female genital mutilation (fgm)...female genital mutilation (fgm) 1 introduction the following...
TRANSCRIPT
Female Genital Mutilation (FGM)
SAFEGUARDING PATHWAY AND RISK ASSESSMENT
October 2018
1Female Genital Mutilation (FGM)
Introduction
The following safeguarding pathway and risk assessment tools have been developed by the Safeguarding Board for Northern Ireland (SBNI) to support all staff who work with and who deliver services to children and young people, women and families. The purpose of this resource is to help professionals appropriately identify, safeguard and support girls who may be at potential risk of Female Genital Mutilation (FGM) and/or women who have suffered FGM. The pathway and tools are adapted versions of similar tools published by Department of Health, London.
The pathway and risk assessment tools should be used alongside the FGM Multi-agency Practice Guidelines and the SBNI Regional Core Child Protection Policy and Procedures.
Use the FGM Pathway and Risk Assessment Tools to:
1. Start the conversation and confidently discuss FGM with individuals and their families.
2. Assess:
• Whether the person is either at risk, or has experienced FGM.
• Identify whether the person has children/young people at risk of FGM.
• Identify whether there are other children/young people in the family/close friends who are potentially at risk of FGM.
3. Safeguard the child/young person appropriately including understanding when to refer to Social Services/PSNI.
2 Female Genital Mutilation (FGM)
Starting the conversation
The approach to starting the conversation about FGM will differ depending on the circumstances. However, in all cases you should ask the following introductory questions. Please note it may be appropriate to use other terms or phrases common to FGM - see later in document.
The questions should be asked directly to the person. Where the person is a child/young person (depending on age and stage of development) the question should be directed to the parent or legal guardian.
1. Do you, your partner or your parents come from a community where FGM is practiced?
2. Have you been subject to FGM?
If you receive a YES answer to questions (1) or (2) please complete one of the following:
Individual Status Template to use
Adult Woman Pregnant Template A
Adult Woman Not Pregnant Template B
Child/young person (Under 18)
At risk/FGM status unknown Template C
Child/young person (Under 18)
Has had FGM/FGM suspected Template D
If during your conversation/assessment you are concerned by any answers received from the person or their family, you should enquire further and consider asking other related questions to further explore this concern.
3Female Genital Mutilation (FGM)
Points to Remember:
Always:
• Ensure all discussions are approached directly but in a sensitive and non-judgmental manner.
• Document all actions in the person’s record.
• Seek consent to share this information with the person’s GP.
• Seek consent to share information relating to a child/young person with the child/young person’s GP, school nurse and/or health visitor. However, if there is a clear child protection concern the information should be shared whether consent is obtained or not.
• Inform the individual and their family that FGM is illegal in the UK and it is considered child abuse if it involves a child/young person under the age of 18 years.
• Explain the negative health consequences of practicing FGM.
• Use an accredited translation service and not a family or community member.
• Ensure that any further action complies with all statutory and professional responsibilities in relation to safeguarding, and meets local processes and arrangements outlined in the SBNI Regional Core Child Protection Policy and Procedures.
The pathway and risk assessment tools do not replace the need for professional judgment in relation to the circumstances which present.
4 Female Genital Mutilation (FGM)
FGM: Safeguarding the child/young person
Having used the pathway and risk assessment tools, you will need to decide:
• Whether the child/young person is at immediate risk? If so, contact the PSNI by ringing 999.
• Whether or not to make a referral through to Social Services as outlined in the SBNI Regional Core Child Protection Policy and Procedures?
• Is this a new risk?
• If risk has already been identified, has the risk increased or reduced since your last contact with the family?
• Whether there is a risk to any other girl/child member of the household?
• Do I need to seek help from my local safeguarding lead or other professional support before making a decision?
Decisions must be noted on the child/young person’s record.
You should consult with children’s Social Services or safeguarding lead if you are uncertain about your decision or you require additional support.
