FGM: UK's first female genital mutilation prosecutions announced

An offence was allegedly carried out by a doctor at the Whittington Hospital in London

The first UK prosecutions over female genital mutilation have been announced by the Crown Prosecution Service.

Dr Dhanuson Dharmasena, 31, of Ilford, east London, will be prosecuted for an alleged offence while working at the Whittington Hospital in London.
Hasan Mohamed, 40, of Holloway, north London, faces a charge of intentionally encouraging female genital mutilation.
Dr Dharmasena and Mr Mohamed will appear at Westminster Magistrates' Court on 15 April.
'Sufficient evidence' In a statement, director of public prosecutions Alison Saunders said the CPS was asked by the Metropolitan Police to consider evidence in relation to an allegation of female genital mutilation (FGM).

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Female genital mutilation

• FGM includes procedures that alter or injure female genital organs for non-medical reasons
• About 140 million girls and women worldwide are living with the consequences of FGM
• Dangers include severe bleeding, problems urinating, infections, infertility, complications in childbirth and increased risk of death for newborns

Source: World Health Organisation

• Find out more from the WHO
• BBC ethics guide: Female circumcision

It was alleged that following a patient giving birth in November 2012, a doctor at the Whittington Hospital repaired female genital mutilation that had previously been performed on the woman, allegedly carrying out female genital mutilation himself.

Ms Saunders said: "Having carefully considered all the available evidence, I have determined there is sufficient evidence and it would be in the public interest to prosecute Dr Dhanuson Dharmasena for an offence contrary to S1 (1) of the Female Genital Mutilation Act (2003).
"I have also determined that Hasan Mohamed should face one charge of intentionally encouraging an offence of FGM, contrary to section 44(1) of the Serious Crime Act (2007), and a second charge of aiding, abetting, counselling or procuring Dr Dharmasena to commit an offence contrary to S1 (1) of the Female Genital Mutilation Act (2003).
"These decisions were taken in accordance with the code for crown prosecutors."
NHS trust Whittington Health, which runs the Whittington Hospital, said it had contacted police and started its own investigation when staff raised concerns following a birth in November 2012.
Misunderstanding The CPS has decided to take no further action in four other cases of alleged FGM.
In one of those cases it was alleged that two parents had arranged for their daughter to undergo female genital mutilation while abroad.
In another, a suspect contacted an FGM helpline to request the procedure for his two daughters after misunderstanding the purpose of the service for victims.
The CPS is currently considering whether to proceed with four other cases.
Prosecutors have also had discussions with police over investigations into two further cases, which are at an early stage.
'Unforgivable' The UK has in the past been compared unfavourably to other countries over the issue, such as France where there have been more than 100 successful prosecutions.

Specialist midwife on the impact FGM has on women

MPs have said it is "unforgivable" that there have been no UK prosecutions since laws against FGM were introduced nearly 30 years ago.
This was despite more than 140 referrals to police in the past four years.
The Female Genital Mutilation Act 2003 replaced a 1985 Act, in England, Wales and Northern Ireland, raising the maximum penalty from five to 14 years in prison.
It also made it an offence for UK nationals or permanent UK residents to carry out FGM abroad even in countries where it is legal.
Home Office minister James Brokenshire said the government had "stepped up its response" to "take this crime out of the shadows" and give victims the confidence to come forward.
He said the "key message" was that the government took FGM "extremely seriously".
Education Secretary Michael Gove is writing to every school in England to ask them to help protect girls from FGM.
credt: BBC NEWS

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Miscarriage risk linked to low IVF success

The study analysed 124,351 IVF pregnancies between 1991 and 2008

Women who produce fewer eggs during IVF treatment are more likely to miscarry, research suggests.

Scientists analysed 124,351 IVF pregnancies between 1991 and 2008.
About 20% of pregnancies in women who produced fewer than four eggs after the ovarian stimulation phase of IVF ended in miscarriage.
The research indicated the quality of the eggs in these cases was poorer - clinicians said this information would help them to counsel patients.

