Report of the First Workshop

1. List of abbreviations

AIDOSAssociazione Italiana Donne per lo Sviluppo

AMAMAssociación De Mujeres Africanes contra la Mutilación

BBCBritish Broadcasting Company

CBOCommunity based organisation

DAFIDeutsch – Afrikanische Frauen Initiative

DGDirectorate General

ECEuropean Commission

EUEuropean Union

FGMFemale genital mutilation

FORWARDFoundation for Women’s Health, Research and Development

FSANFederatie van Somalische Associaties in Nederland

GAMSGroupement pour l’Abolition Des Mutilations Sexuelles

HCPHealth care professionals

IACInter African Committee

ICRHInternational Centre for Reproductive Health

IECInformation Education Communication

NGONon governmental organisation

PHAROSNational Foundation Health Care for Refugees in the Netherlands

UKUnited Kingdom

WHOWorld Health Organisation

2. Table of contents

1.List of abbreviationsp. 1

2. Table of Contentsp. 2

3. Executive summaryp. 3

4.Backgroundp. 4

5. Report of the first workshopp. 5

5.1. Objectives of the workshopp. 5

5.2. Methodology of the workshopp. 5

5.3. Terminologyp. 6

5.4. Communication, media and co-operationp. 8

5.5. Training of fieldworkersp. 13

5.6. Involving religious leadersp. 14

5.7. Tackling socio-cultural aspectsp. 15

5.8. Support and counsellingp. 15

5.9. Educational materialp. 16

5.10. Future networkingp. 20

5.11. Evaluation of the workshopp. 25

5.12. Conclusionp. 28

6. Annexesp. 31

6.1. Programme of the first workshopp. 31

6.2. Programme of the second workshopp. 32

6.3. Evaluation questionnaire for the workshopP. 33

6.4. List of participantsp. 34

6.5. Final recommendations Ghent meeting, Nov. ’98p. 36

6.6. Gothenburg Declaration, July 1998p. 40
3. Executive summary

In the past several years, Europe received many thousands of immigrants and refugees from African countries practicing female genital mutilation (FGM). As a consequence, many NGOs, governments and professionals from various European countries developed initiatives to prevent this harmful traditional practice.

At several occasions, the development of a European network was discussed: at the Fourth Regional Conference of the Inter-African Committee on Harmful Traditional Practices (November 1997) in Dakar, at the Second Study Conference on FGM in Gothenburg (July 1998) and at the FGM Expert Meeting in Gent (November 1998).

Following the recommendations of the Gothenburg Conference and the Ghent Expert Meeting, the International Centre for Reproductive Health (ICRH) took the initiative to write a project proposal, in close collaboration with the Gothenburg Group, in order to get funding[1] for establishing a network at European level. The project was approved and the network was initiated in December 1999. The networking project ran for one year in partnership with the (former) Immigration Services Administration of the City of Gothenburg. Another project proposal for empowering the network for the coming 3 years was submitted to the European Commission (EC), but unfortunately it was not approved.

This year’s networking project aims at 1) exchanging information and experiences and disseminating models of good practices at community level; 2) harmonising various training and management guidelines of circumcised/infibulated women currently available for health professionals; 3) harmonising research efforts in Europe. Two workshops are scheduled for exchanging experiences at community level, one workshop for setting a research agenda on FGM topics in Europe and two workshops will be held for discussing various guidelines for health care services for women with FGM, prevention of FGM through the health care sector and for training of health care professionals on FGM related issues.

This report reflects the discussions of the two workshops on “Exchanging experiences and information at community level”, organised in Gothenburg (April 26-28 and September 28-30, 2000). Topics that were considered paramount to fieldworkers have been listed and used as a basis for discussion at the workshops. These topics were drawn from the issues brought up by the experts who attended the Ghent Expert Meeting and the Gothenburg Study Conference. Where possible discussions are summarised per country – with the main conclusions listed at the end of chapter 5. Based on these conclusions, guidelines for empowering NGOs/CBOs in their prevention work could be further elaborated and assembled in a manual or handbook for “models of good practice”.

