Ritual Circumcision Research Articles

The Untold Symbolic Significance of African Cultures, the Case of the Bukusu Circumcision Ritual in Kenya

Most Africans cultures were observed and practiced within the confines of their moral values that carried coded meaning which required more attention to understand hidden symbolism contained therein. Among the Bukusu people of Western Kenya for instance, circumcision was perhaps a cultural routine that was practiced with strict observance of several stages and rituals that indirectly communicated important messages to the initiates and the society at large. Hence, this paper examines key stages that are involved in order to successfully complete a Bukusu circumcision ritual. Such phases contained unique features and moral values that have not been told in many academic and scholarly writings since the inception of African leadership after colonialism. For the success in this objective, the tenets of the structural functionalism approach were very relevant in the illustration of the significance of the ritual itself and its key components that are deeply embedded and enshrined in the doctrines that dictated the operations of this rite. The study heavily relied on primary data which was corroborated by the existing secondary date to generate findings contained in this paper. Much of the primary data was collected through Oral Interviews (abbreviated as O.I in the entire text) and also through extensive readings from the Kenya National Archives (abbreviated as KNA in the text).

Israeli neonatal herpes simplex infection: Unique epidemiology and clinical profile

AbstractTo gather national level data on Israeli neonatal HSV (NHSV) infection and to evaluate the distinct clinical characteristics of NHSV and neonatal enteroviral meningitis (NEM). Israeli NHSV patients, hospitalized between January 2015 and April 2022 in 22 medical centers were assessed, together with NEM patients, hospitalized at Sheba Medical Center during the same period. NHSV demographic and clinical characteristics were documented and compared to those of NEM. Eighty‐five NHSV (73% males) and 130 NEM (62% males) patients were included. The incidence of NHSV was 5.9/100 000 live births, the common phenotype and HSV type were SEM (53%) and HSV1 (91%), respectively. Horizontal transmission was suspected in 50% cases (of which 67% underwent a Jewish ritual circumcision with direct wound sucking, 33% had relatives with highly suspicious herpetic lesions). Compared with NEM, NHSV tends to present with rash (14% vs. 60%, p‐value < 0.01) and seizures (0% vs. 6%, p‐value 0.02), while fever, irritability and poor feeding appear more frequently in NEM (94% vs. 18%, p‐value < 0.01; 37% vs. 1%, p‐value < 0.01; 25% vs. 1%, p‐value < 0.01 respectively). Of NEM patients, 28% were treated with acyclovir. Our results mark a decrease in the incidence rate of NHSV in Israel and a prominent mode of horizontal infection acquisition. We underscore the unique localized phenotype of NHSV, in contrast to enterovirus, which tends to cause a systemic disease with constitutional symptoms. These findings should be considered when evaluating the need for comprehensive empirical treatment for HSV in the context of neonatal fever, or according to a certain clinical presentation.

The Moral and Normative Foundation of Idumi Circumcision Ritual among the Tiriki of Hamisi Sub-County

This paper relates to the moral and normative foundation of Idumi circumcision ritual to explain the reasons for its persistence in many African communities. The main objective of the study was to explore the moral and normative foundation of Idumi circumcision ritual among the Tirikis. The study was guided by Stuarts Hall’s Cultural Identity Theory to explain its persistence and continuity. A qualitative exploratory design which was phenomenological was adopted for the study. Purposeful sampling was utilized to select twenty – six (26) respondents for the study including; four (4) Tiriki elders, four (4) initiates, four (4) ritual leaders, four (4) counselors, four (4) women, four (4) initiation chiefs and two (2) sub-chiefs. Twelve (12) key respondents were interviewed and fourteen (14) respondents participated in two focus group discussions of seven (7) members each. Data was analyzed qualitatively using the thematic method and presented by reporting key findings using appropriate verbatim quotes. The study revealed that there is a moral and normative foundation of Idumi circumcision ritual which contributes to the persistence and continuity of this cultural ritual.

