A flurry of surveys and studies

A girl prepares for perhaps a clitoridectomy in Indonesia

The FGM world has been active in the last few days. No one has told it that it's summer.

Firstly, news of a DoH funded intiative in partnership with FORWARD. It is a questionnaire that goes out to various health professionals in the UK, asking about their interaction with FGM over a certain time period.

Secondly, a study that FORWARD has released, called rather heartbreakingly: "FGM is always with us" - experiences, perceptions and beliefs of women affected by FGM in London.

Thirdly, a services and support guide to FGM, particularly aimed at young people and teachers. It tells in extremely plain language who is at risk, what to do if you suspect a girl is at risk and gives a list of support services that people can access.

All can be accessed from www.forwarduk.org.uk

Fourthly (yes, there's more!) UNFPA have put out their Global Consultation 112 page report into FGM, its trends and issues for maternal and newborn health (here: http://bit.ly/5uhmi)

But the wider issues continue. In the twittersphere, @taskforce FGM tweets: "Reflecting the last days: studies, conferences, blablabla: Damn hypocrisy! When will UN & Co. start to truly ACT for an end of #FGM?"

One of the things I've noticed more since my involvement in this world is that things are changing slowly - we have heard of women who have decided not to cut their daughters, of villages that have abandoned the practice.

Partly this is a communications issue - who is telling the stories? Who is saying what is happening that is positive? But also, who is doing the proper monitoring and evaluation? How to work out if the situation is improving?

A few years ago, the statistics used by the UN jumped. It used to be two million girls a year were affected by FGM. Now it's stated that it's three million girls a year. A sudden jump of one million. The range of those living with FGM is in the region of 100 - 140 million. Yet even a cursory mathematical glance shows how difficult this is. If Indonesia has a population of 250m and therefore, about 125m are women, and at the very very lowest, say there's a 20% prevalence rate (although we know it to be higher) - already that's 25m women, without taking on Africa at all.....

Some may argue that Indonesia practices type 4, which is scraping or pricking the clitoris. But a USAID report from 2005 states that because of the medicalisation of FGM, nurses are using scissors instead of a blade, and of course the easiest thing to do with scissors is to cut the entire clitoris off, so clitoridectomies are growing in Indonesia.

So how to know if any change is being made if we are unable to start with a baseline figure that everyone agrees upon?

And even if we have a good baseline, how to monitor it and ensure we are changing anything?

As ever, we are reliant on local action, global voices.

As summer holiday season clouds to an end, I am slightly heartened that things are happening on the FGM front. But is it enough?

August, holiday mode

Today, the offices are quiet. Offices everywhere are quiet. Outside is a beautiful summer's day, with achingly blue skies. Opposite me is an oil painting done by a women who has gone through FGM. She sits naked, legs apart fearfully gazing down between them, at a present - a wrapped yellow box with green flowers on the paper. It has an orange bow. A veritable gift. Onto the gift are fallings, streams of her blood, intermingling with the tears coursing down her face. It seems to sum up the fearful juxtaposition of the gift and celebration by which FGM is ushered in.

My mission is to look at the inbox from the website, that handles general enquiries.

A heart-rending mix. Some are straightforward requests from healthcare organisations wanting training, others are about linking to our website. So far, so good. But the ones that make me pause for a time and stay with me on the bus home are about people asking for help. Real help. Mothers and fathers, boyfriends, girls themselves. Some are UK based, others are wider afloat. All have their own story.

In a recent discussion about sexual health and reproductive rights and women being able to access their own sexual pleasure, I was struck by how FGM precedes this whole discusion. How to access these if girls are wounded at such a young age?

As ever with my blog, more questions than answers.

I leave you with two thoughts - one is that a recent study in Iraqi Kurdistan showed a prevelance rate of around 80% FGM (here: http://tinyurl.com/ptx98s) the second is that Egypt has arrested its first person for practising FGM (here: http://bit.ly/v5jxK)

Coming at it from a different angle...

You'll know that I've been struggling with the "direct intervention" ideas behind eradicating FGM. If it were that easy, it would have ended years ago. Various people have talked to me about systemic change and not looking at the problem head-on.
Two recent news stories made me ponder.

The first, in The Huffington Post, by H'Rina DeTroy outlines a new practice in the Sudan (80% prevalence) where women are communicating through henna designs on their hands that they do not want their daughters to undergo FGM:

"Called the henna technique, a special design dyed temporarily on the skin can indicate to a midwife that a mother wants to avoid genital mutilation on her daughter. The tattoos serve as a bridge to discuss what is traditionally taboo. In turn, a midwife can stage a fake circumcision."

NGOs are apparently teaching midwives how to fake FGM and henna artist is the go-between that allows the mother to safely communicate what she wants to happen to her daughter. What is wonderful about this "intervention" is that it purely picks up on the mother's wishes and communicates it in a way that is kept within the women's "code" of communication. I wonder how the midwife "fakes" it? Just a small nick to the clitoris perhaps?

Here's the full link to the story: http://bit.ly/1a1Gqu

The second story was equally compelling. A report for Women's Hour on another NGO in India, that is teaching girls to play netball. This freedom of expression through sport has led to a strong sense of freedom of expression overall. Of course, the girls are also taught other skills and are offered training courses in wider issues, such as HIV/AIDs and Sexual Reproductive Health but the netball has seemed to have had the most positive impact.

The report states that child marriage (14/15 years) is still very prevalent in the area of India that they are working in and a girl's voice is unlikely to be heard. Through this empowerment, this physical allowance of getting girls to express themselves through sport, they are literally more free to express themselves in the home. Link to the BBC website below.

It's, once again, far far too late to be posting. But I feel slightly invigorated by this - and by, finally a long talk with my best friend and my god-daughters, oh so far away.

Sleep well, all.

http://bit.ly/I9ZDA