Home' Trinidad and Tobago Guardian : July 29th 2013 Contents A37
Monday, July 29, 2013 www.guardian.co.tt Guardian
JOHANNESBURG---This is a grim time of year for
a hospital in the rolling hills of South Africa s Eastern
Cape province, where mattresses are laid on floors
to cope with the stream of young men with severe
injuries from botched circumcisions at initiation
Some patients with amputations, a doctor says,
were told by their handlers that their genitals would
grow back, reflecting a fog of misinformation that
makes it hard to stop what has become an annual
It wasn t supposed to be this way. The traditional
ritual, which goes back centuries, is meant to usher
youths into manhood, inculcating them with the
responsibilities to become valued members of their
Former South African President Nelson Mandela
wrote about the spiritual meaning of his own cir-
cumcision in the same province where the Holy Cross
Hospital is struggling to handle the influx of wounded
At least 60 males have died at initiation schools
in eastern South Africa since the start of the initiation
season in May, health officials confirmed. Thirty of
them died in the Eastern Cape in the last six weeks,
and 300 others were hospitalised with injuries.
Dingeman Rijken, a doctor at Holy Cross Hospital,
has treated so many cases that he is campaigning for
better practices at the ceremonies, circulating a training
manual that calls for proper medical precautions. The
manual contains graphic images of circumcisions and
offers an ideal method of performing the procedure,
which he s shared with people involved in initiation
ceremonies around Eastern Cape s Pondoland region.
"It is becoming a psychological issue," said Rijken,
who has treated 140 initiates in the last year and
admitted another 150 for serious injuries.
"I have had to tell eight boys this season that they ve
lost their glans or parts of their penis, so it is a health
problem. We can t run away from it, we need to
He said nurses struggle to keep up with the overflow
of more than 68 initiates who were admitted in the
last two weeks with badly infected genitals, dehydration
or other serious injuries.
The worst of the injuries occurred after botched
circumcisions performed by inexperienced traditional
nurses, who use the same spear on multiple initiates
without protecting against the spread of infections,
then cover up wounds with tightly wrapped bandaging
that cuts off blood supply to the area.
After about ten hours the genitals can become gan-
grenous and in some cases permanently damaged,
but many initiates do not seek hospital treatment for
another five to ten days, Rijken said.
By this time very little can be done. Doctors cannot
perform surgery because initiates suffer from sleep
deprivation and dehydration and are not in a condition
to give consent.
In minor cases, Rijken cleans off loose gangrenes
around the affected area, bandages it and treats it
with antibiotics, which eventually may result in a
partial amputation of the penis. In more serious inci-
dents, boys wait a period of one to six weeks until
the entire organ falls off, he says.
Initiations are mostly practiced, though not exclu-
sively, by the Xhosa tribe in eastern South Africa.
Young males participate in the ritual as a formal
preparation for adulthood, usually undergoing cir-
cumcision and survival tests in secluded sites outside
Most of the deaths in the Eastern Cape were in
Pondoland, where the practice was banned in the
1820s by its then ruler, and then reintroduced in the
last three decades as men who left their communities
to work in mine fields were ostracised because they
were not considered men if they were not circumcised,
Rijken said, citing his research of its history.
Government legislation stipulates that participants
should be at least 18, but parents can sign a consent
allowing younger boys to participate. Rijken has mon-
itored more than 60 ceremonies and rescued several
injured boys, and says he sees initiates mostly between
ages 14 and 17, but has treated boys as young as 12
who are too young to understand the implications of
losing their male organ.
He said initiates rarely complain about pain because
they fear being beaten by nurses and ridiculed by
peers for not properly observing a tradition that
encourages initiates to develop a tough demeanor.
One patient had part of his injured penis "yanked
off" as punishment for complaining, and those who
suffer penile amputations are frequently told by han-
dlers that their penises would grow back, Rijken said.
"But that s why we need to involve the community,
to tell them it won t grow back," he said.
Like others who have spoken about the long-held
tradition, Rijken believes it will take the combined
effort of traditional leaders, provincial health depart-
ments and effective government regulation to end the
killings and save the cultural practice, but he said it s
time the community is educated on the dangers. (AP)
Circumcision victims overwhelm SA hospital
a problem, medic
Men dance around a boy, fourth from right in rear, covered with a blanket, after
he completed his initiation ceremony near Qunu, South Africa, earlier this month.
A Xhosa boy covered with a blanket and smeared with chalky mud sits in a field
as he and others undergo traditional Xhosa male circumcision ceremonies into
manhood near the home of former South African president Nelson Mandela in
Qunu, South Africa, last month. AP PHOTOS
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