Procedures for Communicating with Victims or Those at Risk of Harmful Practices

The reception of women victims or at risk of HPs:

  • Women must be guaranteed regular and timely access to information and training on their rights in a language they understand.
  • Practitioners must know, and act accordingly, that every child, every woman, beyond all traditions and conventions, has the right to health and the integrity of her person.
  • Knowing the traditions and typical practices of other cultures is a fundamental element in building an equal relationship between operators and guests of the facilities, always bearing in mind the universal principles of protection of the human rights of women, children and girls.
  • Knowing these traditions in their proper dimension and avoiding stigmatisation and/ or criminalisation helps to prepare for a dialogue that welcomes women who have been victims of these practices.
  • It is important that the reception workers are also prepared to deal with these issues, informed about the existence of these traditions and able to offer the women bearers the necessary assistance.
  • The interviews with women must consider the possible ethical, psychological and therapeutic implications, should use cultural mediation and must constantly be marked by respect for the principle of the person’s autonomy and that of their benefit.
  • In conducting an interview with women who may have been subjected to a traditional HP, a balanced attitude must be maintained, without prejudice and judgement of either the phenomenon or the culture of origin, and without assuming that all women have been subjected to the practice.
  • Considering that sexuality remains taboo in many communities, the approach of verifying a woman’s reproductive health and well-being can provide insight into whether she has been subjected to FGM or other HPs.
  • In the specific case of healthcare professionals in identifying FGM, if deemed necessary, the healthcare professional should identify the type of incision or alteration present, taking care to minimize repeated examinations that may cause the individual to experience increased discomfort or feelings of intrusion into their personal privacy.

At the initial interview stage, it is recommended to:

  • Identify the woman’s geographical and cultural background.
  • Ask the victim or person at-risk if they feel comfortable talking to you in your current location, and make sure to speak to them in a secure and private space. If the person is accompanied by someone, do not assume it is safe to talk about their experience in front of that person, you should always speak to them on their own.
  • Reassure the victim or person at risk about confidentiality and explain informed consent, namely that you will not give information to anyone (including family, friends or community) without their consent or against their wellbeing.
  • Understand whether she has a minimum of schooling and primary knowledge of her body.

Once these two elements are understood, discuss with the woman the possible traditional practices present in her culture and linked to rites of passage and/or purification. This will make it possible to understand with what terminology the woman identifies the phenomenon, and then to relate with her to identify what type of practice was performed.

Once a relationship of trust and confidence has been established, one can proceed with more specific questions concerning, for example, the regularity of the menstrual cycle, possible pain during the cycle and/or during sexual intercourse, and how any pregnancies and births have taken place. Depending on your professional capacity and how the victim or person at risk of harmful practice reaches you, when you contact them they may not disclose directly what has happened to them, or may only indirectly hint it. Victims may not step forward easily because of insecurity, feelings of shame and guilt, and out of loyalty to the family. In the case of FGM, at times victims do not even perceive it as an issue or the cause of other health problems.

Things to do:

  • Inform the woman about her rights and the course of the interview that is to be conducted;
  • Use simple, clear language, without the use of adjectives that might indicate judgement with respect to the woman’s culture of origin;
  • Conduct the interview in a protected place and with female staff (including the linguistic-cultural mediator, trained on the subject);
  • Engage on a “need to know” basis. This means that you should only ask what you need to know in that moment in order to fulfil your role in supporting or protecting the person in need;
  • Do not ask unnecessary intrusive questions that might further traumatise the victim;
  • Say some statements of comfort and support and reinforce that what happened to them was not their fault;
  • Consider that, if possible, this conversation might require longer time allocation. It is not easy to speak about traumatic experiences, so it should not be rushed;
  • If the level of risk does not demand otherwise and it is possible for you to do so, you may need to evaluate whether or not the victim or at risk person is ready to talk about the harmful practice. If they are not yet ready to talk more and it is possible for you in line with your professional capacity, give them time. Try to find what fears and anxieties are interfering, reassure them about confidentiality, encourage to meet again and provide them with accurate and up-to-date information about relevant available services;

Reassure the victim or at-risk person that actions to be taken will be discussed with them and also that they can ask for help at any point, even if later on, unless there is a risk requiring an immediate action.

Things not to do:

  • Take for granted what FGM or other HPs are and consider it as negative practices;
  • Use aggressive and/or stigmatising language;

Avoid conducting the interview with multiple people present, or excluding a woman from the interview process, especially when the victim is female.

The reception of potential women victims of forced marriages

  • All interviews with the woman must take place confidentially;
  • For the interview, it is essential never to use relatives, friends or mediators belonging to the community of reference as interpreters, because this would prevent the woman from expressing herself clearly about the situation of violence suffered and prevent her from asking for help directly;
  • The interview should always take place in a place that is perceived by her as safe. All risk factors must be considered and assessed in the interview;

The woman must be explained, briefly and clearly, the possibilities of aid she can avail herself of and the possible solutions from a legal point of view.

Pregnant women after a forced marriage

In cases where the woman has chosen to keep a child born because of the unwanted marriage, the path of protection is flanked by that of accompaniment to motherhood. Loneliness, feelings of guilt, and nostalgia for a “family community”, even if violent and disrespectful, may have devastating effects on the woman’s psychological and physical health.

It must be borne in mind that, until the child reaches the age of six months, stringent security measures must be taken: in fact, this is the time limit in which the father may have an interest in tracing and recognising the child to obtain regularisation if he has entered irregularly in such European country.