With just a couple of days before publishing the recommendations from my overseas travel last year, I find myself worrying. Lots. Have I fairly reflected the views and thoughts of those I met? Have I gleaned the best ideas? Does it make sense? Is it too long, too dry, too many / too few pictures?
I never find myself asking whether my report (and other similar work) is needed though. I am convinced it is. I thought I would try to explain why.
Recently, I have been providing some advice to the team at NHS England who are working on FGM Prevention. I want to take a moment firstly to just explain this, as it’s pretty nifty. I completed the Churchill Fellowship not only so I could carry out the research, but so that I could carry on contributing after my return. To have starting being able to advise the NHS leaders nationally again before the report is even published is therefore pretty fabulous. But, it also means I came across these examples.
- Someone close to the national team said ‘so why do we need to do anything more on FGM? Hasn’t it been done?’
- I was asked for an opinion about whether one of our most important projects should continue. I was shocked, not that the question was asked because I firmly believe that all questions can be asked, but that there wasn’t an incredibly short answer, ‘yes – obviously, it’s a bit like asking if oxygen helps us breath’.
- Someone high up asked if we have an exit strategy for another very important project. Again, I don’t mind that the question was asked (much), but the immediate response should have been ‘of course not, why on earth would we?’.
At the same time, every week I hear examples from NHS clinicians about how women today are still not getting the treatment they need.
These kind of questions worry me greatly, but I think they are symptomatic of problems we have across the End FGM work in the UK and globally.
One of the findings in the report is how the End FGM movement struggles to introduce new people to the work by not passing on a good understanding of what is really happening. When new people get involved, we don’t help them to understand what has happened, or what is still needed. In Australia, I heard about the wasted effort and investment caused by projects repeatedly stopping projects, only to re-start when the circumstances were once again supportive of the work happening.
Earlier in my travels, I met someone who was immensely frustrated because they had built up a real expertise in the End FGM work, but were being moved into a new completely unrelated job. Their replacement was not going to be in post until several months after they moved. The corporate memory of why things were happening, and what was happening would, of course, be lost. The progress and momentum would be lost. Despite asking to stay, the individual was not going to be allowed to. In the UK, we have seen similar things happening.
Other findings also play into what I’ve described above. It is incredibly difficult to do this work, and the people involved face personal and professional burdens because of what they are doing. There is insufficient evidence to back up the work done so far, and I think we have a wide-spread unconscious bias in the work in the NHS, because we still struggle to really appreciate what FGM as a social norm is.
So with this perfect storm starting to come together, it starts to be quite easy to just ask ‘is this really needed anymore’?
I hope my worries make sense now, but this is also why I don’t doubt that my report is needed.
I think this is one of the most bleak blogs I’ve yet written (and this is the cheery version – I couldn’t possibly have put out the first draft!), so I want to end of a positive note. When I get gloomy, it takes about two ticks to cheer myself up. I just remember the many survivors, midwives, nurses, doctors and other professionals in the UK and further afield who are carrying on and will keep going. We need to improve, but we need to work together so that we can.
Supporting those who work to end FGM 