On Sunday, as I watch the show again with millions of you, I will be doing so in Bristol with my family – probably in silence – but above all, with pride and the peace of mind that the cycle of FGM has ended in my family. In spite of the bruises and tears along the way, today I can say my niece, Sofia, will know FGM as a historical act and not as a chapter in her life and story.
It used to be near-impossible to talk openly about FGM, but this is no longer the case. Forming major storylines in BBC’s Casualty, Law and Order and now Call The Midwife, and with the help of amazing newspaper campaigns, the silence on FGM has been truly shattered. It is no longer seen as a cultural practice, but rather an extreme form of violence against girls. Groundbreaking work by politicians such as Jane Ellison and Lynne Featherstone have meant that the British public finally knows what FGM is and what measures are needed to end it.
Yet, although there is now much better awareness – and strong policies at UK domestic level at least – funding has not really increased for the front-line organisations around the world, which are leading efforts to end it. Without this, we run the risk of not making progress quickly enough.
FGM is almost universal in the region of East Africa where Nadifa was born. We don’t have separate data for Somaliland, but according to UNICEF, 98 per cent of women and girls have been affected in Somalia – largely unchanged since Nadifa’s time, but is finally reducing at last for girls who are now aged 15 or under.
Women – most of whom are over 60 and many of whom use their pensions to help fund their work – are having the most success in ending FGM on the African continent. They are rarely talked about. Edna Adan quit a highly-paid job at the WHO to set up a hospital in Somaliland and is on the road to training 1,000 midwives as part of her work. In the Puntland region of Somalia, Hawa Aden Mohamed runs the Galkayo Education Centre for Peace and Development, which teaches over 2,000 disadvantaged girls and makes sure that they are protected from FGM. It is a constant battle and Hawa’s life and wellbeing is often at risk.
Some donors and women’s organisations do understand though what’s needed. An international group called Donor Direct Action has set up a fund for African activists, which is named after my late friend and colleague, Efua Dorkenoo, a leading figure in the anti-FGM movement for over three decades. Their rationale is simple – we need to break free from funding international ‘middle-men’ and get as much funding to the frontlines as we can, to enable inspiring women around the world to be able to do even more. It seems like a simple solution because it is.
Leading anti-FGM campaigners on the African continent and around the world know how to do this work. They can be trusted to make the most of every single penny. It’s time we made it easier for them to just get on with doing it.
Ending FGM is finally a tangible reality for the first time I can remember. The UK is twinned with Somaliland in my heart, and we cannot end it in one place but not the other. In making this happen, women like Nadifa and girls like her baby – but born in 2017 – will have a much better chance of living safe and fearless lives on their own terms.
Nimco Ali, the co-founder of non-profit organisation Daughters of Eve, was the victim of FGM as a child and worked closely with show bosses on the BBC drama series.
She said she hopes the story will have a “positive effect” in the fight against it.
An estimated 200 million girls around the world have been put through the procedure, which involves the partial or total removal of parts of the female genitals for non-medical reasons.
Sunday night’s episode of Call The Midwife will highlight the plight of a pregnant Somali woman who is fighting for her life in the aftermath of an FGM procedure.
Nimco told the Press Association that viewers will relate to the character and her storyline, and praised the writers for their sensitivity around the topic.
She said: “I think viewers will see that this is a young woman just like many of them, who needs kindness and understanding.
“The fact that she is given both means so much. I think that’s the most touching aspect of it.
“It mirrors my own personal life in many ways and brings to life what has happened to so many women while giving birth, after having undergone FGM.”
Nimco said: “It is a beautiful episode and very sensitively done. It is hopefully going to have a very positive effect.”
She said: “The writers really wanted to listen – they came to the first meeting passionate about the issue but really wanted to tell the story of a young north Somali woman as true as they could.”
Writers also enlisted the help of campaigner Edna Adan, the former foreign minister of Somaliland and the founder of a maternity hospital in the country.
Nimco said: “(She) was a great help in giving, really, details information about what the midwife could expect having delivered many women with FGM herself.
“The story is told sensitively and there is no judgment, so for them it was about bringing it to life with these key details.”
The episode of Call The Midwife is set against the terror of the Cuban Missile Crisis, as the sisters of Nonnatus House listen to US president John F Kennedy’s ultimatum to Russian president Nikita Khrushchev.
Jessica Neuwirth, founder of international women’s group Donor Direct Action, said it is “fantastic” that shows such as Call The Midwife and others, including Casualty and Law And Order, are bringing the issue into the mainstream.
She said: “Awareness of FGM has increased dramatically in recent years in the UK, but activists working on the front-lines to end it are still not able to access the funds they need to scale up their work in countries such as Somalia, where prevalence is 98%.
“We need to fund efforts locally to end FGM globally and the UK and other governments need to do more to make this happen.”
Donor Direct Action runs an anti-FGM fund for frontline groups, which are ending the practice in Somalia and around the world.
