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Circumcision SA style – the unkindest cut of all

It demands a certain je ne sais quoi for someone of apparently sound mind to allow a man clad in animal skins to slice off their foreskin with a rusty assegai. And that in an isolated bush camp in the dead of winter, nogal.

Especially since this rite of passage to manhood comes parcelled with a string of complications that put in the shade the tribal rights it confers to marry and inherit. Gruesome things like “sepsis, genital mutilation, gangrenous penis, excessive bleeding, septicaemia, gangrene, permanent disability from complete or partial amputation of glans or shaft, the formation of a skin-bridge between shaft and glans, urinary retention, ulcers, loss of sensitivity, sexual dysfunction and oedema of the glans”, to cite from the litany identified in an Eastern Cape study.

Oh, and let’s not forget the most important one — death. So far, this winter’s circumcision season has led to the hospitalisation of 141 and the death of 14 young men around the country. Over the past five years more than a 1,000 have died and each year South African hospitals perform hundreds of genital amputations.

There is an upside to all these involuntarily emasculated men, in sparking medical innovation. In December last year an SA team performed the world’s first successful penile transplant.

The patient was clearly thrilled with the results and soon got his girlfriend pregnant. It is not known, if the infant is male, whether junior will be exposed to the same butchery as dad, or whether the boykie’s name will be put down at birth — as one is forced to do with the best schools — with a top-class initiation college.

Such trauma is quite unnecessary, since this ancient practice is not complicated. Tribal whiteys also have their peckers pecked, but tend to have it done in a sterile hospital environment. Consequently, in the United States a relatively paltry – any surgery carries some risk – 35 deaths are attributed annually to circumcision.

And since voluntary male circumcision can be a powerful tool against the spread of HIV – it is estimated to reduce risk in Africa by 60% – it would make sense for the government to do everything possible to make this a safe procedure. But as with virtually every issue that President Jacob Zuma’s incompetent administration confronts, expediency always trumps good governance.

Despite continuing deaths from unsafe tribal circumcisions, no one has ever been prosecuted for culpable homicide or in terms of any other serious charge. According to the National Prosecuting Authority there are currently only 10 cases relating to circumcision before the courts and all are for operating an unlicensed initiation school.

“Most cases are withdrawn for various reasons,” NPA spokesperson Luvuyo Mfaku concedes. “But we are engaging traditional leaders by arranging workshops because we believe we first have to educate before we can be harsh on them.”

So pussyfooting around cultural traditions is elevated above all other constitutional rights, including the right to life. The NPA’s reluctance to prosecute kidnapping – this week 19 boys were rescued from a Soweto initiation school and taken to a place of safety – maiming and killing of young males is a function of Zuma’s cultivation of the conservative, rural political constituency.

Traditional leaders are courted and pampered, never challenged or offended. Last month the government upped by more than 28% the annual payment for the country’s 5,000 headmen and women to R84,125.

Similarly, the profligate Zulu king’s household grows ever more lavish, with an annual budget of R54m that the king says is woefully inadequate. One cannot, in all fairness, blame His Majesty. He is merely trying to keep up with the Zumas, in their R246m pad down the drag at Nkandla.

There is other evidence of government’s cavalier willingness to literally sacrifice life and limb to political expediency. As part of its campaign to combat HIV by encouraging medical circumcision, the national health department tested a non-surgical, disposable circumcision device that allows the procedure to be easily performed by nurses, freeing up doctors and operating theatres.

The device, endorsed by the World Health Organisation and already used in Rwanda, Uganda and Kenya, sailed through all the clinical trials. However, it is not going to be used in SA, after all.

The Congress of SA Trade Unions informed the government that the device was completely unacceptable because it is made in Israel. Were it to be introduced in state hospitals, Cosatu nurses would be instructed to refuse to use it.

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  • This Jaundiced Eye column appears in Weekend Argus, The Citizen, and Independent on Saturday. WSM is also a book reviewer for the Sunday Times and Business Day. Follow @TheJaundicedEye.