Although the number of participants to the workshops was limited, representatives of organisations of the following countries were present: Austria, Belgium, Denmark, France, Germany, the Netherlands, Italy, Spain, United Kingdom, Sweden and the president of the Inter-African Committee on Harmful Traditional Practices. A list of participants and organisations is included in chapter 6.

The outcome of the workshops has been disseminated through the website of ICRH ( through an e- mailing list and through the members of the network.

October 2000

Report of the Gothenburg 2000 workshops “Exchanging experiences at community level” – Page 1

4. Background

In 1998, the International Centre for Reproductive Health was commissioned by the EC to carry out a study on FGM in Europe with funds from the EC (DAPHNE), in partnership with the Royal Tropical Institute of Amsterdam and Defence for Children International, section the Netherlands. This study provided the European Commission with background information on medical aspects of FGM, with an inventory of European laws under which FGM is liable, and with an extensive paper on socio-cultural aspects of FGM. Recommendations on eradication strategies of FGM within Europe have been discussed by 50 experts in the field, coming from Europe and Africa, during an expert meeting in Ghent, Belgium (November 1998) and were submitted to the European Commission. At the expert meeting, networking has been initiated between interested groups and individuals within Europe. As recommendation s at European policy level have now been developed, NGO's and community based organisations (CBO's) have expressed the need to keep the momentum, created at the expert meeting, going and recommended networking at community level.

Taking this into consideration, the International Centre for Reproductive Health submitted a second proposal to the European Commission (DAPHNE) and the second project started on December 1, 1999 and ends on November 30, 2000. The project consists of the implementation of a network at European level, aiming at the prevention of female genital mutilation within African communities in Europe. This network co-ordinates actions carried out in different parts of Europe. It is also used for disseminating the final recommendations and is building on the results of the first project year.

The networking project aims at:

1)Exchanging information and experiences and disseminating models of good practices at community level;

2)Harmonising various training guidelines and guidelines for caring of circumcised/infibulated women currently available for health professionals;

3)Harmonising research efforts in Europe.

Network participants from NGOs and CBO’s, universities and health care professionals from 11 EU member states worked together in a series of workshops. Portugal, Ireland, Luxemburg and Finland did not attend one of the workshops, as accurate knowledge on initiatives regarding prevention activities of FGM is still missing.

The project ran in co-operation with the Gothenburg Immigration Services Administration, Sweden.The Immigration Services Administration of the City of Gothenburg has worked for five years on the “Mother and Child Health Care Project – Female Genital Mutilation”. The objectives of the Gothenburg project were to 1) organise preventive work in order to stop girl children living in Sweden from being mutilated and 2) to give proper medical and psychosexual care to genitally mutilated women, particularly during pregnancy, delivery and after care. The Swedish partner organised the two workshops at community level.

The workshops on “Exchanging experiences and information at community level”, organised in Gothenburg in April and September, were part of a series of 4 workshops of the networking project. Two workshops were scheduled for exchanging experiences at community level, one workshop for setting a research agenda on FGM topics in Europe and one workshop was held for discussing various guidelines for the care of women with FGM that exist for health care professionals.

5. Report of the workshops “Exchanging experiences and information at community level”

5.1. Objectives of the workshops

Initially, the two workshops at community level had different specific objectives: the first workshop aimed at exchanging educational material and the second at exchanging practical work examples and to show models of good practice. 3 days of discussing educational material would have been too much. Hence, at a meeting between the project coordinator and the project partner (Gothenburg, February 28-29, 2000), both objectives have been integrated into one, namely “exchanging experiences, information and models of good practice”.

