• Rowenna Davis
• The Guardian,
• Tuesday July 22 2008

Yasmin is beautiful. She has long black extensions, perfect cheekbones and Bambi eyes. She sits opposite me sipping pineapple juice in blue jeans, her large hoop earrings sparkling. She could be a model, but this 19-year-old is dedicated to her BTec in health and social care.

"I want to become a social worker so I can stop other girls going through what I went through," she says. "Female Genital Mutilation is not taken seriously enough here - people really don't believe that it's going on."

Female Genital Mutilation is not a problem reserved for distant tribes in foreign lands - it affects British girls in UK classrooms. As the summer holidays approach, families are booking international holidays for their unsuspecting daughters, the long stretch providing the perfect opportunity for circumcision.

Brutal lessons

If you watch closely, you realise that Yasmin shuffles as she talks. This is because of the Female Genital Mutilation carried out on her in Sierra Leone when she was 14:

"One morning my uncle just woke me up and took me to the house of a woman I didn't know. They tied my hands, blindfolded me and took off my pants. I was tall and I was fighting, but the woman sat on my chest. I couldn't scream - they put a cloth in my mouth. It felt like I was suffocating."

Yasmin pauses, looks down at her hands. "There were no anaesthetics, they just cut me," she says.

The latest research from the Female Genital Mutilation charity Forward suggests that 20,000 girls may be at risk in the UK, 6,000 of whom are based in London. Most Female Genital Mutilation takes place at primary school age. Forward says the average age is eight,but that this is declining as families try to avoid detection.

Although there are many different types of Female Genital Mutilation, almost all involve the removal or cutting of some part of the female genitalia. Health risks from this practice include urinary tract infections, infertility, and the spread of tetanus and HIV from unsterilised blades. Because most Female Genital Mutilation is carried out on young children under duress, there is almost always a psychological fallout.

Female Genital Mutilation may take place behind closed doors, but the results are seen in classrooms. Yasmin says that her studies were affected for years afterwards, with problems all the way through her BTec.

"I had to keep asking my teacher if I could go to the bathroom, and my classmates couldn't understand why I got so upset sometimes. I was always getting infections, and my period was so painful that I had to take time off every month."

The clues left by Female Genital Mutilation can often escape busy teachers' radars. Even when recognised, the signs can seem too ambiguous to address. Many teachers would rather push nagging worries to the backs of their minds than bring such culturally sensitive issues out into the open.

These problems have been recognised by Jennifer Bourne, a specialist worker at the African Well Women's Service in Waltham Forest in London. Bourne's team was involved in drawing up guidelines for safeguarding children from Female Genital Mutilation in London, and they have recently started going into schools to offer teacher training on the subject. "Teachers are worried about how to approach families," she says. "People are naturally afraid to raise the subject, and if they're not informed then it becomes even more difficult."

Talk to the families

But she insists that communication is essential. "Most families are receptive to conversation; it's how you approach them that matters. Talk to them about their holiday; say that you understand members of their community practise circumcision Female Genital Mutilation and let them know what the law is."

Female Genital Mutilation has been illegal in the UK since 1985, but new legislation in 2003 in England, Wales and Northern Ireland, and in 2005 in Scotland, also made it an offence to force a child to undergo Female Genital Mutilation abroad. If a teacher has reason to believe a child may be vulnerable to Female Genital Mutilation and fails to take action, they may be liable for negligence.

"Teachers tell us they're worried about being seen as racist, but they have a statutory responsibility to safeguard children and protect their welfare," says Clare Chelsom, an officer working for Project Azure, the Metropolitan police's leading team against Female Genital Mutilation.

This month, Project Azure will launch its annual awareness campaign to stop children being taken away over the summer. Chelsom says that its focus is prevention rather than prosecution.

"We know that Female Genital Mutilation can be seen as an act of love for children. We know that some parents would like to say no to FGM but feel under pressure. We're more interested in the perpetrators making money from this practice than the parents."

Despite the new legislation, there have been no convictions, something that Chelsom puts down to massive under-reporting. "According to our records, Female Genital Mutilation doesn't even exist," she says.

"Like most cases of child abuse, we have to rely on a child telling on their parent or in some cases their whole community. There may be fears of authority, language or immigration issues. In some cases, hard to reach communities may not even know the law."

Although often justified on Islamic grounds, Female Genital Mutilation is generally confined to particular ethnic and tribal groups. In certain countries it is mainstream, with prevalence rates reaching as high as 98% in Somalia. In the UK, an estimated 279,000 women have undergone Female Genital Mutilation although they hold British passports.

Girls who speak out against circumcision are vulnerable to a backlash from their communities. This was what happened to Salimata Badji Knight, who underwent Female Genital Mutilation in Senegal when she was four years old. After moving to Europe she started campaigning against Female Genital Mutilation, openly giving media interviews and touring schools.

"I was isolated for many years," she says. "Death threats were sent to my house and I wasn't welcome in certain parties. I don't want to vilify my community, but as a woman I want the freedom to celebrate my femininity. It's very difficult to communicate this message."

