Cultural awareness – advice for practitioners
Although some cultural practices are subjective as to whether they constitute abuse, there are a number which can be definitely classified as significant harm and should not be ignored by practitioners.
These include Female Genital Mutilation (FGM); Breast Ironing; Forced Marriage; ‘Honour’ based violence and abuse; and abuse linked to a belief in witchcraft or spirit possession. There are other cultural abuses that originate from traditional practices, including traditional medicines and rights of passage. Some of these may not always constitute ‘significant harm’ to a child or adult.
Whatever the context of ‘family’, it can be broadly defined as a collection of people who care for each other and any children in the family. A family cares for children by building resilience and self-esteem through the provision of childcare, such as providing physical needs, emotional support, play and learning opportunities, moral guidance and a sense of identity and belonging.
Extended families not only care for their children but also older generations may be involved in child rearing or be in need care and support themselves: there may be 3 or even 4 generations of a family living together.
When asylum seekers, refugees and migrant families arrive and settle in the UK, there are sometimes tensions in culturally based perceptions of family attitudes and expectations regarding children’s behaviour and parenting methods.
The independence and free expression experienced by western children and young people differs from the co-dependency and respect for adults expected in other cultures. Even within similar cultural and socio-economic groups there will be a range of different attitudes and values. It is therefore important to take account of an individual family’s frame of reference and diverging child rearing practices should not be seen as requiring ‘westernisation’ simply because they are different. Safeguarding should be viewed through the lens of child welfare, rather than the norms of Western culture.
For more infornation visit www.includingfamilies.org.uk
It is likely that asylum, refugee and migrant families will rely upon different ideas of how ‘family’ is organised, using their own beliefs and values based on culture and religion. This can impact on parenting styles, child rearing practices and the roles and expectations of different members of the family.
It is important for practitioners to develop cultural competency by familiarising themselves with a family’s make up and functioning. This enables a better understanding of the influences on the family and interactions between family members and together with how the family interacts with the local and wider community, will enable a more comprehensive and holistic assessment of family needs. Some of the issues affecting asylum, refugee and migrant families may include:
- beliefs, rituals and rights of passage around key life stages
- gender roles and tensions
- intergenerational roles and tensions
- stress due to uncertainty about the future
- parenting styles and different approaches to parenting
- children’s behaviour
- children’s expectations
- children’s education
- caring responsibilities
A cultural competency based approach to providing services should enable practitioners to assess how a family is structured, the roles played by various family members and the interactions within the family, as well as how the family engages with the outside world. Tension between family responsibilities and obligations and the differing relationships of individual family member with the outside world puts the family structure under varying amounts of strain and pressure. This in turn will affect how families interact with practitioners and cross-cultural factors should be taken into account when proposing or discussing interventions.
Traditional and Folk Practices
Talking to the parents, to find out what it is they are doing and the reasons for it, can help practitioners to make a more accurate assessment of the situation, and prevents misunderstandings.
If there are language difficulties, an interpreter should be brought in; children should never be asked to act as interpreters for their parents.
It is also important to speak to the child to ascertain their views on whether a practice is harmful. It can often be helpful to involve community leaders who will be familiar with individual families and their practices, especially where language may be an issue.
Where disciplinary, traditional or folk practices appear to be overly harsh or harmful, the practitioner should carefully explain the law regarding abuse, to the parents and inform them of any course of action that may be taken, if there continues to be child protection concerns.
The MSCB adopts the GMSP procedures and the guidance for Culturally Appropriate Practice can be found in chapter 1.9 of the greatermanchesterscb.proceduresonline.com
There is no requirement in law for professionals undertaking male circumcision to be medically trained or to have proven expertise. Traditionally, religious leaders or respected elders may conduct this practice.
Male circumcision that is performed for any reason other than physical clinical need is termed non-therapeutic circumcision.
Doctors are under no obligation to comply with a request to circumcise a child and circumcision is not a service which is provided free of charge. Nevertheless, some doctors and hospitals are willing to provide circumcision without charge rather than risk the procedure being carried out in unhygienic conditions.
Poorly performed circumcisions have legal implications for the doctor responsible. In responding to requests to perform male circumcision, doctors should follow the guidance issued by the:
- General Medical Council: Guidance for doctors can be found on their website at www.gmc-uk.org/undertaking_procedures
- British Medical Association: response to requests to perform male circumcision can be found on their website www.bma.org.uk/male-circumcision
- Royal College of Surgeons: Male Circumcision: Guidance for Healthcare Practitioners available from their website www.rcseng.ac.uk/male-circumcision
Non-Therapeutic Infant Male Circumcision Services in Greater Manchester
In Greater Manchester circumcision is not provided by the NHS unless there is a medical reason. Many families however choose to have their son circumcised privately for religious or cultural reasons.
To safeguard boys from the potential harm associated with a poorly conducted procedure parents need support to help them access a quality assured service.
A leaflet is available that includes information about what to expect before, during and after the circumcision is available in various languages (Arabic بية, Farsi, Urdu, Somaali, Turkish and Bengali) on the GMSP website at www.gmsafeguardingchildren.co.uk/non-therapeutic-infant-male-circumcision-services-in-greater-manchester
The eight circumcision services featured on the GMSP website have achieved quality assurance status for 2016 for services provided to infant boys aged 12 months and under. These services have voluntarily provided information to a group of experienced child health and well-being professionals.
Although the services have not been individually visited, they have sent in evidence to show they are providing a service at an appropriate standard. This list is updated every year.
Service providers can download a self-assessment form below along with the standards their service will need to provide evidence against.
Further advice can be found at:
- NHS Choices on their website www.nhs.uk/Circumcision-in-children
- AFRUCA the Safeguarding African Children Network provide an opportunity for mutual learning and support among African communities and faith organisations interested in the safeguarding of African children. Contact AFRUCA on tele: 0844 660 8607 or visit their website www.afruca.org.
- Coram Legal Centre find out more on their website www.protectingchildren.org.uk
- Including Families Project find out more on their website www.includingfamilies.org.uk