5.2. Methodology of the workshops

Discussions in both workshops were organised according to a list of topics, which was drawn from the issues brought up by the experts of the FGM Expert Meeting (Ghent, November 1998) and participants at the Second Study Conference (Gothenburg, July 1998). These topics were considered to be paramount to fieldworkers of NGOs. The discussions in the workshops will be used for developing guidelines and should empower NGOs in their prevention work. If feasible a manual for “models of good practice” will be drafted in the future.

All topics mentioned below were sent beforehand to the participants, accompanied by several questions to prepare discussions.

-Terminology: what terminology do you use while working with the communities, for example female genital mutilation, female circumcision, female genital cutting, female sexual mutilation? What difficulties do you encounter with terms you use, for example when you translate the term female genital mutilation into a local language? Does the local community understand the same thing as you when you talk about female genital mutilation?

-Communication: how do you communicate your message to the different target groups: do you bring it as a human rights/women's right issue, as a health issue, as a religious issue, as a legislative issue? And what are the (dis)advantages of each of these approaches? How do you bring your message to your target group? How do you organise awareness-raising campaigns? For who do you organise these campaigns? Are they effective? Can you evaluate this effectiveness? Do you encounter problems while communicating with for example health professionals? Where do you get your information, advice on FGM?

-Media: the different roles of the media concerning the issue of FGM (preventive role, image building, distributors of your message...). Media can be used by NGOs, but NGOs need to be informed on how to use the media (for example, media are powerful and can influence the field work in a constructive way, but they can also damage the fieldwork severely). Training is needed for NGOs on how to communicate with the media, but the media need to get enough and correct information on the subject of FGM.

-Training: In what should fieldworkers be trained to become good fieldworkers (e.g. knowledge of legislation, health consequences of FGM, …)?

-Co-operation between Western people and migrants, with youth, between men and women, between European NGOs and between Europe and Africa: how do you organise this? what are the difficulties? What are the advantages of this co-operation?

-Educational material:All participants were asked to bring as much educational material as possible to the first workshop (video's, brochures, leaflets, drama, poems, ...). This material was discussed at the workshops, to see what needs to be updated, what is not being used, what is available and where, ...

-Support and counselling for field workers: What are the emotions and feelings that your fieldwork brings up, and how does it influence your fieldwork? Where do you go for help and support?

-Religious aspects: How do you involve religious leaders in your fieldwork on FGM?

-Advocacy/lobbying/fund-raising: What are the main obstacles for finding funds? How do you communicate towards funders, local and national authorities? How do you organise lobbying activities? How do you support African community based organisation fighting for the eradication of FGM?

-Socio-cultural aspects: How do you tackle questions of virginity, female roles, sexuality, marriage etc. when you talk to the communities involved? How do you tackle questions on this issues when asked the older generation? How do you respond to questions concerning the return to Africa and the possible switch in attitude this might cause?

Terminology, communication, media, co-operation and educational material have been discussed during the first workshop, the remaining topics during the second workshop. The workshops ran for 3 days, in which discussions in small groups have been alternated with plenary sessions. Discussions on educational material were held entirely in plenary so that all participants received information on the educational materials available.

Although there is a wealth of NGOs in Europe that carry out fieldwork on female genital mutilation, only a small number of NGOs have been invited due to budgetary constraints[2]. However, this limited number of participants was seen as an advantage as it enhanced discussions in the small working groups. Participants came from Austria, Belgium, Denmark, France, Germany, the Netherlands, Italy, Spain, UK, Sweden and the IAC (Switzerland), and represented several community-based organisations and non-governmental organisations. The majority was from several African migrant communities living all over Europe. Participants have been selected based on a description of their activities that was obtained during the first project year.

Communication in the workshops was based on dialogue, and workshops brought together various experiences from all over Europe. In this way, an atmosphere was created in which participants supported each other in their work and exchange valuable information on methodologies.

5.3. Terminology

The discussion of terminology has been going on for years now. The most commonly used term at international level is female genital mutilation. However, discussions in the working groups revealed that terminology is playing a major role when communicating with the communities. For example, there are 77 different ethnic groups in Ethiopia and each community is practicing FGM differently, which makes it impossible to use a uniform term with all these communities.