Yasmin was also scared of speaking out. Before agreeing to talk to me, she made me promise that I would change her name and not include any photos. Like many women in her position, the shadows of of the past still hang over her. "It took me three years to tell anyone what happened," she says. "I tell my story so that no one else has to go through it, but I'm scared someone will attack me because I'm a disgrace."

Yasmin believes that teachers have a key role to play. "Teachers should speak out - if I heard about any of these cases, I'd be the first one to tell the police."

Fashion supermodel Waris Dirie, an Female Genital Mutilation victim her foundation has put up half of the £10,000 reward (c)

MORE than 1,000 women and girls in Waltham Forest are likely to have experienced female genital mutilation (FGM).

This information emerged as the Metropolitan Police launched Project Azure on Tuesday, offering a £20,000 reward for information that leads to the UK's first ever prosecution for Female Genital Mutilation, a dangerous form of child abuse (see page 2).

Sometimes misleadingly called female circumcision, it leaves a woman in physical pain and emotionally scarred for life.

Some girls die from haemorrhage, infection or shock after Female Genital Mutilation has been carried out.

One of the speakers at the launch was specialist nurse Jennifer Bourne from the African Well Women's Clinic, based at the Community Health Centre, in Kirkdale Road, Leytonstone, and run by Waltham Forest Primary Care Trust.

The service offers black women advice and support on health issues.

Ms Bourne said: "Many people are affected by Female Genital Mutilation in our borough. We need to look at the funding going into services to tackle it.

"The mental health implications should not be under-estimated and many women who come to our service have long term complications such urinary problems, menstrual problems and trouble having children.

"I am really excited the police have got this together today. The profile has been raised."

In some African countries more than 90 per cent of the female population have suffered.

Ms Bourne said:"The last census showed that there were more than 1,000 young girls in the borough of black African origin from Nigeria, Ghana, Somalia and Kenya. These countries practise Female Genital Mutilation.

"Young women have come to us in the past and also said that Female Genital Mutilation is happening in Waltham Forest, but because it is hidden it is difficult to know whether this is still the case."

Ms Bourne said she has been aware of victims of Female Genital Mutilation as young as seven days old.

She said that many young girls do not realise what is going to happen to them and are merely aware that they are going for a "special celebration."

But she said: "Through the work we do there has been a change within the communities, there is beginning to be a shift in thinking.

"Many women saying they won't have it done to their daughters. It is changing, but it is still going on."

Leyla Hussein, a youth outreach worker at the African Well Women's Clinical Centre, said: "Some young people actually ask their parents to have Female Genital Mutilation done, but they didn't know what it is.

"They fear they will be isolated and considered dirty and nobody will marry them if they don't have it done."

l For information about the African Well Women's Clinic call 8928 2244.

POLICE are offering a £20,000 reward for information that leads to the UK's first ever prosecution for female genital mutilation.

On Tuesday the Met announced a new clampdown called Project Azure, which aims to combat Female Genital Mutilation perpetrators operating in the UK and people who take their victims abroad.

Female Genital Mutilation is believed to affect about 60,000 women and girls in the UK, and is prevalent in boroughs with higher proportions of African immigrants, such as Waltham Forest.

The launch featured four speakers, including Waltham Forest Primary Care Trust's Female Genital Mutilation specialist nurse Jennifer Bourne.

The head of the Met's child abuse investigation team, Det Chief Supt Alistair Jeffrey, said the project was being set up now to co-incide with the start of the summer, a time when some young girls and children are taken abroad for Female Genital Mutilation.

Det Chief Supt Jeffrey said: "It is child abuse, pure and simply, it is happening in London and we want to stop this.

"We want to get this message across now and prevent children being subjected to these attacks.

"This is not an attack on somebody's culture, it is an attack on those that abuse children."

It is illegal in the UK to carry out Female Genital Mutilation, or to send children abroad to have the procedure carried out and is punishable by up to 14 years in prison.

* People with information about Female Genital Mutilation should call police on 7230 8392 or Crimestoppers anonymously 0800 555 111.

FEMALE Genital Mutilation, also known as circumcision, involves girls of all ages, including children, having their genitalia removed.

The procedures are usually carried for cultural or religious reasons and can range from injury to the clitoris to complete removal of the labia and clitoris, which is then sewn up leaving only a tiny opening.

Parents usually send their children abroad for Female Genital Mutilation and it is often carried out in unsanitary conditions, without an anaesthetic and using instruments such as tin lids or razors.

The practice is widespread in 28 African countries and a handful of Middle Eastern nations and there is evidence that it is happening in London.

Female Genital Mutilation often leads to long term medical problems, including urinary and menstrual problems, severe infection and infertility.

It can have long term mental health implications, including flashbacks. Met child abuse investigator Det Insp Carol Hamilton said: "We cannot stand by still while our girls are being taken to foreign countries and mutilated in this way.

"It is totally unnecessary. There is nothing in the Bible or the Koran that mentions Female Genital Mutilation.

