Tag: male circumcision

Circumcision: South Africans should stop allowing our boys to be butchered

In my village in the Eastern Cape Province of South Africa, a male who has not undergone circumcision is called ‘inkwenkwe’ – a boy.

A young man who has undergone this rite of passage takes great pride in it. If he has not, he is not considered an adult, and will not be respected by men and women alike. He won’t be able to sit with the village men during ceremonial functions or important discussions. He’ll be shunned and told that his foreskin smells. Women who date him will also be looked down upon for dating an ‘inkwenkwe’.

As a young girl growing up in Mbizana, Eastern Pondoland, every year I looked forward to the celebrations at the end of each circumcision season. I had thought this was the way things had always been done here among my Pondo people, but in his book Faku: Rulership and Colonialism in the Mpondo Kingdom, Timothy J Stapleton writes: “Sometime in the mid-1820s, Faku prohibited circumcision, which was the customary initiation for young men in Xhosa-speaking societies… Oral informants in the early twentieth century stated that circumcision frequently made the initiates ill, probably through infection.”

The reason our King prohibited circumcision in the early 19th century is increasingly evident; over 180 boys have been admitted to hospital and 35 have died so far since the initiation season started this year alone, many due to botched procedures.

As the mother of an 11-year-old boy and responsible for his health, I have to question: is this practice justifiable in the 21st century? In a society that shuns those who are not circumcised, does my son really have a choice about keeping his penis intact or will he just have to submit to having part of himself amputated because ‘it is the way things are done here’.

We celebrate our cultural practices, yet we silently bury the dead, and the victims who live continue to suffer at the hands of the men who cut them.

Boys from the Xhosa tribe who have undergone a circumcision ceremony are pictured near Qunu in the Eastern Cape on June 28 2013. (Pic: AFP)
Boys from the Xhosa tribe who have undergone a circumcision ceremony are pictured near Qunu in the Eastern Cape on June 28 2013. (Pic: AFP)

As a mother with a duty to protect my son, I find I can no longer celebrate this customary rite of passage. I am now faced with the daunting task of speaking to my family about this. As mothers, we are told to stay out of it because this is a sacred rite of passage that boys must go through. Do I have a right to say no when it comes to my child?

The entire subject is deeply taboo. We passively accept that scores of young men in our country will inevitably die each year after being circumcised and that many more will be permanently maimed. Many young men end up losing the one thing they ‘go to the mountains’ to attain: their manhood.

It is not only the surgical side of the tradition that is cause for concern. Boys in my village go through initiation to get a pass to drink alcohol in front of and with the elders. Often we have seen these boys change from polite and well-behaved into abusive, violent, drunken young men. My cousin came back from initiation severely beaten, and a friend so badly beaten that he couldn’t walk for months. A neighbour’s son came back permanently mentally disturbed by what he had experienced.

I am angry at the complacency of our men and the silence of our women in the face of this horror. So many young mothers are appalled by the prospect of their sons being circumcised, yet tell me they feel powerless to stop it.

It is recognised that some deeply entrenched harmful cultural practices need ending with legislation. In some areas of the Eastern Cape and KwaZulu-Natal, for instance, young girls were legally abducted and raped in a traditional marriage practice called ukuthwala. Today it is illegal.

Likewise, female genital mutilation is now outlawed in eighteen countries, including South Africa. An estimated 100–140 million women worldwide have suffered FGM, and about three million girls and women continue to be mutilated every year. As awareness spreads and opposition grows, however, attitudes are changing. A spotlight is being directed on the shame and secrecy surrounding FGM, and more and more people are starting to appreciate that there is no developmental, religious or health reason to mutilate any girl or woman.

We must appreciate that cultures evolve, and we must leave harmful practices behind. Can we really say that if we decided to stop the circumcision of our boys we would lose our essential sense of identity as black South Africans? If we have banned the genital butchery of girls, why do we allow it for boys?

