House of Commons - Violence Against Women and Girls - International Development Committee

Violence Against Women and Girls - International Development Committee Contents

3 Targeting everyday forms of violence against women and girls

35. International agreements recognise and condemn a wide range of different forms of violence against women and girls—including rape, sexual violence, physical violence, emotional violence, honour crimes, female genital mutilation (FGM), acid attacks, and early marriage. Yet, in many communities on the ground, some of these practices have been treated as a 'normal', expected and/or accepted part of everyday life for women and girls. This chapter will examine three forms of violence that are a common feature of everyday life for millions of women and girls globally and are mainly perpetrated by members of their own families and local communities: female genital mutilation, early marriage and domestic violence.

Female Genital Mutilation

36.  The World Health Organisation estimates that globally, up to 140 million girls and women have been subjected to some form of female genital mutilation.[44] Used to control women's sexuality, female genital mutilation involves removing or otherwise cutting the external female genitalia (see Box 3). It is usually performed on children and is generally carried out by unskilled practitioners who use unsterilised instruments and no anaesthetic, risking potentially lethal infection. Other consequences include severe pain during urination, menstruation, sexual intercourse, and childbirth, and psychological trauma. Often perceived as an African problem—it is practised in up to 42 African countries—it is also widespread in some Asian countries and the Middle East (for example, in Iraqi Kurdistan more than 70% of women have undergone female genital mutilation). Prevalence rates vary significantly between and within countries according to differing community practices. The highest rates are found in countries in the Horn of Africa. 98% of women in Somalia have experienced female genital mutilation.[45]

Box 3: The four main types of female genital mutilation

The World Health Organisation classifies female genital mutilation into four major types:

-  Clitoridectomy: partial or total removal of the clitoris
-  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.

Source: World Health Organisation, Fact Sheet no 241: FGM, online at @SCLINK@http://www.who.int/mediacentre/factsheets/fs241/en/@FCLINK@

37. In March 2013, DFID announced dedicated funding of £35 million and programming to "end female genital mutilation in one generation". Its business case for the new programming highlighted that collective donor effort and funding to address the practice is currently low (totalling approximately $18 million globally in 2011).[46] Although DFID has had only had limited engagement in this issue so far, it says that there is now a "window of opportunity to end female genital mutilation" due to "strong African leadership and real momentum for change in Africa" with increasing numbers of communities, traditional and religious leaders, national policy-makers and other high-profile champions working to end female genital mutilation.[47] DFID aims to "provide a comprehensive package of support" to practising communities, whilst also ensuring legislation and policy is in place and implemented. It will also fund "social change communications" (including in the UK) and research. DFID states that this will be the first phase (5 years) of DFID's work towards ending female genital mutilation in one generation (20 years).[48]

38. DFID's business case admits that there is "limited robust evidence on effectiveness of interventions to end female genital mutilation".[49] It says that the approach to bringing about behaviour change via "village empowerment"—as pioneered by the NGO Tostan in Senegal starting in the late 1980s—"has probably shown the best results on the ground" compared to other interventions to reduce female genital mutilation in African countries.[50] However, when we asked the DFID Minister, Lynne Featherstone MP, about the approach DFID would take, she said she had made no firm decision and would be led by research.[51]

39. Whilst recognising the achievements of Tostan, NGO Equality Now questioned an over-reliance on the village empowerment approach. It said that DFID's business case "appears to show a strong bias towards the Tostan approach [...] over other approaches whilst at the same time noting the lack of robust evidence on effectiveness of interventions to end female genital mutilation".[52] Equality Now highlighted that the 27% decline in the prevalence of female genital mutilation in Burkina Faso—which has followed a different approach based on law and policy enforcement—is greater than in Senegal (5%).[53] A recent research paper found that evidence on the effectiveness of a range of interventions to tackle female genital mutilation was insufficient to judge whether they had actually led to a decline in the practice. The same research found that success of the type of approach used in the "community-led"/village empowerment process varied greatly between communities.[54]

40. We welcome DFID's announcement of £35 million for programming to "end female genital mutilation in one generation". If this aspiration is to be met, the £35 million funding must see rapid—but careful—investment. DFID's Business Case says that the NGO Tostan's approach on village empowerment, pioneered in Senegal, has probably shown the best results on the ground. Yet we have been told that it is too early to be sure that this approach is the most effective way to reduce FGM. We remind DFID of our earlier recommendation to adopt a phased and flexible approach to programming, and to build the evidence base as it works, rather than to rush into large-scale programming to address violence against women and girls based on a single model where the evidence on alternative models of intervention is incomplete.

