“THEY cut out what you are born with, something that’s supposed to be a part of you.” Mehret Yemane is a survivor of Female Genital Mutilation (FGM). Born in The Sudan, she has lived in Ireland for eleven years. She lives in the midlands, but in the wake of Action Aid’s recent call for Cork-based services for survivors of FGM, she’s sharing her painful story to raise awareness in Cork.
“At the end of the day, there’s nothing they can do for me, but I want to make sure that it doesn’t happen to the future generation,” Mehret says.
“Young girls shouldn’t have to go through what I went through, because there is no advantage to it. Only the consequences of constantly feeling not fully a woman.” Female Genital Mutilation is the surgical removal of parts of the female genitalia common in some African, Middle Eastern and Asian countries. The practice is traditionally believed to dampen women’s desires, making them faithful wives. But global activists are calling a halt to the practice, and reframing it not as a necessary rite of passage, but as a form of violence against the female body.
It is known that over 3,700 adult migrant women with FGM are living in Ireland. Now, Irish activists, health care professionals and NGOs are warning that the silence must be broken on the risk to young girls living in Ireland, who may be Irish citizens. Some of these girls may even be at risk within the state; in Action Aid’s study, released in January, a survey revealed that just one in five migrants interviewed were aware that FGM is illegal in Ireland.
Mehret’s message, both for immigrant communities from FGM-practicing countries and for their Irish friends and neighbours, is stark and simple: “It is child abuse,” she says. To mothers from FGM practising countries, she says: “Even if it happened to you, just make sure that you know better and that you don’t pass it on. It can stop with you.” Having campaigned for better recognition and services for women with FGM in Ireland, Mehret was one of the activists who worked with AkiDwA, the Irish migrant women’s network, on the bill that eventually illegalised FGM in Ireland. There is currently one case pending relating to a child in Crumlin whose relatives may have performed FGM on her within the state; it is the first prosecution under the legislation passed in 2013.
Mehret agrees with Action Aid that there are girls at risk in Cork. She says it is more common for girls to be flown back for a holiday to their parents’ country of origin to undergo the procedure, but that girls are also at risk within Ireland. “When they can’t do it by bringing a child back home, sometimes it’s cheaper to fly the practitioner to Ireland to get it done,” she says. “But if no-one speaks out, you’ll only see it if kids end up in hospital.” Mehret herself was operated on not once, but four times, with the last occasion occurring when she was ten years old. “It was a relation who did the mutilations in the family,” she says. “I don’t know why, but she kept coming back for me and saying, ‘the last time I didn’t do it properly, I need to take more.’ My mother didn’t know better. She was of a generation where that was a normal thing to do.” “They celebrate you for a week, and your friends come and they hold your legs open and fan you because it is so hot, and hold a party,” Mehret says. “It’s considered a rite of passage, but now I know that what happened to me was wrong.” The last time Mehret returned home, in 2012, her mother apologised for permitting her to be cut.
Variants of FGM can include removing the visible part of the clitoris and the protective labia, and in some cases, known as infibulation, also involve stitching closed the opening to the vagina, leaving just a small hole to pass urine and menstrual blood. This leaves women at the constant risk of infections, and in a higher category of risk during childbirth.
Although Mehret is not infibulated, she still deals with the complications caused by the removal of her clitoris and labia. “I suffer with infections all the time,” she says. “I have to be careful how I wash; everything can irritate me, because they took everything that’s there naturally to protect you.
All those exterior parts are there to protect your reproductive organs. Your sexual life is out the door because there is so much nerve damage.” But Irish health care practitioners, especially outside the capital, are not well equipped to deal with FGM, she says. Women with FGM can have complex healthcare and counselling needs; there is currently one clinic, in Dublin, that specialises in treating women with FGM. “We need to reach health professionals, midwives, schools and creches,” Mehret says, adding that there appears to be an educational deficit within the HSE when it comes to FGM.
UCC final year medical student Ruth Nagle conducted a survey of health care practitioners in hospitals in Cork, Waterford and Wexford that certainly seems to support Mehret’s assessment. The results of Ruth’s survey are troubling. 71% of the 112 doctors, nurses and midwives she surveyed had encountered at least one case of FGM, and half of these had seen more than three cases, but:
-65% said that they did not screen for FGM in women from at-risk countries. Of these, -44% didn’t broach the subject with patients because it was “culturally sensitive,” while 43% said they didn’t have enough knowledge to engage with patients on the topic.
-45% said that they most frequently first encountered FGM in a patient during labour or delivery.
-almost 70% of doctors surveyed said that they may have failed to detect FGM during an obstetrical examination.
- 35% said they didn’t know that reinfibulation (re-stitching of the vaginal passage following delivery) was illegal in Ireland. One commented that they had seen it performed.
-92% said they wanted to receive additional training on the topic.
Dr Máiread O’Riordan, Consultant Obstetrician at Cork University Maternity Hospital (CUMH) confirms that there have been cases of women and family members requesting reinfibulation following delivery at CUMH. “We do education, and it’s on the curriculum,” she says. A new electronic chart system now provides for screening for FGM: “Now, every time I conduct a vaginal exam, it is one of the questions I must consider.” However, even if FGM can be detected when women access maternity services, Dr O’Riordan says, this doesn’t mean that non-childbearing women are seeking healthcare for the side-effects of their FGM. “I’m sure that a huge number of women will avoid presenting,” she says.
Dr Caroline Munyi is the Project Coordinator with the “AFTER” (Against Female Genital Mutilation / Cutting Through Empowerment and Rejection) project, Action Aid Ireland’s first dedicated anti-FGM programme in Ireland.
“Cork is Ireland’s second largest city and we have a huge migrant population living in Cork,” she says.
“A gap was identified that there’s a need to create awareness and work with the women who are in Cork, because currently all the services are concentrated in Dublin.” “When it comes to whether or not there are cutters operating here, we suspect that it is happening,” Dr Munyi says. “One way we identify children at risk is when a mother goes to the maternity hospital and gives birth to a baby girl. If the woman herself has been cut, that child is automatically a child at risk because, for cultural reasons, that mother is more predisposed towards having a child that will be cut.” Referring these women to social workers for support, and enforcing the law, are both important tools in protecting at risk children, Dr Munyi says, but the largest change is an attitudinal one.
“FGM must come to be regarded as a form of violence against women,” she says. “We are trying to create awareness amongst women about their rights so that such practices can’t thrive. We need to show the women what we call their ‘basket of choices’: that they can break the chain and not pass the practice on to a next generation.”