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Couple accused of female genital mutilation claim daughter sustained injuries when she fell on toy

Two doctors told a court that the injuries sustained by the girl are not consistent with falling on an object.

File photo
File photo
Image: RollingNews.ie

Updated Nov 20th 2019, 4:50 PM

A COUPLE ACCUSED of carrying out female genital mutilation (FGM) on their daughter at their home in Dublin in 2016 have claimed she sustained her injuries after falling on a toy.

The trial of the couple, who can’t be named for legal reasons, began before Judge Elma Sheahan today.

Yesterday they both pleaded not guilty to one count of carrying out an act of FGM on the girl at an address in Dublin on 16 September 2016.

The man, aged in his 30s, and woman, aged in her 20s, also pleaded not guilty to one count of child cruelty on the same day.

The State is not arguing that the couple carried out FGM on their daughter, rather that they “intended to aid, abet, counsel or procure” the procedure, prosecuting counsel Shane Costelloe SC said.

The accused brought their daughter to Our Lady’s Children’s Hospital, Crumlin (OLCHC) on 16 September 2016. They asked for immediate assistance because she was bleeding.

The young girl, who was just under two years old at the time of the incident, was triaged and brought to the emergency room.

A paediatric surgeon, Professor Thambipillai Sri Paran, carried out a procedure to stop the bleeding, Costelloe told the court. He added that Paran took the view that the injury the girl sustained was non-accidental. The head of her clitoris had been removed.

The case was referred to An Garda Síochána.

Toy shown in court

The accused claim their daughter sustained her injuries after falling on a toy while not wearing a nappy. The toy in question was seized by gardaí during a search of the couple’s home following the alleged incident.

The toy, which was shown in court, was described as an activity centre with a steering wheel and other protruding objects including a mirror.

Professor Paran this afternoon told the court he carried out surgery on the girl in an operating theatre in OLCHC on 16 September 2016.

Attempts to stop the bleeding, such as applying pressure, had been unsuccessful and the decision to carry out surgery was made prior to his arrival, Paran said. He was the consultant on call that day and carried out the surgery at around 5pm.

“When it doesn’t stop and there’s significant bleeding we need to bring [the patient] to theatre to control and stop [the bleeding],” Paran told the court.

He noted that he carried out electrocauterisation on the child. He said this process involves passing electricity between two metal prongs and the area which is bleeding – in this case, the girl’s vaginal area. Paran said anything that is in between the metal prongs will be “literally burned”.

Paran said the bleeding was “quite brisk for a child of that age”, adding: “For a surgeon who observes bleeding all the time, it was going, it wasn’t planning on stopping.”

He said a haemoglobin test – which was done when the child was in the emergency department – indicated that the wound was sustained about four hours beforehand. He said it can be difficult to ascertain the exact time a wound is inflicted, but added: “It was a fresh wound and was bleeding.”

Paran said if the girl did not undergo surgery, she would have had difficulty breathing due to a lack of oxygen, and would have gone into shock by the following morning.

No clitoral head 

Paran said the surgery was “carried out where clitoral head would be expected to be”. When asked to clarify if the clitoral head was present on the girl, he said it was “not there”. “The clitoral head is a little mound so when it’s absent the whole area looks flatter, and there is bleeding coming out of it the whole time,” he stated.

Paran said he noted a laceration on one side of the girl’s labia minora. He initially thought the labia minora “may be gone” too but a later examination carried out by him and colleagues found it “was still there but had been cut”.

When being questioned by the defence, he said it initially appeared to him that the left labia minora was “partially missing” and the right labia minora was “mostly missing”. He said a certain amount of “guesswork” was involved as he was not sure what the size of a 21-month-old’s labia should be. “It’s so small, we’re talking about 2.5mm to 3mm,” he noted.

‘Story didn’t match injury’

Paran told Costelloe, prosecuting, that after the surgery was carried out, he spoke to the girl’s father about how she was injured. Paran said the father told him the girl had a dirty nappy and that her mother brought her into the bathroom in the family home to change her.

