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2.7 Abuse linked to Faith, Cultural and Religious Beliefs

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Breast Ironing also known as ' Breast Flattening' is the process whereby young pubescent girls' breasts are ironed, massaged, massaged, pounded down through the use of hard or heated objects, or by other methods in order for the breasts to disappear or delay the development of the breasts entirely. It is believed that by carrying out this act, young girls will be protected from harassment, rape, abduction and early forced marriage and therefore be kept in education.

Breast Ironing is a harmful cultural practice and is child abuse. Professionals working with children and young people must be able to identify the signs and symptoms of girls who are at risk of or have undergone breast ironing. Breast ironing is physical abuse and as such, professionals must follow their local safeguarding procedures and take immediate action.

The United Nations (UN) states that Breast Ironing affects 3.8 million women around the world and has been identified as one of the five under-reported crimes relating to gender-based violence The custom uses large stones, a hammer or spatulas that have been heated over scorching coals to compress the breast tissue of girls as young as 9 years old. Those who derive from richer families may opt to use an elastic belt to press the breasts so as to prevent them from growing.

The mutilation is a traditional practice believed to originate from Cameroon as a way of making teenage girls look less "womanly" and to deter unwanted male attention, pregnancy and rape. The practice is commonly performed by family members, 58% of the time by the mother (see  Breast Ironing... A Harmful Practice That Has Been Silenced for Too Long', 2011).

In many cases the abuser thinks they are doing something good for their daughter, by delaying the effects of puberty so that she can continue her education, rather than getting married.


Legal position

There is no specific law within the UK around Breast Ironing, however it is a form of physical abuse and if professionals are concerned a child may be at risk of or suffering significant harm they must follow the local procedures for responding to abuse Responding to concerns about a child.

There have been no prosecutions related to breast ironing and no true figures available for the number of teenage girls who might be affected or at risk in the UK. CAME Women's and Girl's Development Organisation (CAWOGIDO) is working in Cameroon and the UK to tackle the issue of breast ironing and believe that the practice is happening but due to the hidden nature of the act it is difficult to detect.

The rights of women and girls are enshrined by various legislation including:

All these documents highlight the right for girls and women to live free from gender discrimination, free from torture, to live in dignity, respect and with bodily integrity.



Suspicions may arise in a number of ways that a child is being prepared for Breast Ironing or is subjected to Breast Ironing.

If any agency becomes aware of a child who may have been subjected to or is at risk of Breast Ironing they must make a referral to Children's Social Care Services (see Referrals Procedure) or where the risk is imminent call the police on 999.



The girl generally believes that the practice is being carried out for her own good and she will often remain silent. Young pubescent girls usually aged between 9 - 15 years old and from practicing communities are most at risk of breast ironing.



Breast Ironing is a well-kept secret between the young girl and her mother. Often the father remains completely unaware. Some indicators that a girl has undergone breast ironing are as follows:

  • Unusual behaviour after an absence from school or college including depression, anxiety, aggression, withdrawn etc.
  • Reluctance in undergoing normal medical examinations;
  • Some girls may ask for help, but may not be explicit about the problem due to embarrassment or fear;
  • Fear of changing for physical activities due to scars showing or bandages being visible.

There may be older women in the family who have already had the procedure and this may prompt concern as to the potential risk of harm to other female children in the same family.


Health consequences

Due to the instruments which are used during the process of breast Ironing, for example, spoon/broom, stones, breast band, leaves etc. combined with insufficient aftercare, young girls are exposed to significant health risks. Breast Ironing is painful and violates a young girl's physical integrity. It exposes girls to numerous health problems such as cancer, abscesses, itching, and discharge of milk, infection, dissymmetry of the breasts, cyst, breast infections, severe fever, tissue damage and even the complete disappearance of one or both breasts.

This form of mutilation not only has negative health consequences for the girls, but often proves futile when it comes to deterring teenage sexual activity. The practice not only seriously damages a child's physical integrity, but also their social and psychological well-being.



The practice is carried out under the misguided intention to 'protect' women and girls from men's sexual harassment. These violent acts are not only perpetrated by men on women, but by older generations of women on young girls. In practicing communities, it is believed many boys and men believe girls whose breasts have grown are ready to have sex; therefore elders (mothers, grandmothers, aunties etc.) believe that by suppressing a girl's development of her breast she will be protected from rape, kidnapping, sexual harassment and early forced marriage.

Children's Social Care will liaise with the Paediatric services where it is believed that Breast Ironing has already taken place to ensure that a Medical Assessment takes place.