5Female Genital Mutilation (FGM)
Urgent referrals to PSNI/Social Services
An urgent referral must be made when:
• A child/young person under 18 years shows signs of very recently having undergone FGM. This may allow for the police to collect physical evidence.
• You believe that there are plans to take a child/young person abroad and there is an imminent risk that she is likely to undergo FGM.
In these cases children’s Social Services and the Police will consider what action to take. The risk to any other girl/child member of the household needs to be considered.
FGM Risk Assessment Checklist
Have you:
• Discussed FGM with the person and their family?
• Completed an appropriate FGM risk assessment template?
• Recorded your actions and the outcome of the assessment in the person’s record?
• Followed the SBNI Regional Core Child Protection Policy and Procedures and made a referral to Social Services if appropriate, or contacted the Police if a child/young person is in immediate risk?
• Sought and shared relevant information with other health professionals including the GP, health visitor, school nurse, your local safeguarding lead?
6 Female Genital Mutilation (FGM)
FGM SAFEGUARDING PATHWAY
PRESENTATION PROMPTS PRACTITIONER TO SUSPECT/CONSIDER FGM E.g. Repeated UTI, vaginal infections, urinary incontinence, dyspareunia, dysmenorrhea etc.
Also consider difficulty getting pregnant, presenting for travel health advice or patient disclosure (e.g. young girl from community known to practice FGM discloses she will soon undergo ‘coming of age’ ceremony).
QUESTIONS: I understand that you, your partner or your parents come from a community where FGM is practiced?
Has this ever happened to you? (It may be appropriate to use other terms of phrases)
NONo Further Action
RequiredNO
Person is over 18Person is under 18
YES
If a girl appears to have recently undergone FGM or you believe she is at imminent risk, act immediately –by phoning the PSNI - 999
REMEMBER: Always ask your local safeguarding lead if in doubt&The Rowan, the regional Sexual Assault Referral Centre for Northern Ireland (0800 389 4424) facilitates and has experience of sensitive examination. They will advise and guide as required.
YES
Complete appropriateRisk assessment
See (A)-(D)
Do you believe the patient has had FGM?
NO - But family history
Individual is under 18 or a
vulnerable adult
If you suspect she may be of risk of FGM:Use the safeguarding risk assessment (A)-(D) tool to help decide what action to take:
• If child/young person is at imminent risk of harm refer to PSNI/Social Services
Can you identify other female siblings or relatives, household members at risk of FGM?
• Complete risk assessment if possible; or• Share information with multi-agency partners to
initiate safeguarding response.
AVAILABLE SUPPORTS:The Rowan Sexual Assault Referral Centre (SARC) for examination: 0800 3894424
NSPCC FGM Helpline: 0800 028 3550Agency Safeguarding LeadLocal Gateway TeamRegional Emergency Social Work Service
Details of FGM risk and safeguarding guidance for staff from the Department of Health is available online (FGM Multi-Agency Practice Guidelines)
National FGM Centre: http://nationalfgmcentre.org.uk/
Does she have any female children/young people or siblings at risk of FGM?
And/or do you consider her to be a vulnerable adult?
Complete safeguarding risk assessment (A)-(D) and use tools to decide if a social services referral is required
FOR ALL WOMEN/GIRLS who have HAD FGMConsider need and offer referral to:
1. ROWAN/Obstetrics/ Gynecology services to confirm if FGM is present, FGM type and/or for deinfibulation
2. Uro-gynae specialist clinic3. Community Mental Health Services
If under 18 refer for a paediatric appointment and physical examination, following local processes and liaison with the Rowan.
In ALL Cases: 1. Clearly document all discussion and actions with patient/family in
client’s record.2. Explain FGM is illegal in Northern Ireland 3. Discuss the adverse health consequences of FGM4. Share safeguarding information with Social Services, health visitor,
school nurse and GP.
