Children centre staff trained to spot signs of FGM

Staff in two children's centres in Islington in London have undertaken training to help them recognise children who might be at risk of FGM, and to be able to reach out to parents in practising communities.

The training, arranged by Manor Gardens, a local charity, forms part of a wider council programme aimed at protecting girls from the practice. If successful, Islington Council plans to roll out training to all 16 of its children's centres.

The training comes as the NSPCC raises concerns that girls are being subjected to FGM at a younger age because parents are becoming wise to the fact that teachers are now more aware of the issue.

The charity's head of child protection, John Cameron, said, 'Historically children were more likely to be cut around puberty. However, there is some evidence to suggest that young girls are becoming victims.

'It is a big worry that with older children being encouraged to say no to FGM, communities will be more likely to carry out the practice on nursery-age children.'

For this reason, Mr Cameron said early years staff need a high level of awareness as they are crucial in identifying children at risk.

His thoughts are echoed by Elaine Hook, education consultant and safeguarding expert, who says that all early years practitioners need to be aware that FGM might be happening in their community.

FGM is most prevalent among African communities. However, it is also practised by some countries in Asia and the Middle East, and among migrants from these areas.

Ms Hook added, 'It is important that practitioners are educated in how to recognise the signs that FGM may be occurring in a child's life and how to challenge these within the realms of safeguarding a child, safely, confidentially and sensitively and all within the laws of this country.'

In the UK, FGM is illegal. It is also illegal to take a British national or permanent resident abroad for FGM or to help someone trying to do this.

According to Ms Hook, signs that a child may have been subjected to FGM include being introvert, not attending nursery for a length of time, and presenting with sudden flu-like symptoms, which could be due to an infection.

Other signs to look out for are if a child has returned from holiday and is complaining of tummy ache or hesitant about going to the toilet, said Mr Cameron.

Often, girls are taken to their countries of origin so that FGM can be carried out. The procedure is traditionally carried out by a woman, commonly an older member of the family, with no medical training.

However, Mr Cameron says it can prove difficult to determine if a child has been a victim of FGM as the way girls are cut can emulate some medical conditions, so when nursery staff change a child's nappy it might not be obvious.

Girls are also told by their parents not to talk about what has happened.

Ms Hook advises practitioners who know an at-risk child is going on holiday to ask them about where they are going and who they are going with.

'While young children are unlikely to be aware they are going to be subjected to FGM, they may know that they are going on holiday to see their grandparents, so practitioners can ask them questions about their holiday.'

Both Ms Hook and Mr Cameron also recommend early years staff talk to the child's parents to find out more information, and if they believe there is an issue to remind them that FGM is a criminal offence in this country.

'Practitioners shouldn't be afraid to talk about FGM with parents, put up a poster about the practice or have leaflets in their setting', said Elaine Hook. 'Those who suspect a child is at risk should follow safeguarding procedures as normal.'

FGM: The facts

Female Genital Mutilation (FGM), also known as female circumcision or female genital cutting, is defined by the World Health Organisation (WHO) as the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons.

• It is practised by ethnic groups in 28 African countries and some in the Middle East and Asia. UK communities that are most at risk of FGM include Kenyan, Somali, Sudanese, Sierra Leonean, Egyptian, Nigerian and Eritrean. It is illegal in this country. UK nationals who are found guilty of carrying out the practice or of aiding FGM could face up to 14 years in prison and/or a fine.
• FGM is usually performed on young girls between infancy and the age of 15, using a blade or razor, with or without anaesthetic. There are four main types of FGM.
• FGM is carried out for cultural, religious and social reasons. Some communities believe it prepares a girl for adulthood and marriage, while others believe it will reduce a women's libido and discourage sexual activity before marriage.
• Girls/women that are subjected to the practice can suffer a number of health problems including recurrent infections, chronic pain, cysts, infertility, complications during childbirth and fatal bleeding.
• UNICEF has estimated that more than 125 million girls and women globally have undergone FGM and that three million girls in Africa are at risk each year.
• A Home Office report, published in July, suggests that from 1996-2010, 144,000 girls were born in England and Wales to mothers from FGM-practising countries. It is thought that 60,000 of these girls aged 0-14 in 2011 were born to mothers who had undergone FGM. The report is at www.city.ac.uk/__data/assets/pdf_file/0009/226287/ FGM-statistics-report-21.07.14-no-embargo.pdf

Further information

• NHS, www.nhs.uk/conditions/ female-genital-mutilation/pages/introduction.aspx
• The NSPCC runs a free 24/7 FGM helpline. If you are worried that a child is at risk of FGM or would like advice, information or support you can call 0800 028 3550 or email fgmhelp@nspcc.org.uk.
• WHO factsheet, www.who.int/mediacentre/factsheets/fs241/en

ISLINGTON TRAINING

Outreach workers, health visitors, midwives and creche workers were among those who attended FGM training in Islington recently, led by specialist midwife and FGM expert Joy Clarke based at the Whittington Hospital NHS Trust.

It is estimated that there are about 1,300 girls in Islington who come from communities that practise FGM.

The three-hour session covered the types of FGM, where in the world it is carried out, the physical, psychological and emotional impacts on girls and women, how to ask parents about FGM and explain the legal, health and emotional consequences for parents and families, and the pressures on families from practising communities.

Jennifer Savage, family support and outreach manager for the London Borough of Islington, said the training equipped staff with measures to prevent FGM from happening.

'We work with many mothers who have undergone FGM themselves and we provide them with support to deal with the consequences.

'The training gave me a stronger understanding of the pressures families face to practise FGM, and what I, as an individual, can do to help those families protect their daughters.

'There were some ideas that we were able to put in to practice right away, such as ordering posters and leaflets, and distributing them to parents.

'Some of the ideas, like bringing FGM training to our fathers' group, will take a little longer. We will be reviewing our progress as a team and thinking about what more we can do in November.

'The last half of the training was devoted to developing a local children's centre action plan to raise awareness of FGM and help parents resist community and family pressures to have the procedures done to their daughters.'

Ms Clarke said, 'Children's centres should give women whose children may be at risk of FGM the Government's health passport (statement on FGM).

'This outlines what FGM is, the legislation and penalties in the UK if found guilty of the practice, and the help and support and available to them. They can also show the health passport, which is available in 11 languages, to their families abroad.'