By Elias Tibane
Circumcision, which involves the surgical removal of the foreskin of the penis, is practised worldwide for religious and traditional rites, as well as for health reasons.
In South Africa, circumcision has for many years been practised by various religious groups and some African cultures as a rite of passage to adulthood. However, even young children are being circumcised for a variety of reasons, including personal hygiene.
The National Department of Health (NDOH) has since endorsed Medical Male Circumcision as an HIV-prevention strategy for men in South Africa, as part of the comprehensive HIV-prevention strategies recommended by the World Health Organisation and United Nations Programme on AIDS for countries with a high prevalence of HIV and low coverage of circumcision.
According to the NDOH, this followed three independent clinical trials in South Africa, Kenya and Uganda that provided evidence that male circumcision reduces the risk of sexual transmission of HIV from HIV sero-positive women to HIV sero-negative men by 53 to 60%.
Prior to the outbreak of the Coronavirus Disease (COVID-19) in 2020, an alarming number of deaths were recorded at traditional initiation schools, mainly attributed to botched circumcision conducted by unscrupulous and inexperienced traditional surgeons. Each year, many young men either died owing to serious complications or had their infected penises amputated.
For over two years during the national state of disaster declared by government to stop the spread of the COVID-19 pandemic, no initiation deaths were reported after the practice was suspended. It was later allowed on a limited basis, included limiting the number of people accompanying initiates and those attending homecoming celebrations.
Following the lifting of the national state of disaster, there has been a higher than normal influx of young boys going to initiation schools. Homecoming celebrations where families and friends feast and dance to celebrate the safe return of young men are also back in full swing. At the same time, so-called fly-by-night initiation schools maliciously created by unscrupulous people have been mushrooming in different parts of the country.
To regulate the initiation practice, government introduced the Customary Initiation Act, 2021 (Act 2 of 2021), which became effective in September 2021 and among others, requires that “an initiation school must be registered at least three months prior to the commencement of an initiation season, and such registration is valid only for a specific initiation season indicated on the registration certificate.”
The Act provides for the establishment of an 11-member National Initiation Oversight Committee to, among other things, monitor the implementation of the Act and promote compliance with its provisions by all role players involved in initiation practices and initiation schools. It also provides for the establishment of Provincial Initiation Coordinating Committees.
The Act provides for norms and standards regarding age and health requirements. It guards against harmful practices and mandates the involvement of parents to give consent prior to a circumcision being performed. More importantly, it strengthens the integrated approach between health institutions and cultural practitioners to ensure the safety of initiates.
As we approach the upcoming winter initiation season between May and July, we must be vigilant against illegal initiation schools and safeguard the lives of young boys. Responsible initiation schools will not take any young boy without the consent of their parents and they only operate within official health guidelines.
Initiates should be treated with dignity and allowed to have access to medical care while at initiation schools. Of particular concern are unqualified traditional surgeons and schools not adhering to stringent quality health standards during circumcision, which invariably leads to initiates either dying or left permanently disfigured.
In some cases, surgical instruments had reportedly been used on more than one initiate, which exposes them to the potential risk of contracting communicable diseases such as HIV and AIDS. Through the legislative intervention, government has demonstrated its commitment to restore the integrity of this practice and clamp down on illegal schools.
However, the safety of our young men and boys is not the sole responsibility of government but a societal one. Every parent and guardian must play a part by ensuring that their loved ones return home safely from legal initiation schools.
All illegal initiation schools must be reported to law-enforcement agencies so that owners can be arrested and prosecuted. The National Prosecuting Authority has been mandated to ensure full compliance with the law and prosecute those found contravening it when performing circumcision.
While the practice may seem old-fashioned to some, it has profound spiritual and cultural significance to those who partake in it. Initiation schools are part of our culture and it is therefore crucial to perform cultural circumcision with utmost care, respect, dignity and adherence to the law, to ensure the safety and well-being of all initiates.
Elias Tibane is Director: Content Development at Government Communication and Information System