7Female Genital Mutilation (FGM)
(A) R
isk
of F
GM
: PRE
/PO
STN
ATA
L W
OM
AN
ACTI
ON
Ask
mor
e qu
estio
ns –
if o
ne in
dica
tor
lead
s to
a p
oten
tial a
rea
of c
once
rn,
cont
inue
the
disc
ussi
on in
this
are
a.
Cons
ider
risk
– if
one
or m
ore
indi
cato
rs
are
iden
tified
, you
nee
d to
con
sider
wha
t ac
tion
to ta
ke. I
f uns
ure
whe
ther
the
leve
l of
risk
requ
ires r
efer
ral a
t thi
s poi
nt,
disc
uss w
ith y
our n
amed
/ des
igna
ted
safe
guar
ding
lead
.
Sign
ifica
nt o
r Im
med
iate
risk
– if
you
id
entif
y on
e or
mor
e sig
nific
ant/
im
med
iate
risk
s, or
if in
you
r opi
nion
ot
her r
isks a
re su
ffici
ent t
o be
con
sider
ed
serio
us y
ou m
ust r
efer
to so
cial
serv
ices
in
acc
orda
nce
with
SBN
I Reg
iona
l Cor
e Ch
ild P
rote
ctio
n Po
licy
and
Proc
edur
es.
If th
e ris
k of
har
m is
imm
inen
t you
mus
t co
ntac
t the
Pol
ice
and
Soci
al S
ervi
ces.
In a
ll ca
ses:
- • S
hare
info
rmat
ion
of a
ny id
entifi
ed
risk
with
the
pers
on’s
GP/
HV
• Rec
ord
in n
otes
• Rai
se a
war
enes
s of t
he h
ealth
co
mpl
icat
ions
of F
GM
and
the
law
in
Nor
ther
n Ire
land
.
This
is to
hel
p yo
u m
ake
a de
cisi
on a
s to
whe
ther
the
unbo
rn/n
ewbo
rn c
hild
or o
ther
fem
ale
child
ren/
youn
g pe
ople
in th
e fa
mily
are
at r
isk
of F
GM
or w
heth
er
the
wom
an h
erse
lf is
at r
isk
of fu
rthe
r har
m in
rela
tion
to F
GM
.
Dat
e: C
ompl
eted
by:
Ass
essm
ent:
Initi
al/O
n-go
ing
Indi
cato
rYe
sN
oD
etai
ls
CON
SID
ER R
ISK
Wom
an c
omes
from
a c
omm
unity
kno
wn
to p
ract
ice
FGM
Wom
an h
as u
nder
gone
FG
M h
erse
lf
Hus
band
/par
tner
com
es fr
om a
com
mun
ity k
now
n to
pra
ctic
e FG
M
A fe
mal
e fa
mily
eld
er is
invo
lved
/will
be
invo
lved
in c
are
of c
hild
ren/
unbo
rn c
hild
or i
s in
fluen
tial i
n th
e fa
mily
Wom
an/f
amily
has
lim
ited
inte
grat
ion
in U
K co
mm
unity
Wom
an a
nd/o
r hus
band
/par
tner
hav
e lim
ited/
no u
nder
stan
ding
of h
arm
of F
GM
or t
he
law
in N
orth
ern
Irela
nd
Wom
an’s
rela
tives
hav
e un
derg
one
FGM
Wom
an h
as fa
iled
to a
tten
d fo
llow
-up
with
an
obst
etric
ian
for a
n FG
M re
late
d ap
poin
tmen
t
Wom
an’s
husb
and/
part
ner/
othe
r fam
ily m
embe
r is
ver
y do
min
ant i
n th
e fa
mily
and
ha
ve n
ot b
een
pres
ent d
urin
g co
nsul
tatio
ns w
ith th
e w
oman
Wom
an is
relu
ctan
t to
unde
rgo
geni
tal e
xam
inat
ion
SIG
NIF
ICA
NT
OR
IMM
EDIA
TE R
ISK
Wom
an a
lread
y ha
s da
ught
ers
who
hav
e un
derg
one
FGM
Wom
an o
r wom
an’s
part
ner/
fam
ily re
ques
ting
rein
fibul
atio
n fo
llow
ing
child
birt
h
Wom
an s
ays
that
FG
M is
inte
gral
to c
ultu
ral o
r rel
igio
us id
entit
y
Fam
ily a
re a
lread
y kn
own
to s
ocia
l car
e se
rvic
es –
if k
now
n, a
nd y
ou h
ave
iden
tified
FG
M
with
in a
fam
ily, y
ou m
ust s
hare
this
info
rmat
ion
with
Soc
ial S
ervi
ces
Plea
se re
mem
ber:
any
child
/you
ng p
erso
n un
der 1
8 w
ho h
as u
nder
gone
FG
M m
ust b
e re
ferr
ed to
ch
ildre
n’s
soci
al s
ervi
ces
for a
ctio
n.
