Traditional Circumcision Research Articles

Leveraging on indigenous knowledge systems for leadership development in young men: Discernable lessons from Ulwaluko amongst Xhosa speakers.

Ulwaluko or Traditional Male Circumcision is an old African practice that has survived years of criticism and attenuation of Western civilization through religion and education. With the growing Western influence on the continent, there is mounting questioning of the virtues of ulwaluko in some circles even amongst Africans themselves. Proponents of ulwaluko see the ritual as a potent tool for leadership development amongst young men. By adopting a qualitative research design, the authors collected data by interviewing young men who recently performed the ritual. Adopting a phenomenological approach helped the author understand the lived experiences of the target group. The researcher found that over time, there have been influences that sought to weaken and derail the intended objectives of ulwaluko. The researcher also found that leadership development has always been and continues to be integral to the ritual. The recommendations from the study are that the custodians of African cultural beliefs, customs, and values should reclaim their scope of influence and dominance on cultural practices. Greater awareness also needs to be created of the virtues of ulwaluko particularly amongst the younger generations. The author concludes that ulwaluko still plays a pivotal and prominent role in leadership development amongst young African males and that its benefits cannot be undermined.

Sexual Orientation Hiccups Surrounding Traditional Male Circumcision (Ulwaluko) in the South African Context: Implications for Social Work

Incontrovertibly, ulwaluko (traditional male circumcision) remains one of the essential rituals in developing an individual’s growth and construction of social identity, yet one of the ancient and patriarchal cultures. While some studies have been done on the experiences of homophobia by the LGBTQIA undergoing ulwaluko, there is a dearth of research on how social work professionals can intervene in curbing the homophobic and patriarchal undertones surrounding the traditions. Underpinned by Anti-Oppressive Practice as a theory, this paper argues that ulwaluko becomes problematic because it promotes heterosexualist practices which negate realities and experiences of self-identifying amaXhosa gay men. Through reviewing available literature, this paper argues that although human rights are universal, constructionists believe that social norms and values have an impact on how those rights are implemented, the paper further defined sexuality within the context of amaXhosa and also argues that social workers are not well trained with cultural competency.

Optimizing treatment strategies for pediatric phimosis and redundant prepuce: a comparative study of traditional circumcision and disposable circumcision stapler.

To investigate the surgical outcomes and complication rates of traditional circumcision and disposable circumcision stapler in the treatment of pediatric patients with phimosis and redundant prepuce. A retrospective analysis was conducted on pediatric patients with phimosis or preputial redundancy treated at our pediatric surgery department from January 2022 to December 2023. The patients were divided into two groups: treated with traditional circumcision (control group) and treated with a disposable circumcision stapler (experimental group). Surgical parameters (operation time, intraoperative bleeding), postoperative outcomes (postoperative pain scores, wound healing time, severe edge swelling, wound dehiscence, postoperative rebleeding, postoperative infection, aesthetic satisfaction), were compared between the two groups. A total of 301 pediatric patients were included in our study, with 146 in the traditional group and 155 in the stapler group. The stapler group showed significantly lower values in operation time, intraoperative bleeding, and postoperative rebleeding compared to the traditional group (P < 0.05). However, the traditional group had a significant advantage in postoperative wound healing time and the occurrence of severe edge swelling (P < 0.05). There were no significant differences between the two groups in terms of anesthetic drug dosage, postoperative pain level, postoperative infection rate, wound dehiscence, and aesthetic satisfaction (P > 0.05). In the treatment of pediatric phimosis and redundant prepuce, the advantage of traditional circumcision lies in faster postoperative recovery and less severe edge swelling. The disposable circumcision stapler excels in thorough hemostasis, easy and safe operation, suitable for primary medical use, but lags behind in postoperative recovery compared to the traditional method. Each treatment approach has its own advantages, and the choice should be based on the actual condition and circumstances of the patient. Personalized treatment decisions should be made collaboratively to achieve the best therapeutic outcomes.