Tachoni Male Circumcision Rituals: Navigating Cultural Revitalization, Heritage and Identity through Lexico-Semantic Analysis

The research explores the cultural significance of male circumcision ceremonies within the Tachoni community. Its objectives include analyzing the linguistic elements used in these rituals and their cultural implications, and examining how these rituals contribute to preserving, renewing, and adapting cultural practices and heritage among the Tachoni. Grounded in lexico-semantic theory, the study investigates the intricate relationship between language, meaning, and cultural identity in Tachoni male circumcision rituals. Conducted in Webuye East Sub-County, Bungoma County, Western Kenya, the research employed qualitative ethnographic methods during August and December 2022, and April 2023. Purposive sampling involved two Tachoni elders, custodians of circumcision knowledge, who were interviewed as key informants. Data collection methods included participant observation and library research. Through interpretive phenomenological analysis (IPA), findings revealed that Tachoni circumcision rituals play a central role in shaping culture and language, reinforcing heritage and identity through a nuanced vocabulary of literal and symbolic meanings. These rituals symbolize rites of passage, affirming masculinity and promoting cohesion among circumcised males. However, the trend towards hospital circumcision, influenced by westernization and Christianity, threatens the continuity of Tachoni cultural practices and their associated lexicon. Consequently, documenting Tachoni circumcision rituals and their lexicon is crucial for preserving cultural heritage.

Protection of minors and perspectives of balancing fundamental rights

Tutela dei minori e prospettive di bilanciamento di diritti fondamentali ABSTRACT: The article analyses the complex issue of child protection in the context of ritual circumcision, identifying the fundamental rights to be balanced. In particular, the text focuses on the diverse landscape of regional health policies, which only in some cases provide coverage for non-therapeutic circumcision, with clear disparities between regions. SUMMARY: 1. Premise - 2. Circumcision and children's rights - 3. Circumcision in public health - 4. Perspectives.

Characteristics and management of post-circumcision Urethrocutaneous Fistula: a retrospective study in surgical units in Cameroon.

Urethrocutaneous fistula (UCF) is one of the major complications of circumcision. The risk factors associated with UCF are not clear-cut but its repair remains a challenge for urological surgeons. The aim of this study was to highlight the epidemiological, and clinical features and outcomes obtained from the management of UCF in the context of a country with limited medical resources where ritual circumcision is widely practiced. From February 2010 to December 2022, 35 patients underwent surgical repair for post-circumcision UCF in two tertiary hospitals in Yaounde, Cameroon. Simple closure, Thiersch-Duplay-Snodgrass and Mathieu techniques were performed. The mean age of patients was 7.4 ± 4.1 years with a range of 2 to 21 years; the median age at circumcision was 24 months (12; 48). Most (95%) of circumcisions were performed by paramedical staff. The majority of patients (n = 26) consulted for a bifid stream, Three-quarters of fistulae were located at the corona. Small fistulae represented 74.28% (n = 26) of cases as opposed to large fistulae (25.71%). More than 70% of patients underwent a simple closure. The therapeutic results were satisfactory in 91.4% of cases (n = 32) after an average follow-up of 91.85 ± 51.92 months. There were no statistically significant differences between the patients with coronal fistula and patients with distal penile fistula concerning demographic, clinical and surgical characteristics. Urethrocutaneous fistula is a major and frequent complication of circumcision mostly practiced by non-qualified personnel on children aged 24 months. The usual presentation is micturition with a bifid stream occurring on average 3 months after circumcision. Coronal fistulas are the commoner location. Simple closure, Thiersch-Duplay-Snodgrass and Mathieu technique appear to be safe with the advantages of low recurrence rate. An accurate diagnosis with a timeframe respecting the principles of fistula surgery combined with regular follow-up is mandatory for good long-term results with a low recurrence rate. Further prospective studies on the factors affecting the formation of urethrocutaneous fistula should be performed to prevent this complication of circumcision.

Histological and morphological development of the prepuce from birth to prepubertal age.

