1. Female Genital Mutilation/ Cutting Gillian Kariuki Program Coordinator – Refugee Women Health and Safety WHS

2. Introduction > FGM Program Goals > Definition of FGM > History of the practice > Types of FGM > Prevalence of FGM > Reasons given for the practice > Health consequences > Health needs of the women affected by FGM > Efforts to address FGM > What the law says about FGM in SA > Assessing the controversy

3. FGM Program goals > To prevent the occurrence of FGM in South Australia through an emphasis on community education, information, referrals, advocacy, linkages and support. > Promote community awareness of health and the psychosocial effects of the practice of FGM. > To develop culturally appropriate information and educational resources for women and their communities. > To provide education and training for professional groups on the prevention and illegality of FGM in SA.

4. Definition of FGM > Female Genital Mutilation is defined, as comprising ‘all procedures that involve partial or total removal of the female genitalia and /or injury to the female genital organs for cultural or any other non-medical reasons’. (WHO 2000a) > Communities’ definition of FGM

5. International symbol of FGM

6. History of the practice > Mummies of Egypt dating back to the 16th century. > In Roman times forms of Infibulations was used on female slaves as a form of contraceptive(French,1992) > United States (1890s) FGM was practiced by doctors to cure female weakness > Western countries including England have used FGM to “cure” women for psychological ailments and so called “female deviances”(Toubia 1995,p.21)

7. Partial or total removal of the clitoris.Other terms used to describe Type 1 procedures include circumcision, ritualistic circumcision, sunna, clitoridectomy. Types of Female Genital Mutilation - Type 1 :

8. > Excision: Partial or total removal of the clitoris and the labia minora including partial or total excision of the labia minora. Type II:

9. > Removal of part or all of the external genitalia and stitching and/or narrowing of the vaginal opening (infibulations) leaving a small hole for urine and menstrual flow Other terms used to describe Type III procedure include Pharaonic circumcision and Somalian circumcision Type III:

10. Type IV: Unclassified: > Pricking, piercing or incising of the clitoris and/or labia > Stretching of the clitoris and/or labia > Cauterisation by burning of the clitoris and surrounding tissue > Scrapping of the tissue surrounding the vaginal orifice (angurya cuts) or cutting of the vagina (gishiri cuts) > Introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it, > And any other procedure which falls under the definition of female genital mutilation

11. Prevalence of FGM > World Health Organisation estimates > FGM in Australia > With migration, women and girls from these countries are now living in Europe, Australia, New Zealand, Canada and America (Toubia 1995)

12. FGM practicing countries

14. Reasons given for the practice > Tradition > Sociological reasons > Religion > Economics > Aesthetics and hygiene > Gender roles and sexuality > Marriageability

15. Health Consequences of FGM These will depend on the type, practitioner, where it’s performed, and method used. The following are some of the possible consequences > Immediate/short term complications include > Long term complications include > Psychosocial consequences

16. Health needs of the women affected by FGM > Education > Counselling > Regular gynaecological check ups > Intensive ante-natal and post natal care > Restorative surgery (De-infibulations) > Menopausal care > Access to female health care workers and centres

17. E fforts to Eradicate FGM > International response > Australian response > South Australian response

18. International response > In December 2012,the UN General Assembly accepted a resolution on the elimination of female genital mutilation > In 2010 WHO published a Global strategy to stop health care providers from performing female genital mutilation together with other key UN agencies and International organizations > In 2008 WHO together with 9 other UN partners, issued a new statement on the elimination of FGM to support increased advocacy for the abandonment of FGM > Since 1997,great efforts has been made with revised legal frameworks and growing political support with 24 African countries outlawing the practice of FGM > Research show that in most countries, the prevalence of FGM has decreased and an increasing number of women and men in practising communities support ending its practice

19. Australia response > All states and territories have developed laws that prohibit the practice of FGM. > In December 2012,the then PM announced a $500,000 Commonwealth grant to support action to end FGM. > In July,2013 the Minister for Health announced a further $500,000 for 15 new projects aimed at ending FGM in Australia. > The projects will focus on raising awareness in affected communities, training health professionals and gathering more information on FGM in Australia. > A National Compact has been developed which States and Territories have signed and committed to eradicating the practice of FGM.

20. What the law says about FGM in SA In South Australia FGM is covered by section 26 of the Children’s Protection Act,1993 and section 33 of the Criminal Law Consolidation Act. > 33A : Prohibition of female Genital Mutilation (1) A person who performs female genital mutilation is guilty of an offence Penalty :Imprisonment for 7 years. (2) This section applies irrespective of whether the victim, or a parent or guardian of the victim consents to the mutilation > 33B : Removal of child from State for genital mutilation (1) A person must not take a child from the State or arrange for a child to be taken from the State with the intention of having the child subjected to Female Genital Mutilation Penalty : Imprisonment for 7 years

21. References World Health Organization, Female Genital Mutilation: Fact sheet,2012,World Health Organisation, Geneva. Masterson, J.M and Swanson,J.H. (2000). Breaking the Silence, Enabling Change. International Centre for Research on Women. The Royal Women’s Hospital, Victoria,2009, Fact sheet for health professionals: female Genital Mutilation. Brockington, M.H, Assessing the Controversy: Female Genital Mutilation or Legitimate Rite of Passage,(2012).Honors College, Paper 36. South Australian Criminal Law Consolidation Act,1997

22. Conclusion In every culture important practices exist which celebrate life- cycle transitions, perpetuate community cohesion, or transmit traditional values to subsequent generations. These traditions reflect norms of care and behaviour based on age, life stage, gender, and social class. While many traditions promote social cohesion and unity, others erode the physical and psychological health and integrity of individuals, particularly girls and women. Factors such as limited access to education, information, and services allow those that may be most harmful to persist.