41. During our inquiry we also looked at how the UK is affected by female genital mutilation, where it is estimated that around 20,000 girls are at risk and 66,000 women are living with the consequences of FGM.[55]We thought it important to know how effectively the UK was tackling the practice within its own shores, so that we could judge its credibility in calling to end the practice internationally. We were disappointed to find out that despite the fact that female genital mutilation has been illegal in the UK since 1985, and punishable by up to 14 years in prison, there has not been a single prosecution—even after the law was tightened in 2003 to criminalise female genital mutilation taking place on UK citizens overseas. This is despite 148 referrals being made to the police since 2009.[56]

42. We questioned the Metropolitan Police Service about the failure to prosecute for FGM in the UK. They said that it was difficult to get victims, who tended to be young girls, to come forward. They told us they were looking at ways to provide support and prosecute without having to rely solely on the victim's testimony.[57] We asked them whether they collaborated with social services to ensure that at-risk girls were placed on the Child Protection Register. They were not aware of this ever happening for referrals they received.[58] Nimco Ali, an anti-female genital mutilation activist, suggested that political correctness was preventing police and other professionals—teachers, social workers, the NHS—from stepping in, and that the UK must stop "treading on cultural eggshells".[59]Dr Purna Sen of the London School of Economics told us that:

Cross-cultural conversations on violence against women and girls can suffer from excessive deference to difference and diversity or an aggressive sense of cultural superiority [...] Dialogues on child marriage, crimes of 'honour', dowry, female genital mutilation and many other forms of violence often become tangled in angst about interference in the cultural norms of others.[60]

43. The 2011 UK Government Call to Action and Action Plan on Violence Against Women is a cross-Whitehall effort that includes actions to tackle female genital mutilation. This is accompanied by the Multi-Agency Guidelines for Female Genital Mutilation (also 2011). However, the NGOs Equality Now and FORWARD both questioned their effectiveness of these strategies, saying that in practice no effective multi-agency response was in place.[61] We wrote to Rt Hon Jeremy Hunt MP, Secretary of State for Health, to ask what action he was taking on female genital mutilation. He told us he was "exploring" how to collect and report data within the NHS in line with Department of Health commitments in the recent Action Plan on female genital mutilation prosecution launched by the Director of Public Prosecution (DPP), Keir Starmer QC.[62]

44. We also wrote to the DPP regarding efforts to obtain prosecutions within the UK. We were told that there had been four referrals to the Crown Prosecution Service (CPS) since 2011, but it had been decided that no action would be taken for the first three cases and the fourth was under consideration but at an early stage. The DPP also said that the CPS was considering the possibility of using child protection legislation to prosecute cases of female genital mutilation.[63] At an evidence session with the Justice Select Committee on 21 May 2013, the DPP said that he was "confident enough now to amend our guidance" to use alternative means of prosecuting.[64] Recent press reports suggest the Met Police will re-open six female genital mutilation cases from between 2009 and 2011.[65] The reports quote Met detectives as saying they want prosecutors to rule on the use of alternative charges, such as that of allowing or causing a child to suffer serious injury.[66]

45. We were shocked to discover that there are estimated to be 20,000 girls at risk of female genital mutilation within the UK. Whilst it is beyond our remit to comment on domestic policy, we believe that—as it stands—the UK's credibility in calling to end the practice overseas is undermined by the failure to tackle the problem at home. Witnesses recommended that the UK must put aside political correctness and adopt a far more robust, cross-agency approach, where the police proactively track girls at risk of female genital mutilation and step in to prevent parents having the procedure performed on their daughter(s). We commend these recommendations and urge the Government to act upon them. We were appalled to discover that, despite 148 referrals of female genital mutilation cases in the past four years, police and social services do not place at-risk girls on the Child Protection Register. This must change.

