A CHILD screams. Pain, isolation, terror, torture. The seven-year-old’s cries shatter against the cold, hard walls of a secluded room. The stench of blood and scorched flesh fills the air.  The restraints tighten and rub her skin raw.

She has just had her clitoris cut off, her vagina sewn together and her genitalia burnt with corrosives. She will not be able to walk for months.

Every day across the UK, young girls become the victims of female genital mutilation. These girls are usually between four and 13.

FGM is a practice embedded in ancient beliefs surrounding women’s fertility and control of their sexual and reproductive capacity. It is mostly carried out in African cultures, but also in some Asian and Middle Eastern communities.

Common justifications for the practice include reducing the sexual desire of girls and women, promoting virginity and chastity and maintaining fidelity in married women.

It is not supported by any religion. Muslims, Christians and Jews have been known to inflict FGM on their girls.

It has been a criminal offence in the UK since The Prohibition of Female Circumcision Act came into force in 1985, and yet research done by the Foundation for Women’s Health, Research and Development (FORWARD) shows that more than 20,000 females in the UK are still at risk.

FGM is most prevalent in areas where there are high African, Asian and Middle Eastern communities, such as Ealing. The black and minority ethnic peoples in this borough constitute 40% of the population.

Ealing’s NHS-funded African Well Woman Centre offers support and advice for health issues as a result of FGM, as well as a clinic where women can get the reversal procedure carried out for free. The clinic provides confidentiality and anonymity for all women.

Since the end of 2008, around 200 women have come to the clinic for treatment but Juliet Albert, its midwife, says it is hard to know exactly how many women have been victims as many of them cancel their appointments out of fear.

The clinic tries to offer the safest and most secure environment for these women, to try to combat that fear.

Juliet said: “The clinic provides a therapeutic environment. In the clinic, the counsellors hold their hand and try to chat to them.

“We also give them control. They can say ‘stop’ at any point.”

She explained that women who want to come forward, but who are scared should know they provide a completely different service to that of the authorities.

“We are there to help them with their health. We are not there to judge. We just want to help,” she added.

Seeking treatment is incredibly important as there are seriously damaging physical and psychological effects from FGM.

The short-term impacts include pain and shock and infection. Victims can die immediately from blood loss. Complications in childbirth, sexual dysfunction, painful menstruation and cysts are some of the long-term effects.

Going through an horrific procedure at the hands of your family also means victims may suffer from post-traumatic stress disorder, depression and anxiety disorders.

Juliet says at least half of the women she sees have been deeply traumatised and a lot of them say: “I wanted it done. It was my fault.”

She says training for nurses in dealing with FGM should not only be compulsory but should be government-funded.

Southall Community Alliance and the Southall Black Sisters are two council-funded groups working to prevent FGM. But is this enough?

The National Alliance of Women’s Organisations Coordinator, Vicki Dabrowksi, thinks government policies serving females are disproportionate.

She asked: “Although we have laws, when was the last court case where someone was prosecuted?”

There has never been a conviction for FGM in the UK.

She recognises, however, that some admirable steps have been taken against FGM and violence against women.

One of these was The Female Genital Mutilation Act, which came into effect in March 2004.

Criminalisation of the practice unfortunately created other issues. Not only did it drive the practice underground, it also meant many families waited until the summer holidays to take their daughters away to be mutilated.

The Act aimed to deal with this, making it illegal to take British nationals or permanent residents of the UK abroad for FGM, whether or not it is lawful in that country.

It also increased the penalty from five to 14 years in prison.

More recently, on March 12 this year, David Cameron announced that the UK would adopt Europe’s convention on preventing and combating violence against women, which recognised FGM as a violation of human rights.

Since this recent legislation, attempts to prevent FGM have been extended by the Met Police.

They have joined forces with London Safeguarding Children Board, British Medical Association, AFRUCA, FORWARD, Agency for Culture and Change Management and Crimestoppers to develop Project Azure.

They were responsible for setting up the National FGM forum, which sits bi-monthly and is now headed by the Foreign and Commonwealth Office.

They have also worked with the Crown Prosecution Service to produce national guidelines for all prosecutors on the subject of FGM.

Sarah Mahoney, MPS press officer, said: “A lack of prosecutions does not reflect a lack of progress or rigour in the tackling of FGM. All allegations are thoroughly investigated and receive senior manager scrutiny.

“The MPS remains committed to protecting victims and pursuing those involved.”

She explained the real problem was that FGM was often a 'hidden crime' and remains a taboo within families and practising communities. Also the children involved are often from loving and caring families but it is their parents who decide to put them through FGM.

She added: “The perception may be that we are asking these girls to come forward and 'tell on' their parents.”

If you know someone at risk of FGM, contact Project Azure on 0207 1612888.

If you need care and support, call Juliet on 0208 3838712