8 Female Genital Mutilation (FGM)
(B) R
isk
of F
GM
: NO
N-P
REG
AN
T A
DU
LTS
WO
MA
N (o
ver 1
8)Th
is is
to h
elp
deci
de w
heth
er th
e w
oman
is a
t ris
k of
furt
her h
arm
of F
GM
or w
heth
er th
ere
are
othe
r chi
ldre
n/yo
ung
peop
le a
t ris
k of
FG
M, f
or w
hom
a ri
sk
asse
ssm
ent m
ay b
e re
quire
d.
Dat
e: C
ompl
eted
by:
Ass
essm
ent:
Initi
al/O
n-go
ing
ACTI
ON
Ask
mor
e qu
estio
ns –
if o
ne in
dica
tor
lead
s to
a p
oten
tial a
rea
of c
once
rn,
cont
inue
the
disc
ussi
on in
this
are
a.
Cons
ider
risk
– if
one
or m
ore
indi
cato
rs
are
iden
tified
, you
nee
d to
con
sider
wha
t ac
tion
to ta
ke. I
f uns
ure
whe
ther
the
leve
l of r
isk re
quire
s ref
erra
l at t
his p
oint
, di
scus
s with
you
r nam
ed/ d
esig
nate
d sa
fegu
ardi
ng le
ad.
Sign
ifica
nt o
r Im
med
iate
risk
– if
you
id
entif
y on
e or
mor
e sig
nific
ant /
im-
med
iate
risk
s, or
if in
you
r pro
fess
iona
l op
inio
n ot
her r
isks a
re su
ffici
ent t
o be
co
nsid
ered
serio
us y
ou m
ust r
efer
to so
-ci
al se
rvic
es in
acc
orda
nce
with
the
SBN
I Re
gion
al C
ore
Child
Pro
tect
ion
Polic
y an
d Pr
oced
ures
.
If th
e ris
k of
har
m is
imm
inen
t, yo
u m
ust c
onta
ct P
olic
e an
d So
cial
Ser
vice
s.
In a
ll ca
ses:
-• S
hare
info
rmat
ion
of a
ny id
entifi
ed
risk
with
the
pers
on’s
GP
• Rec
ord
in n
otes
• Rai
se a
war
enes
s of t
he h
ealth
com
pli-
catio
ns o
f FG
M a
nd th
e la
w in
Nor
th-
ern
Irela
nd.
Indi
cato
rYe
sN
oD
etai
ls
CON
SID
ER R
ISK
Wom
an a
lread
y ha
s dau
ghte
rs w
ho h
ave
unde
rgon
e FG
M –
who
are
ove
r 18
year
s of a
ge
Hus
band
/par
tner
com
es fr
om a
com
mun
ity k
now
n to
pra
ctic
e FG
M
A fe
mal
e fa
mily
eld
er (m
ater
nal o
r pat
erna
l) is
influ
entia
l in
fam
ily o
r is
invo
lved
in c
are
of c
hild
ren/
youn
g pe
ople
Wom
an a
nd fa
mily
hav
e lim
ited
inte
grat
ion
in U
K co
mm
unity
Wom
an’s
husb
and/
part
ner/
othe
r fam
ily m
embe
r is
very
dom
inan
t in
the
fam
ily a
nd
have
not
bee
n pr
esen
t dur
ing
cons
ulta
tions
with
the
wom
an
Wom
an/f
amily
hav
e lim
ited/
no u
nder
stan
ding
of h
arm
of F
GM
or t
he la
w in
Nor
ther
n Ire
land
.
