A light wind blows in the midlands giving way to a hospital scent that I am so familiar with. I sit in the waiting room, fussing over my long skirt and head wrap.
I am shadowing Alison, a Specialist Midwife, who runs a Female Genital Mutilation (FGM) Clinic here in the Women’s Wing of the a major hospital in Birmingham.
‘Culture is not static; it moves with time’ my mentors had told me. I was thinking of the deep tribal marks that African tribes used to make on their faces, it is said that they marked themselves to disguise their looks to slave hunters so they could find them undesirable and unmarketable.
Ok Women in Ethiopia have a long tradition of inserting a wide disk in between their lower lips. The wider the lip the greater the number of cows fetched.
‘So why are you interested in FGM?’ Alison asked me as she tossed her hair into a ponytail.
For a moment we are just two women, frontline clinicians, a midwife and a nurse sharing and learning.
We huddle in her office over a cup of tea. Alison explains the four types of FGM, their impact on women sexual, menstrual lives and the medical complications that can arise when a woman has been circumcised.
She hovers her hand over the big map of Africa and parts of Asia. In some cultures, it was believed that if a baby touched its mother’s clitoris, in childbirth, the baby would be doomed to an unfortunate life.
Historically, circumcised women were viewed as ‘cleaner’ than those uncircumcised. The cutting is traditionally done by older women, who are respected and experienced in cutting girls. In some countries the event is usually ceremonial, festive, and celebrative. The girl is flowered with presents, older women sing and dance around her. When the cutting ceremony begins, the singing and dances increases in volume to drown out the young girl’s cry.
Alison’s monthly clinic follows up pregnant women who have previously had FGM, or have been ‘cut’ as most in the African community prefer to call it. Her clinic addresses any possible medical complications that might arise at delivery if a woman has had FGM and how these can be managed.
‘In this hospital, we are very much used to looking after women who have been cut’ Alison reassures our first patient.
She gracefully engages her patients with deep sense of compassion and cultural competency. She listens, then she addresses the UK laws and options of care.
‘Be careful about the terminology you use when assessing women’ she tells me.
‘Use the term that the patient uses’ she affirms. Most women are more comfortable with the word ‘circumcised’ not mutilation.
The women we saw in our clinic were not angry or traumatised, but they were consistently clear that they would never cut their own children, stopping a practise in their generation
We must therefore validate and appraise the efforts that these communities are making to put an end to harmful cultural practises
Dorcas Gwata
My book ‘Street Clinic’ is out in early 2025
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