Penis transplants? How about we stop botched circumcisions

In 1967 South Africa made international headlines for the world’s first heart transplant, thanks to Dr Chris Barnard and his team. It was a medical sensation that stood as a neat allegory for our social condition. The 1960s was a time in our history when South Africa was sorely in need of heart in our public life. The apartheid regime was at its most brutal: repressive laws were intensified, and resistance driven underground. We needed a wholesale change of heart as symbolised by Barnard, an outspoken critic of the apartheid government.

Forty-eight years later we’ve moved down the human anatomy and made history elsewhere: by effecting the world’s first penis transplant. It has caused an international sensation of course, the word “penis” being so pleasing a headline booster. 

The article itself kept a straight face, thankfully. But the doctors involved told reporters one of the biggest issues in the operation were not the usual complications such as infection or the risk of the body rejecting the organ. It was the ego. There were “huge psychological effects” involved, according to Professor André van der Merwe, head of the urology division at Stellenbosch University. “If you add an organ you make a ripple effect on somebody’s ego, you can even induce psychosis.”

Perhaps it is this psychosis that allowed us a to trumpet the operation as a victory without really commenting on the devastating social context that made it necessary. In an ego-driven society we’re all about the successes.

Prevention is better than cure
So we don’t talk enough about the practice of traditional initiation and circumcision, which made all this necessary. Proponents of the practice tell us it is a beautiful and symbolic journey, and I am sure it is, when done right. It’s another story when there are dirty and blunt instruments wielded by someone with little medical knowledge and boys kept in a hut for days, forbidden to drink water to prevent them urinating, leaving them dehydrated and infected.

Some piloted studies combine modern medicine with prayers to the ancestors and have seen great success.

But many traditionalists refuse to discuss the issue and forbid others from getting involved. So we come up with workarounds, like a penis replacement surgery, allowing some among us to keep their ego problems in place. But should we?

Prevention is better than cure, the medical maxim goes, but in this case talking prevention is taboo. It is ludicrous to refuse to allow minor medical help to prevent hundreds of boys dying or living the rest of their lives with botched or no penises.

The young man who received the world’s first successfully transplanted penis had his penis amputated three years ago after a circumcision went wrong. He was left with just 1cm of his original penis and that’s considered lucky.

Censorship the last resort of the irrational
Dr Dingeman Rijken, a Dutch doctor who worked in the rural former Transkei, was so shocked by the condition of the boys brought into the hospital after the rite that he went on a long educational drive in the area.

“Sunken eyes from dehydration, flaky skin from malnourishment, bagged eyes from sleep deprivation,”  he described. After all that training and campaigning he was met by the same situation the next year, following initiation season. “I spend hours cleaning their wounds, struggling to insert urinary catheters in their botched penises, battling to explain 17-year-olds that they had lost their manhood.” 

Of course, as a woman and someone outside the culture I am not “allowed” to talk about this and neither was Dr Rijken, censorship being the last resort of the irrational.

I am inviting certain recriminations and demands to stay out of it with this column. But I won’t.

When I stumbled across the topic on a general discussion about youth issues in a Mail & Guardian hangout in 2013 I was shocked by the backlash on social media. I was told to mind my own business and that no one could interfere with cultural practices. 

The hypocrisy of arguing for tradition
This is ridiculous. The Indian practice of Sati, where widows were expected or forced to kill themselves, usually by burning themselves on their late husbands’ funeral pyres, had loads of cultural kudos too, offering the woman a chance to become the spiritual embodiment of goodness and bless her family. 

That did not stop it from being discussed by those outside the culture and outlawed and I’m glad it was. But maybe culturally-tolerated suicide is a bit of an extreme analogy, you’re thinking. Fine. Let’s talk child brides, the potentially financially debilitating practice of dowry and more. There are so many other aspects of Indian culture I am more than glad I no longer have to subscribe to. Or, if it is beautiful enough to keep alive, I have no qualms with allowing a modern update.

Arguing for tradition above all else is a bit hypocritical; tradition itself is not static and changes all the time. Traditionalists will tell you the way they did circumcision worked for generations. That is true, but they are no longer carried out as they once were.  ” target=”_blank”>Thanks to the complications of history, much of the knowledge disappeared and circumcision ceremonies fell into the hands of young inexperienced men or quack doctors. Dr Rijken pointed out traditional methods effective in safeguarding the health of initiates, such as frequent washing and using animal skins as bandages, have been abandoned. 

We’ve had a massive change of heart as a country, and shook off the burden of apartheid. Do we have the balls to have a change of ego too?

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