Harmful practices

Harmful practices can cover, amongst other forms of abuse, child marriage, forced marriage, female genital mutilation, breast flattening, hate crimes, child abuse linked to faith or belief and so called “honour-based” abuse.

All of these practices in isolation are physically and / or emotionally abusive, however their perseverance in society means that they stop being seen as abusive and start to be seen as acceptable and even a rite of passage therefore losing the label of abuse.

As seen in the definition below, all forms of harmful practices are grounded in some form of discrimination and are likely to cause harm and suffering.  Violence does not necessarily need to be involved, however it is often a feature.

‘Harmful practices are persistent practices and behaviours that are grounded on discrimination on the basis of sex, gender, age and other grounds as well as multiple and/or intersecting forms of discrimination that often involve violence and cause physical and/or psychological harm or suffering.’ National Female Genital Mutilation Centre

That something is linked to a person’s faith or culture is not an excuse for child abuse.  Whilst we should be aware that culture and faith is an important part of many families lives, as professionals we need to maintain a culturally competent approach – not alienating the families we are working with, but not losing sight of any potential harm. As the National Working Group identify “… this is not about challenging people’s beliefs, but where these beliefs lead to abuse that should not be tolerated.”

Culturally competent practice – Many serious case reviews identify a lack of knowledge about a particular culture or faith as an issue leading to abuse not being identified and / or challenged.  It is not possible for one person to know everything about every different culture or faith, but we can be culturally competent in our approach.  This means having an awareness of our practice so that we do not alienate the family, but not being distracted by faith or culture meaning that we lose sight of potential harm.  The over-riding question should always be “what does this mean for this child?”

Vulnerable groups – Unicef identify that both boys and girls are at risk of harmful practices, although girls are often at greater risk.  They also note that in every society where harmful practices take place they reflect values that hold girls in low esteem.  In many cases the vulnerable groups are the same as the groups vulnerable to other forms of abuse, e.g. those with additional needs, children where there are other issues in the family home.  However harmful practices may also take place in households where no other issues are present other than it being because of the beliefs to the family and associated wider community.

So called “honour-based” abuse – is referred to as “so called” as there is a need to be clear that there is no honour in abusing someone. Honour-based abuse is often carried out as a result of the victim bringing shame on their family or the wider community.  Transgressions can be relatively minor, but the consequences significant potentially resulting in the victims death.

Honour-based abuse (HBA) is the term used to refer to a collection of practices used predominantly to control the behaviour of women and girls within families or other social groups in order to protect supposed cultural and religious beliefs, values and social norms in the name of ‘honour’.

For example, HBA may be committed against people who:

• Become involved with a boyfriend or girlfriend from a different culture, religion or caste;
• Want to escape an arranged or forced marriage

• Have adopted Westernised dress or take part in activities, which may not be considered traditional within a particular culture

Women and girls are the most common victims of HBA. However, it can also affect men and boys. Crimes committed in the name of honour may include: assaults, disfigurement, versions of sati (burning), sexual assault and rape, forced marriage, dowry abuse, female genital mutilation, kidnap, false imprisonment, stalking.

In the most extreme cases, people are killed because their actions are thought to be dishonourable. Honour based crime may not involve violence. It can also include:

• Psychological abuse
• Written or verbal threats
• Abusive phone calls, emails and messages

Victims may also be ‘cast out’ by their family and community with very little support. This is high risk to those who have no access to any money or financial support. Culture teaches victims that they will not survive without their family and community and many victims believe this as they have no life experience (and in many cases are not allowed to gain life experience) to prove this notion false.

The people who commit HBA are usually family members or friends within the same community.

HBA is under-reported because those at risk can feel tied by family or community loyalty or are too distressed to speak out.

Due to the complexity of issues surrounding HBA, it is important for professionals to understand the psychology of the perpetrators. Perpetrators of HBA often use honour as an excuse and try to control a victim in any way possible under the guise of cultural standards. Whole communities make this system work by creating a sense of respect for those who are in control. Failing to control their wives or children may therefore actually confer a feeling of shame on the part of the perpetrator – so the feeling of shame may well be real for the perpetrator.

The perpetrator, to ‘save face’ threatens or commits acts of violence in order to control their wives/children in order to prove to the community that they are worthy of respect. Mothers can be guilty of the same behaviour against their children for the same reasons – they are culturally conditioned to believe they have failed as a mother if their child is disobedient. Many perpetrators have convinced themselves that they are only doing their duty as a good parent or member of the community.

Female Genital Mutilation (FGM) is a form of child abuse and is an act of violence against women and girls. It is sometimes also known as female circumcision. Other local terms are:

• Tahoor
• Absum
• Halalays
• Khitan
• Ibi
• Sunna
• Gudnii
• Bondo
• Kutairi

The term FGM is used to refer to the removal of part or all of the female genitalia for cultural or other non-therapeutic reasons. This is extremely painful and has serious consequences for physical and mental health. It can also result in death.

It is illegal to practice FGM in the UK. It is also illegal to take a child abroad for FGM even if legal in that country.

FGM is sometimes incorrectly believed to be an Islamic practice. This is not the case and the Islamic Shari’a Council, the Muslim College and the Muslim Council of Britain (MCB) have condemned the practice of FGM.

FGM is classified into four categories:

• Clitoridectomy: partial or total removal of the clitoris and, in very rare cases, only the prepuce

• Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora

• Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris

• Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area

The age at which girls undergo FGM varies enormously according to the community. The procedure may be carried out when the girl is newborn, during childhood or adolescence, just before marriage or during the first pregnancy. However, the majority of cases of FGM are thought to take place between the ages of 5 and 8 and therefore girls within that age bracket are at a higher risk.

