a phenomena which concerns me deeply: I have heard from various sides, that more and more often young women from immigrant families will only be sent to Africa when they have reached a nubile age (of approximately 12, 13, 14 years) to be mutilated there and then they are forced into marriage. They never return to Europe, the USA, Canada or Australia. Their parents stay there and believe that this way they can get away with it without punishment. This needs to be changed! Also those parents who send their daughters to Africa to have them mutilated and forced into marriage must be convicted by a European, American, etc. court and put into prison for years! There must not be an alternative!
3. Effective protection of children
What applies to the laws on the prohibition of FGM also applies to the protection of children. Possible genital mutilation can be prevented by the protection of children. In many countries regulations are implemented for the protection of children – but there are also loopholes.
Key messages for an effective protection of children:
1. interventions should already be possible at an early stage – not only in the case of “imminent danger”
2. every suspected threat of genital mutilation must lead to obligatory consequences – until it is ensured that the danger is eliminated in the long term
3. it must be possible for a judge to order a gynaecological examination of a girl and her sisters, as well as routine control examinations – also without the parents’ consent
4. the departure of the girl must be – if necessary – prohibited
5. judges should have the right to deprive the parents temporarily of their custody rights and to order that the girl shall not stay with her family for a certain time
6. as a final measure: the final deprivation of custody must also be possible
4. Unrestricted obligation to report
It is necessary that individual cases are reported to the authorities – often the principal obstacle – so that measures for the protection of children and prohibition laws can be enforced, and successful investigations can be undertaken.
That is why:
a) every citizen shall be obliged to report any suspicion of mutilation or threat thereof to the authorities (police, prosecutors, social institutions)
b) this shall also include vocational groups, which are frequently confronted with possible victims of Female Genital Mutilation: doctors, nurses, midwives, social workers. Since they play such an important role in the revelation of such cases, they should be held liable in the event that they do not obey their obligation to report.
c) the duty of secrecy must be released in such cases
5. FGM as a reason for asylum – all over the world!
FGM is a crime against women, committed only because they are women. Those who are reluctant against this practice are put under pressure, threatened, prosecuted. Sometimes they are in danger even in the country they immigrated to. FGM is a political prosecution and it must be recognised as such. Those who make it all the way to another country in order to escape from this practice have the right to be protected. What several politicians, women’s rights activist and NGOs have demanded for years must finally become reality: Female Genital Mutilation must be explicitly accepted as a reason for asylum all over the world.
6. Coverage in vocational training
Everybody who might be confronted with FGM in his/her profession must be informed about this practice. This does not only apply to doctors, psychologists, nurses, midwives and social workers, but also to representatives of the authorities: police officers, judges and public prosecutors.
Only somebody who knows exactly what Female Genital Mutilation is, where, how and for what reasons it is performed, is able to ask the right questions and to find out whether the statements made are correct. For example, a mother who states in a courtroom that her child did not cry during the mutilation, lies – a judge who is not informed about this practice might have difficulties judging this statement.
FGM must therefore become a constituent part of all forms of vocational training and education for professionals who might be confronted with this practice. In the event that this is either not useful or impossible to realise, specific courses shall be held in order to bridge this gap of knowledge. Furthermore, I consider advanced training courses for different professions at one time, to be necessary. A close co-operation of various institutions is required to fight FGM effectively. Such advanced training courses may help to get a better understanding of the role of other professionals involved and co-operation may be improved significantly.
7. Specific prevention
Sufficient public funds are required for effective prevention.
a) general awareness campaigns on TV, in newspapers and magazines as well as on billboards to raise awareness for this topic and to inform the public of the legal situation and of opportunities for action
b) specific awareness campaigns in homes for refugees, schools, nursery schools and during the course of social work
c) specific education in medical practices and hospitals
d) during the visa issuance process, all consulates should precisely inform primarily immigrants, but also travellers (to confront as many people as possible with this topic) on the legal situation regarding FGM in their country and on the attitude of the UN towards this problem
e) regular, obligatory examinations of all (!) girls in schools
f) protection and adequate support for possible victims and their relatives - this means to provide, for instance, anonymous apartments and aid for women who escaped from their families to save their daughters from genital mutilation
8. Dialogue with the governments of the countries of origin
The United Nations must clearly and accurately convey their position to the governments of the countries of origin and must clarify that this crime is not tolerated anywhere. In some African countries the governments have started initiatives to prohibit genital mutilation. These governments must be supported. The same applies to the governments which have already prohibited FGM and which are now trying to enforce the respective laws.
9. More research on FGM
Even though a lot is known about Female Genital Mutilation – there is still an enormous need for further research. The strategies used so far in the fight against Female Genital Mutilation are often based on vague assumptions or on so-called “experiences”, which have never been revised. Research on FGM must be supported and intensified by appropriate public funds.
