Female Genital Mutilation in the Netherlands, a matter of human rights?
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Female Genital Mutilation in the Netherlands,
a matter of human rights?
The policy on combating Female Genital Mutilation assessed according to human rights
obligations.
By Margreet de Boer, in cooperation with Alem Desta
VON (Refugee Organisations in the Netherlands), 2007
82 pages
-English summary-
Introduction
In August 2005, the Dutch government published a policy paper on combating Female
Genital Mutilation (further: FGM) in the Netherlands. With this policy paper, the government
reacted on a research by the Council for Health, which was published earlier that year.
VON (Refugee Organisations in the Netherlands) decided to analyse the governmental policy
on FGM, from a human rights point of view. Main question of this analysis is: To what extent
does the Dutch policy on combating FGM comply with the requirements of human rights?
And subsidiary: Which adjustments have to be made to the policy in order to achieve
compliance with these international legal norms?
For the analysis, we used HeRWAI1, a methodology on assessing women’s health rights,
developed by Aim for human rights, and of the working methodology used in the project
‘Support women’s rights in the western Balkans’, a project of Aim for human rights regarding
domestic violence and human rights.
FGM in the Netherlands
FGM is a wide spread practice in 20-30 countries in Africa, and does also exist in some Asian
countries, and within immigrant communities in Western-Europe, Northern America and
Australia2. In 2003, over 20.000 girls aged between 0-16 from the ‘risk-countries’ (African
countries where FGM is quite common) were living in the Netherlands. In theory, all these
girls are at risk of being circumcised. No reliable figures are available on the number of girls
that are actually being circumcised in the Netherlands, or the number of women/girls living in
the Netherlands that have been circumcised in their home country. The government estimates
that per year at least 50 girls become a victim of FGM. This estimation seems rather low. If
the same percentage of girls would be circumcised in the Netherlands as the percentage that is
circumcised in the countries of origin, the number of cases of FGM in the Netherlands would
be around 900 per year. Although it can be assumed that the percentages in the Netherlands
are lower; the figure of 4% (which equals the estimation of 50 cases a year) seems very low.
1
Health Rights of Women Assessment Instrument. See for more information:
http://www.aimforhumanrights.org/themes/women-s-human-rights/health-rights-of-women
2
Unicef: Child Protection Information Sheet Female Genital Mutilation/Cutting, May 2006.
1Since the early nineties, NGOs are working to eliminate FGM in the Netherlands. Political
attention for the topic fluctuated, and ultimately led to the governmental policy paper of
August 2005.
The Dutch policy on FGM
The aim of the governmental policy as laid down in the policy paper of August 2005 is to
eliminate FGM in the Netherlands. The policy paper contains various measures. In the
analysis all measures are mentioned, in this summary we present a selection.
Although the Council on Health advised otherwise, the government states that specific
incrimination of FGM is not necessary in order to have effective prosecution of FGM.
However, there will be some changes in criminal law. It will be made possible to prosecute an
inhabitant of the Netherlands who conducted a circumcision abroad. Besides that, the period
in which FGM can be prosecuted will be extended.
The government also does not follow the advice of the Council to examine the genitals of all
girls in the Netherlands during the regular contacts with the Youth Health Services.
The government intends to use the Youth Health Services more actively for prevention and
early detection (by using a protocol for discussing FGM), but not by physical examination of
all girls. Professionals will not be legally obliged to report signals which may point at FGM;
but a code of conduct (reporting code) will be implemented countrywide.
In six regions, where the number of girls from the ‘risk-countries’ is relatively high, an
intensive approach will be implemented:
- involvement of the target groups; information and awareness raising; meetings between
professional institutions and grass root organisations;
- information and education for professionals (midwifes, general practitioners, teachers, youth
workers etcetera) and training of the professionals of the Youth Health Service in the use of
the protocol for discussing FGM;
- agreements for better cooperation between ‘chain-partners’: from early detection to
prosecution of FGM.
The government states that the new measures are complementing the already existing policies.
For the realisation of the plans, a total amount of €3 million is available, for a period of 3,5
years (so 0,86 mln per year). This amount is meant for the approach in the six regions, and is
paid to and via the local Health Services. The contributions to the implementation of the
policy by national centres of expertise, NGOs and other organisations and institutions have to
be paid from their regular budgets.