46. There is far greater scope for joint working across Government on tackling female genital mutilation overseas and in the UK, including through engagement with diaspora groups in the UK. We recommend publication of an up-to-date, binding document that requires all service providers—Departments of Health and Education, DFID, the FCO, Home Office, Government Equalities Office, the Metropolitan Police Service, Ministry of Justice, and the Crown Prosecution Service—to play their part. We draw these recommendations to the attention of the relevant select committees.

Early marriage

47. Early marriage is one of the greatest threats to the protection of women and girls. One-third of girls in developing countries are married by the age of 18, some as young as seven years old. Girls may be married off in the (sometimes well-intentioned) belief that this will protect them from conflict or from 'immoral' sexual advances and give them security. Marriage is sometimes offered as an alternative to schooling. During this inquiry, we had an opportunity to talk about this issue firsthand with beneficiaries of the DFID 'End Child Marriage' programme in Ethiopia. A former child bride from Ethiopia told us of the links with poverty:

Child marriage was supposed to relieve pressure on the poor family and guarantee the future economic wellbeing of the child wife, especially if she was married into a wealthy family with plenty of land, cows, goats, sheep and donkeys. In other words, a girl's value was measured in terms of the age at which she got married and the family in which she was married, but not her value as an individual.[67]

48. There is a direct link between early marriage and violence. Girls who marry early are more likely to experience domestic violence, abuse and forced sexual relations.[68] Girls may be taken away from their families and communities and early marriage forces girls into responsibilities for which they may lack the emotional and physical maturity to cope. Those who marry early are more likely to experience poorer levels of sexual and reproductive health—including early pregnancies, which carry higher risks for the mother and the child.[69] There is also sometimes a link with female genital mutilation, as mutilated girls are often perceived as more appealing to husbands. In some contexts, there is anecdotal evidence that girls who have been infibulated (the most extreme form of female genital mutilation) attract a higher bride price.[70]

49. We visited Ethiopia to see how UK aid was being spent on violence against women and girls, and on ending child marriage specifically. We made a short film about our findings, which is can be viewed via our website.[71] We saw a flagship DFID project, Finote Hiwot—the End Child Marriage programme—funded with £10 million over 5 years (to 2016). The programme aims to reach 200,000 girls in the Amhara region, where 50% of girls are married by age 15—a factor in the region's high adolescent birth rate. It is hoped that tackling child marriage will also help reduce Ethiopia's high maternal mortality ratio (676 per 100,000 live births in 2011) and boost school enrolment figures for girls (net primary enrolment rate currently stands at 65% of girls, falling to 13% at secondary level).[72] Project activities include school radio programmes, community conversations and discussions with influential local leaders. ActionAid told us of a similar approach it was supporting in Tanzania, where priority was given to talking with men, women, boys and girls about the implications of early marriage, and of using school clubs to convey the links with girls' education.[73]

50. We asked Dr Gro Harlem Brundtland, former Prime Minister of Norway, about the recent campaign on child marriage she has helped lead for The Elders.[74] She stressed that the practice of early marriage is rooted in gender inequalities and norms that place a lower value on women and girls and see them as possessions to be exchanged. She emphasised political leadership, saying that "when Foreign Ministers and Prime Ministers speak out on these issues, it is intensely important".[75] The NGO World Vision supported this and called on the UK Government to demonstrate international leadership in committing to ending early marriage by 2030, specifically through a public commitment by the UK Prime Minister to a global campaign.[76]

51. We were impressed with DFID's Finote Hiwot programme, which is working to end child marriage in the Amhara region of Ethiopia. It is supporting vital community-level work that is addressing social norms and helping girls, boys and their communities understand the implications of early marriage, including the serious consequences for maternal health and girls' schooling. We ask DFID to consider where it could roll out similar programmes, and to report back on this in its response to this report. We also urge the UK Government to make a political commitment to ending child marriage internationally, as it has done with female genital mutilation. The two practices are linked, and—as with female genital mutilation—political leadership will be crucial to ending the practice.