Breast ironing is a practice whereby the breasts of girls typically aged 8-16 are pounded using tools such as spatulas, grinding stones, hot stones, and hammers to delay the appearance of puberty.

Breast ironing is often carried out by the girl’s mother with the belief that she is:

• Protecting her daughter from sexual harassment and / or rape
• Preventing the risk of early pregnancy by “removing” signs of puberty
• Preventing her daughter from being forced into marriage, so she will have the opportunity to continue with her education

Breast ironing is often a well-kept secret between the girl and her mother. This can make it difficult for professionals to identify. Care must be taken to navigate the deep-seated cultural belief and familial sensitivity of this practice. Many girls will not disclose that they are a victim of breast ironing for fear that their mother will get into trouble; or they believe it is being done for their own good. Like other forms of FGM, breast ironing is an extremely painful process for the victim. The process of breast ironing combined with insufficient aftercare leaves young girls exposed to significant health risks, such as:

• Cysts and lesions
• Breast cancer
• An inability to produce breast milk
• Complete or partial eradication of single or both breasts

The practice of breast ironing is not explicitly covered under legislation. However, it is understood by the Government to be physical abuse.

Breast Flattening – is when a girl’s breasts are flattened to slow down or stop them growing.  Childline has some really useful information on this.  Click here to learn more.

Signs and Symptoms of So Called “Honour-Based” Abuse

• Social relationships have narrowed
• Suspected perpetrator makes all the rules and the victim has no say in his/her own life
• Extreme restrictions on movement and contact with others
• Victim shows signs of fear
• Victim has been injured
• Victim is withdrawn
• Victim may excel in school work or employment as symbols of freedom

Signs and symptoms of FGM may include:

• constant pain
• repeated infections
• problems passing urine
• incontinence
• bleeding, cysts, abscesses
• pain during sex
• depression, flashbacks
• sleep problems
• self-harm

Later in life women may experience difficulty in becoming pregnant and those who do conceive can have significant problems with childbirth.

Some signs that a girl is at risk from breast ironing include:

• Unusual behaviour after an absence from school or college including depression, anxiety, aggression, becoming withdrawn
• Reluctance in undergoing medical examinations
• Some girls may ask for help, but may not be explicit about the problem due to embarrassment or fear
• Fear of changing for physical activities due to scars showing or bandages being visible

If you believe there is a risk of FGM you must notify MASH immediately, without seeking consent from the family.

The Serious Crime Act 2015 introduced a duty on all teachers and registered health and social care professionals to notify the police of any known cases where FGM has taken place on a child (i.e. anyone under the age of 18).  If you fall into one of these categories it is therefore your duty to report it directly to the Police, as well as notifying your designated safeguarding lead.

The duty does not apply where there are concerns that a child may be at risk of FGM. With regards to the “observing of physical signs”, the guidance notes that it will be rare for professionals to see visual evidence and they should not be examining children.

Under UK law, HBA is a breach of the victim’s human rights and a form of domestic abuse. Five best practice tips for working with victims of HBA:

• Listen to what the individual is saying about their needs
• Don’t use family members, community leaders, friends, etc. as interpreters
• Speak to the person alone. They may be influenced by others to say something they don’t mean
• Ensure completion of a thorough risk assessment and remember the ‘one chance’ rule. Many potential victims of forced marriage may only have one chance to speak to a professional before it is too late
• Mediation, reconciliation and family counselling as a response to forced marriage and honour based violence can be extremely dangerous

• Female Genital Mutilation (FGM)
• Forced Marriage
• Honour Based Abuse

There are a range of resources for professionals providing help, support and guidance on forced marriage. The Forced Marriage Unit (FMU) is a joint Foreign and Commonwealth Office and Home Office unit which provides support and advice to victims, professionals, and those at risk. It operates both inside the UK, where support is provided to individuals, and overseas, where consular assistance is provided to British nationals including dual nationals.

The FMU has also developed free forced marriage e-learning for professionals. The modules aim to enable professionals to recognise the warning signs and ensure that appropriate action is taken to help protect and support all those at risk.

Guidance on what to do if you’re trying to stop or leave a forced marriage, please visit the GOV.UK support page.

Free on-line training in FGM awareness is available at: www.fgmelearning.co.uk

The National FGM Centre has developed a Direct Work Toolkit to help social workers carry out direct work with families and girls at risk of FGM, or who have undergone FGM. The toolkit provides plans for sessions aimed at children aged seven and older with separate activities for parents, carers and young people. The Centre has also published Guidance for Schools and Colleges that outlines what schools and colleges should consider and the action they should take when concerns are raised regarding a range of issues, including harmful practices such as FGM.

The Home Office has also produced a FGM Resource Pack that includes:

• case studies where FGM has been experienced by girls and women in the UK
• information on what local authorities and others can do to raise awareness of FGM in their local area
• links to support organisations, clinics and helplines which can help people who think they might be at risk

The ‘Ending Female Genital Mutilation’ short film gives a first-hand account of a woman’s experience of FGM and health professionals talk about the physical and psychological effect.

National Guidance: Multi-agency statutory guidance on female genital mutilation (updated October 2018)

FGM factsheet

NSPCC: Information on the signs and indicators that a girl may be at risk of FGM, as well as lots of helpful resources for your organisations.

FGM Zero Tolerance Day is on 6 February.  In support of this the OPCC has filmed a short video