“[She] was coming out of the bathroom without a nappy on and something happened and while she was moving backwards she fell onto a toy and sustained the injury,” Paran said of the conversation with the girl’s father.

Paran said that, at a “much later stage” he saw the toy in question at a meeting with other medical consultants and gardaí.

“The story didn’t match the injury that I saw,” Paran said, stating: “I felt that this is not a crush injury, if you fall onto something it will crush.” He said tissue would typically hang loose if it was crushed and this was not the case in this instance.

When being questioned by defence solicitors, Paran said: “When the story and the injury doesn’t tally, we know we are legally obliged to raise the alarm.” He said doctors know they have to “gather evidence”, and that a clinical photographer is employed by the hospital but was not available at the time in question (after 5pm on a Friday).

He said in the absence of this photographer, medical staff would typically use a digital camera which is normally left in the operating theatre. Staff members are not allowed to take photos on any other device. The camera was not available on the date in question so he used a cystoscope – a thin tube with a camera and light on the end of it – to examine the girl and record same so there would be photographic evidence.

‘Frightened by a toy’

Dr Sinéad Harty, a paediatrician and clinical lead in child protection at OLCHC, also gave evidence today. She carried out an examination of the girl on 19 December 2016, three days after the surgery.

Harty noted that a urinary catheter had been installed “to drain urine” after the surgery.

She said that one side of the girl’s labia minora “was a bit shorter, I think the right, but wasn’t in any way damaged”. She said the clitotal hood was “in tact” but that, underneath the hood, she “couldn’t see the head of the clitoris”.

When asked directly by Costelloe, “Was there a clitoral head?”, she replied: “I didn’t see it.”

Harty noted that the girl’s father was present during the examination and had consented to it. She said the father explained to her how his daughter sustained the injury.

“He told me that [the girl] had a dirty nappy on the Friday and that her mother brought her into the bathroom to change her … the mother was washing her hands in the bathroom, [the girl] came out of the bathroom without her nappy on. He showed her a toy that frightened her and caused her to run backwards and that she fell on a toy,” Harty said.

She stated that the injury “wasn’t consistent with” falling on a toy, noting there was no bruising or abrasions.

Harty agreed with solicitor Patrick Gageby SC, who is defending the female accused, that the parents have denied being part of any kind of FGM being carried out on their child.

Both Harty and Paran confirmed to the defence that the girl in question and her siblings seem to be well cared for and have a loving relationship with their parents, something social workers assigned to the case also stated.

“She was a well-grown child, clean, appropriately dressed and she looked very well cared for,” Harty said, adding that the girl was “in reasonably good form” when she met her.

When asked by the defence about why she had changed her initial opinion that the labia minora was damaged, she said she had queried this because “sometimes it’s not only clitoris that is damaged during FGM”.

Photographs

Earlier today, the jury was shown photographs of the couple’s house, taken by gardaí in the days after the alleged incident.

Detective Sergeant David Conway took photos of areas in the house as well as items considered to be evidence on 23 September 2016.

He confirmed that the carpet near the kitchen had been “disturbed”, when being questioned by John Byrne BCL, acting on behalf of the State. Conway took photos of the carpet and its underlay, which have been made available to the jury.

Markings believed to be blood were visible on the carpet, the court heard.

FGM has been outlawed in Ireland since 2012 but no one has been convicted to date. The offence, on conviction, carries a sentence of up to 14 years.

The Criminal Justice (Female Genital Mutilation) Act 2012 lists FGM as “any act the purpose of which, or the effect of which, is the excision, infibulation or other mutilation of the whole or any part of the labia majora, labia minora, prepuce of the clitoris, clitoris or vagina of a girl or woman”.

The trial will continue tomorrow before Judge Sheahan and a jury of eight men and four women.

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Órla Ryan

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