DETROIT — Nearly five years after it emerged, the nation's first female genital mutilation case has taken yet another turn in a heated feud between a government that says children were unlawfully cut and a doctor who says she only "scraped" young girls as part of a religious practice.

The historic prosecution involves minor girls from Michigan, Illinois and Minnesota, including some who cried, screamed and bled during the procedure and one who was given Valium ground in liquid Tylenol to keep her calm, court records show.

The 2017 case has taken many twists and turns over the years, with bulk of the charges being dropped and the FGM law being declared unconstitutional in 2018. The case was set to go to trial in April 2019 on a single obstruction charge, but COVID-19 hit and the prosecution came to a halt.

Then this year brought new charges, and the defense is crying foul.

In March, the government issued its fourth superseding — or new —indictment that includes a fresh batch of charges, including conspiracy to make false statements and witness tampering. Prosecutors allege that Dr. Jumana Nagarwala and and her three cohorts lied to the FBI about FGM that was going on in their community, and instructed others in their religious sect to do the same if the FBI came asking questions.

The defendants are all members of a small Indian Muslim sect known as the Dawoodi Bohra, which has a mosque in Farmington Hills. The sect practices female circumcision and believes it is a religious rite of passage that involves only a minor "nick."

Meanwhile, the defense claims the new charges are about vengeance, citing the many blows the prosecution took in years past, specifically 2018, when a judge declared the federal FGM law unconstitutional and dismissed nearly all charges.

"The government is acting with extreme prosecutorial vindictiveness in issuing yet another superseding indictment nearly half a decade after charges were first issued," the defense has argued in court filings, calling the latest indictment "retaliation for the defense successfully decimating the government's case."

"The government is engaging in vindictive prosecution," defense lawyers have argued in seeking to have the new indictment dismissed.

A hearing will be held on that request Wednesday before U.S. District Judge Bernard Friedman, who declared the FGM ban unconstitutional and previously dismissed all but one count.

Prosecutors allege that nine girls — four from Michigan, two from Minnesota and three from Illinois — underwent FGM during after hours at a Livonia clinic at the hands of Nagarwala. Her co-defendants are: Dr. Fakhruddin Attar, the owner of the Livonia clinic where the FGM allegedly took place; his wife, Farida Attar, who is accused of being in the room and holding the girls' hands during the procedures; and Fatema Dahodwala, the mother of one of the alleged victims.

The prosecution took a major blow in 2018 when Friedman ruled that the federal law banning FGM was unconstitutional, concluding Congress lacked the power to regulate the act to begin with. Friedman dismissed the mutilation charges and removed four defendants from the case, which sparked outcry and triggered a new Michigan law banning FGM.

Friedman's ruling also dismissed charges against three mothers, including two Minnesota women whom prosecutors said tricked their 7-year-old daughters into thinking they were coming to metro Detroit for a girls' weekend, but instead had their genitals cut at a Livonia clinic as part of a religious procedure.

Friedman concluded that "as despicable as this practice may be," Congress did not have the authority to pass the 1996 federal law that criminalizes female genital mutilation, and that FGM is for the states to regulate.

The Department of Justice did not appeal Friedman's ruling, though federal prosecutors in Michigan have sought to revive the case by attacking it form a different angle: charging the defendants with conspiracy to lie, hide what they did, and intimate others into doing the same.

While the case involves nine minor girls, prosecutors have argued that Nagarwala subjected as many as 100 minor girls to FGM procedures over a decade, including one girl who screamed, "could barely walk after the procedure, and said that she felt pain all the way down to her ankle." Another girl said that she was "pinched" in the genital area, that it "hurted a lot" and that there was "pain and burning."

Both girls were told to keep the procedures a secret, prosecutors wrote in court records.

Assistant U.S. Attorney Sara Woodward has long argued that the defendants knew what they were doing was illegal, but did it anyway, and that Nargarwala "is aware that female genital mutilation has no medical purpose."

FGM is banned worldwide and has been outlawed in more than 30 countries.

Currently, 27 states have laws that criminalize female genital mutilation, including Michigan, whose FGM law is stiffer than the federal statute, punishable by up to 15 years in prison, compared with five under federal law. Michigan's FGM law was passed in 2017 and applies to both doctors who conduct the procedure and parents who transport a child to have it done. The defendants in this case can't be retroactively charged under the newer state law.

Copyright 2021 Tribune Content Agency.

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