It should be remembered that this is an act of abuse to a child, although it will have lifelong consequences, and can be highly dangerous at the time of the procedure and directly afterwards.



Children's Social Care Services in consultation with the Police will undertake a Section 47 Enquiry if it has reason to believe that a child is likely to suffer or has suffered Breast ironing.

Where a child has been identified as at risk of significant harm, it may not always be appropriate to remove the child from an otherwise loving family environment. Parents and carers may genuinely believe that it is in the girl's best interest to conform to their prevailing custom.

Where a child appears to be in immediate danger of Breast ironing, legal advice should be sought, and consideration should be given, for example, to seeking an Emergency Protection Order or a Prohibited Steps Order, making it clear to the family that they will be breaking the law if they arrange for the child to have the procedure.


Definition of 'belief in spirit possession'

For the purposes of this policy, the term 'belief in spirit possession' is the belief that an evil force has entered a child and is controlling him or her. Sometimes the term 'witch' is used and is the belief that a child is able to use an evil force to harm others. There is also a range of other language/terms that is used to describe such abuse, including black magic, kindoki, ndoki, the evil eye, djinns, voodoo, obeah, demons, and child sorcerers. With all these terms, there are genuine beliefs held by families, carers, religious leaders, congregations, and the children themselves that evil/unknown forces have entered the child and are controlling him or her. Families and children can be deeply worried by the evil that they believe is threatening them, and abuse often occurs when an attempt is made to 'exorcise', or 'deliver' the child. Exorcism is the attempt to expel evil spirits from a child. (Safeguarding Children from Abuse Linked to a Belief in Spirit Possession 2007).

The beliefs which are the focus of this policy/ procedure are not confined to one faith, nationality or ethnic community.

Any concerns about a child which arise in this context must be taken seriously.



A number of faith groups have beliefs, which affect how they use health services and specifically treatment and immunisations for children. A number of churches and faith groups believe in the power of prayers and faith in God and as a result may refuse medical interventions and treatments including assistance at child births, health checks and immunisations. Where a practitioner becomes aware of a belief held by the parents, where it may impact on the health and development of the child, the practitioner should consult with other professionals to assess the potential risks of significant harm to the child.



The number of known cases of child abuse linked to accusations of 'possession' or 'witchcraft' is small, but children involved can suffer damage to their physical and mental health, their capacity to learn, their ability to form relationships and to their self-esteem. It is likely that a proportion of this type of abuse remains unreported.

Such abuse generally occurs when a carer views a child as being 'different', attributes this difference to the child being 'possessed' or involved in 'witchcraft' and attempts to exorcise him or her.

A child could be viewed as 'different' for a variety of reasons such as, disobedience; independence; bed-wetting; nightmares; illness; or disability. There is often a weak bond of attachment between the carer and the child.

There are various social reasons that make a child more vulnerable to an accusation of 'possession' or 'witchcraft'. These include family stress and/or a change in the family structure.

The attempt to 'exorcise' may involve severe beating, burning, starvation, cutting or stabbing and isolation, and usually occurs in the household where the child lives.

Any siblings or other children in the household may be well cared for with all their needs met by the parents and carers. The other children may have been drawn in by the adults to view the child as 'different' and may have been encouraged to participate in the adult activities.

A range of factors can place a child at risk of abuse for reasons of faith or belief.  Some of the most common ones are listed below:

  • Belief in evil spirits: Belief in evil spirits that can ‘possess’ children is often accompanied by a belief that a possessed child can ‘infect’ others with the condition.  This could be through contact with shared food, or simply being in the presence of the child.
  • Scapegoating: A child could be singled out as the cause of misfortune within the home, such as financial difficulties, divorce, infidelity, illness or death.
  • Bad Behaviour: Sometimes bad or abnormal behaviour is attributed to spiritual forces. Examples include a child being disobedient, rebellious, overly independent, wetting the bed, having nightmares or falling ill.
  • Physical differences: A child could be singled out for having a physical difference or disability. Documented cases include children with learning disabilities, mental health issues, epilepsy, autism, stammers and deafness.
  • Gifts and uncommon characteristics: If a child has a particular skill or talent, this can sometimes be rationalised as the result of possession or witchcraft. This can also be the case if the child is from a multiple or difficult pregnancy.
  • Complex family structure/changes in family structure: Research suggests that a child living with extended family, non-biological parent or foster parents is more at risk. In these situations, they are more likely to have been subject to trafficking and made to work in servitude.