Wom
an’s
niec
es (b
y si
blin
g or
in-la
ws)
hav
e un
derg
one
FGM
Wom
an h
as fa
iled
to a
tten
d fo
llow
-up
with
an
obst
etric
ian
for a
FG
M re
late
d ap
poin
tmen
t
Fam
ily a
re a
lread
y kn
own
to S
ocia
l Ser
vice
s –
if kn
own,
and
you
hav
e id
entifi
ed F
GM
w
ithin
a fa
mily
, you
mus
t sha
re th
is in
form
atio
n w
ith s
ocia
l ser
vice
s
SIG
NIF
ICA
NT
OR
IMM
EDIA
TE R
ISK
Wom
an/f
amily
bel
ieve
FG
M is
inte
gral
to re
ligio
us o
r cul
tura
l ide
ntity
Wom
an a
lread
y ha
s da
ught
ers
who
hav
e go
ne th
roug
h FG
M
Wom
an is
con
side
red
to b
e a
vuln
erab
le a
dult
and
ther
efor
e is
sues
of m
enta
l cap
acity
an
d co
nsen
t sho
uld
be tr
igge
red
if sh
e is
foun
d to
hav
e FG
M
Plea
se re
mem
ber:
any
child
/you
ng p
erso
n un
der 1
8 w
ho h
as u
nder
gone
FG
M m
ust b
e re
ferr
ed to
ch
ildre
n’s
soci
al s
ervi
ces
for a
ctio
n.
9Female Genital Mutilation (FGM)
(C) R
isk
of F
GM
: CH
ILD
/YO
UN
G P
ERSO
N
(und
er 1
8 ye
ars
old)
This
is to
hel
p w
hen
cons
ider
ing
whe
ther
a c
hild
/you
ng p
erso
n is
AT
RISK
of F
GM
, or w
heth
er th
ere
are
othe
r chi
ldre
n/yo
ung
peop
le in
the
fam
ily fo
r who
m a
ris
k as
sess
men
t may
be
requ
ired
Dat
e: C
ompl
eted
by:
Ass
essm
ent:
Initi
al/O
n-go
ing
ACTI
ON
Ask
mor
e qu
estio
ns –
if o
ne
indi
cato
r lea
ds to
a p
oten
tial a
rea
of
conc
ern,
con
tinue
the
disc
ussio
n in
th
is ar
ea.
Cons
ider
risk
– if
one
or m
ore
indi
cato
rs a
re id
entifi
ed, y
ou n
eed
to
cons
ider
wha
t act
ion
to ta
ke. If
un
sure
whe
ther
the
leve
l of r
isk
requ
ires r
efer
ral a
t thi
s poi
nt, d
iscus
s w
ith y
our n
amed
/des
igna
ted
safe
guar
ding
lead
.
Sign
ifica
nt o
r Im
med
iate
risk
(s
ee b
elow
) –If
you
iden
tify
one
or m
ore
signi
fican
t / i
mm
edia
te ri
sks o
r if i
n yo
ur
prof
essio
nal o
pini
on o
ther
risk
s are
su
ffici
ent t
o be
con
sider
ed se
rious
yo
u m
ust r
efer
to so
cial
serv
ices
in
acco
rdan
ce w
ith th
e SB
NI R
egio
nal
Core
Chi
ld P
rote
ctio
n Po
licy
and
Proc
edur
es.
If th
e ris
k of
har
m is
imm
inen
t, yo
u m
ust c
onta
ct th
e Po
lice
and
Soci
al
Serv
ices
.
