Circumcision: No harm in asking the question

To say that there was an outcry when the Mail & Guardian asked readers if they would be willing to share their initiation experiences with us would be an understatement. 

There was a deluge of angry tweets and Facebook posts. Many accused the M&G of undermining those who follow the practice, and claimed the media was disrespecting their culture.

"Such dialogues [are] not allowed to be shared with the public and I think such a survey violates respect for the sanctity of the ritual," said one reader.

Another reader told the reporter to "go ask the Jews".

Fortunately, I don't have to go ask the Jews. I am a Muslim, and circumcision is also part of my culture. 

In the days after my son was born, I was caught up in an internal struggle between what my culture told me to do, which is to have my son circumcised, and what my mind was telling me to do – leave him intact with the equipment God gave him. 

If I'd had it my way my son would still have his foreskin. As a mother, I didn't want to be the one responsible for putting my newborn through a world of pain. And my personal interpretation of the religious injunction to circumcise had me arguing that there was no reason to do it now and that we should wait until he was an adult and could make the decision for himself.

But in the end I couldn't hold out against the urging of my husband, my parents and my in-laws.

My mother and husband stayed with my son while a doctor applied a Plastibell device to my 10-day-old son's penis. I sat in the waiting room with my white-faced father, dabbing at my eyes with a tissue, imagining everything that could possibly go wrong with the procedure.

The anaesthetic they gave him was supposed to last for hours but we barely made it out the door before he began screaming blue murder. I had never known my son to cry that way and nothing I did consoled him.

He spent the next two days strapped to my chest and we nursed him through the initial period with regular doses of Panado.

By the third day he seemed okay but on day five he started to cry hysterically. When I opened his nappy I found the Plastibell had fallen off and my son's penis was bleeding. At that point, I almost collapsed. I burst into hysterical tears. This was it, the complications I'd dreaded. My son was going to bleed out, his penis would get infected, he would lose the organ.

My husband stayed calm and called the doctor, who told us to keep pressure on the site of the bleeding for a minute or two and see if it stopped. It did and by this time the baby was calm. The wound had healed. I've been assured that he got "a very good result". 

But that feeling of horror I had when considering the idea that my decision and actions might have changed the quality of life my son would have for the rest of his days comes back to me whenever I read about a boy who's lost his penis to infection from a botched circumcision. And my heart breaks for the hundreds of parents who have waited anxiously for their sons to return home from initiation school, only to be told that their children have died because someone failed to be diligent. 

The Constitution tells us that everyone has a right to practice their culture but also that everyone has a right to life and to healthcare. 

If people are not asking hard questions about how initiation practices can be made safer for boys, then as a society we are failing those who bear the brunt of the destruction wrought by charlatans, "culturepreneurs" and unskilled traditional surgeons.

When elected officials such as Mpumalanga health minister Candith Mashego-Dlamini state that they cannot get involved in an issue like the deaths of the 27 initiates in that province last month because culture forbids it, they are failing in their duty to uphold the Constitution and the Bill of Rights.

As a representative of government, Mashego-Dlamini cannot claim her hands are tied, as if there are no other alternatives to ensure accountability from those responsible, especially when provinces such as the Eastern Cape are doing so much more to maintain oversight and reduce the negative outcomes of poorly performed circumcisions.

I'm willing to bet that none of the people urging me to mind my own business when it comes to traditional circumcision have lost the tip of their penis, part of the shaft of their penis, or the entire penis as so many boys do each year. 

I am sure they are not among the dozens, if not hundreds, of boys – for we do not know the full extent of the damage caused by botched circumcisions in this country – who have to urinate sitting down and who will never be able to have what we consider a normal sex life.

The idea that no one should ever discuss what happens at initiation is a scary one, not least because it allows unscrupulous people to continue with dangerous practices without fear that they will be called to account.

The sheer lack of statistical data on how many boys undergo traditional circumcision, how many are mutilated and how many die, not to mention the lack of data on whether anyone is ever tried or prosecuted for negligence and malpractice, shows a failure of government to uphold the Constitution and protect the vulnerable. 

The annual handwringing on this issue is disingenuous if it is not accompanied by serious interventions in areas where there have been deaths or injuries.

If traditional leaders and the departments of health and traditional affairs are doing what they can to keep boys safe during the initiation season, we are not hearing enough about it and we are not seeing results – not least because there are no results to be seen.

I must admit I was taken aback by the angry tone of many of the responses to our request for those who are interested in sharing their experiences to do so in our survey. Our intention was merely to get a conversation going on this, which is so important to so many people in the country but only ever makes headlines when someone dies or is mutilated or assaulted. We never hear from the tens of thousands of men who go through culturally affirming, medically uncomplicated initiation each year. 

