By Olga Bialostocka

As South Africa celebrates the first, successful penis transplant in the world, with much-deserved public awe, the question we should ask is why there’s a demand for this sort of specialist treatment. The results of the medical efforts of Stellenbosch University surgeons should be praised but the reasons why young men lose their sexual organs in the first place should be addressed.

The Eastern Cape, Limpopo and Mpumalanga are the provinces in which initiations into manhood, known as ulwaluko in Xhosa or koma/lebollo in Sotho, are the most prevalent. Every year traditional circumcision, celebrated as a rite of passage for boys being prepared to become men in their respective communities, costs the health and often lives of numerous young initiates.

Complications resulting from botched surgical procedures lead to gangrene and septicaemia, caused by the impairment of the blood supply and bacterial infections, and often end up with amputations of the phallus.

Zero tolerance
In 2014 a group of prominent South African health research scientists issued an open letter in which they called for the “abolishing of unsterile traditional male circumcision surgical practices” in the country. The group advocated for a medical circumcision. One of the arguments brought to the fore was the fact that culture is fluid, created by the members of a particular cultural group, thus traditional practices can take different forms and can change to be in line with modernity.

The message issued by the academics coincided with a zero tolerance to initiation fatalities campaign organised by the Department of Traditional Affairs in cooperation with the National House of Traditional Leaders, the Department of Health, the South African Police Services, the Commission for the Promotion and Protection of the Rights of Cultural, Religious and Linguistic Communities (CRL Rights Commission) and the Congress of Traditional Leaders.

The adoption of a national policy on initiation was planned as one of the immediate outcomes of the campaign. The document was to “enforce male medical circumcision … without interference with the rites, cultural rituals, customary and traditional affairs matters” and put in place standards to which all the initiation schools were to abide to operate legally.

Culture and development
The cultural aspect of initiation into manhood was brought up also in the “executive summary of the report on public hearings on initiation schools in South Africa”, prepared by the CRL Rights Commission in 2014. The authors of the document stated that “culture and cultural products are constantly being changed and altered … cultures are never static. They are dynamic realities which are in constant flux”. And given the changing realities, the practice of circumcision should be made more suited to present times and modern technologies to prevent the unnecessary, fatal surgeries performed by negligent traditional practitioners.

Through the report, the CRL Rights Commission circumnavigated between protecting the importance of initiation as a cultural heritage of many South Africans while condemning unprofessional, life-threatening circumcisions. The position of the commission was made transparent only at the end of the report, where without any disclaimer the authors called for “initiates who wish to attend initiation schools to continue doing so”.

Therefore, one does wonder, since the number of deaths among young men subjected to the ritual is not falling — despite the efforts of provincial governments (and recently also national) to regulate initiation schools — shouldn’t the problem be addressed from the opposite end, in line with the rationale that demand fuels supply? How useful is a policy if it is considered illegitimate and thus ignored by the people. What are the real chances in such a situation for it to be implemented? The policy in place will not protect young initiates raised in a society which believes that true manhood can only be achieved in a certain “cultural” way, even if it involves a high amount of risk.

What makes an amakrwala?
There is nothing wrong with respecting cultural rights and observing customs and traditions that give one a sense of belonging. In fact, cultural heritage has an important role to play in building peaceful and sustainable societies, which has been emphasised by Unesco. But it is important to first understand what “culture” is and how it orientates us in the modern world, giving us values, norms and background for our lives, but without defining upfront our identity and delimiting our individualism. Treating culture as static, inflexible rules of engagement with the outside world is not only dangerous, it easily creates conflicts, but most of all ignorance.

We cannot pretend that customs and rituals handed over to us by previous generations have remained “frozen in time”. For instance, even in the case of traditional circumcisions, the instruments used nowadays are not the same: take the bandages that replaced animal skins for that matter. They have changed over time. What remained and what matters is the meaning of ulwaluko, the rite of passage that has served to prepare boys for adulthood, for roles and responsibilities within a community associated with being a man.

Will a young boy be less of a amakrwala (young man) if his foreskin is removed by a medical practitioner rather than a traditional one? Will he be less prepared for manhood if traditional methods are replaced by modern ones?

Isn’t the knowledge that the young man will receive at the initiation school more important than the piece of skin he will lose in a hospital?

Olga Bialostocka is a research specialist in sustainable development with the Human Sciences Research Council.


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