To study the histological changes of the preputial tissue from birth to prepubertal age in order to define unnoticed morphological changes. Prepuce samples were obtained from 79 healthy boys who underwent routine ritual circumcision. Specimens were divided into six groups according to the boys' age: newborn, 0-1 year of age, 2-3 years of age, 4-5 years of age, 6-7 years of age, and 8-9 years of age. Histologic analysis of the specimens was performed by H&E, Masson's trichrome, Verhoeff-Von Gieson, immunohistochemical staining. Microscopic examinations showed that average epithelial thickness increased after the neonatal period (p=0.001). When collagen fiber density was evaluated, no significant differences between groups were found (p=0.083). When the elastic fibers in the dermis were evaluated, it was determined that the number and thickness of elastic fibers increased with age. Immunohistochemical examinations showed that the number of peripheral nerves marked with S100 was lower in the neonatal period than at other ages (p=0.048). When the vessels marked with CD105 antibody were counted, there was no significant difference between the groups (p=0.078). This is the first study to examine the age-related structure of connective tissue elements in the foreskin. Our results showed that the prepuce's prepubertal maturation process is continuous, and the first 2 years of life are appropriate not only in relation to the physiological effects of age but also the optimum structural changes for wound healing, such as vessel diameter, epithelium thickness, peripheral nerve count.

An Examination of the Spiritual and Moral Importance of Contemporary Male Circumcision Ritual Among the Ameru in Kenya

Ritualistic circumcision has been carried out in West Africa for over 5000 years. This was a revered rite and upheld in indigenous societies. In Kenya, almost all ethnic groups traditionally practice male circumcision. Those that do not include some people spilling over the Ugandan border (e.g., Teso and Chapadola), and the Turkana and Luo. The purpose is generally to facilitate a seamless transition of adolescent males to adulthood. However, this revered rite has been transformed in contemporary times and some societies do not practice it as it was done in the past.The study thus examined how circumcision is practised among the indigenous Ameru who inhabit both the Meru and Tharaka Nithi Counties of Kenya. It further underscored the changes that have affected the conduct of this ritual in contemporary society. It finally expounded on the future and continuity of this significant ritual among the Ameru. The research was carried out in the Ameru and Tharaka Nithi Counties in Kenya. The mixed methods approach proved appropriate for this study since the empirical data gathered from the field is important in examining the contemporary male circumcision ritual among the Ameru of Kenya. A total of eighty-eight respondents were purposefully sampled to participate in the study. They comprised 24 Njuri Ncheke Elders, 32 males from the eight age sets among the Ameru who underwent the traditional circumcision rite, and 32 youthful males from the Ameru age sets who underwent modern hospital circumcision. Apart from employing oral interviews with the selected respondents, open and closed-ended questionnaires were administered to them. The research findings established that circumcision is an important rite among the Ameru enabling the youth to transform into mature and responsible adult men. Religion, education, intermarriage, and other modern ways of life have transformed male circumcision among the Ameru. The churches, schools, and the Njuri Ncheke now undertake the educational and moral teachings of this important ritual. Apart from the physical nature of circumcision, elaborate seminars should be conducted to educate adolescent males on the importance of this ritual. Keywords: Culture, Male Circumcision, Modernity, Rite, Traditions, Kenya, Ameru Tribe

Idumi & Heritage Conservation in Kenya

Circumcision is an ancient practice worldwide. This research article seeks to demonstrate that the rite of circumcision among the Tiriki people of Western Kenya goes beyond the surgical procedure. It is a lengthy process marked by ceremonies at various stage. This initial study investigated the origin and symbolic meaning embedded in circumcision (idumi) material culture among the Tiriki. The findings established that idumi material culture originated from the Terik, and symbolism is ascribed to all material culture utilized at every stage in the idumi. The information we gathered can guide policy on heritage conservation in order to promote the rich history of Tiriki people and for cultural tourism. The research article recommends that more study needs to be carried out in order to explain why the Tiriki do not circumcise women while the Terik still do so.

Causes of changes in male circumcision rite among the Ameru of Imenti South Sub-County, Meru County, Kenya (1950 – 2016)

The purpose of this study was to establish the causes of changes from the traditional method of circumcision to the modern male initiation rite of circumcision among the Ameru of Imenti South Sub-County, Kenya. The period considered was between 1950 and 2016. The topic has been difficult to penetrate because of the secrecy of the traditional circumcision rite. The study used Modernisation Theory (MT) as a tool for analysis. Methodologically, the study used a descriptive research design. The study was carried out among the Ameru of Imenti South Sub-County, because of the modern changes in male initiation rite of circumcision. ata was collected from primary, archival and secondary sources. Interview schedules focus group discussions and observation. The target population was 61,091 adult men from Imenti South Sub-County, and the sample size comprised 50 randomly selected respondents. The main research findings were that changes in the male initiation rite of circumcision were caused by urbanisation, formal schooling, the establishment of health facilities and colonisation, all of which were intended to Christianise the operations. This research contributes to the wider comprehension of the male initiation rite of circumcision among the Ameru of Imenti South Sub-County between 1950 and 2016. The study contributes to the Ameru historiography.

