Every year young boys die during circumcision camps. Pierre W Brouard wonders what we can do to create productive and discursive dialogue around the big chop
It’s 5.30am on a cold Monday morning in May and Themba and I are driving to Pretoria West Hospital for his circumcision. I try to tell him cheerful stories, but also show that I understand his anxiety.
Themba stayed at my home last night so he wouldn’t have to explain to his mother where he was going so early in the morning. I would find out later that none of the four males circumcised in Themba’s ward has told his mother — one even told his mother he was having a knee operation. “Hai, re tsamayile grand [we got away with it],” he says, laughing reassuringly into his cell afterwards.
This story began a few months ago when Themba told me he had a problem with his penis. Not the problem of too big or too small, or that it only wants to go five rounds; rather that his foreskin is too tight and it interferes with sexual pleasure and performance, not to mention hygiene. He is aware of the evidence about HIV and circumcision but his primary motivation is comfort.
Themba is 20, gay and lives at home with his mom, dad and older brother. As an older gay man who had an adult circumcision for similar reasons about 15 years ago, it was I who suggested this step to him. We’re just friends, having met through my ex, although the looks and comments I get through the day will hint at people’s confusion about an older white man and a younger black man together.
On arrival Themba pays his R30 fee for the day. Twenty-one young men are expected, although only 11 will make it. We are the first; slowly three other young men come into the ward — a 20-year-old on his own and two teenagers, one with his dad and one with an older brother. They look so slim and young — and very nervous. No one speaks and eye contact is minimal.
A nurse comes in to record basic medical information, checking biographical details and consent forms. She is kind and efficient and she smiles in a way that makes you feel safe. She reminds me of Nozizwe Madlala-Routledge and absentmindedly I wonder if she’s moonlighting now that she’s not in Parliament.
I notice that the blood pressure of each young man averages about 145 over 90 — their faces are impassive but these high readings tell another story. The father and the brother leave to come back later, but I stay until 8am to make sure Themba is okay. Apart from a nurse asking Themba who I am, no one speaks. I’ve taken the day off to support Themba and I go home to occupy myself while worrying if he is okay.
He sends me an SMS at 11am: “Just got back. They gave me painkillers. Very impressed with the nurses’ concern for us. We just chatting as boys.” I arrive at 1.15pm and Themba looks relieved, but sore. “Do you want to have a look?” he says. Blood has seeped on to the bandages but it looks fine to me.
The brother of one of the teenagers laughs and says: “You must wear the underpants that are more tight and put it [the penis] so that it is up, not down, or it will hurt more.” We chat about comfortable penis positions, as men do, and Themba decides to get dressed. It is difficult for him because he can’t quite get the right penis position in his boxers. Eventually it sits there like a partially wrapped boerewors, sticking out of the top of his pants. “Ag, it’s ok,” he says. “I’ll cover it with my shirt” — his bravado does not quite convince.
The brother turns to me and says: “This is a very good thing you are doing for your friend, you will be blessed. We need to be there for these young men to show them the right way to do this and to support them.” His brother is not back from theatre and he looks a little worried. The other two youngsters are in a post-operative daze, but they chat a bit.
There is a new camaraderie among them now and, yes, they seem to be different. Themba tells me later that “we really respect those guys who go to the mountain, but this was our own mountain, even if it was with anaesthetic and painkillers”.
The father comes back and he makes jokes and says in Shangaan: “You must look after your love machine now.” Everyone laughs, including me, because, even though I don’t understand what he is saying, he speaks the universal language of male bonding. When he walks out, his son, walking awkwardly, half grabs his dad’s arm to steady himself and I feel moved by the vulnerability in this gesture.
We leave with Themba’s sick note, because he has been given the week off college, and we walk out into the warmth of the afternoon sun. “Surely you’re going to tell your mom now that you are in pain and may be walking awkwardly,” I say in the car. “No ways,” he says, “it’ll be too weird. I mean, they know that I’m gay, but if we talk about my penis it will lead to talking about sex and I don’t think she wants to be confronted by it.” I am quiet now, wondering what I would do in his situation. “None of those guys is going to tell his mother,” says Themba. “It’s just how it is. Even here this is still a patriarchal event,” he says, reflectively.
I ask what the guys talked about. Apparently the brother, laughing at one of them getting a post-operative erection, said: “At your age your biggest worry is trying to stop an erection; for us older men it’s trying to get one. And when we can’t satisfy and pleasure our women they turn to younger men.” He also told them that they must still use condoms when they have sex because the circumcision does not completely protect them against HIV. This is the only message on HIV Themba hears all day.
Themba’s last reflection on his experience is about the nursing staff. I’d wondered what their hymns and songs meant as they’d echoed through the ward at the start of the shift. “They were very nice to us,” he says, “and they seem to treat us as men now, with reverence.” Later that night Themba sends me an SMS: “Hey babes, I wanna thank you for your support and help today. I honestly appreciated your wisdom, care and sensitivity in ushering me into my manhood. Have a good night.”
So, as I sit with all these thoughts about Themba’s experience and I think about the young men across South Africa who have traditional circumcisions in much more difficult conditions I wonder about a whole lot of things.
I wonder about how circumcision goes to the heart of what it means to be a man: our penises, which is the chief way we express our sexuality, our manliness, our identity. I can remember how anxious I was after mine and what I would do if it had to be amputated: would I still be a man, what would I do with my life?
I wonder how even a hospital circumcision comes with meanings and interpretations about becoming a man, so much so that Themba could talk about it as his own “mountain”. Even though they were all there for medical circumcisions, the young men gave it meanings of manliness, tradition and transition.
I wonder what the journey of circumcision means to all these men and why we men, gay and straight, need rites of passage, watched over, guided and nurtured by our mentors. I wonder why I felt surprisingly proud and moved to have supported Themba and how for a few hours I felt part of something bigger than me.
I wonder about the messages about being a man and whether these messages are useful or problematic or both. How do gay men fit into all of this, especially as it seems a “real” man must be strong, insensible to pain, always ready for sex, responsible for “pleasuring” a woman, or many women, and heterosexual? Even in all these contradictions Themba could find a way to fit in. But was this easier because he didn’t tell anyone there he was gay?
I wonder about silences between men and women about these things. About why it is acceptable for a female nurse to talk openly about penises and yet these men wouldn’t speak to their mothers, the same mothers who birthed them, wiped them and cleaned the very same foreskins now disposed of in a hospital incinerator.
And I wonder about the opportunities presented by circumcision for new and more progressive conversations about masculinity, sexual orientation, sexuality and gender in relationships.
And so I am left with many questions and conflicted feelings. But I believe we need to be talking about these things — youngsters are dying, boys are sometimes becoming the kinds of men we fear and the divide between men and women is growing. Can we have a national conversation about circumcision that is calm, sensible and productive, that can transform all of us?
Pierre W Brouard is deputy director of the University of Pretoria’s Centre for the Study of Aids