A few months ago ‘Ardo’ had to tell a 12-year-old orphan she’d been “cut”.
“This girl knew a little bit about female genital mutilation. I sat with her and I said if you don’t mind me asking, ‘have you ever been circumcised’ and she said ‘I’ve heard about it but I don’t know’,” she told The Huffington Post UK.
As a nurse in a sexual health clinic, she sees a lot of females who have had female genital mutilation (FGM) referred to her after they come to a doctor complaining of abdominal or back pain.
The girl had come to Britain to live with her aunt when she was just two years old, after her parents died.
“She didn’t know if she was or not. I said ‘do you mind if I examine you?’ I had to tell this child that she was circumcised and we could send her to the doctors and send her to see the consultants. She was just crying and she couldn’t believe she’d gone through it,” Ardo explained.
“A lot of medical staff are not trained about FGM. They know about it, they just hear about it.
“Let’s say the doctor’s examining or another one of my colleagues is examining, and they’re not sure if she’s been circumcised, then I go in and I have a look at it. I find it hard when somebody says it’s hard to tell.
“Everything’s been cut off. They can see the girl’s labia has gone. It does not look ‘normal.'"
Daughters of Eve, a campaign group which speaks out against FGM, say it’s not unusual for doctors, nurses, or teachers to miss the signs of FGM.
The organisation’s co-director Nimco Ali, tells The Huffington Post UK: “A lot of these young women when they go and see doctors they are going with their parents and their parents are very clever about hiding things.
Some of the blunt and dirty tool used to carry out female genital mutilation (FGM) which were surrendered to Afnet, the anti-female genital mutilation network in Dodoma, Tanzania
“Younger women will say they have a urinary infection and get the antibiotics - there's not that kind of thinking. You've got two minutes with a GP, you get the antibiotics. I don't necessarily think they're getting better. What's more shocking is that midwives haven't even got the training to deal with FGM.”
Ardo, now a 33-year-old woman living in London, isn’t scared about talking about FGM with patients and colleagues because she knows all about it.
When Ardo was seven years old, she and her six-year-old sister were taken to a special ceremony with sweets and popcorn in their hometown of Mogadishu in Somalia. An older woman applied henna to her hands and feet, gave her something to numb the pain, then sliced off her inner and outer labia and sewed her up.
Back then, she says, everyone thought female genital mutilation was "normal." Every single woman in her family had been, as she calls it, “cut.”
Twenty-six years later, she sees that day in Somalia as the day her problems started. By 12, just as war erupted in her country, she started suffering health problems.
“I got really, really sick and nobody knew what was wrong with me,” she says.
Ardo and her family fled the conflict and went to Djibouti, near Somalia. She spent her early teenage years in and out of hospital, spending two years between the ages of 14 and 16 living permanently on a ward. Ardo had been sewn up so tightly that when she menstruated the blood stayed in her womb, causing her to bleed internally.
She and her family eventually moved to Europe, and settled in Britain. When she came to Britain, and fell in love, the complications from the FGM and the many operations meant she could not have children. After a round of failed IVF, and a miscarriage which left her in intensive care, her doctor told her she could not try again.
"He said to me ‘you are in danger of dying in their hands. We’re not going to do that.’
"To me it felt like the whole world had just fallen apart. I survived the war, and I survived the FGM and the IVF and I survived all the operations and now as a big woman I want to have a family and just be happy for once and that is not going to happen."
Now, when she meets women who are planning to take their pre-pubescent daughters out of Britain to get circumcised, she tells them her story.
"They come through my work," she says. "They have back pain, and when I talk to them I ask if they have children.
"Some mothers can’t get through their head. I literally have to show them the scars I have on my stomach."
"That is what the FGM has done to me and that is what I use when I talk to women who are going to cut their daughters. They don’t actually believe that anything is wrong with FGM. They really think there’s nothing wrong.
"Women always say ‘it’s been done a lot, it’s been done to my mother, it’s been done to my grandmother, there’s nothing wrong, blah, blah.’ They don’t realise how many girls are suffering."
So what does her mother think now? “Every time I have a period, my mother says sorry.”
According to rough estimates, around 24,000 girls are at risk of FGM in Britain. Nancy Durrell McKenna, of SafeHands, an organisation that campaigns to make pregnancy and birth safer, says “many more” have come to Britain that have already been mutilated.
A 2011 report, The Missing Link, says FGM is performed by communities from Somalia, Sierra Leone, Guinea, Egypt, Djibouti, and, to a lesser degree, communities in Uganda, Niger, Ghana and Cameroon as well as by some groups in India, Indonesia, Malaysia, Pakistan, as well as Oman and Yemen.
The report says FGM can be seen as a “self-enforcing social convention.”
“Families and individuals continue to do it because they believe that their society expects them to do so” and families fear social consequences such as derision, marginalisation and loss of status.”
For Ardo, it’s going to be a “really long fight” against the practice. “It’s not going to finish anytime soon but slowly, slowly. People are getting there.”
Ardo says FGM is child abuse, and British authorities who try and stay out of the fight to avoid upsetting different cultures are enabling child abuse.
“To me, if a child is getting abused, and FGM is abuse then you should be talking for that child and forget about the culture and who you are going to upset.
“A lot of people I think don’t do anything about it because they think they’re going to upset a community and that is not right.
“If you upset somebody that is their problem, and if that person is doing something wrong then you should do your best to help that child.
“As a teacher, if a child goes a holiday and comes to your class and she can’t even sit down properly, it is your job to talk to that child and find out why. I don’t think there’s a lot of teachers doing that.
“To me, it’s my fight. My fight is not finished and my fight is not going to finish for my health and my fight is not going to finish until every single mother says they are not going to do this. I have to keep fighting.”
Ali of Daughters of Eve likens the fight against FGM to that against domestic abuse in the 1970s and 1980s. Initially it was seen as a private thing, but eventually it became socially unacceptable. For now, however, she believes the police “don’t take it seriously.”
“They will give you lip service and no action behind investigating it. Social services will have a conversation about it being a 'loving family',” she says.
To date there have been no convictions, and no cases have come to trial for those practising FGM despite it being illegal and despite police in London investigating 46 allegations of female genital mutilation in 2008/09 and 58 in 2009/10.
“Asking for a conviction is wishful thinking,” Ali says. “I just want things to be taken seriously. Those that carry out FGM and believe in FGM will still do it because they know that nothing will happen to them.
“No one is sitting down and saying ‘how can we help we help you, what's going on?’ I don't think prosecutions would help as a deterrent. The deterrent is things being taken seriously, the police actively helping up, social services investigating. The prosecution will prove they are investigating things and taking them seriously.”
For Ardo, it’s about mothers being “strong headed” and the message not getting through.
“I thought it was normal until 1999-2000. I stopped thinking that because I looked at the medical side. That’s when I started thinking to become a nurse.
“It was like, 'oh my God.' A lightbulb went off in my head. It just went ‘bing’ and the more and more I started talking to people I realised it’s wrong.
“That’s when I decided I was going to speak up. If I’m in the park, I’ll talk to girls. If I’m on the bus, I’ll talk to them. It’s good as well if you have a second language and you are in a public place, you can talk the language and nobody will understand.
“I make it my mission to talk to every single girl. I try to educate them. Because, remember, I can’t stop anybody. You can listen to me and tomorrow go and say no, but I have to really try and make them understand.”