More than 30 years ago, I began working in the NHS and became concerned that health professionals were ill-equipped to deal with women living with female genital mutilation (FGM). I researched what doctors, midwives and nurses knew, and found they had a lack of knowledge, and with this came a lack of understanding about women who would consider allowing their daughters to be subjected to FGM.
I founded the African Well Woman's Clinic at Guy's and St Thomas' NHS Foundation Trust (GSTT) in 1997. GSTT serves a large multicultural community, including refugees and asylum seekers, and they recognised the need for a specialist. At the time, I was the only FGM specialist midwife in the UK; we now have several clinics and midwives in this role. This has benefited women, as screening for FGM has become an integral part of midwifery services.
Women often feel nervous about coming forward and talking to a health professional about their FGM, because they feel that the professional won't understand, or that they will be judged. For this reason, it is important for professionals to know how to help women and sensitively care for them, so that women can feel comfortable talking about their experiences.
FGM is recognised worldwide as a fundamental violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes and constitutes an extreme form of discrimination against women. FGM violates a person's right to health, security, physical integrity, and to be free from torture and cruel or degrading treatment. Sometimes the procedure even causes death.
I have engaged with key players around FGM—governments, professional bodies and communities—at an international level. I also endeavour to work closely with the communities affected by FGM. My passion and fight to end FGM in one generation led me to visit Nigeria this year, along with representatives from the Guardian newspaper, to establish a dialogue with some circumcisers at the Summit to End FGM in Nigeria, held in Ibadan on Monday 23 May.
As a result of a scoping visit in Nigeria with Sister Efua Dorkenoo in 2014, along with my visits in February and May 2016, I have decided to set up the first ever FGM clinic in Nigeria. The aim is to provide support to women and girls living with FGM in a safe and welcoming environment.
Unfortunately, the practice of FGM is still widespread in Nigeria; the country has the highest absolute number of cases of FGM in the world, amounting to about a quarter of the estimated 115–130 million women who have been cut throughout the world.
My most recent visit to Nigeria was very successful. We provided training to a Nigerian media team so that they could be empowered to go back to their local areas to enlighten their communities with the aim of bringing about change. We collaborated with and had support from chiefs, Obas, and community and religious leaders. This is key in moving the campaign forward and ending FGM.
Some of the young people I spoke to felt that they need more support to question and challenge their communities, especially the elders.
This visit to Nigeria was a real eye-opener for me. I wanted to see for myself what was being done to facilitate attitudinal change and support for girls who may be at risk of FGM, then share my learning and experience with colleagues in the UK.
I always raise the question: now that we are aware of the consequences of FGM, what services do we have for women and girls living with those consequences? I believe it is very important to set up a service in Nigeria as this type of offer is currently lacking. There is a great need for psychosocial and psychosexual support. While I was in Nigeria, I had more than 20 young women coming to my hotel room for advice and support. Their needs were focused around sex, emotional issues, contraception, infertility issues and holding onto their marriages—some of them feared that their lack of sexual interest due to FGM might encourage their husbands to leave them. I will now write a proposal and look for funds to offer a support service in Nigeria.
I strongly believe that we are still failing thousands of girls and women, and I urge all professionals and communities to work in partnership. Meanwhile, governments must encourage a better structure and guidelines for all concerned.
I will continue to campaign tirelessly to raise the profile of FGM at both a national and international level.