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In conversation with Celia Jeffreys, head of the award-winning National FGM Centre

Celia Jeffreys is the head of The National FGM Centre, which was set up in March 2015. The centre is led by the UK’s largest children’s charity, Barnardo’s, in partnership with the Local Government Association

National FGM Centre

Celia PhotoCelia Jeffreys is the head of The National FGM Centre, which was set up in March 2015. The centre is led by the UK’s largest children’s charity, Barnardo’s, in partnership with the Local Government Association (LGA), to eradicate Female Genital Mutilation (FGM) for women and girls across England. Last year, the centre’s team won the Safeguarding Award at the Children and Young People Now Awards. Celia also has nearly 16 years of experience in midwifery. She spoke to 1000women about her experiences safeguarding women against FGM, and what needs to be done to end the practice for good.

Celia, what does The National FGM Centre do?

Celia: We work within six local authority areas in the South-East of England: Hertfordshire, Norfolk, Suffolk, Essex Local Authority, Thurrock, and Southend Local Authority. We provide social workers, who work within local authority areas only on cases of FGM.

Our initial grant, from the Department of Education, was for targeting areas of low prevalence, in the view that these areas have a lower response rate from professionals but still have cases of FGM. We work in such areas to skill up the social workers, to train and teach professionals. We found that these areas that were deemed low risk actually have a high prevalence of FGM. Across all of them, we’ve had over 160 referrals of girls at risk of FGM; that is a large number.

In 2015, reporting FGM cases became mandatory. Do you find more cases are being reported as a result?

I don’t think that’s the case. Professionals still don’t fully understand what mandatory reporting duty involves. The increase in the south-east has not been due to the mandate, but because we have done awareness raising in those local authorities, and due to factors like government campaigns such as survivor campaigns. The mandatory reporting duty makes it incumbent on professionals to report to the police when they know a girl has been cut. As far as cases are concerned, it is about knowing what the risks are to girls and how to identify them. There are essentially two parts to this, where professionals must be empowered and have that training to know what the risks are, and knowing how to open up that conversation with the girl and her family. Professionals have a duty to report regardless of the wishes of the family or the girl who has gone through FGM. They should be able to explain to the girl and her family what they are going to do and why. A professional may only potentially see this once in their career especially if they are in a rural area or if they are a social worker, health professional or policeman. Without effective training, it would be a confusing and difficult case to work on.

Do you think the current government is doing enough to safeguard services for girls at risk and those who have undergone FGM?

We are seeing the Home Office and Department of Health honoring their promises to continue with this work on FGM. Barnardo’s as a charity has really started working on this in the last two years but the Home Office has an FGM Unit and the Department of Health has an FGM office. Within government, we see a more strategic workforce around the issue and more knowledge of the topic. All in all, it looks good.

In an article for The Guardian, you likened FGM to ‘child abuse, full stop‘. What do you think is the biggest challenge for people, especially families of survivors, to understand this?

Families feel that they are safeguarding their girls by doing this, that they are protecting their children from being seen as being ‘dirty’ and prostitutes, not marriageable, not having honour. The honour and the integrity of the family is seen as dependent on having gone through FGM. It’s all in the view of how families see safeguarding and protection which is not the way we see it. We see safeguarding and protection as against child abuse, neglect, sexual and emotional abuse. We see FGM as abuse.

We need to help people understand the associated risks and outcomes that come with FGM. A lot of women who have had FGM don’t understand that the reason it takes them 20-30 minutes to visit the toilet is because they have Type III FGM. With a bit of education, they start associating the flashbacks they were having, or the fact that they can’t menstruate and have all these psychosocial issues – it all comes full circle with their FGM, and you start to see this change in their thinking.

Children are now learning about this is school, and parents are starting to further their education too. Are we seeing a shift in their way of thinking?

Yes, there is a shift happening and when you talk to community members and leaders and even faith group leaders more and more, you find them saying that they don’t tolerate it. We also have the tools to help protect at-risk individuals: the criminalisation of FGM, the mandatory reporting duty, and FGM protection orders. We have an arsenal of tools now that were not there before. Even though the law against FGM has been present since 1985, changes in the law and legislation have created this shift since 2015. That is filtering down to organisations such as ours, and then reflected in the communities and the public. There is a shift happening but it’s not very fast. We need to understand that this practice has been passed down from generation to generation for over 2000 years, and has been instilled into these families as tradition. We work in education with professionals, community groups, survivors and children – and it is all these groups that are integral in supporting what we do and what we achieve.