Charity Barnardo’s, which runs the National FGM centre in partnership with the Local Government Association to prevent new cases of FGM in the UK and also support survivors in England and Wales, has spoken about the Call The Midwife storyline.
The centre’s director, Michelle Lee-Izu, said: “FGM, was a shocking discovery for midwives in the latest episode of the BBC TV drama, Call the Midwife, set in the 50s and 60s.
“What’s even more shocking is that this physically and emotionally damaging practice still goes on in the UK today. Despite FGM being illegal here since 1985 there still hasn’t been a single prosecution.
“Barnardo’s is tackling the issue by working with communities through training and education programmes at the National FGM Centre, run in conjunction with the Local Government Association.
“Agencies must also work better together to prevent FGM from happening by identifying girls at risk and helping to prosecute those who fail to protect girls from this type of abuse.”
The show’s creator Heidi Thomas has previously said she wanted to write about FGM for a long time but had to wait until the timeline of the show reached the 1960s.
HARGEISA – It was 9 p.m. when a little girl arrived in critical condition at the maternity teaching hospital in Hargeisa. She had been bleeding all day after undergoing female genital mutilation (FGM) that morning. “When she is brought to us, she is almost dead,” recalled Edna Adan Ismail, the founder of the hospital and a pioneer in the effort to eradicate FGM.
“How could you do this?” Ms. Adan remembers asking the girl’s family. The mother replied, simply, “We wanted to purify her.”
In 2002, after working for the United Nations and World Health Organization for over 15 years, Ms. Adan, a nurse and midwife, opened the Edna Adan Maternity and Teaching Hospital in Hargeisa. Since 2006, the hospital has worked with UNFPA to develop and implement a midwifery curriculum. At Ms. Adan’s own insistence, no midwife or other health personnel can enrol in the training programme without first agreeing to work towards ending FGM.
“I insist that if you are going to be a health worker and you are going to be a midwife or a pharmacist or a lab technician or any other health professional who is trained in my hospital, then you need to commit to me that you are going to fight FGM,” she said.
Medical complications common
FGM, a practice that involves altering or injuring the female genitalia for non-medical reasons, can cause chronic pain, infections, increased risk of HIV transmission, birth complications, infertility, and even death. It is internationally recognized as a violation of the human rights of girls and women, yet 98 per cent of women aged 15-49 in Somalia have undergone some form of the practice. While rates of FGM appear to be declining, Ms. Adan says, it is still “far from [where] I would like it to be.”
Her hospital confronts the effects and complications of FGM on a daily basis. Cases have included girls who are haemorrhaging or unable to pass urine because of their stitches. Often, the girls have been cut hours or sometimes days before being brought to the hospital. In the most severe cases, not enough skin remains to allow health workers to suture the wound.
The hospital also sees frequent labour complications stemming from FGM, including prolonged and obstructed labour, foetal distress, and even stillbirth.
Fighting the tradition of FGM “I cannot keep quiet about this because it is prolonging labour. It is delaying the birth of a child. It is causing pain. It is causing an infection that should not be there. It is causing complications in women that women need not be experiencing,” Ms. Adan said.
Ms. Adan instructs her staff to educate community members about the harms of FGM. This includes dispelling common misperceptions about FGM, such as the belief that it is a religious requirement.
“Islam does not require women to be circumcised,” Ms. Adan said. “So we spread this information that it is contrary to the teachings of Islam.”
Even explaining what the practice involves can help change people’s minds, she said. “We teach what happens, because many people do not know what female circumcision entails.”
Ms. Adan also highlighted the need for FGM to be seen as a community issue – one that involves a girl’s entire family, including the men. “In recent years, we have also concentrated on the fathers,” Ms. Adan said, “and we insist the fathers also become involved in the decision whether their daughter is going to be cut or not. The family together, the father and the mother, must protect their child together.”
Midwives on the front lines
UNFPA, jointly with UNICEF, leads the largest global programme to accelerate the abandonment of FGM. The UNFPA-UNICEF Joint Programme on FGM/C and the UNFPA Midwifery Programme have begun to mobilize midwives to prevent FGM and to care for complications resulting from the practice.
UNFPA has also launched an e-Learning module to teach midwives about the harms of FGM, and to strengthen their ability to serve as champions for change.
As Ms. Adan’s experience has shown, midwives have unique knowledge about the practices and social dynamics within a community, and they are well-positioned to identify when and where FGM occurs.
They also see its gravest consequences. “When child […who] has been bleeding all day, and has almost a foot in the grave, not because of a disease but because of what another human had done to that child – I think it is the most horrible thing,” said Ms. Adan.
“We thought we were going to lose her,” she added. “But she made it.”
– Talitha Dowds
– See more at: http://www.unfpa.org/news/eradicating-fgm-one-midwife-time#sthash.rAyM2A9s.dpuf