Research and reports from cases of abuse linked to faith and belief have involved children aged 2 to 14, both boys and girls, and have generally been reported through schools or non-governmental organisations.  Referrals usually take place at a point when the situation has escalated and become visible outside the family. Note: This means that the child may have been subjected to serious harm for a period of time already, that has been undetected.

Initial concerns referred are commonly in reference to:

  • Issues of neglect such as not being fed properly or being 'fasted', not being clothed, washed properly etc. but left to fend for themselves especially compared to the other children in the household;
  • Often the carer is not the natural parent and the family structure can be complex;
  • Children often appear distressed and withdrawn;
  • The child is seen as the scapegoat for a change in family circumstances for the worse;
  • In a group of children, it may be the child who is relatively powerless vis-a-vis the parents/carers, maybe a child with no essential role in the family;
  • The child is seen as someone who violates the family norms by being physically different perhaps because of illness, disability or, in some cases, a suspicion by the father of adultery by the mother.

In working to identify such child abuse it is important to remember every child is different.  Some children may display a combination of indicators of abuse whilst others will attempt to conceal them.  In addition to the factors above, there are a range of common features across identified cases.  These indicators of abuse, which may also be common features in other kinds of abuse and include:

  • a child’s body showing signs or marks, such as bruises or burns, from physical abuse
  • a child becoming noticeably confused, withdrawn, disorientated or isolated and appearing alone amongst other children;
  • a child’s personal care deteriorating, for example through a loss of weight, being hungry, turning up to school without food or lunch money, or being unkempt with dirty clothes and even faeces smeared on to them;
  • it may be directly evident that the child’s parent or carer does not show concern for or have a close bond with the child;
  • a child’s attendance at school becoming irregular or the child being taken out of school altogether without another school place having been organised, or a deterioration in a child’s performance at school;
  • a child reporting that they are or have been accused of being ‘evil’, and/or that they are having the ‘devil beaten out of them’.

All agencies should be alert to the indicators above and should be able to identify children at risk of this type of abuse and intervene to prevent it.


Protection and action to be taken

Any practitioner who comes in to contact with children should be able to recognise that a child is being abused or neglected and know what to do to safeguard and promote the welfare of a child.  This may be the crucial intervention that protects the child from further abuse or neglect.  In any situation in which there are concerns for the safety and welfare of a child the Referrals Procedure must be followed.

Where there are concerns that a child is suffering or likely to suffer Significant Harm, Children’s Social Care will convene a Strategy Discussion / Meeting involving health, police and other relevant agencies.

The strategy discussion / meeting should give particular consideration to:

  • Whether the beliefs are supported by others in the family or in the community and whether this is an isolated case or if other children from the same community are being treated in a similar manner;
  • Practitioners need to establish if there is a faith community and leader to which the family and the child adhere;
  • The details of the faith leader and faith community which the family and child adhere to;
  • The exact address of the premises where worship or meetings take place;
  • Further information about the beliefs of the adherents and whether they are aligned to a larger organisation in the UK or abroad (websites are particularly revealing in terms of statements of faith and organisational structures);
  • If there is a designated safeguarding lead within the faith community or larger organisation.

Given the potentially complex nature of Section 47 enquiries it may be appropriate to hold additional strategy discussions to ensure that informed decisions are made. Where a community or organisation is involved in the abuse, consideration should be given to the Organised and Complex Abuse Procedure.

Consideration should also be given to Working Together 2018, guidance that many faith & community based organisations and agencies who work with children, should have appropriate arrangements in place to safeguard and protect children from harm. Many of these organisations and agencies will be subject to charity law and regulated either by the Charity Commission and/ or other “principal” regulators, so thought should be given to involving these regulators if applicable.

When working with a child and their family particular consideration should be given to:

  • Building a relationship of trust with the child, and whether there is another professional who already has a trusting relationship with the child;
  • Whether to involve the family. A child who is believed to be possessed may be stigmatised in their own family. If the child has been labelled as possessed, professionals should find out how this affects the child’s relationship with others in the extended family and community;
  • What the beliefs of the family are;
  • Where to obtain expert advice about cultures or beliefs that are not their own;
  • What pressures the family are experiencing; as in some cases abuse may present and relate to blaming the child for something that has gone wrong in the family. Professionals should consider whether there is anything that can or should be done to address relevant pressures on the family; and
  • That the abuser may have a deeply held belief that they are delivering the child of evil spirits and that they are not harming the child but actually helping them. Holding such a belief is no defence or mitigation should a child be abused.