African women at the Inter-African Committee (IAC) General Assembly ” (1989) and at the First FGM Study Conference in London in 1992 chose the term “female genital mutilation. However, in the field using the term “female genital mutilation” seems to be difficult. Communities may feel offended by it as they have performed the practice on their girls because they love them. Female genital mutilation can also be difficult to translate into a local language, because the connotation of the word changes in translation. Other fieldworkers, however, want to stick to this term because it clearly suggests that the practice is damaging to the body, or because it shows feminist credentials, which can in turn dissuade others from using this term. Once the communities have been informed that the traditional practice is harmful to the health of women and children, the term female genital mutilation might be profitably introduced.

Female sexual mutilation is also not an appropriate term, as it suggests the lack of sexual feelings in circumcised women.

Female circumcision is considered to be misleading, due to the comparison with male circumcision.

The term “sunna” was considered to cause confusion. Sunna can imply various degrees of cutting and has a positive connotation because it means tradition and has a religious meaning. All participants agreed that this term should be avoided. It was suggested that if you use the term “sunna,” because you judge it appropriate in a certain situation, the fieldworker should define it as more harmful than the word suggests.

Conclusions concerning topic “Terminology”

1. There was a consensus in both working groups that the terminology used differs according to the ethnic community. Therefore, it was suggested that when working in the field with a particular community, social workers, health professionals etc. should use local words for female genital mutilation.

1. To facilitate this job, the suggestion was made to develop a kind of glossary, which summarizes all terms used by the different communities, explains what is understood by these terminologies, and lists which communities use them. The glossary should be distributed.
2. Concerning the "sunna," a word used in several communities, participants agreed it is not a good term because it is confusing, covering different degrees of cutting. It also means “tradition” in a religious sense, which suggests that the practice is accepted as normal and positive.
3. The term “female genital mutilation” should be maintained in public discourse and at political level. Switching to another word, such as female genital cutting, would only cause confusion.
4. Reinfibulation: This term is unclear. More discussion and research are needed concerning its use, its meaning, and which terms are used by local communities. It is suggested that this term should be brought up in researchers' meeting and the meeting for health professionals.

Report of the Gothenburg 2000 workshops “Exchanging experiences at community level” – Page 1

5.4. Communication, media and co-operation

5.4.1. Communication

Bringing up the subject of female genital mutilation among communities affected by it, as well as the general public, is difficult. FGM is still taboo and a highly sensitive issue for field workers to tackle. Hence, well-considered communication is paramount for establishing good contacts with the African communities involved and with the residents of the country, and will enhance the efficacy of Information, Communication and Education (IEC)-activities.

Discussions on this topic were held in two separate discussions groups. Main points were the target groups for field workers and how to approach them. A review of the discussions is listed by country, followed by the main conclusions.

Spain: As a starting project, AMAM wants to target both women and men of the African community in the Catalonia region, where most Senegambian immigrants live. The subject of FGM is communicated to this target group as a health issue, as well as to the health care sector (mainly gynaecologists, paediatricians and nurses).

Germany: One NGO, INTACT, does not work in Germany but gives funding and technical assistance to projects in Africa. However, INTACT developed a nation-wide awareness-raising campaign using billboards to address the German public, resulting in significant funding to continue their activities. The MAISHA project in Germany does not tackle the problem -- except in rare cases in which an African woman resident in Germany asks for counselling -- as it was not brought up by the community itself. FORWARD - Germany, is addressing the Somali community through its vice-chair, Dr. Asili Barre-Dirie. DAFI (Deutsch-Afrikanische Frauen Initiative) was launched in Berlin in 2000 to address the issue of FGM. NGOs in Germany target the youth of the second generation by organizing discussion groups which aim to make them understand social pressures and to offer support to peers.