A new film by leading African film-maker Ousmane Sembène opens in the UK this week, and highlights a practice that, according to the UN, still threatens 2 million girls each year. Moolaadé is about a woman in an African village standing up against ritual "purification", or female genital mutilation (FGM), the removal of all or part of the clitoris and labia. The procedure is still practised in 28 African countries and almost universally in parts of north Africa, but is not, however, an issue for Africa alone. It is a real and present problem in the UK - and one increasingly recognised by the police and the NHS.
Thousands of women a year are presenting to medical and community staff in Britain with problems resulting from genital mutilation. There are 12 specialist FGM clinics across the country within the NHS, and hundreds of operations are being carried out to reverse the most extreme form (type 3) in which girls are stitched almost closed.
The child protection arm of the Metropolitan police has become involved in the issue, launching a prevention campaign aimed at raising awareness of the law and opening up debate within the communities concerned. A legal loophole was closed last year making it illegal not only to carry out FGM in this country but also to take a girl abroad to undergo the ritual. In Britain the procedure is usually performed on girls between seven and nine. "With the school summer holidays approaching, this is a crucial time," says Detective Superintendent Carol Hamilton of the Met's child abuse investigation command, who is leading the awareness project.
The Met wants to ensure that all the practising communities in Britain are aware of the harmful effects of FGM, understand the new law and know that the police intend to enforce it.
Hamilton does, however, recognise the sensitivity of the issue. "This is a crime of love. Parents believe their daughters won't have a life without it. Most people don't really want to do it. If we can empower them, they will stop it themselves."
The police recently joined forces with Somali community leaders to run a conference in Brixton, south London, on FGM. The campaign is thought to have reached about half of London's Somali population, and it is now starting work with the Sudanese community and other Arabic-speaking groups. It hopes to take the campaign to cities around the country. Hamilton has been amazed by the support she has received from community leaders.
"The law and the police involvement are really useful," says Said Ahmad, director of Somali Human Hope, who helped organise the Brixton event. It sends a clear message, and provides a much-needed excuse. It gives parents a way to stand up to sometimes extreme pressure from the older generation, he says, especially on visits back to Africa: "Now we can say: 'I can't do this or I can't go back to Britain'."
There are no reliable statistics for the number of women in Britain affected by genital mutilation. The influx of refugees from civil strife in Somalia and Sudan keeps the numbers changing. Forward, a leading UK organisation devoted to the elimination of FGM, and organiser of this week's charity premiere of Sembène's, Moolaadé, is about to start some systematic research. Meanwhile, it estimates that there are around 100,000 women in the UK and some 20,000 girls "at risk" of genital mutilation.
"Many people are not ready even to consider opposing such a long-standing tradition," says a Somali community worker who does not wish to be named, "and they often still believe it is required by their religion." Having undergone the procedure herself, she was astounded when she first came to Britain to discover there were many Muslim girls who had never even heard of the ritual.
FGM is not practised by the majority of Muslims, but has acquired a religious dimension by those who do. Islamic leaders are not unanimous on the subject. Certainly it is not, as some would have it, "cleaner". Quite the reverse: it can cause appalling health problems both at the time of the procedure - often done with traditional instruments and little or no anaesthetic - and throughout life. Girls can find it difficult to pass urine, periods can be extremely painful, unexplained abdominal or pelvic pain is not uncommon, along with cysts and chronic low-level infections. There are psychological and social costs, too, which almost always go unspoken.
Mutilated women will often travel across the country to attend clinics known to have sympathetic and well-informed staff. Harry Gordon worked with Forward to start the first specialist clinic in the UK in 1993, and is now consultant in charge of the African women's clinic at Central Middlesex hospital. He has carried out more than 300 reversals of type 3 FGM.
All sorts of stories are told in different parts of Africa to make women accept genital mutilation, Gordon says. Besides the religious ones, there is a Nigerian tale that the clitoris will continue to grow, "so you wind up with something like an elephant", and in parts of west Africa, girls are told that if a baby touches the clitoris during birth it will die. So clinics need to do much more than the merely clinical. They need to go out into the community and educate and inform.
Leila Hussein agrees. The 24-year-old is a youth outreach worker for the FGM clinic that is part of the African well women service, in Waltham Forest, east London. She has been working with Hamilton on training sessions and runs a Saturday group for Somali young people. She does feel that progress is being made in Britain. Four girls of her acquaintance recently prevented their little sister from being circumcised. "They told their mother: 'You touch her and we'll have you arrested.'" It worked.
· Moolaadé is showing at the Renoir, Ritzy, Rio Dalston and National Film Theatre cinemas in London.
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