'You feel everything during the operation. Everything'

AMINA Ahmed was 11 when she was circumcised. She knew what was about to happen but nothing prepared her for the excruciating pain she experienced. Held by women from her village, she was pinned to the ground for two hours while her clitoris was hacked away. There was no anaesthetic and she felt every cut and gouge.

"You feel everything during the operation. Everything," she says. "You want to be free and run away but you can't. The strongest women in the family hold you down, sitting on your shoulders and your legs. You can't do anything. You cry and you want it to be over but it lasts forever."

The instruments were unsterilised and the woman carrying out the operation had no medical training; she was practising techniques that had been passed down through the generations.

To westerners, female circumcision - or female genital mutilation (FGM) as it is perhaps more accurately known - is barbaric, but in Somalia, where Amina grew up, it is commonplace.

Now in her 50s and sitting on a park bench in Middlesbrough, enjoying the spring sunshine, she seems far removed from her childhood experience. She has two daughters of her own, who are shopping in town.

Being circumcised not only scarred her body, it made a deep and lasting impression on her mind, and for the last few years, she has dedicated her life to eradicating what she now regards as a brutal practice.

At the time, Amina had no choice about the procedure. In fact, she wanted to be circumcised. "We didn't understand what we understand now. It was the culture. Every woman had to accept it otherwise she was isolated," she says.

"It is about purity, protecting women from sexual activities, and it's also about moving to womanhood. It means a girl can get married and that gives dignity to her and her family. I wanted to be circumcised because I wanted to belong to society. I was not scared because I knew it was something that was good for me. That's what I believed and what everyone else believed."

She didn't begin to question FGM until the late 1970s when she became more aware of life outside her community and realised that other Muslim women were not circumcised.

"I couldn't understand and I started to ask why it happened to us. I questioned the imams, my parents, villagers. I found out it wasn't in Islam to circumcise women. It was about our culture. From then, I wanted to go against the practice. I know every woman has suffered and it is always in my heart to do something about it. It is very, very painful and it is also baseless."

FGM is common in Asia and the Middle East but is most widely practised in Africa, usually on girls between the ages of four and 13. It also takes place in immigrant communities in the West. An estimated 135 million of the world's girls and women have undergone FGM. In Britain, experts believe 74,000 first-generation African women have undergone female circumcision and around 7,000 girls are currently thought to be at risk from the procedure.

Reasons to justify the practice include religious obligation, cleanliness, preventing infidelity and male sexual satisfaction, all of which reflect the tradition and power structure of the communities in which FGM has developed and reinforce the subservience of women.

The type of mutilation varies from country to country, even from area to area, but there are three main types of FGM. The first involves the removal of the clitoris, while the second also includes the removal of surrounding labia. Type three is the most devastating, consisting of the partial or total removal of the external genitalia. The two sides of the vulva are then sewn up with sutures or thorns, leaving only a small hole for urine and menstrual blood. Women often have to be re-cut before they have sex or give birth.

Mutilation may be carried out using broken glass, a tin lid, scissors, a razor blade or a sharp stone. Anaesthetic is rarely available, nor is antiseptic, although the wound may be covered with herbs, milk, ashes or dung, which are thought to encourage healing.

Wealthier families pay to have their daughters circumcised in hospitals but because of the primitive conditions in which it usually takes place, many girls die, some from blood loss and others from infections contracted during the operation. Infections of the urinary tract and pelvis, abscesses and nerve damage are common. Even if the operation is successful, healing can take months or even years, and for circumcised women, sex can often be a painful ordeal.

FGM has been outlawed in Britain for almost 20 years but some African communities have evaded the law by sending girls abroad for the procedure. Last month, a new Act came into force to close the loophole by making this illegal. Amina is now working to publicise the Act and hopes that raising awareness will eventually eradicate the practice Britain.

Amina arrived in Middlesbrough from Somalia in 1989 and lived there until two years ago when she moved to Sheffield to work for the Agency for Culture and Change Management. ACCM was set up in 1997 and has developed FGM services around the country, working with families and young women who have been affected by female circumcision.

Amina is a family support worker, providing information and advice to African communities across Britain. A regular visitor to Middlesbrough, she works closely with the town's Somali and Middle Eastern communities. When we meet, she has just been talking to a group of women about the new Female Genital Mutilation Act.

"FGM doesn't really happen in this country but they might take the girls back to Somalia," she explains. "The new law stops that and I've been telling them that it's not a joke or something you can ignore. If you take girls back home and do female circumcision, you will be liable to be prosecuted. It's important to explain, especially when there are refugees coming in all the time."

Cases of FGM are not always picked up in Britain because many people are ignorant of the practice. ACCM offers training to professionals - midwives, social workers, teachers. It helps them provide appropriate support for women who have been circumcised, as well as identify those who may be at risk.

Amina say: "Although FGM happens, a lot of professional people have never heard of it and when they do, they can't believe it. Even when we're training midwives and nurses, they feel sick just hearing about it. We need them to understand so they can help prevent it happening in the future."

Progress is slow. A recent report for BBC2's Newsnight found that cases of FGM are on the rise in Britain, despite the new law. Doctors have reported seeing more cases because of the rise in the number of African refugees in the UK. But Amina believes the situation will change.

"It's a big problem because it's a very strong and old culture and the only way we can change it is to educate people. I am hoping that the law will make a difference and people will get the message. It will take a very long time but it will happen in the end."

The Agency for Culture and Change Management can be contacted on 0114 2750 193. The website is www.accmsheffield.org