A Historical investigation into the changes in male circumcision among the Ameru of Imenti South Sub-County, Kenya (1950 and 2016)

The study aimed to document the changes from traditional to modern methods in the male rite of circumcision in the said community. Male circumcision as a rite of initiation has been a subject of discussion, but the truth about the practice among the Ameru had not been adequately revealed. Researchers have often presented the topic of circumcision among the Ameru as difficult to penetrate because of the secrecy of the rite. This study investigated the changes that have taken place in the rite of circumcision among the Ameru of South Imenti Sub-County, in Meru County, Kenya. The period taken was from 1950 to 2016. The research employed the Descriptive Survey Design. The target population was 61,091 adult men from Imenti South Sub County, and the sample size comprised 50 randomly selected respondents. Research instruments used were mainly interview schedules, Focus Group Discussions and observation, and data was collected from oral, secondary and archival sources. The findings were that between 1950 and 2016, there were changes in male circumcision rite in Imenti South, Sub-County. These changes could thus be traced from the time of colonialism, which started in this community in the 1950s. The changes were meant to Christianise the operations as colonisation and evangelisation went hand in hand. The study recommends that since changes are inevitable, there is a need for the blending of traditional and modern aspects of the male rite of circumcision.

Penile amputation after neonatal circumcision: a case report.

A 7-day-old male term baby was circumcised with a cauter by an unexperienced practitioner, and the patient was admitted to the department of pediatric surgery. Both the glans and the body had become discolored and necrotic. The patient was taken into the theater and given general anesthesia. The authors removed the debridement and inserted a catheter into the urethra to prevent urethral stenosis. The procedure of circumcision has several medical benefits and is widely performed for religious, cultural, and medical reasons. It is generally agreed that circumcision prevents against sexually transmitted diseases, penile and cervical cancer in adults, as well as urinary tract infections in children.Partial or complete penile amputation injuries are rare and frequently the result of psychotic self-harm. Operators must correctly conduct the circumcision in order to prevent the potential complications that can happen when the procedure is performed out by untrained hands.The most common cause of penile amputation injuries, whether partial or total, is psychotic self-harm. Operators must carry out the procedure carefully to prevent the potential complications that can happen when circumcision is performed by untrained hands. The authors present here a case of a 7-day-old boy who had ritual circumcision with a cauter complicated by an entire penile amputation, which was treated with the insertion of a catheter to prevent the closure of the urethra. The patient reported his penis was circumcised with cautery one day later the glans and the entire penis became discolored and necrosis, unfortunately, the entire penis was lost with the overlying skin.

Dairy goat production in Kenya: A review

In sub-Saharan Africa, dairy goat farming presents a viable option to ensure food and nutrition security in addition to playing an important socio-economic function among rural farmer households. Dairy goat production can improve people’s livelihoods mainly by providing milk for household nutrition and agro-income. Additionally, the dairy goat enterprise supplies breeding stock, meat, skins, fibre (hair), manure, and also acts as an insurance against emergencies. Further, in most rural households, dairy goats also serve socio-cultural functions including weddings, blessing ceremonies and circumcision rites, among others. In 2009, the dairy goat sub sector contributed about 15.2% of the total livestock and 4.8% of the overall household incomes in Kenya. Milk production is a high-priority function for those involved in dairy goat production. In the year 2006, exotic dairy goat genotypes (Alpines, Toggenburg and Saanen) were introduced in various semi-arid lands of Kenya which were characterised by low, erratic rainfall amounts (below 750 mm annually), high day temperatures (29o to 35o Celsius), insufficient and low quality feeds, inadequate health care and inappropriate husbandry practices. Dairy goats are more adapted to semi arid conditions and climate change in general than dairy cows due to their smaller body size and physiology and thus they are becoming more important to the dairy industry. Goat milk is more nutritious than cow milk, is more digestible and is thus recommended for young children, the sick and the aged. Besides, dairy goats can survive a myriad of biotic stresses including diseases and parasites, have low feed and labour requirements, need little start-up capital and thus can be raised by the vulnerable members of the society. This review was aimed at describing dairy goat production and related husbandry practices among dairy goat farmers in Kenya. Policy guidance on the necessary interventions to improve the sub-sector is provided based on identified opportunities and constraints. Key words: Kenya, dairy goats, production systems, productive performance, constraints, opportunities