Partner violence

52. Domestic violence, sometimes more appropriately described as 'intimate partner violence',[77] is the most common form of violence globally and its prevalence greatly exceeds that of all other forms of physical and sexual abuse suffered by women.[78] Globally, up to seven out of every ten women experience intimate partner violence (physical and/or sexual violence) in their lifetime.[79]Women with disabilities are twice as likely to experience domestic violence as non-disabled women.[80]

53. A recent evidence review commissioned by DFID revealed that more research is available on partner violence than on other forms of violence against women and girls (although most evidence is from developed country contexts).[81] The review concluded that three factors contributed to high levels of partner violence: (i) social norms related to male authority, acceptance of wife-beating and female obedience; (ii) childhood exposure to violence; and (iii) excessive alcohol abuse. Although the review found that the evidence base on what works to reduce partner violence was limited, the review's author, Dr Lori Heise of LSHTM's Gender Violence Unit, told us a key lesson was the need better to integrate work on intimate partner violence with DFID's work with children and social protection programmes.[82]

54. The evidence review points out that addressing partner violence can provide a way to reduce violence more broadly. First, because the family, where the majority of violent acts occur, is also where attitudes and behaviours are formed and transmitted between generations. Secondly, because many of the determinants of partner violence are the same as for other types of violence against women and girls and hence a focus on preventing partner violence can support preventing other forms of gender-based violence. It flags up specific interventions that evidence suggests may work in reducing partner violence, including: work to change gender norms; parenting programmes to help address childhood exposure to violence; work on childhood health and development, especially when targeted at adolescents; and treatment of alcohol abuse.[83] In our first evidence session, both Bernice Sam of the Ghanaian organization Women in Law and Development in Africa, and Annemarie Mavenjina of Action Aid Tanzania, confirmed that domestic violence was the most prevalent form of abuse suffered by women in their countries and said that more must be done to address violence in families.[84] Several written submissions supported this and called on DFID to prioritise domestic violence through its policy and programme work.[85]

55. We were pleased to see that DFID has recently commissioned a review of evidence on partner violence, given that domestic violence is the most widespread form of violence against women and girls suffered by women and girls worldwide. It is important that DFID's programmes seek to tackle domestic violence, and that they are targeted at household level, given that social norms and behaviours are largely formed here. The review also indicates that DFID should seek better to integrate violence with its work with children and social protection programmes. In its response to this report, DFID should report back on its plans for programming in this area in follow-up to the review.

44 The terminology used to describe the practice varies. Within the UK Government, the Foreign and Commonwealth Office, Department of Health and Home Office use 'FGM' whilst DFID uses Female Genital Mutilation/Cutting. A witness (Efua Dorkenoo of NGO Equality Now, see Ev 71) called cutting "an apologetic term" and highlighted that many multilateral organisations-including the World Health Organisation, European Union, UN Women, Convention of the Elimination of all forms of Discrimination against Women, Commission on the Status of Women, UN General Assembly and the African Union-and African women activists use the term FGM. We have decided to follow their lead and refer to the practice as female genital mutilation within this inquiry. Back

45 Ev 71. 97% of Somali girls aged 15-19, and 99% of women aged 35-39, have experienced FGM. Back

46 DFID Business Case for ending FGM, 'Towards ending of FGM/C in Africa and beyond' (March 2013) Back

47 DFID Business Case for ending FGM, 'Towards ending of FGM/C in Africa and beyond' (March 2013) Back

48 DFID Business Case for ending FGM, p.15 Back

49 DFID Business Case for ending FGM, p.16 Back

50 DFID Business Case for ending FGM, para 19 Back

51 Q 194 Back

52 Ev 75 Back

53 Ev 74 Back

54 R.Elise B.Johansen et al, 'What Works and What Does Not: A Discussion of Popular Approaches for the Abandonment of FGM', p.6, Obstetrics and Gynaecology International , Volume 2013 (2013) Back

55 Data on the prevalence of FGM in the UK is incomplete. The available estimates for England and Wales from secondary data show that 66,000 African women resident in England and Wales in 2001 had FGM and more than 23,000 girls largely from African communities under the age of 15 were at risk of FGM or may well have undergone FGM (Ev 70). We received evidence from the Scottish Government, which told us that it is currently considering data that might help it estimate the prevalence of FGM in Scotland, where data is incomplete. The Scottish Government said that, according to the 2001 Census data, there were 2,946 women between the ages of 0-49 living in Scotland and born in one of the 29 countries in which FGM is reported to be a traditional practice. They suggest that numbers from the 2011 Census (when available later this year) are likely to be significantlyhigher, as is demonstrated by the increase over time in numbers of births registered in Scotland to mothers who were born in one of these countries (from 120 births in 2001 to 656 births in 2011) (Ev 94). Back