In a
ll ca
ses:–
• Sha
re in
form
atio
n of
any
iden
tified
ris
k w
ith th
e pe
rson
’s G
P• D
ocum
ent i
n no
tes
• Disc
uss t
he h
ealth
com
plic
atio
ns o
f FG
M a
nd th
e la
w in
Nor
ther
n Ire
land
.
Indi
cato
rYe
sN
oD
etai
ls
CON
SID
ER R
ISK
Child
/you
ng p
erso
n’s
mot
her h
as u
nder
gone
FG
M
Oth
er fe
mal
e fa
mily
mem
bers
hav
e ha
d FG
M
Fath
er c
omes
from
a c
omm
unity
kno
wn
to p
ract
ice
FGM
A
fem
ale
fam
ily e
lder
is v
ery
influ
entia
l with
in th
e fa
mily
and
is/w
ill b
e in
volv
ed in
the
care
of t
he g
irl
Mot
her/
fam
ily h
ave
limite
d co
ntac
t with
peo
ple
outs
ide
of h
er fa
mily
Pa
rent
s ha
ve p
oor a
cces
s to
info
rmat
ion
abou
t FG
M a
nd d
o no
t kno
w a
bout
the
harm
ful e
ffect
s of
FG
M o
r the
law
in N
orth
ern
Irela
nd
Pare
nts
say
that
they
or a
rela
tive
will
be
taki
ng th
e gi
rl ab
road
for a
pro
long
ed p
erio
d –
this
may
not
on
ly b
e to
a c
ount
ry w
ith h
igh
prev
alen
ce, b
ut th
is w
ould
mor
e lik
ely
lead
to a
con
cern
Fam
ily a
re a
lread
y kn
own
to S
ocia
l Ser
vice
s –
if kn
own,
and
you
hav
e id
entifi
ed F
GM
with
in a
fam
ily,
you
mus
t sha
re th
is in
form
atio
n w
ith s
ocia
l ser
vice
s
Girl
has
spok
en a
bout
a lo
ng h
olid
ay to
her
coun
try
of o
rigin
/ano
ther
coun
try
whe
re th
e pr
actic
e is
prev
alen
tG
irl h
as a
tten
ded
a tr
avel
clin
ic o
r equ
ival
ent f
or v
acci
natio
ns/a
nti-m
alar
ials
FGM
is re
ferre
d to
in co
nver
satio
n by
the
child
, fam
ily o
r clo
se fr
iend
s of t
he ch
ild (s
ee A
ppen
dix T
wo
for
tradi
tiona
l and
loca
l ter
ms)
– th
e co
ntex
t of t
he d
iscus
sion
will
be
impo
rtan
tG
irls
pres
ents
sym
ptom
s th
at c
ould
be
rela
ted
to F
GM
Fa
mily
not
eng
agin
g w
ith p
rofe
ssio
nals
(hea
lth, s
choo
l, or
oth
er)
Any
oth
er s
afeg
uard
ing
aler
t alre
ady
asso
ciat
ed w
ith th
e fa
mily
SIG
NIF
ICA
NT
OR
IMM
EDIA
TE R
ISK
A c
hild
or s
iblin
g as
ks fo
r hel
p in
rela
tion
to F
GM
A
par
ent o
r fam
ily m
embe
r exp
ress
es c
once
rn th
at F
GM
may
be
carr
ied
out o
n th
e ch
ild
Girl
has
con
fided
in a
noth
er th
at s
he is
to h
ave
a ‘sp
ecia
l pro
cedu
re’ o
r to
atte
nd a
‘spe
cial
occ
asio
n’.
