As yet there is nothing more than kitchen table butchery, no standards, professional involvement or supervision.
The mashed spoon picture is but one of any home-made scalpels used by the cutter, who could be your uncle Aziz in that there is no regulation other than sketchy directives put fort in Sharia. At this moment a terrified child somewhere is being held down by relatives while her most sensitive parts are being hacked on,. Lots of blood. Lots of pain Iots of fear.