While cultural injunction not to discuss sacred matters in public is well known, it is not unreasonable to assume that some people would be comfortable discussing their experience and view on initiation with others. After all, culture is mutable and different people interpret their own culture for themselves in their own ways.

Last month, when Parliament held a snap debate about the spate of initiation deaths in Mpumalanga, the ANC's chief whip Mathole Motshekga spoke about initiation at length and described several rituals that form part of the initation process. 

He also quoted Nelson Mandela, who described his own initiation, saying: "It was a sacred time; I felt happy and fulfilled taking part in my people's customs and ready to make the transition from boyhood to manhood."

The M&G survey did not ask for details on the sacred teachings imparted to boys who underwent initiation. It asked a very broad, open-ended question: "Tell us more about your experiences during the initiation process", one which could be interpreted any way the respondent chose.

Some readers kept their responses brief ("To respect elders"), some focused on the circumcision aspect ("It only took me two weeks to recover") and others focused on the emotional aspects ("It was the first time I felt loved by … the whole community all at the same time"). One reader, who wrote at length about the importance of initiation in his belief system, responded simply by saying "It is difficult to explain … it is sacred and should be afforded the respect it deserves."

In the past few days, the survey has already yielded as many responses as some of our previous surveys. Readers have been almost entirely positive and supportive of the practice and almost all said they would recommend it to their own sons and to other boys.

One reader described the sense of community and brotherhood that he gained from the experience.

"Men who have completed five years or more after being initiated and elderly men would visit initiates at the school to share their manhood experiences. In particular elderly men would teach us more about how as a man you would be expected to conduct yourself. Further, they would teach us about our community responsibilities and roles as young men. What you gain from them is undisputed wisdom that no money can buy," he wrote.

Another pointed to the significance of the experience for boys who have grown up without a father.

"Most of us who never really grew up with our fathers get a chance to experience that when you're there as you're surrounded by men only, who look after you, offer advice and pass on words of wisdom from their experiences and of those before them. For me it was one of the most interesting times, I learnt a lot about myself and I felt part of a team and surrounded by people who were there to listen, teach and counsel," he said.

A reader described how he went to initiation school at age 10, against the wishes of his mother and grandmother, because he didn't want to be left out of his group of friends, who were slightly older. He described the event as "one of the greatest things to ever happen in my life outside my career".

"It taught me that no challenge or hardship is big enough to break any person, for as long as a person is committed and determined to achieve the best possible results," he wrote.

Only one reader expressed conflict on the question of whether he would recommend that other boys undergo initiation, saying times had changed in the 20 years or so since his own initiation.

"People used to take leave-days from work, drive from Cape Town or Johannesburg to the Eastern Cape just to contribute and impart their wisdom in this process. The logic was simple: 'Today it's my son's initiation, tomorrow it's yours.' There was no room for error here, and everybody knew that any deviations from the traditional routine tend to have dire consequences. However, this is no longer the case," he wrote. 

"It's no longer a community event, elders are disrespected by youngsters and are no longer keen to be part of this. And as a result, we have lost people with tacit knowledge and experience of this practice. Also, most people nowadays live in urban or semi-urban lifestyles and do not necessarily practice their traditions."

The reader has a point. 

In the Eastern Cape the number of boys undergoing initiation has dropped from 60 812 in 2010 to 39 010 in 2012 – a more than 30% decline in just three years. Could this be due to rapid urbanisation of people originally from the Eastern Cape? Could it be due to fears over the medical outcomes of traditional circumcision? 

As with many things related to initiation, we simply do not know.

Meanwhile, according to the department of cooperative governance and traditional affairs, the number of initiates in Limpopo has jumped dramatically from 6 903 in 2010 to 35 621 last year – a 400% increase in three years.

Why? Has everyone there suddenly become more traditional? And has the sudden and dramatic jump in numbers been accompanied by a sudden and dramatic rise in the number of skilled traditional surgeons to attend to all of these boys? 

One assumes it would be difficult to train that many surgeons in just three years. So the question then is, are traditional circumcision-related deaths, amputations and injuries in Limpopo on the rise?

We don't know because the Limpopo health department does not keep those statistics and the department of cooperative governance and traditional affairs has not been able to provide them.

As for Mpumalanga, we do not even have year-on-year numbers to compare.

Culture may be sacred and it may be protected by the Constitution but we cannot willingly choose to disengage from this matter to the detriment on unknown numbers of boys.

There is no harm in asking the question.

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Faranaaz Parker
Faranaaz Parker is a reporter for the Mail & Guardian. She writes on everything from pop science to public health, and believes South Africa needs carbon taxes and more raging feminists. When she isn't instagramming pictures of her toddler or obsessively checking her Twitter, she plays third-person shooters on Xbox Live.

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