Project Co-ordinator – Halima Awad Female Genital Mutilation Project Project Co-ordinator – Halima Awad Halima.awad@whfs.org.uk

Background WHFS is a multi-cultural community health charity organisation based in Tower Hamlets for 34 years; Main aim is empower and support women from different backgrounds; Female genital mutilation/cutting (FGM / C) mainly affects the Somali community in Tower Hamlets; FGM is still taboo particularly amongst elderly women; WHFS has been working hard to eradicate FGM within local communities and increase women’s awareness to recognise the health risks of the practice and work with other organisations and local clinical services.

Our current FGM work We were funded by Rosa Comic Relief in 2013 and the Dept of Communities and Local Govt in 2014/15 and LBTH in 2015/16 to: consult women affected by FGM build trust within the community to hear their voices, identify and train FGM Peer supporters to support women, raise awareness in the community to dispel the myths about why FGM is still practised, discuss the harmful, health and psychological effects of FGM work in partnership with the Council’s specialist social work team to support women affected by FGM

The impact of these 2 FGM projects, showed: deep rooted and prevalent cultural attitudes and the importance of creating safe spaces to discuss FGM the importance of recruiting and training local women affected by FGM to become Peer Supporters to provide support to other women lack of confidence in health, education and social care professionals in relation to supporting and women affected by FGM low engagement amongst women affected by FGM with existing support services statutory sector professionals need the opportunity to develop a better awareness/ understanding of FGM issues to better support and protect women.

Project Aims Development of 10 community peer supporters, who were trained in safeguarding, confidentiality, befriending and were supported throughout the project. Increasing awareness of FGM among those who are affected or those at risk, leading to an increase in the number of women making positive health behaviour changes and allowing them to access preventative services. Providing support to women who have been referred to the FGM clinic in Mile End hospital

Developing FGM Peer Supporters to support women and community change WHFS’s FGM work has shown how important it is to lead change from within the community. Although the affected the women are keen to support changes in community attitude and now have a lot of understanding about the harmful effects of FGM and how they can be supported, they are insufficiently confident/skilled at speaking out about FGM publicly. They need to build skills to deliver more sustainable community change.

Increased awareness of FGM and Outreach sessions A number of visits were made to community organisations to inform them about the project and explore how we could work in partnership to raise awareness around FGM and support those who have been affected by FGM. At the Alpha Grove Community Centre in the Isle of Dogs, a group of more than 10 Somali women attended a discussion about FGM and how they could participate in the project to stop the practice. As most women attending this discussion had FGM and some had health complications since having FGM, they agreed to have a one to one sessions so they can get support from WHFS or be referred to the appropriate health services. Three of these women have since signed up to become peer supporters and have been involved in other WHFS activities.

Outreach sessions 26 January: A brief introduction about the FGM project was explained to a group of Somali women who attended a Cervical Cancer Awareness. The women were encouraged to take part in the project and support other women. 12 March: session held with the Maternity Mates team and 12 Somali women. The women raised the issue that they were unaware of any support services in the borough for women who have had FGM to improve their physical, mental and sexual health. 12 May: A group of women met to discuss several issues such as employment, FGM, further education and volunteering. Many issues were raised about the concerns on availability of services across the borough and the need of a representative from their community to encourage individuals to overcome any barriers in accessing health services and educate service users regarding availability and accessibility of FGM services.

Working with Schools A number of schools have now been visited by WHFS staff to inform the parents about the project and to discuss continued partnership working with schools. One of our main events at a local school where FGM was the main item of discussion a group of North African (Arabs) women said they were unaware that the practice still happens now. They stated that religion was the reason some of the affected community still carry out the practice. They requested more sessions to discuss this issue with a wider Arabic group in the borough and wanted to be involved in delivering the message to their own communities to eradicate the practice by increasing people’s knowledge that religion is not the reason to perform this practice.

Support services for local women with FGM related health problems WHFS volunteer FGM Project Co-ordinator worked in partnership with Dr Geetha Subramanian, (WHFS Patron) and more recently Dr Janet Barter and her staff to set up a referral pathway to identify women who require support to attend the FGM clinic. WHFS would provide a trained peer-supporter with emotional and practical support to enable them to understand and tackle their FGM related health issue.

Student Placements Samira from University of East London did a student placement with the Project and attended the Council FGM training. Samira took part in outreach and attending community events to promote FGM awareness and encourage discussion on how the affected communities can speak out against FGM.

Somali Health Conference funded by THCCG 29 Apri 2015 The aim of the Somali Health Conference was for the health professionals to hear the voices of the Somali community and explore how these concerns can be addressed. Key health areas were identified to be explored during the workshops at the conference, such as women’s health services. 80 Somali men and women attended the conference. Two workshops were specifically on women’s health services and FGM was discussed in both workshops

Issues raised: Needed more discussions on FGM within the community itself – how should this be tackled? Important to have men’s involvement in the campaign, awareness building is needed. Men as well as women need to be involved and engaged Knowledge about the services available is key (eg: at Mile End Hospital ) Some services are not accessible, the community is not aware of many other services

Resistance There was resistance from the older Somali women’s group as they believe that FGM is a cultural issue and the media publicity of recent years has not changed their viewpoint on the practice. More work needs to be done with this group as they play a vital role to convince them this practice must stop!

Evaluation The impact of the project was monitored through the number of women who have attended the sessions and booked appointments to attend the FGM clinic. Quotes Amina (Peer Supporter): “By talking to other women about FGM and my experience with it, I gained a lot of confidence and was able to reassure other women that they do not need to go through this alone and must encourage each other to stop the practice for the sake of our daughters” Shadia: “I have found this project very helpful, I am now more aware than ever of the seriousness of the FGM practice in women and I would like to spread the message around to other Somali women within the community”. Shadia has started to campaign against the practice and has asked her family in Somalia to help stop the practice.

Numbers of men & women reached over the last 4 months October 2015 - 22 November 2015 - 36 December 2015 - 33 January 2016 - 42 Total = 133 Organisations engaged over 4 months = 18

Interactive training module to engage with women affected by FGM Working with Dr Geetha Subramanian WHFS Patron to develop a (3 hour) training module where health professionals would have the opportunity to interact and role play on how they interact sensitively with women affected by FGM. The aim will be that health professionals would be more confident in engaging with women to collect (mandatory) information around FGM and also to provide sensitive, positive support to affected women.

Recommendations: Preventative awareness and community discussion around FGM /C need to continued; FGM /C Peer Supporters need to develop their skills further; FGM /C awareness and training needs to be extended to health professionals; Peer support must be provided for affected women to gain access to health services. Work with men and religious leaders within the community needs to develop and continue.

Conclusion This project started in order to raise awareness of the health risks of FGM within the community so it can be prevented and to help and support women affected by FGM. The project succeeded in delivering sessions on FGM to women who have been affected by it or who are at risk of it. It also succeeded in encouraging women to use the service that has been readily available for a number of years. In order to stop the practice the approach has to be multi-faceted e.g. working with health professionals, schools, local authority and voluntary organisations. The women that we were able to reach are keen to help the community stop the practice.

Contact: Sharon Hanooman – CEO Email: sharon.hanooman@whfs.org.uk The Brady Centre 192-196 Hanbury Street London E1 5HU T: 020 7377 8725 Contact: Sharon Hanooman – CEO Email: sharon.hanooman@whfs.org.uk Website: www.whfs.org.uk