Girl
has
talk
ed a
bout
goi
ng a
way
‘to
beco
me
a w
oman
’ or ‘
to b
ecom
e lik
e m
y m
um a
nd s
iste
r’
Girl
has
a s
iste
r or o
ther
fem
ale
child
rela
tive
who
has
alre
ady
unde
rgon
e FG
M
Fam
ily/c
hild
are
alre
ady
know
n to
soc
ial s
ervi
ces
– if
know
n, a
nd y
ou h
ave
iden
tified
FG
M w
ithin
a
fam
ily, y
ou m
ust s
hare
this
info
rmat
ion
with
Soc
ial S
ervi
ces
Plea
se re
mem
ber:
any
child
/you
ng p
erso
n un
der 1
8 w
ho h
as u
nder
gone
FG
M m
ust b
e re
ferr
ed to
ch
ildre
n’s
soci
al s
ervi
ces
for a
ctio
n.
10 Female Genital Mutilation (FGM)
(D) R
isk
of F
GM
: CH
ILD
/YO
UN
G P
ERSO
N
(und
er 1
8 ye
ars
old)
Th
is is
to h
elp
whe
n co
nsid
erin
g w
heth
er a
chi
ld/y
oung
per
son
has
had
FGM
.
Dat
e: C
ompl
eted
by:
Ass
essm
ent:
Initi
al/O
n-go
ing
ACTI
ON
Ask
mor
e qu
estio
ns –
if o
ne in
dica
tor
lead
s to
a po
tent
ial a
rea
of c
once
rn,
cont
inue
the
disc
ussio
n in
this
area
.
Plea
se re
mem
ber:
any
child
/you
ng
pers
on u
nder
18
who
has
und
ergo
ne
FGM
mus
t be
refe
rred
to th
e Po
lice
usin
g th
e 10
1 no
n-em
erge
ncy
num
ber.
If yo
u su
spec
t but
do
not k
now
that
a
girl
has
unde
rgon
e FG
M b
ased
on
risk
fact
ors
pres
entin
g, y
ou m
ust r
efer
to
Soc
ial S
ervi
ces G
atew
ay Te
am in
ac
cord
ance
with
the
SBN
I Reg
iona
l Cor
e Ch
ild P
rote
ctio
n Po
licy
and
Proc
edur
es.
In a
ll ca
ses:
–• S
hare
info
rmat
ion
of a
ny id
entifi
ed
risk
with
the
pers
on’s
GP
• Rec
ord
in n
otes
• Dis
cuss
the
heal
th c
ompl
icat
ions
of
FGM
and
the
law
in N
orth
ern
Irela
nd.
Indi
cato
rYe
sN
oD
etai
ls
CON
SID
ER R
ISK
Girl
is re
luct
ant t
o un
derg
o an
y m
edic
al e
xam
inat
ion
Girl
has
diffi
culty
wal
king
, sitt
ing
or s
tand
ing
or lo
oks
unco
mfo
rtab
le
Girl
find
s it
hard
to s
it st
ill fo
r lon
g pe
riods
of t
ime,
whi
ch w
as n
ot a
pro
blem
pre
viou
sly
Girl
pre
sent
s to
GP
or A
&E
with
freq
uent
urin
e, m
enst
rual
or s
tom
ach
prob
lem
s
Incr
ease
d em
otio
nal a
nd p
sych
olog
ical
nee
ds e
.g. w
ithdr
awal
, dep
ress
ion,
or s
igni
fican
t ch
ange
in b
ehav
iour
Girl
avo
idin
g ph
ysic
al e
xerc
ise o
r req
uirin
g to
be
excu
sed
from
PE
less
ons w
ithou
t a G
P’s l
ette
r
Girl
has
spo
ken
abou
t hav
ing
been
on
a lo
ng h
olid
ay to
her
cou
ntry
of o
rigin
/ano
ther
co
untr
y w
here
the
prac
tice
is p
reva
lent
Girl
spe
nds
a lo
ng ti
me
in th
e ba
thro
om/t
oile
t/lo
ng p
erio
ds o
f tim
e aw
ay fr
om th
e cl
assr
oom
Girl
talk
s ab
out p
ain
or d
isco
mfo
rt b
etw
een
her l
egs
SIG
NIF
ICA
NT
OR
IMM
EDIA
TE R
ISK
Girl
ask
s fo
r hel
p
Girl
con
fides
in a
pro
fess
iona
l tha
t FG
M h
as ta
ken
plac
e
Mot
her/
fam
ily m
embe
r dis
clos
es th
at fe
mal
e ch
ild h
as h
ad F
GM
Fam
ily/c
hild
/you
ng p
erso
n ar
e al
read
y kn
own
to S
ocia
l Ser
vice
s –
if kn
own,
and
you
ha
ve id
entifi
ed F
GM
with
in a
fam
ily, y
ou m
ust s
hare
this
info
rmat
ion
with
Soc
ial S
ervi
ces
Plea
se re
mem
ber:
any
child
/you
ng p
erso
n un
der 1
8 w
ho h
as u
nder
gone
FG
M m
ust b
e re
ferr
ed to
ch
ildre
n’s
soci
al s
ervi
ces
for a
ctio
n.
