NHS is ‘failing' British FGM victims
Women and girls are forced to leave the UK to have reconstructive surgery abroad due to the lack of treatment available in Britain, The Telegraph has found.
Germany has emerged as one of the main destinations for victims of the practice, with many having to crowdfund up to £30,000 to afford the travel and surgery due to NHS failings, survivors say.
FGM involves the cutting of the genitals and is often justified by those who advocate for it as a cultural and religious norm.
But it is illegal in most countries, including in Africa and Asia, where it is most prevalent. Human rights groups say the practice is a violation of a woman's sexuality and autonomy.
The World Health Organisation states FGM has no health benefits for girls and women and can result in severe bleeding, problems urinating and infections.
According to the organisation's updated guidelines, countries should provide comprehensive, trauma-informed care for FGM survivors, including access to reconstructive surgery and effective psychosocial support.
The UK falls short of that.
Only about 10 per cent of the UK's estimated 170,000 FGM survivors, approximately 17,000 women, are eligible for the NHS's sole surgical intervention – deinfibulation.
Deinfibulation is the surgical opening of scar tissue formed from FGM. It is limited to treating only those with Type 3 FGM, the most severe form, which consists of the removal of part or all of the external genitalia and the stitching together of the vaginal opening (often called infibulation).
This leaves roughly 153,000 women without any surgical option. Numbers are estimated to be even higher, with many cases not recorded in official statistics.
Shamsa Araweelo, an FGM survivor living with chronic pain, was forced to raise £30,000 for reconstructive surgery in Germany, where work in the field is among the most pioneering in Europe.
She said: 'The NHS failed to provide me with the healthcare I needed.
'No survivor should have to crowdfund their right to a pain-free life.
'Even if I did have a deinfibulation in the UK, it would mean that they would open you up until they can see the urethra, and then they stop. The NHS won't repair any of the damage.'
Dr Dan mon O'Dey, a specialist in reconstructive surgery, said he's seen an influx of patients from the UK visit his practice in Heidelberg, Germany.
He said: 'Every week, I have contact with new patients from England… every week, two to three more patients coming from England.
'What I hear, especially from patients… is that [FGM surgery] is something that needs to be improved in England.'
His clinic offers procedures beyond deinfibulation, including full reconstructive surgery and structured aftercare.
He said deinfibulation has benefits for the patient, especially the ability to urinate freely, but 'more care and treatment might be needed to ensure long-term comfort and prevent complications'.
Huda Mohamed, an MBE recipient and a lead specialist midwife at the Whittington, said: 'In Germany, they'll have aftercare, they'll have ongoing support.'
Ms Mohamed highlighted that the unmet needs of those with Type 1 and Type 2 FGM can still cause chronic infections, painful menstruation and problems in childbirth, despite it being less severe than Type 3.
She said: 'Sometimes they damage the nerves… the women complain about not being able even to wear tight clothes… we don't have that specialist thing. We can't do reconstruction.'
July is deemed the 'cutting season', a period during school holidays when girls are considered to be at heightened risk of being taken abroad – mostly to East Africa – to undergo female genital mutilation.
In 2023, Amina Noor was convicted of assisting a non-UK person to carry out the procedure overseas 17 years ago.
It was the first conviction of its kind under the FGM Act of 2003 and followed the only other successful prosecution related to FGM, in 2019, when a Ugandan woman from east London, was jailed for 11 years for cutting a three-year-old girl.
Leyla Hussein, an activist and a survivor, said: 'Because of the convictions they are now taking girls younger and younger. They know now they have to be more careful.'
According to research published in February by the University of Birmingham, a girl dies every 12 minutes as a result of FGM-related complications.
Ms Hussein said the UK's limited surgical provision for FGM survivors was woefully inadequate.
She said: 'Just deinfibulation is not enough… I can give as much therapeutic support as I can but reconstructive surgery would be life-changing for these women.
'The NHS has a duty of care to these women. These are British women. These are women who are suffering, and it's literally a basic duty of care.'
The UK's last campaign to raise awareness of FGM was in 2018 and ended in January 2023, according to the Equality and Human Rights Commission.
The Government hosts resources on FGM, but does not specify that it is a form of child abuse and violence against women and girls.
An NHS spokesman said: 'The NHS is committed to supporting FGM survivors, which is why it has rolled out more than 20 national FGM support clinics across England, where patients can receive a range of support, including referral to a specialist consultant where needed.
'All NHS healthcare professionals have responsibilities to safeguard women and girls at risk of FGM or other abuse, and FGM is part of mandatory safeguarding training for staff.'
Juliet Albert, a NHS midwife and advocate for FGM reconstructive surgery, said, 'We are failing FGM survivors.
'It's embarrassing that the UK has not taken this forward for all these years. I mean, in France, since 1998 more than 7,000 women have had reconstruction surgery, and yet we don't even offer it here.'
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