Human rights as framework for assessment
The human rights and international norms which are relevant for FGM can be found in
international conventions (UN-treaties, European Convention on Human Rights), consensus
documents (such as Cairo Declaration and Beijing Platform for Action) and views of
international bodies on the implementation of human rights obligations in Netherlands
(Concluding comments and views of treaty bodies, reports of special rapporteurs). From
these sources, a great number of relevant norms can be deduced. Norms on personal liberty,
on participation, on women’s and children’s rights, on gender based violence and on health.
2In the study, the relevant norms are summed up, and translated into a checklist for assessing
the Dutch policy on FGM. The checklist has three categories of questions:
1. Does the government take the measures which it should take according to the positive
obligations in the documents it is committed to?
2. Does the policy itself and its implementation cause violations of human rights?
3. Does the policy have a human rights based approach?
These main questions are worked out in 44 specific assessing-norms. In the survey, the policy
and its implementation plans are assessed regarding these 44 norms, which leads to more than
50 recommendations.
Main conclusions
In answer to the central question of the survey, the conclusion is that the Dutch policy on
FGM is partly in compliance with the requirements of human rights. And following: a great
number of adjustments is necessary and desirable.
The fact that the Netherlands did develop a policy to combat FGM is very positive. The
policymaking has not been done rashly; several studies preceded the policy. The result is a
multi-track approach: via criminal law, youth health care and grass root organisations / NGOs,
with the main focus on the youth health care.
However, the policy has several shortcomings, which are listed in detail in the survey.
In the conclusion, five main shortcomings of the policy are described:
1. too little attention for human rights as basic principle for the policy
2. prevention and enforcement are mixed up
3. no attention for girls and women who are circumcised
4. too little attention for participation by the target group
5. no structural anchoring of the policy
1. too little attention for human rights as basic principle for the policy
Although some policy papers do mention that FGM is a violation of human rights, human
rights are no topic in the policy. The policy is limited to measures aimed at the decrease of the
number of circumcisions; FGM and the combat of it is not placed within a broader framework
of women’s and children’s rights. It is important to do so. Not only because international
documents oblige or call to do so, but also because it means that the approach is more than
symptomatic treatment. Attention for the human rights of women implies attention for the
underlying stereotype gender roles and attention for improving the position of women and
girls. This means that not only the symptoms are dealt with, but also the underlying causes.
The human rights based approach should be placed more central in the policy and
implementation plans:
The policy should explicitly acknowledge that:
- FGM is an expression of unequal positions between men and women, and is maintained by
traditional attitudes in which women are viewed as inferior to men.
- all women have control over their own sexuality and reproduction, and the right to a
satisfying and safe sex life.
- FGM is occurring within various cultures and religions; the rejection of FGM does not
imply the rejection of a culture or religion as such.
3The policy should be aimed at:
- changing the existing attitudes and gender stereotypes that contribute to the continuing
existence of FGM;
- empowerment of women and girls
The policy should contain measures to:
- change traditional attitudes in which women are viewed as inferior, and the cultural patterns
of behaviour of men and women which are based don that attitudes,
- ensure equal relations between men and women regarding reproduction
- empower women and girls.
The policy should pay attention to:
- cultural differences and language-barriers
- the role which women and girls, and (women’s) NGOs play in the development and
implementation of the policy.
Regarding the privacy-aspects of the policy on FGM, further research is needed
2. prevention and enforcement are mixed up
The policy contains measures in the area of prevention, and measures in the area of
enforcement. However, these measures are highly mixed. This might have a negative effect
on the effectiveness of both prevention and enforcement.
The focus of the combating of FGM lays with the approach via the Youth Health Service. The
efforts of the Youth Health Service are aimed at preventing FGM. For this purpose, a protocol
for discussing FGM within the regular contacts of the Youth Health Service has been
developed. So far, so good.
However, elsewhere in the policy, this protocol for discussion is also mentioned as a specific
form of the reporting-code for child abuse. This means that the Youth Health Service is given
a key role in the early detection of child abuse, and the reporting at the Reporting Centre for
Child abuse and the police.
Although prevention and enforcement are both necessary to eliminate FGM, mixing them up
in practice might make both less effective. With a view to the accessibility and acceptability
of services, it should be totally clear for girls and parents that the main focus of the Youth
Health Service is the health of the child, and therefore prevention of FGM and victim-support.