"We all accept and embrace cultures and customs in different communities, but cultural acceptance does not include accepting the unacceptable."

Theory explains why 25 percent of cultures cut male genitals

Katoucha Niane family seek inquiry into death

The family of African-born former supermodel Katoucha Niane have asked French judges to investigate their suspicions that she was murdered after her body was found in the River Seine nine days ago.

he 47-year-old Guinean-born ex-model, who at the height of her career was Yves Saint Laurent’s muse, had been missing since the night of February 1, when friends accompanied her home after a party at which considerable amounts of alcohol were consumed.

However, her family have now filed a legal complaint with a French investigating magistrate, saying they suspect she was murdered.

Roland Dumas, former Socialist Foreign Minister under Francois Mitterrand and the former head of France’s highest legal body, the Constitutional Council, has agreed to represent the family as their lawyer.

He said the family had "serious doubts" about the French investigation following the discovery of Katoucha’s body and had requested a second autopsy.

"The family told me that Katoucha’s face was intact, which is troubling after a month in the water," he said. "Katoucha’s father has many questions" about the circumstances surrounding his daughter’s death.

"An investigating magistrate will automatically be designated on Monday," Mr Dumas added.

Tests are under way to determine whether the ex-model had been under the influence of alcohol or drugs at the time of her death.

In her autobiography, Dans Ma Chair (In My Flesh) published last year, Katoucha admitted that she had misused drugs as well as alcohol and had suffered from bouts of mental illness.

The daughter of the writer and historian Djibril Tamsir Niane, Katoucha was born in Conakry, the capital of the former French colony of Guinea, in 1960.

Her book describes her happy, privileged childhood, until the day, aged nine, that her French-educated mother told her they were going to the cinema to see the Beatles film Help!

Instead, her mother handed her over to an aunt to be circumcised according to ancestral custom, an agonising procedure which was carried out without anaesthetic and in filthy conditions.

She fled to Paris in 1980 after being sexually abused as a teenager and falling pregnant at the age of 17.

She quickly climbed into the top echelons of the Paris fashion world, becoming a star of the catwalks and succeeding the French Carribean model Mounia as Saint-Laurent’s "ebony princess".

After retiring from modelling in 1994, she launched her own clothing label Katoucha the following year and founded a campaign against genital mutilation, Katoucha pour la Lutte Contre L’Excision (KLPCE).

She travelled across Senegal visiting villages to try to persuade women to give up the practice.

Before she died she was planning to establish an orphanage there.

On Friday some 500 people, including Naomi Campbell and Pierre Bergé who represented Yves Saint Laurent, attended a memorial ceremony for the ex-model at the Grand Mosque in Paris.

While doctors regulate themselves, the innocent suffer

THE evidence against the doctor they call "the butcher of Bega" is horrifying enough. Graeme Stephen Reeves ruined the lives of scores of women by mutilating their genital organs with surgical procedures that were usually botched and often unnecessary — and which he should not have performed at all, given that he had been banned from performing obstetric work after the death of a patient and of a baby.

But even worse than the actions of one criminally careless and dangerously deluded doctor is the fact that a brotherhood of fellow practitioners failed to stop him. In fact, it seems that the quaint, cosy system of self-regulation Australian doctors enjoy actually helped to bury the truth about the damage Reeves inflicted on women placed in his care.

Other surgeons called in to attempt to repair Reeves' botched operations knew who was responsible but it appears that they — and other hospital staff — preferred to observe a code of silence of the sort usually associated with organised crime: an appalling silence that is completely at odds with the Hippocratic oath doctors swear but which too many of them seem to regard as a relic.

Disturbingly, as shown in William Birnbauer's report today, the Reeves case is only one among many that underline a gaping hole in our system of medical regulation. In one case a woman came forward after 20 years of hiding her pain to reveal the sexual abuse she had suffered from her psychiatrist. She worried that she would not be believed — and she was right. When she went to the Medical Practitioners Board in Victoria she was "grilled" as if she were on trial, an ordeal that had the effect, intended or not, of intimidating her. Her case mirrored that of victims of a Melbourne dermatologist who last week pleaded guilty to a series of rapes and indecent assaults on female patients at his three suburban practices between 2001 and 2007. In common with other victims who complained about Dr David Wee Kin Tong's predatory and disturbing sexual assaults, she felt there was a sense that the board was protecting its own. It is not difficult to see why. As one angry woman said: "Trust was put in the hands of a professional and that was abused. All of it could have been avoided had the medical board acted."

It is not doctor-bashing, nor any reflection on thousands of dedicated medical practitioners, to say that the current system of self-regulation is too weak to be trusted to weed out the incompetent, the predatory, the mentally unbalanced and the drug-addicted from their ranks. Some doctors continue to argue that self-regulation is a right but The Sunday Age backs the proposition that it is a privilege.

It is vital that a fearless, independent regulator has the power to investigate doctors who abuse patients' trust. On this, physicians cannot be expected to heal themselves. Governments must act.