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The information will empower women”

Dr Sesh Sunkara Reproduction Unit, King's College London

IVF involves stimulating a patient's ovarian cycle, extracting eggs from their ovaries, fertilising them with sperm in a laboratory, then transferring the embryo into the womb to develop.

Ovarian surgery risk In the study, carried out at King's College London and the University of Birmingham, the miscarriage rate fell to 15.5% for women who produced between four and nine eggs, and 13.8% for those with between 10 and 14 eggs.
The average risk of miscarriage across the population is 15%.
The co-author of the research, Dr Sesh Sunkara from the Reproduction Unit at King's College London, said: "I think the information will empower women.
"IVF treatment can be a distressing experience, and miscarrying makes it even more agonising."
Dr Sunkara said the study could indicate new risk factors such as ovarian surgery, which could increase miscarriage risk if it lowered the number of eggs a woman produced.
The fact women with fewer eggs had more miscarriages indicated the quality of the eggs must be lower, she said, as it was through such eggs miscarriages happened.

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It is really devastating for women... you want to cry with them”

Prof Siobhan Quenby Professor of obstetrics, University of Warwick

Early menopause

Prof Neil McClure, professor in obstetrics and gynaecology at Queen's University, Belfast, said: "This study is vast in terms of its numbers, and reached a very logical conclusion."

He said reduced egg production was linked to a woman's age, as young women produced lots of healthy eggs, which decreased in number and quality with age.
Prof McClure said he thought the younger women in the study who produced fewer eggs did so because they were on the brink of an early menopause, which was "more common than we might think".
Women who had miscarried after IVF and were worried about miscarrying again could opt for an egg donor, he said, adding that cutting down on smoking and eating a healthy diet would also help.
Help for clinicians Prof Siobhan Quenby, professor of obstetrics at the University of Warwick, said: "It [the study] will be very helpful for me as I see a lot of people who have miscarried after IVF."
She said uncovering the link between low numbers of eggs and egg quality was important to inform people in deciding whether to carry out another round of IVF, which costs on average about £10,000 if done privately, or opt for an egg donor.
Prof Quenby added: "There is a lot of emotional trauma involved in miscarrying after IVF. It is really devastating for women who wait 10 years to have a baby and then with eight weeks to go they miscarry.
"You want to cry with them."

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Malaria: High risk focused in 10 African countries

Paris – Gains in fighting malaria in sub-Saharan Africa have left the highest risk for the disease concentrated in 10 countries, according to a study published on Wednesday by The Lancet medical journal.
Nigeria, Democratic Republic of Congo, Uganda, Ivory Coast, Mozambique, Burkina Faso, Ghana, Mali, Guinea and Togo together account for 87 percent of areas that have the highest prevalence of malaria, it said.
The study assessed the effectiveness of the battle against malaria, which went into higher gear with the launch of the Roll Back Malaria initiative in 2000.
Since then, financial support has risen from $100 million (73 million euros) annually to about $2 billion (1.46 billion euros).
The researchers drew up a map of the changing face of malaria from thousands of surveys of prevalence of the disease among children in 44 countries.
They set down three categories of risk: high, meaning places where more than 50 percent of the population were likely to be infected by the Plasmodium falciparum parasite; moderate (10 to 50 percent of the population infected); and low (less than 10 percent).
From 2000 to 2010, the number of people living in areas of high-risk infection fell from 219 million to 184 million, a decline of 16 percent.
But the numbers living in moderate-risk locations rose from 179 million to 280 million, a rise of 57 percent.
The good news was that the tally of people living in low-risk areas rose from 131 million to 219 million.
Four countries — Cape Verde, Eritrea, South Africa and Ethiopia — joined Swaziland, Djibouti and Mayotte in the elite club of countries where transmission levels are so low that elimination of malaria is a realistic goal.
The researchers said the overall picture was mixed, and important gains had been partly offset by population increase — over the decade, an extra 200 million people were born in places with malaria.
“Substantial reductions in malaria transmission have been achieved in endemic countries in Africa over the period 2000-2010,” the paper said.
“However, 57 percent of the population in 2010 continued to live in areas where transmission remains moderate to intense and global support to sustain and accelerate the reduction of transmission must remain a priority.”
In its 2013 report on malaria, the World Health Organisation (WHO) last December said 3.3 million lives had been saved worldwide since 2000.
Even so, the mosquito-borne disease still killed 627,000 people last year, mainly children in Africa and Southeast Asia.
The agency pointed to a shortage of funding and a lack of access to artemisinin malarial medicines and basic remedies such as bed-nets remained a serious problem, it said. (AFP)

