January 19, 2022
Alice is from Malaysia and heard about FGM from friends, most of whom had it done to them when they were babies.
Dot -When did you first become aware of FGM?
Alice– I became aware of FGM in my teenage years through conversations with friends. It was something that was talked about but we never explored in detail, and I thought this was interesting. When I asked them ‘did it hurt?’ they didn’t know if it affected them or not because most of them had it done when they were young.
Later on, I trained as a midwife and my first client ever came into the delivery suite and upon examination I thought ‘this doesn’t look right’ but you can’t stop a woman from pushing. I cried my eyes out afterwards thinking it was my fault that the lady had such a traumatic delivery. Upon discussion with a colleague, I found out I had encountered my first FGM survivor.
I started looking into it and discovered there were different degrees of FGM, and certain communities that practiced it. I wrote a paper on it years later to increase awareness among midwives. I felt it necessary because during my training there was no mention of FGM and London has a multicultural community.
I attended quite a few advocacy events hosted by Reading or Oxford groups but none in Berkshire. I felt we needed to increase awareness because it is a topic that is not talked about. It has no religious implications. The trauma is to the woman; the trauma is to her family; her daughter. That is where my interest has come from.
Dot– Do you ever speak to your friends about FGM now that you’re all adults?
Alice– Interestingly I have asked them whether they have stopped their daughters from having it to which they replied that it is a part of the culture and they feared stigmatisation if they didn’t practice it. Studies have shown that this is something that happens all the time and people don’t challenge it. There is conflicting messaging here because people claim it is a religious obligation which they must uphold hence it is up to religious leaders who issue the orders. To clarify, FGM is not a religious requirement and has no health benefits whatsoever. Religious leaders have a lot to say because they can make a difference.
Dot– Aside from religious leaders speaking out, how else do you think we could create change or change the views of people to not cut their daughters?
Alice– A lot of creating change is about empowering the mums and dads because it can make all the difference. Increasing their awareness and showing them their daughters don’t have to go through it as well. I have had a lady tell me that after the birth of her daughter it was the staff at the hospital who supported her to ensure the daughter did not undergo FGM. We all have a duty of care, a duty of empowering people. However, we shouldn’t judge them rather we ought to support them, and see how we can make this better for them.
Dot– What reasons do you think are given for FGM?
Alice– One of the reasons is about controlling women’s sexuality. Another reason they give is to enhance the man’s sexual pleasure because we have women asking to be stitched back up for this. It is also out of fear of losing control over women because once they stand up for themselves it means they are having a voice. It is a way through which the community ensures control over women because it is very much a community-led practice. As well as being rooted in gender inequalities as a form of violence against women and girls, it is a social norm in some places and seen as a rite of passage to enable girls to get suitors for marriage while upholding the honour of the family. But is it right? Personally, I don’t think so because it is violating a woman.
Dot– What would the consequences of not having a daughter being cut be in your community?
Alice– They will be isolated for not conforming and maintaining the social norm. Just like the stiff-upper-lip in British culture, other societies also have their own cultures.
Dot– Why do you think families still practice FGM despite awareness of the harm it can cause?
Alice– I believe a lot of it is the pressure of being regarded as an outsider for not practicing it.
Dot– What would be most the single most effective way of raising awareness of the harms of FGM in Malaysia?
Alice– I would turn around and say in any country it is about raising awareness and looking at how we can work together, collectively. We’ve stopped so many other practices so why not FGM? Educating people so they realise that the risks of FGM far outweigh the benefits would be the most effective way to raise awareness.
Dot– Do you think families speaking out openly against FGM will influence others in the community?
Alice– I think it is about trust, and how the messaging is conveyed. We have to be truthful about the messaging-and consistent. Also, we need to give people time to absorb and ask questions without judgement. As a generational practice, younger people are bound to turn around and say FGM is not right with time. Helping communities to understand over time is the most important thing and eventually it [ending FGM] will happen.
Health professionals have a duty of care; they have to talk about it. I am aware that it is getting better in multicultural environments like London, but it is where you have the pockets of people that are isolated, like West Berkshire for example, that makes it harder. Even though FGM figures are low, survivors tend to seek help in established FGM clinics elsewhere which doesn’t reflect actual numbers on the ground. This is why I am keen on increasing awareness in West Berkshire. I feel that sometimes we don’t ask the questions that need to be asked-just like with mental health. When we don’t talk about it we don’t realise the survivors’ experiences, and the trauma that people have gone through.
Dot– What is the best way to start the conversation in a medical setting?
Alice– Start by asking the question ‘Have you heard of FGM?’ Give them time to share because they need to learn to trust you. Like other forms of abuse, people do not always declare it immediately. Another approach is to ask whether they have been for cervical smears and if they haven’t you can have a conversation about why. Asking them about their gynaecological health like UTIs, difficulties with periods and infertility is another starting point to address a lot of things. They are like alarm bells.
Dot– Do you think professionals are better trained now to deal with FGM?
Alice– I think as professionals we have a long way to go, not just those in healthcare but also the police and anyone who deals with ethnically diverse communities all need to know how to ask the right questions.
Dot– How can we support women who have experienced FGM?
Alice– First and foremost, we need to gain their trust. To this end it is important if women have the same doctor or healthcare professional, so it gives them enough time to open up. But the system isn’t always helpful. For example, having different interpreters work with a patient over time doesn’t allow for that trust to be built. Named midwives like myself can develop friendly relationships with survivors who are often isolated in a foreign country or environment which enables them to confide in us. Language and the workings of the system are barriers in this instance.
Dot– Do you think that more men need to be involved in the conversation? If so, how do you suppose we can achieve this?
Alice– Men should be involved in the conversation around FGM because it takes two to tango. Having men talk about it in platforms is quite important. They need to hear about women survivors’ experience of living with FGM so they can understand better. And when women talk, men don’t always listen. I did a study on men’s role in childbirth and found out that men did better in ante-natal classes held by other men and not women because of the language they use. Male health professionals are in the best position to appeal to men.
Dot– How can we engage faith leaders more?
Alice– Having more awareness sessions with faith leaders will help. Passionate doctors and fathers who refuse to cut their daughters can advocate with them. Men suffer the consequences of FGM too, watching the women they love go through pain. We never ask them this question, but I think we should. They must be affected by it.
Dot– Do you think faith leaders will listen to men more?
Alice– I believe so. It is a good place to start by having men open the dialogue and then a woman sharing her experience afterwards. Religious leaders seldom talk with women so there is a need for this. We should also be respectful towards them so they can share their religious views regarding FGM with us. I think some faith leaders use religion as an excuse to advocate for FGM.
I am worried about cutters coming into the UK under the guise of relatives because now girls cannot freely travel outside the country to have FGM done like before due to increased awareness.
Dot– What evidence is there that cutters are living in the UK?
Alice– The fact that FGM figures are on the increase despite there being a legislation that makes it illegal. It makes you wonder where all the numbers are coming from.
Dot– Is there anything we can do to support more prosecutions?
Alice– We can speak more to the police to see what is needed for a successful prosecution. There must be a loop hole somewhere if there are not as many successful prosecutions in the UK. We need to have an understanding of how the law is interpreted. Organisations working against FGM need to come together and collaborate and give anti-FGM campaigning a better voice.