Abstract
The aim of this study was to assess the safety of traditional male circumcision practices among Ndebele traditional surgeons following a five days training by direct observation of circumcision procedures. The sample included eight Ndebele traditional surgeons and traditional nurses and 86 initiates (abakhwetwa) from two districts in Gauteng province in South Africa. A structured observations tool was administered by a trained research doctor during circumcisions and (wound) care of the initiates of the trained traditional surgeons. Results indicate that from the observations of 86 traditional male circumcisions a high number (37%) of adverse events were recorded (excessive bleeding, excessive skin removed and damage to the penis) and in six cases the use of one instrument for the circumcision was observed. Before scaling up and/or considering integration traditional male circumcision services into medical male circumcision services in South Africa, a careful strategy to minimize unnecessary morbidity, and fundamental improvements on current traditional male circumcision techniques, are required. In addition, legislation and control of traditional male circumcision in Gauteng province, where the study took place, are recommended to make traditional male circumcision safer and to prevent adverse events to happen.
Highlights
And co-workers (2008) found in a national survey in South Africa in 2002 that of a sub-sample of 3025 men, 15 years and older, 35.3% who had been circumcised, the majority (57.2%) had been circumcised traditionally and 42.8% medically
The age of traditional male circumcision is across ethnic groups mainly 18 years and above (58.2%), followed by 12 to 17 years (33.1%) and 0 to 11 years (8.8%), while there are differences by ethnic groups; for example for the Ndebele, Xhosa, Southern Sotho, and Tswana the age of traditional male circumcision was mainly 18 years and above, and for the Swati, Northern Sotho and Tsonga it was mainly 12 to 17 years, and for the Venda it appears the age of traditional male circumcision was below 12 years (Peltzer, 2009)
Traditional surgeons and nurses entered the field of traditional male circumcision and initiation into manhood and acquired their knowledge and skills through an apprenticeship, e.g. traditional surgeons (50%) had been trained by another traditional surgeon, 62.5% were trained by relatives and 92.9% of traditional nurses had learnt from observation of other traditional nurses
Summary
And co-workers (2008) found in a national survey in South Africa in 2002 that of a sub-sample of 3025 men, 15 years and older, 35.3% who had been circumcised, the majority (57.2%) had been circumcised traditionally and 42.8% medically. The vast majority of Whites (97.8%), Indians (92.8%) and Coloureds (87.4%) were circumcised medically, compared to only 21.8% of black Africans. The median age of circumcision for black South Africans was 18 years compared to 10 years for Coloureds, 2 years for Whites and 1 year for Indians. The age of traditional male circumcision is across ethnic groups mainly 18 years and above (58.2%), followed by 12 to 17 years (33.1%) and 0 to 11 years (8.8%), while there are differences by ethnic groups; for example for the Ndebele, Xhosa, Southern Sotho, and Tswana the age of traditional male circumcision was mainly 18 years and above, and for the Swati, Northern Sotho and Tsonga it was mainly 12 to 17 years, and for the Venda it appears the age of traditional male circumcision was below 12 years (Peltzer, 2009)
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