Of course, professionals who are responsible for prevention of FGM, should report a case of
FGM if they come across it; but criminal investigation should not be the aim of their
intervention. Prevention workers should give priority to prevention and police and
prosecution workers to the criminal investigation. It is important to have interdisciplinary
contacts, ‘chain-cooperation’, a good reporting code and clear guidelines for each profession,
but it has to be clear who has which responsibility and priority.
The study recommends that the policy should make a clear division between prevention on
the one side, and registration and investigation on the other side. This means that the protocol
for discussing FGM (aimed at prevention and support) should be a different document from
the reporting code, which gives guidelines on when and how to report a case of FGM to the
police and other institutions.
43. no attention for girls and women who are circumcised
The policy on FGM is merely focused on the prevention of FGM, and to some extent on the
enforcement of the criminal provision which prohibits FGM. There is no attention at all for
the support of women and girls who are circumcised. This is a serious shortcoming of the
policy. It is necessary to develop additional measures with regard to victim support, both
towards girls who became a victim recently, as well as towards women who have been
circumcised in the past, and are still dealing with the effects. A complete range of support
services should be made available, including medical, sexuological, psycho-social and legal
support for both the victim and her family. Information on the support services must be
widely available, both to the various target groups as well as to professionals.
4. too little attention for participation by the target group
Since approximately 1990 some NGOs and a lot of African women have been very active in
combating FGM in the Netherlands. They made the topic discussible within (mainly) the
Somalian communities, developed awareness raising activities and trained both key persons
from the communities and professionals. However, these organisations were only slightly
involved in the development of the current policy as formulated by the government.
The Commission in Health Care which studied the topic and advised the government on the
policy did pay attention to the target group. The governmental policy however, does not
mention the African women and their organisations, and thus fails to recognise their efforts,
and ignores the fact that the contribution from the target group is essential for an effective
combat of FGM.
Although the government promised in parliament to pay more attention to the role of grass
root organisations, they pay very little attention to it in the first annual report on the
implementation of the policy. Also in practice, the organisations are not involved at policy-
making level; it seems that they are still no discussion partner for the ministry of health,
which coordinates the policy.
In the implementation on local level, the grass root organisations do have a role, especially in
the six regions. However, Local Health Services coordinate and supervise the implementation;
the task of the grass root organisations is to carry out certain parts of the policy. There is no
equal participation. Apart from inequalities in position regarding the policy and budget; other
inequalities between the Local Health Services and the grass root organisations should be
taken into account. Professional institutions are often ‘white’ institutions, which are not used
to cooperate with the (black) target group. Also the difference of working as professionals and
working as volunteers lead to different positions. It is very important to recognise and value
the role of grass root organisations. By giving them a real position in decision making and
budgeting; by acknowledging their expertise, by respecting their culture and way of work, and
by rewarding them for their work in a way that makes clear that their efforts are as valuable as
that of the paid professionals.
5. no structural anchoring of the policy
The policy on combating FGM is limited in time, place and target group. The approach is
concentrated in six regions (cities), and focuses with in those regions on the inhabitants from
six risk countries. This approach in the six regions will be financed for three years. No budget
is available to implement the approach on FGM outside the six regions. Also no budget is
5available to anchor the approach structurally within the six regions (extended capacity of
Health Service and other institutions, continuation of training of professionals and awareness
raising campaigns).
Therefore, there is a huge risk that the approach is nothing more than a 3-year project, of
which the impact will have disappeared after a few years. Some aspects of the policy will
maybe lead to some sustainable effects (the awareness raising within the risk group might be
the beginning of an irreversible process), but without extra earmarked financial resources, it
can be expected that within the Youth Health Services the attention for FGM will loose the
competition with other important issues as obesity, diabetes and possible new developments.
To make the approach of FGM effective in the long term, it is absolutely necessary to develop
a plan for implementation of the (improved) policy in the whole country and for all women
and girls at risk. This plan has to be developed in short notice. Also, structural resources for
implementation of the policy are required.
Follow up
VON (Refugee Organisations Netherlands) intends to present the original Dutch study at 6
February 2008, at the international day against FGM.
VON also intends to use the recommendations in the study for future advocacy work.
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