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Scientists: Global Warming Likely to Surpass 2°C Target

Look a long time for nations to set a speed limit on the road to a warming world.

But for the past four years, even though negotiators have never arrived at a plan for avoiding dangerous climate change, they have agreed on a goal: limiting the increase in the Earth’s global average surface temperature to 2°C (3.6°F) above the preindustrial level.
Now, two Union of Concerned Scientists (UCS) climate scientists and two colleagues argue that policymakers need to acknowledge that the world is already on track for warming beyond 2°C.
“A policy narrative that continues to frame this target as the sole metric of success or failure to constrain climate change risk is now itself becoming dangerous,” wrote Todd Sanford and Peter Frumhoff of UCS in the commentary published Wednesday in Nature Climate Change. “[It] ill-prepares society to confront and manage the risks of a world that is increasingly likely to experience warming well in excess of 2°C this century,” said the piece, co-authored by Amy Luers of the San Francisco-based Skoll Global Threats Fund, and Jay Gulledge, of the U.S. Department of Energy’s Oak Ridge National Laboratory.
Rethinking the Target
The authors are by no means the first to suggest a rethinking of the 2°C goal. Todd Stern, the lead U.S. climate negotiator in President Barack Obama’s administration, provoked anger in 2012 when he said a more “flexible, evolving” approach might be more effective in spurring a political accord. Coming at the issue from an entirely different angle, retired NASA climate scientist James Hansen and a group of colleagues wrote in December the 2°C target was not stringent enough, and “so dangerous” as to be “foolhardy.” At that level, the world risked initiating feedbacks in the climate system, such as the melting of ice sheet area, that could trigger irreversible warming out of humanity’s control.
Hansen and colleagues suggested a 1°C target was far less dangerous. The Earth has warmed 0.85°C from 1880 (preindustrial times) to 2012, according to the latest consensus science reported in September by the Intergovernmental Panel on Climate Change (IPCC), the scientific body established by the United Nations to inform governments of climate risks.
The UCS scientists and colleagues took the IPCC to task for issuing reports that present different future scenarios, while making no judgment on the relative likelihood of the varying projections, “implicitly treating all scenarios as equivalently plausible.”
“Inadvertently, the [IPCC] reinforces the present narrative by failing to provide policymakers with guidance on how to weigh the relative likelihood of the scenarios of future concentrations of heat-trapping gases and other drivers of warming on which its climate change projections are based,” the authors said.
In an email, Rajendra Pachauri, who has been chairperson of the IPCC since 2002 and who is an adviser to National Geographic’s Great Energy Challenge initiative, declined to comment on the opinion piece. “The Panel has an established process for producing its reports and in every respect we make efforts to see that our reports are policy-relevant,” he added.
Gavin Schmidt, a climate scientist with the NASA Goddard Institute for Space Studies, agreed that the world needs to assess the risks of high-magnitude warming, but he said criticism of the IPCC is misplaced.
“We do need to assess the risks of high scenarios, not just assume that [2°C] guiderail is achievable, but the call for IPCC to give probabilistic information about different [scenarios] is just a non-starter,” Schmidt said in an email. “What is the probability of an international carbon tax? A breakthrough in nuclear power generation? Solar? Of missing feedbacks in models becoming important? These are undefinable, and yet essential for what they are calling for.

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