Consideration should also be given to the child and family’s communication needs, particularly if English is not their first language. If required a professional interpreter should be provided; family or community members should NOT be asked to act as interpreters.

Where a child is from a migrant community, particular care should be taken to assess the risk of that child being taken out of the county to avoid investigation. Legal advice and Police action should be considered.

Where it is believed a professional or someone in a position if trust ((a legal term that refers to certain roles and settings where an adult has contact with children) is involved in the abuse, consideration should also be given to the Managing Allegations Against Staff or Volunteers procedure.

Abuse linked to a belief in spirit possession can be hard for professionals to accept and it may be difficult to understand what they are likely to be dealing with; it can often take a number of visits to recognise such abuse.  In cases of suspected abuse linked to a belief in spirit possession it may be particularly useful to consider the following questions:

  1. What are the beliefs of the family?
  2. What is the family structure?
  3. Are there reasons why the child might be picked on?
  4. Do I need a professional interpreter?
  5. What is the preferred language of the child and family?

Practitioners should seek advice if dealing with a culture or set of beliefs that they do not understand, or which are unfamiliar to you. Practitioners need to have an understanding of religious beliefs and cultural practices in order to help gain the trust of the family or community.

An assessment should aim to fully understand the background and context to the beliefs and should involve the particular faith group or person advising the family about the child in order to establish the facts i.e. what is happening to the child. Consideration should be given to asking an independent person to act as an adviser and mediator.

The assessment may include key people in the community especially when working with new immigrant communities and different faith groups.  In view of the nature of the risks, a full health assessment of the child should take place to establish the overall health of the child, the medical history and current circumstances.

Any suggestions that the parent or carers will take the child out of the country must be taken seriously and legal advice sought regarding possible prevention. The child must be seen and spoken to on his or her own. The child’s sleeping and living arrangements must be inspected.

In assessing the risks to the child, the siblings or any other children in the household must also be considered as they may have witnessed or been forced to participate in abusive activities.

Further information about the beliefs of the adherents and whether they are aligned to a larger organisation in the UK or abroad (websites are particularly revealing in terms of statements of faith and organisational structures).



Whilst specific beliefs, practices, terms or forms of abuse may exist, the underlying reasons for the abuse are often similar to other contexts in which children become at risk. These reasons can include family stress, deprivation, domestic violence and abuse, substance abuse and mental health problems. Children who are different in some way, perhaps because they have a disability or learning difficulty, an illness or are exceptionally bright, can also be targeted in this kind of abuse.

The accusation of witchcraft dehumanises and criminalises the child thereby opening the door for many forms of abuse including, physical, emotional abuse and neglect while at the same time also places a child at risk of sexual abuse.

Any suggestions that the parent or carers will take the child out of the country must be taken seriously and legal advice sought regarding possible prevention. The child must be seen and spoken to on his or her own. The child's sleeping and living arrangements must be inspected.

In assessing the risks to the child, the siblings or any other children in the household must also be considered as they may have witnessed or been forced to participate in abusive or frightening activities.

Concerns about a place of worship may emerge where:

  • A lack of priority is given to the protection of children and there is reluctance by some leaders to get to grips with the challenges of implementing sound safeguarding policies or practices;
  • Assumptions exist that 'people in our community' would not abuse children or that a display of repentance for an act of abuse is seen to mean that an adult no longer poses a risk of harm;
  • There is a denial or minimisation of the rights of the child or the demonisation of individuals;
  • There is a promotion of mistrust of secular authorities;
  • There are specific unacceptable practices that amount to abuse.


There are a number of laws in the UK that allow the prosecution of those responsible for abuse linked to faith or belief. One of the biggest challenges is raising awareness and encouraging victims and witnesses to come forward.

Children Act 1989

Section 47 of the Children Act 1989 empowers LA’s to investigate a referral that a child may have suffered or is at risk of suffering harm. Whilst the Children Act 1989 does not mention the terms witchcraft or spirit possession, it does clarify what constitutes child abuse, which can include harm through witchcraft or spirit possession.

Children Act 2004

Under Section 11 of the Children Act 2004, government bodies and agencies must ‘make arrangements for ensuring that their functions are discharged having regard to the need to safeguard and promote the welfare of children.’ This applies to children’s services, Health bodies and Trusts and Police authorities (including transport police).


Further infomation

Further contacts for advice can be found from the local representatives for some faiths, from organisations such as:

See also:

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