11Female Genital Mutilation (FGM)
Traditional and local terms for FGM
Country Term used Language Meaning
EGYPT Thara Arabic Deriving from the Arabic word ‘tahar’ meaning to clean/purify
Khitan Arabic Circumcision – used for both FGM and male circumcision
Khifad Arabic Deriving from the Arabic word ‘khafad’ meaning to lower (rarely used in everyday language)
ETHIOPIA Megrez Amharic Circumcision/cutting Absum Harrari Name giving ritualERITREA Mekhnishab Tigregna Circumcision/cuttingKENYA Kutairi Swahili Circumcision – used for both FGM and male
circumcision Kutairi was ichana Swahili Circumcision of girlsNIGERIA Ibi/Ugwu Igbo The act of cutting – used for both FGM and
male circumcision Sunna Mandingo Believed to be a religious tradition/
obligation by some MuslimsSIERRA LEONE Sunna Soussou Believed to be a religious tradition/
obligation by some Muslims Bondo Temne/ Mandinka/Limba Integral part of an initiation rite into
adulthood
Bondo/Sonde Mende Integral part of an initiation rite into adulthood
SOMALIA Gudiniin Somali Circumcision – used for both FGM and male circumcision
Halalays Somali Deriving from the Arabic word ‘halal’ ie. ‘sanctioned’ – implies purity. Used by Northern & Arabic speaking Somalis.
Qodiin Somali Stitching/tightening/sewing refers to infibulation
SUDAN Khifad Arabic Deriving from the Arabic word ‘khafad’ meaning to lower (rarely used in everyday language)
Tahoor Arabic Deriving from the Arabic word ‘tahar’ meaning to purify
CHAD– the Ngama
Bagne Used by the Sara Madjingaye
Sara ethnic subgroup
Gadja Adapted from ‘ganza’ used in the Central African Republic
GUINEA-BISSAU
Fanadu di Mindjer Kriolu Circumcision of girls
GAMBIA Niaka Mandinka Literally to ‘cut /weed clean’ Kuyango Mandinka Meaning ‘the affair’ but also the name for
the shed built for initiates Musolula Karoola Mandinka Meaning ‘the women’s side’/’that which
concerns women’
12 Female Genital Mutilation (FGM)
Countries where Female Genital Mutilation is prevalent
FGM Prevalence
0-15%
16-30%
31-45%
46-60%
61-85%
85-100%
Only small scale studies exist/Prevalence Unknown.
All data has been sourced from WHO, DHS, MICS or Unicef unless stated otherwise below and represent women 15-49 years old.
Please click here to view an online interactive map with more information.Malaysia: Muslim Women only (University of Malaya, 2010), Indonesia: 0-14 year olds girls,UAE: Dubai Women's College, 2011.
FGM Global Prevalence Map (%)
National FGM Centre
Safeguarding Board for Northern Ireland,The Beeches,HSC Leadership Centre,Belfast,BT7 3EN
Tel. No. 028 95361810http://www.safeguardingni.org/