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?