The National FGM Centre aims to prevent new cases by building ‘effective strategies’ and creating changes in community attitudes. What do some of these effective strategies involve?

When we first started the National FGM Centre, we looked at what the problem is now and what process we have to get through in order to eliminate new cases of FGM by 2025.

We run different types of events where we engage with a variety of communities, faith groups and organisations. We hold focus groups and women’s health forums to understand where the issues still are within these communities. They see that we need to make a change and that this is not tolerated in our country, but they are still feeling the pressure from home or from outside, so we discuss how to manage that and how we can help them to empower women to keep them safe. Through that we continue working with these communities by identifying ‘champions’ who can take that message forward. We have seen really good outcomes from women-centered health groups, where they bring their children. Women have agreed to be champions within their own communities who from those groups, and go on to do more work around the topic.

We also train professionals far and wide across the country by speaking at conferences, organising training events already paid for, and a number of other courses where people can get accreditation. We are also working on a project in Northern Ireland at the moment because the women there have to travel abroad to get the deinfibulation process done. There is nowhere for them to get it done even though it is a very simple procedure.

Finally, we have a ‘knowledge hub’ on our website. There are so many resources out there and so much you can read but they are not all in one place and it’s not always good, effective, useful and honest material. We brought it all together into one platform where you can access FGM-related material. We also have an interactive prevalence map on the website for researchers, showing that actually this happens not only in African countries but in Indonesia, Russia, and other parts of the world.

We are quite unique in that we have social workers working only with girls who are at risk, but our funding is at risk from March. We are waiting to hear more, but this highlights the problem organisations like ours have, relying on short grants to sustain their work going forward. It can introduce a complication in that women may not have the option to undergo deinfibulation due to lack of resources, knowledge, and experience.

Why education on FGM is so important – a story that inspires me

celia_national fgm centre

One woman who really springs to mind was about two or three years ago, a rare day when I was looking after a woman in the labour ward. She was from the Somali community and she had Type III FGM and she had chosen to not be deinfibulated until she was in the second stage of labour. That was her choice, she was counselled around it. Because it was an interest of mine and she was really open around it, we had a very frank discussion on FGM and it transpired that she had four siblings younger than her but she was the only one out of her family who was cut. Her younger siblings hadn’t been because of some education her mother had had when she was in Somalia. This mother made the very brave decision not to have any of her other children cut.

That created varied feelings in this woman about why she was the only one who was cut. She felt glad and proud that her sisters hadn’t been, but there was also the guilt that her sisters felt that she was the only one to have undergone this and had such horrendous health issues from it, but that they had been saved from it.

We had a lot of conversations around that. She was a real campaigner against FGM, and was inspired by her mum. I wonder how the story could have been different and if her mum had not had that education and made that brave decision. It was truly a brave decision living in Somalia and not having her children undergo FGM, because a family can be viewed very dishonorably as a result. Soon after they moved to the UK and she was supported for her decision. That is an interesting dynamic, and this woman still remembers her mother getting telephone calls from elders and an aunty asking when she was going to get these girls cut, and she would say ‘I’m not.” What really rang out to me in this story was the feelings they all had for each other.

The woman did end up getting it reversed and delivered her baby. That also comes with its own issues, because this is how you know yourself for most of your life, then at your most vulnerable, when you’re having a baby, to be opened up and have to deal with that and have this little person to look after – psychologically it is very difficult to deal with.

The future is bright and hopeful. There is now a recognition that survivors have psychosocial, psychosexual, and physical needs. There is more research being done into that and into the right time to deinfibulate. I think we need to keep the momentum and pressure on the government. We need to keep providing for survivors and for girls at risk, building on the work that has been done.

Getting support if you think you’re at risk, or have undergone FGM

If you think you may be risk of FGM or know someone who might be, call the NSPCC’s free helpline on 0800 028 3550 or email fgmhelp@nspcc.org.uk. If you are a survivor of FGM, there are some psychological support services available like the Dahlia Project, run by Leyla Hussein for Manor Gardens. You can find information about more support services collected by Daughters of Eve here.

saza001@hotmail.com

Sarah is a Master’s student in Psychology. She also volunteers for 'Mary on the Green', a campaign advocating for women’s rights through the life of Mary Wollstonecraft, and domestic abuse charity Refuge.

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