Development of circumcision rates in Germany since the approval of ritual circumcision : Apopulation-based analysis from 2013 to 2018

The religious and cultural circumcision of male infants in Germany is controversially discussed. After the passing of the religious circumcision bill in 2012, an increase of infant circumcisions without medical indication was feared. The aim of this study was to analyze the development of the circumcision case numbers. We used the research database of the German Institute for Applied Health Research with arepresentative anonymous sample of 4.9million insured persons to estimate the annual circumcision numbers in Germany from 2013-2018. We stratified the data according to age (< 18 vs. ≥ 18years). The number of male adolescents in the study period was taken from the database of the German Federal Statistical Office. In the study period, 673,819 circumcisions were performed. From 2014, there was asignificant decrease in the number of cases across all age groups (p = 0.049). Thereby, circumcisions in minors significantly increased (p = 0.002) and procedures in adults significantly decreased (p = 0.01) during the entire study period. The number of male minors increased by 4% from 6,709,137 (2013) to 6,992,943 (2018). The corresponding population-based number increased from 7.5circumcisions per 1000 minors in 2013 to 8 in 2018 (p = 0.037). After the passage of the circumcision bill in 2012, there was asignificant increase of circumcisions in the age group of < 18years in Germany. Amajor limitation of our study is that presumably many ritual circumcisions might not be provided within the health care system.

Questionnaire regarding community awareness of circumcision-related aspects in Saudi Arabia

Objective: The aim was to evaluate different aspects related to early male circumcision, community awareness, and family satisfaction. Methods: A questionnaire-based survey was conducted with the following items on circumcision; time, technique, the performing medical practitioner, and where the circumcision was conducted. Alongside, other questions regarding family satisfaction and cases needing redo circumcision were also included in the questionnaire. Results: The number of participants was 1,118. Timing of circumcision most commonly was neonatal period, first year circumcision, then later throughout their life. Circumcisions were mostly performed in hospitals and carried out by pediatric surgeons. Complications of circumcisions were encountered in 6.9% of cases and circumcision was not affected by the physician&amp;apos;s specialty, timing, place, or technique of circumcision. Conclusion: Ritual circumcision (circumcision in community) is the most common practice. Family counselling regarding postoperative care and sequelae is of utmost importance. Revising practice and audits on circumcision are to be encouraged.

Significance of Context in Performance of Babukusu Chants, Western Kenya.

Oral literature is sub-divided into genres that carry the artistic features like stylistic devices, composition and performance which make oral literature have life and outwit written literature. Chants are among these genres and they carry very vital societal values and norms in African Traditional Society and they are very significant once performed in their right contexts. Their repetitive nature reflects the idea of emphasis and seriousness regarding the purpose or intention of the chant performed. The study categorized these chants according to the four major rites of passage in the Babukusu community. These are; birth-naming rite, circumcision rite, marriage rite and death rite that call for the performance of the chants studied in this paper. Methods of data collection used in the study included; observation, Focused Group Discussions and interviews. The paper used phenomenology theory to depict the connection and relevance of the specific chants performed within specific contexts and their significance.

Glans Anthropometry for Preputial Reconstruction in Hypospadias.