Among the open issues are:
a) exact numbers of victims in every country / state – the data available is only based on rough estimates and vague projections
b) factors which contribute to the condemnation respectively the maintenance of this practice in the country of immigration – in the first instance, a differentiation between the second and third generation is required
c) efficiency of the single strategies (campaigns, educating social work, legal proceedings/punishment) in the fight against FGM – they should be evaluated systematically to determine the most efficient strategies
d) medical procedures for the reconstruction of the clitoris. The method developed by Dr. Foldés seems to be a promising approach. It should be subject to scientific research on a wider scale
What I demand from health insurance funds, doctors-associations and associations of social services
1. Clear guidelines
During the research for my new book I revealed that frightening ignorance on Female Genital Mutilation partly prevails among occupational groups, which play an outstanding role in the fight against FGM: doctors, nurses and midwives, social workers, kindergarten workers and teachers. Even members of such professions who are informed about the topic often feel insecure about the appropriate action to be taken in a particular case.
This is highly problematic, because the authorities depend on these occupational groups for information on FGM. Therefore, professional associations have to establish clear guidelines on what needs to be done in the event of a threatened or suspected mutilation, and which measures need to be taken to prevent such crimes. Such guidelines would be an essential contribution to raising awareness of Female Genital Mutilation among these occupational groups, and to support successful interventions in relevant cases of suspicion. Shared experience across borders and comparison of existing guidelines would also be a valuable contribution.
One thing of great importance to me is the question of re-infibulation, the re-sewing of the vagina, after giving birth for example. Doctors have often reported to me that the affected woman had requested this procedure herself. This may actually be correct, but according to my understanding, a re-infibulation is an indirect approval of Female Genital Mutilation.
It is impossible to condemn FGM on the one hand and to actively participate on the other hand in the perpetuation of mutilation by sewing a woman together again. I truly hope that everywhere in the world consent can be found to condemn and prohibit re-infibulation.
2. Coverage in vocational training
Alongside specific guidelines for certain professions, it is highly important that members of the social sector and the health sector have a profound understanding of this topic. Exhaustive information on the different forms and health consequences of Female Genital Mutilation, but also on the respective legal situation, should therefore be a compulsory part of vocational training.
Furthermore, I consider continuous training courses and further education to be necessary. Knowing that Female Genital Mutilation is a violation of human rights is just as important as the “technical” know-how, because in most cases doctors, midwives or social workers are the first ones who come to know about a suspected case of FGM. As long as there is no clear awareness that FGM is a violation of human rights – and not a part of a culture, a tradition or a religion – it will happen again and again that cases will be concealed and affected girls left without protection. Out of the fear of being labelled a racist; out of the fear of losing somebody’s confidence; or, even worse, out of pseudo-tolerant indifference, while shrugging ones shoulders. This applies in particular to professions which are subjected to professional secrecy. A doctor, for example, will only accept the release from professional secrecy when he/she has understood that this is a crime, and that it is his/her human obligation and responsibility to intervene.
There are certainly specific differences between the various professions which need to be taken into account. A gynaecologist for example needs to know precisely what a mutilated vagina looks like in order to be able to diagnose the mutilation correctly. This does not apply to other medical specialists or other professions to this extent. All occupational groups which might be confronted with Female Genital Mutilation should be aware of basic facts, though. I consider interdisciplinary training, which also includes the police and the legal authorities, to be useful and necessary.
This way mutual understanding and knowledge of the roles of other institutions would be promoted. In the fight against FGM we are all dependent on a sufficient co-operation of authorities and organisations.
3. Extensive and systematic prevention work
a) awareness campaigns in homes for refugees, play schools, schools, hospitals and in connection with social work
b) medical consultation for patients coming from at-risk groups
c) obligatory routine health check-ups for all (!) girls in play schools and schools including gynaecological check-ups
d) This way sexual abuse of children could also be determined more easily
e) Social protection measures (providing e.g. anonymous apartments) for parents who escape from families in order to protect their child from a mutilation
4. Reconstructive surgery free of charge
Every woman who wishes should have the possibility of access to reconstructive surgery free of charge. This includes the opening of the seam in the case of a total excision of the inner and outer labia (de-infibulation) as well as – if requested – surgery to reconstruct the tissue. The health insurance funds in all countries should accept the costs and bear them. During reconstructive surgery the clitoris is at least partly reconstructed, as I describe in my book “Desert Children”. Sexual feelings return in 80 per cent of cases. Unfortunately, only one French surgeon, Dr. Pierre Foldés, who has developed this technique, and his associates are capable of performing such surgery. This surgery is not uncontested and I know that some people reject the Nevertheless, I wish that this technique will spread worldwide and will soon also be applied by other doctors, so that all women who want to (!) can have the possibility of undergoing such surgery.
5. Cross-border exchange, co-operation worldwide
Currently, most efforts to stop FGM are taken only within country borders. In almost every country different practices and regulations are applied to fight Female Genital Mutilation, and experiences are not sufficiently shared. During my journeys while researching my book “Desert Children”, I talked to many people – mostly doctors, who specialise in FGM – about the operation developed by Dr. Foldés. Even though this technique has existed for years, hardly any of them had heard about it. In the short and medium term we need a more intensive exchange through conferences, research projects and seminars addressing international participants from the various national institutions. Only this way will we be able to find the best strategies in the fight against FGM and to avoid time-consuming mistakes. In the long-term we need consistent proceedings by the United Nations against Female Genital Mutilation. Because FGM is an internationl problem!