A doctor in a Detroit suburb performed genital mutilation on as many as 100 girls over 12 years, prosecutors claimed as they tried to convince a judge to keep a man and his wife who assisted the medical professional locked up on Wednesday.
Detroit-based doctors Jumana Nagarwala and Fakhruddin Attar, as well as Attar's wife Farida, have been charged with carrying out female genital mutilation, FGM, on young girls from Minnesota on February 3.
Attar, of Farmington Hills, Michigan, is accused of letting Nagarwala use his Livonia, Michigan, clinic to perform genital mutilation procedures on young girls as part of a religious rite of passage.
His wife is accused of holding the girls' hands during the procedures to keep them calm.
The charges against Nagarwala and the Attars, are believed to be the first case testing the US ban on the practice of female circumcision, which is also known as female genital mutilation or cutting.
In an attempt to keep the Attars behind bars as they await trial, Assistant US Attorney Sara Woodward claimed on Wednesday that Nagarwala, of Northville, performed procedures on up to 100 girls.'Due to the secretive nature of this procedure, we are unlikely to ever know how many children were cut by Dr. (Jumana) Nagarwala,' Woodward said, referring to Nagarwala. 'The Minnesota victims were not the first victims.'
And against Woodward's wishes, US District Judge Bernard Friedman granted bond to the Attars, according to the Detroit Free Press. The couple have been locked up since late April.
Fakhruddin Attar and Farida Attar must stay in their suburban Detroit home and be electronically monitored upon their release on Thursday.
The couple are not allowed to live with their eight-year-old daughter upon their release, as the state tries to end their parenting rights.
Nagarwala, meanwhile, will remain in custody through her pending trial, which is set for October 10.
If convicted, Nagarwala and Fakhruddin Attar face up to life in prison, while Attar's wife could be imprisoned for up to 20 years.The Attars and Nagarwala belong to a
Muslim sect called Dawoodi Bohra. They deny the charges and say a
religious ritual was performed.
To date, the government has identified eight victims who were mutilated at the clinic, including the two girls from Minnesota.
Nagarwala, 44, an emergency room doctor at Henry Ford Health System, is accused of performing genital mutilation on the two young girls at the private Burhani Medical Clinic, Livonia, after hours in February.
An FBI child forensic interviewer who talked to one of the girls, said the child had described how she was brought to Detroit with a second girl for a 'special girls' trip.'
After arriving in Farmington Hills, the girls were taken to a doctor because 'their tummies hurt.'
'While at the doctor's office, a procedure 'to get the germs out,' was performed on the first girl, according to the criminal complaint.
FBI agents leave the office of Dr. Fakhruddin Attar at the Burhani Clinic in Livonia, Michigan, in April after completing a search for documents. The investigation is connected to the case of Dr. Jumana Nagarwala, of Northville, charged with performing genital mutilation on two young girls from Minnesota
The girl was shown a photo of Nagarwala and said she was the doctor who performed the procedure, according to the FBI.
She told the FBI that Nagarwala 'pinched' her on the 'place (where) she goes pee.'
'(The girl) said that she was told not to talk about the procedure,' FBI Special Agent Kevin Swanson wrote in the complaint.
A subsequent medical examination showed that the young girls' genitals did not appear normal and a section had been altered or removed.
'Finally, the doctor observed some scar tissue and small healing lacerations,' the agent wrote.
The complaint details the second girl's experience with the doctor and she said she underwent a procedure and identified Nagarwala as the doctor.
'She said that she 'got a shot,' and that it hurt really badly and she screamed,' the FBI agent wrote. 'Her parents told her that the procedure is a secret and that she is not supposed to talk about it.
'(The girl) said that after the procedure, she could barely walk, and that she felt pain all the way down to her ankle,' the agent continued.
A subsequent medical exam showed the girl's genitalia had a small incision and a small tear.
The doctor, who was arrested trying to board a flight to Kenya, denies the charges claiming she scraped membrane from the girls' genitalia as part of the religious custom. But those claims do not align with severe injuries suffered by two girls who came forward to accuse her of carrying out the practice on them.
Doctors reports obtained by the Detroit Free Press indicate the children suffered more severe injuries including scarring, a small tear, lacerations and what appeared to be the surgical removal of a portion of genitalia.
Dr Attar's attorney says her client may have let Dr Nagarwala use his clinic but claims he had no knowledge of what procedures she was performing.
Nagarwala was arrested on April 12, just days after the two alleged victims identified her as the person who performed medical procedures on them. The girls had been brought into the clinic by their mothers but the parents have not been charged.
Female genital mutilation is the practice in which some or all of the female genitals are removed, typically with a blade or a razor and sometimes without anesthesia.
This includes removing the clitoral and the fold of skin above it, and removing labia – the inner 'lips' of the vagina.
In the most severe form, the inner and outer labia are removed and the opening of the vagina is closed with a small hole so the woman can pass urine and menstrual blood.
A traditional razor blade used to perform female genital mutilation in parts of Africa
Sometimes the vagina is then cut open for sex or childbirth.
Women sometimes bleed to death or can be left with horrifying health effects, such as infections, chronic pain, cysts, infertility and problems giving birth.
Female genital mutilation is prevalent, particularly, in the Middle East and African subcontinent and within pockets of the Muslim, Christian, and Jewish faiths, according to the organization.
Worldwide, an estimated 140 million women and girls have undergone the procedure, according to the World Health Organization. More than 3 million girls in Africa undergo the procedure each year.
Authorities say Dr Nagarwala was never employed at the clinic where the alleged mutilation took place and that she was able to perform the procedures after hours.
Dr Attar and his wife, who works at the clinic as an office manager, were arrested on Friday morning. They allegedly arranged and assisted in the genital mutilation procedures by Dr Nagarwala, police claim.
All three are accused of trying to keep the practice secret within their Indian-Muslim community, according to the indictment.
Authorities claim the trio have been part of a female genital mutilation scheme since 2005 and there could be a number of other young victims. The trio have denied any wrongdoing.
Attar is accused of helping arrange the the Minnesota girls' visits to Michigan during more than 50 phone calls with a Muslim man in Minnesota.
His lawyer said her client was only talking to the woman because he was helping her memorize the Quran.
Prosecutors argue that the defendants knew what they were doing was illegal and tried to cover it up, citing a text message Attar's wife sent her on February 3 - the night the two Minnesota girls were allegedly cut at the clinic - to stay away.
They also allegedly told people in the local community to deny that the doctors carried out the procedure, and simply say it was a medical exam.
The procedure has roots in various cultures in Asia, Africa and the Middle East. It's generally performed as a way of controlling a girl's sexuality, maintaining her purity or even making her more fertile as she grows into adulthood.
But it's difficult to gauge how often genital cutting occurs in the U.S. - a 2012 study from the Centers of Disease Control and Prevention estimated that more than 513,000 girls in the country had been subjected to or were at risk of undergoing genital cutting.