Cases of hypospadias present for poor stream or cosmetic appearance. The main aim is to provide a visibly normal phallus. Preputial reconstruction is technical. A properly planned reconstruction based on anthropometry may improve the result. We are presenting our experience of reconstruction based on glans anthropometry. The aim of the study was to evaluate the importance of glans anthropometry in preputial reconstruction in cases of hypospadias. All cases of hypospadias operated between June 2014 and March 2022 were included. Glans width was measured at the base. The marking sutures for preputial reconstruction were taken at distance thrice the glans width at base. Those requiring religious circumcision along with repair, associated significant chordee, catheter came out before 2 weeks, or history of any previous penile surgery were excluded. All the cases were subjected to urethroplasty, meatoplasty, and preputioplasty. The results obtained were analyzed. One hundred and forty-eight out of 159 cases formed the study group. There were 31 glanular, 42 distal penile, 58 mid-penile, and 17 proximal penile hypospadias. Mean glans width at base was 16 mm (range: 11-21 mm). Mean distance of marking suture at prepuce was 38 mm (range: 33-63 mm). Mean follow-up was 12 months (range: 1-36 months). Mean age at presentation was 23 months (range: 14-72 months). Mean operating time was 50 min (range: 45-60 min). Fistula at the base of preputioplasty was seen in four. Dehiscence of preputioplasty was seen in six. Meatal stenosis was seen in three cases. Preputial reconstruction improves the cosmetic appearance of the hypospadiac penis. Reconstruction based on glans anthropometry improves the result and avoids complications.

Jewish Identity and American Acceptance: Welcoming a Firstborn Son in Two Classic Children's Books

Jewish-American-themed children’s fiction often includes descriptions of ritual observance. Yet, although ritual circumcision (brit milah, or bris) is a requirement in halacha (Jewish religious law) for all newborn males, this event is virtually absent from Jewish children’s books; the incorporation of a surgical procedure would create obvious narrative difficulties. Sydney Taylor and Sadie Rose Weilerstein, two of the most important twentieth century Jewish-American children’s authors, each wrote a series of books including a newborn son. Instead of a bris, they both included the less common, nonsurgical ritual of pidyon ha-ben. Thus, they eluded a problematic description, while informing readers about a lesser-known Jewish practice.

Unveiling the Repressive Culture Towards Female Sexuality: A Critical Communication Ethnography of Sifon Circumcision Rituals in Atoni Pah Meto Ethnic Community

ABSTRACT Indonesia’s ethnic-cultural diversity becomes a paradox when perpetuating discriminatory values and harmful practices. Sifon is a circumcision ritual practised by the Atoni Pah Meto ethnic community in East Nusa Tenggara, Indonesia. This study examines Sifon as a communication event and uses the critical communication ethnography approach and muted group theory to unveil its repressive cultural elements. Data collection techniques include in-depth interviews, participant-observers, and document studies. Observing how power, prestige, privilege, and authority systems construct women’s dependent identity and silence them, the authors argue that Sifon-media women are doubly muted from their embodied experiences to enjoy a healthy cultural life.

Penile skin length can be predicted before frenuloplasty during routine circumcision.

One of the restricting factors for surgical treatment of congenital anatomical pathologies of the penis is the skin structure. Thanks to its structure, the penis is a flexible organ structure, and the treatment can be completed without the need for a free tissue graft. Length changes are obtained on the ventral side of the penis by frenuloplasty. Our study aims to attain an objective formula that could noninvasively predict these changes on the ventral side before the procedure. In our study, 52 patients who were admitted for routine religious circumcision were included, and penile ventral and dorsal skin and inner mucosa lengths were measured before and after frenuloplasty, which is a part of the normal routine circumcision procedure and performed via the "pull and burn" method. Stitches were done to prevent scar formation in the frenuloplasty area. The results were used to estimate the length changes to be obtained on the ventral side by performing a regression analysis of the patient's weight, height, ventral and dorsal inner mucosa, and outer skin lengths. Result: Following frenuloplasty, an increase was detected in the ventral surface ranging from 20% to 177%. This increase was found to be predictable with 62.5% precision (P < 0.01) using the formulation established by assessing the ventral inner mucosa length from pre-procedure values. No significant result was determined in the regression analysis of the patients' other measurements (P > 0.05). Penile length changes that would occur following frenuloplasty can be calculated using a noninvasive method. Frenuloplasty, which would be performed without any vascular change, could be helpful in the surgical planning of some penile surgeries. More studies should be conducted on older boys, in anatomic deviations, and moreover, to establish a reliable formulation.