Abstract
Training designed to improve circumcision knowledge, attitude and practice was delivered over 5 days to 34 traditional surgeons and 49 traditional nurses in the Eastern Cape, South Africa. Training included the following topics: initiation rites; statutory regulation of traditional male circumcision and initiation into Manhood (TCIM); structure and function of the male sex organs; procedure of safe circumcision, infection control; sexually transmitted infections (STIs); HIV/AIDS; infection control measures; aftercare of the initiate including after care of the circumcision wound and initiate as a whole; detection and early management of common complications of circumcision; nutrition and fluid management; code of conduct and ethics; and sexual health education. The evaluation of the training consisted of a prospective assessment of knowledge and attitude immediately prior to and after training. Significant improvement in knowledge and/or attitudes was observed in legal aspects, STI, HIV and environmental aspects, attitudes in terms of improved collaboration with biomedical health care providers, normal and abnormal anatomy and physiology, sexually transmitted infections and including HIV, circumcision practice and aftercare of initiates. We concluded that safer circumcision training can be successfully delivered to traditional surgeons and nurses.
Highlights
Traditional male circumcision is a widely practiced ritual by the Xhosa speaking ethnic groups in South Africa
The training curriculum for the traditional surgeons and nurses included the following content areas: Introduction into initiation rites; Traditional Community Regulation as well as statutory regulation of Traditional Male Circumcision and Initiation into Manhood; Structure and Function of the Male Sex Organs; Procedure of safe circumcision, Infection control; sexually transmitted infections (STIs)/STDs; HIV/AIDS; Infection Control Measures; Aftercare of the initiate including after care of the circumcision wound and initiate as a whole; Detection and early management of common complications of circumcision; Nutrition and Fluid
This study evaluated a training intervention with 34 traditional surgeons and 49 traditional nurses in the Eastern Cape, South Africa
Summary
Traditional male circumcision is a widely practiced ritual by the Xhosa speaking ethnic groups in South Africa. It is the initiation of a boy into the rights and responsibilities of manhood. The procedure is performed under most cases by an experienced traditionally circumcised man (traditional surgeon) on 18 years and above boys. The procedure is performed in a secluded initiation school (mountain or forest). Under these conditions the procedure is very painful and involves excess blood loss. Since the procedure involves permanent amputation of a living tissue, it is a procedure that is characterized by some risk of infection, temporal or permanent complication to the male sex organ (Mayatula and Mavundla, 1997, Meintjies, 1998)
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