1. FGM in Ireland and Abroad
Mairead Hamill*, Fionnuala Kennedy*, Stacey Li Hi Shing*, Fiona O’Driscoll*, Louise Ward*, Dr. Ream Langhe.
Introduction
According to WHO Female Genital Mutation (FGM) refers to all procedures which involve the partial or total removal of the external genitalia or injury to the female genital organs whether for cultural or any other non- therapeutic reasons. It is classified into four distinct types:
Type 1 or Clitoridectomy comprises of the partial or total removal of the clitoris. The prepuce may also be removed. Type 2 predominantly involves the partial or total removal of the clitoris and the labia minora (and sometimes the labia majora).
Type 3 or Infibulation. The vaginal opening is narrowed by creating a seal (formed by the cutting and repositioning of the labiae with or without removal of the clitoris. Type 4 covers all other damaging procedures to the female genitalia for non-medical purposes, e.g. cutting, piercing and cauterization. According to UNICEF, there are greater than 125 million females who have been subject to this procedure in the 29 countries in Africa and the Middle east where FGM is most practiced. Many more girls and women who make up the immigrant population of Europe, America and Australia have also been cut.
AkiDwA
Akina Dada wa Africa (AkiDwA), Swahili for African Sisterhood, was established in 2001 by 7 migrant African women now living in Ireland. It is a minority ethnic-led, non-governmental organization with charitable status that represents migrant and indigenous women living in Ireland. Their aim is to enhance their integration in Ireland, to develop evidence based and representative solutions for them regarding Gender Based Violence(GBV) and Gender Discrimination. FGM is viewed as a form of GBV and also a
Culture and Beliefs
Female genital mutilation is seen as a rite of passage in many cultures and there are various belief systems underpinning this custom. The practice is most commonly seen in societies where the woman’s virginity is a necessity for marriage and thus ensures their chastity and faithfulness to their husband. FGM is also thought to promote fertility, reduce miscarriages and still births whilst increasing the man’s sexual pleasure. These supposed benefits all make for an attractive partner and the person carrying out the act usually sees it as bestowing honour upon the young woman and her family, protecting them against social exclusion. A young girl whose family decides against FGM is often viewed as ‘unclean’ and the family’s standing in society may suffer. Contrary to popular opinion, FGM has little to do with religious beliefs as the custom predates Islam and is not mentioned in the Quran. However it’s mainly practiced in Muslim communities and the practice over the centuries has certainly acquired a religious dimension. However, this appears to be changing as many religious leaders have denounced FGM as a requisite for women practicing Islam.
violation of rights of women and girls. AkiDwA’s key strategies to eradicate FGM are through networking, policy work and individual and organizational capacity development. Up to date, their work has been:
Identifying the needs of and supporting women and girls who have undergone FGM.
The development of supports for Health Care Professionals by providing information, workshops and training to enhance professional capacity with regards to FGM.
Delivery of lectures and seminars to student midwives and social workers on FGM.
Progressing Ireland’s National Plan of Action to address FGM, including lobbying for legislation in Ireland to prohibit such practices. The Criminal Justice (Female Genital Mutiliation) Act 2012 was signed into law.
Working with other European partners on the End FGM European Campaign for a harmonized European Union legislation.
FGM in Ireland and the UK
Ireland is fast becoming a multicultural society. Though not native to Ireland, we now have an estimated 3780 women who have undergone FGM. Despite this, a recent survey of GPs states that 65% of them would not recognise the symptoms of FGM.  Since 2012, the procedure has been illegal in Ireland. This includes carrying out the procedure or helping a child to procure the procedure by bringing them to a country where it is not illegal. Britain have had a similar law since 2003,
with a maximum sentence of 14 years imprisonment.. Even though there is anecdotal evidence stating that FGM still occurs in Ireland, no one has been brought to court. Even in the UK, it is only recently that the first person was arrested under this law. Dr. Dharmasena was arrested for stitching a woman postpartum and effectively redoing the FGM carried out on her as a child; he was acquitted on February 4th In May 2014, the HSE funded Ireland’s first FGM Clinic in Dublin with the Irish Family Planning Association. Dr Caitriona Henchion is the Medical Director of the clinic and has treated about 12 patients who have had FGM in the last year. A very high percentage of these women have required corrective surgery, though the procedure cannot be completely reversed
The Effects of FGM
Acute consequences of FGM include haemorrhage, severe pain, problems passing urine, infection and death, with more severe side effects most commonly seen following infibulations. In addition to these, women also experience various adverse long-term physical, psychological and sexual effects. Such complications include chronic pain, recurring infection, cyst and abscess formation, scarring, diminished sexual enjoyment and PTSD. Along with these, infundibulations carry additional risks of urinary and menstrual problems, infertility and painful sexual intercourse. Sexual intercourse can only take place after opening the infibulation, through surgery or penetrative sexual intercourse. When giving birth, scar tissue is more liable to tear, labour can be prolonged and obstructed which may give rise to secondary complications such as obstetric fistulae, and there is an increased incidence of postpartum haemorrhage and recourse to episiotomies. For women who have undergone infundibulations, the opening must be cut to facilitate the passage of the baby through the birth canal. After childbirth, women from some ethnic communities must undergo reinfibulation whereby the opening is sewn back up. Multiple manipulative and invasive procedures on the genitalia such as this result in painful scar tissue formation and increased risk of infection.
Research launched by IFPA in 2008