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BMJ. 2007 July 21; 335(7611): 116.
PMCID: PMC1925161

BMA backs police campaign against female genital mutilation

A crackdown on female genital mutilation has been launched by London's Metropolitan Police in an attempt to protect the estimated 6500 girls it believes undergo the procedure each year in the United Kingdom.

The BMA backed campaign, dubbed Operation Azure, has been launched at the start of the summer holidays, because that is the time when girls from certain ethnic groups—mainly African communities—are thought to be most at risk. The extended holiday period allows time to recover from the physical effects of the operation. Most girls are sent abroad, but female genital mutilation is also thought to be conducted in the UK, although no one has ever been prosecuted.

A £20 000 (€30 000; $40 000) reward has been offered in an attempt to break the wall of silence surrounding the issue. The Metropolitan Police emphasises: “This is not an attack on culture or faith. It is to raise awareness that this is extreme child abuse, is illegal and will not be tolerated. FGM [female genital mutilation] is both a violation of human rights and a criminal offence, and to administer [it], or arrange for it to be administered, could lead to imprisonment of up to 14 years.”

Millions of girls and women undergo the procedure worldwide, mainly in Africa. In some parts of Egypt, Ethiopia, Somalia, and Sudan the prevalence is thought to be as high as 98%.

All female genital mutilation procedures are unlawful in the UK under the Female Genital Mutilation Act 2003. It is also an offence for UK nationals or permanent residents to carry out the procedures abroad or to “aid, abet, counsel or procure the carrying out of FGM abroad,” even in countries where the practice is legal.

Carol Hamilton of Operation Azure said that signs that a child is being prepared for genital mutilation to take place abroad include “knowing that the family belongs to a community in which FGM is practised and are making preparations for the child to take a holiday, arranging vaccinations or planning absence from school” and the child talking about a “special procedure” taking place.

Indicators that the procedure may have already occurred include “prolonged absence from school with noticeable behaviour change on return or long periods away from classes or other normal activities, possibly with bladder or menstrual problems.”

Detective Inspector Hamilton said that doctors had a key role and that involvement was “a matter of child protection, not patient confidentiality.” Addressing doctors, she said: “If you suspect that any girl is at risk of being subjected to any form of FGM, take action to report it immediately. Time counts, so please act as soon as you suspect that a girl may be at risk . . . If a girl has already undergone FGM, do not think there is nothing you can do. She will be in need of specialist care and support, and if she has sisters they will be in need of protection.”

A BMA spokesperson said, “If a doctor believes a girl they are caring for is at risk of FGM they must inform the family about the health and legal issues. This might involve working with counsellors, local community groups, or other clinicians with experience of working with communities that have a tradition of FGM. The aim is to find effective mechanisms for ensuring the protection of the child in a way that promotes her overall welfare . . . Ultimately, a doctor might have to consider initiating child protection proceedings if there is no other feasible way of protecting the child.”

The police urge anyone with information about children believed to be at risk of undergoing the procedure or about people believed to be carrying out female genital mutilation in the London area to contact the Operation Azure team on 020 7230 8392 or Crimestoppers anonymously on 0800 555 111.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group