Fezisa Mdibi is a freelance journalist and poet. Follow her on Twitter: @fezisa. This post was first published on the Guardian Africa Network.

Uganda tests out rubber band circumcision

With trousers around his ankles, Justin Igalla awaits a tight rubber band for his foreskin, an innovative non-surgical technique rolling out in several African nations to encourage circumcision and cut HIV infection rates.

The simple device – two plastic rings and an elastic band – cuts off blood supply to the foreskin, which then shrivels and is removed with the band after a week.

“I felt nothing, not even a little discomfort,” Igalla said after a procedure taking just minutes, noting there was no blood – unlike traditional circumcision where the foreskin is sliced off by knife – thus reducing the risk of infection.

Igalla, a father of two, said he opted to have his foreskin taken off for “health reasons”.

Scientists have found that male circumcision can significantly reduce the chances of HIV infection because the foreskin has a higher concentration of HIV-receptors than the rest of the penis and is prone to tears during intercourse, providing HIV an entry point.

As well as Uganda, the device is being used in Botswana, Kenya, Mozambique, South Africa, Zambia, Zimbabwe and other sub-Saharan countries. All have been identified by the World Health Organisation (WHO) as “priority” states where the risk of acquiring HIV is high and male circumcision, and access to conventional surgical procedures, is low.

Uganda hopes the device, called PrePex, will convince adult men to be circumcised as part of the battle against Aids, now resurgent in the East African nation after years of decline, with as many as 80 000 people dying of the disease every year.

PrePex, a non-surgical circumcision device. (Pic: AFP)
PrePex, a non-surgical circumcision device. (Pic: AFP)

From a peak of 18% infected in 1992, Uganda’s “ABC” strategy – Abstinence, Be faithful, Condomise – helped slash rates to 6.4% in 2005.

But rates have crept back up, to 7.2%  in 2012. As many as 1.8 million people in the country now live with HIV, and a million children have been orphaned after their parents died of Aids.

The makers of PrePex boast that a man “can resume work and almost all daily activities shortly after the procedure,” with the device “designed to be placed, worn, and removed with minimal disruption”, although they should abstain from sex for six weeks afterwards.

Doctor Barbara Nanteza, male circumcision project manager at Uganda’s Aids Control Programme, said that trials had shown that circumcision reduced risk of transmission from a woman to a man by as much as 60 percent.

Although some contest the validity of these studies, WHO and the United Nations Aids programme push circumcision as an additional prevention measure in high-prevalence countries where HIV transmission is predominantly heterosexual.

The WHO says there is “compelling evidence” circumcision reduces risk of heterosexually acquired HIV infection in men. The organisation has “prequalified” PrePex, meaning the device has been assessed and meets international standards for efficacy and safety.

And with health budgets already overstretched, the device offers a cheaper way to tackle the problem, Nanteza said.

“If circumcision can help reduce the cost, that could very good for the country,” she told AFP.

Uganda, long praised for its efforts in the fight against Aids, launched a general circumcision programme in 2010, when some 9 000 had the conventional treatment.

Since then 1.2 million men have been circumcised – or 13% of men over 15, including 800 000 last year alone, the health ministry said.

The introduction of the PrePex device is expected to boost numbers even further – but it’s still not enough, according to Nanteza.

Though the device greatly reduces the pain of traditional circumcision, she conceded the issue remained an awkward one for married men.

“It is difficult for them to explain to their wife that they want to get a circumcision to prevent HIV infection when they are supposed to be faithful to them,” Nanteza said.

Despite massive health awareness campaigns, problems remain.

James Brian, a counsellor with the Walter Reid Project, a US-based medical organisation supporting the programme, said it was essential to emphasise that while circumcision reduces the risk of infection, it does not prevent it.

“After circumcision someone should not think that they are immune against HIV,” Brian said, who works with patients to highlight the continuing need to practise safe sex.

Emmanuel Leroux-Nega for AFP