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Fighting to combat FGM


Joanne McEwan is truly applying her knowledge to help women affected by FGM

joanne mc ewan

joanne mc ewan

Joanne McEwan plays many roles in her daily life – nurse, mother, and health visitor in the community of Oxfordshire, to name a few. Her schedule is already full, but that hasn’t stopped her from adding yet another title to the list: app developer, for an app that will help women who have been affected by female genital mutilation, or FGM.

“I’ve been involved in the discussion on FGM since I was training as a nurse in the  ’80s,” she says. Though she began her nursing career in Glasgow in 1986, she soon moved to Egypt, where she remained for 13 years with her family. This was also where she became aware of the horrifying realities of FGM, which is a common practice in many African countries.

“I have three daughters, and raised them in Egypt, so they were exposed to the culture of FGM. So I’m quite well aware of the cultural background, even though my own children are free from the practice,” she says. When Ms McEwan returned to the UK in the early 2000s, she began thinking about how to help both those at risk and the survivors of FGM – both in Africa and in the UK.

“No matter where people come from, it’s a concern to society as a whole,” she says. “It’s illegal here, but girls could be sent abroad to have it performed on them. We have a general understanding that about 137,000 women and girls in the UK are at risk or have been affected by FGM.”

“We’re always trying to use technology as a main source of information for our jobs, which is where this idea came from”

These shocking statistics combined with Ms McEwan’s personal background motivated her to get involved. Preparation met opportunity when she received a Mary Seacole Leadership Award in October 2015, which provided her with funding to start work on the app. Ms McEwan’s desire to use technology to support patients has definitely driven this part of the process, especially because technology is so pervasive in healthcare.

“All the other community nurses and I have iPads. We’re always trying to use technology as a main source of information for our jobs, which is where this idea came from,” she says. “This is part of an ongoing process of nurses being innovative to improve patient care.”

Ms McEwan has spared nothing to ensure that the app will be a success. She and her colleagues at Oxford Health and Oxford Against Cutting, an organisation devoted to the prevention of FGM, spent months doing focus groups before they began production on the app. 

“It was very interesting to hear what the focus groups shared about how they felt, what they needed, and the barriers that we have when we talk about these issues surrounding FGM,” Ms McEwan says. “It was a really humbling exercise.”

One of her favourite parts was working with several young women to create a short film that will be featured in the app. “We had three girls and each of them had something unique to say,” Ms McEwan says. “The film was edited and montaged in such a lovely way – it’s interesting and quick and only a couple of minutes long, but I think young people will really enjoy watching it.”

Although the app is designed for communication between women and Oxford Health professionals, Ms McEwan says it can be used by affected women to communicate among themselves as well.

“It’s a tool aimed at opening a discussion, because we understand it’s a difficult subject to talk about for everyone,” she says. “The app helps start the conversation.”

While this app to support women with FGM is Ms McEwan’s current focus, that does not mean she has lost sight of her other roles. “I think the role of public health nursing is key to promoting a healthy population,” she reflects. “It’s really important, and a privilege for health visitors like me to be invited into someone’s home to talk about really personal issues.”

Ms McEwan’s dedication to helping people with difficult personal issues has been an essential part of developing the app, and it will drive her to continue improving it.

“It’s all about making sure that people use this app and making sure that this app is used by others, and making any necessary improvements,” she says. “And then I’ll just see from there.”

Savannah Cordova


Readers' comments (2)

  • It's good to have nurses with real experience comment on the practice generally. I've also spent a lot of time researching and blogging about it on Shifting Sands. But it's also important that someone of Joanne's calibre be circumspect abut how they report what's happening in Britain. “It’s illegal here, but girls are sent abroad to have it performed on them.'' Really? Where's the evidence? And ''We have a general understanding that about 137,000 women and girls in the UK are at risk or have been affected by FGM.” Do we? This is an estimate that is not matching reality. A year of data from the HSCIC (the most accurate data available in England) tells us that there is disparity between the panic about FGM and the reality of FGM. And cosmetic genital piercings in under 18's are being classified and reported as FGM! The most striking thing about the figures so far is just how low they are, given the high number of immigrants from FGM-practising countries, especially Eritrea, Ethiopia and Somalia, now living in the UK. So let's try to keep the issue in perspective. We owe it to fellow professionals as well as the communities considered to be 'at risk'.

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  • Thanks for your comment Brid. There was an element of being misquoted here. I did not say that girls are taken abroad to have it done but only that it was a possibility. Journalists will ask about figures to make an impact.

    So far from all cases that we know of reported to the police (as discussed at FGM zero tolerance meeting in March), girls have been cut before coming to live in the UK. And 137,000 figure is only based on particular ethnic populations - all are estimates. However, what is the reality? We know there are many survivors and new figures were released from UNICEF that the global figure had been underestimated for a long time.
    HSCIC data from the enhanced dataset is not the most accurate data and certainly incomplete. Very few Trusts have submitted data and its purpose is very controversial/breaching patient confidentiality for a political purpose as it means submitting identifiable data. If HSCIC's ethos continues, their data will continue to be unhelpful.

    FGM unfortunately has crossed to the political. Thanks again for your comments.

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