Acceptability of Medical Male Circumcision as an HIV Prevention Intervention among Male Learners in a South African High School.

Circumcision is a long-standing and frequently performed surgical procedure which holds significant cultural significance among AmaXhosa people in South Africa. Due to cultural reasons in some parts of Africa, the integration of medical male circumcision with traditional manhood initiation rituals still lacks acceptance. This study examined the level of knowledge and acceptance of voluntary male medical circumcision (VMMC) among young males in a selected high school in the Nyandeni District of the Eastern Cape Province, South Africa. A descriptive, quantitative, cross-sectional study was conducted, and a self-administered questionnaire was used to obtain information on sociodemographic characteristics, knowledge of VMMC, perceptions of VMMC, and circumcision practices. One hundred participants were recruited from both grades 11 and 12, and 82% of the participants indicated that they had received information about VMMC. Most of the respondents (88%) preferred traditional male circumcision (TMC), and only 12% of respondents preferred VMMC. The participants displayed a good understanding of the distinction between VMMC and TMC. However, results from the study showed that most respondents exhibited low acceptability and knowledge towards VMMC. These findings highlight the need to develop evidence-based strategies to enhance learners' knowledge and acceptance of VMMC.

AN ECLECTIC STUDY ON STIGMA AND DISCRIMINATION SUBJECTED TO LGBTQIA INDIVIDUALS IN A SOUTH AFRICAN CONTEXT

Despite legal advancements and commitments made in South Africa, homophobia remains prevalent. In this article, various sources of literature – particularly journals – have been reviewed and it has been found that LGBTQIA individuals face significant violations of their rights. They also experience physical and mental health issues, are stigmatised and discriminated against, and are excluded from cultural practices such as traditional male circumcision. It has been established that social work can play a vital role in ensuring that LGBTQIA individuals have access to their rights, educating communities, and advocating for strict penalties against those who engage in homophobia.

Penile Injury: Four Years’ Experience of a Single Surgeon in a Limited Resources Setting

Background: Penile injuries (PIs) are uncommon, with the management of severe cases being difficult. This study aims to examine the causes of PIs and present experience for their management using the limited facilities available in a hospital with low-resource settings. Methods: The management of PIs in a limited-resource hospital in eastern Sudan was recorded over four years. Records of 32 cases of emergency penile surgical conditions between January 2016 and March 2020 were retrospectively reviewed, and 17 cases of significant PI were included in the study and divided into pediatric and adult groups with further subdivision of each group according to the nature of the injury. Results: Seventeen patients with PIs were treated during the study period. The pediatric group (n = 4) were victims of traditional circumcision; two of them presented with glans penis (GP) amputation, one with gangrenous GP, and one with mild GP injury. The patients in the adult group were divided into three subgroups; the first group had penile fractures (n = 8), the second group had degloving PIs (n = 2), and the third group had penile amputation injuries (n = 3). Management included various surgical techniques tailored to the individual patients. The outcome of the intervention was presented on a case-by-case basis. Conclusion: Severe PIs should be managed using a case-by-case approach. To enhance the effectiveness of surgical interventions, the field of reconstructive penile surgery must be established and developed. Community orientation and work safety measures should be implemented to avoid PIs that may result from traditional circumcision and machinery trauma.

Urinary tract infection complicating a total buried glans penis after traditional circumcision: a case report

Urinary tract infection complicating a total buried glans penis after traditional circumcision: a case report

The medicalisation of female genital cutting in Kenya: a threefold exposition

In Kenya, the prevalence of Female Genital Cutting (FGC) is slowly decreasing. Simultaneously, the practice is increasingly being performed by healthcare providers rather than traditional circumcisers, which may pose the risk of legitimising the practice. To date, the underlying mechanisms remain poorly understood. Using the 1998, 2008-09, and 2014 Kenyan Demographic Health Surveys, this study aims to enhance understanding by mapping both FGC prevalence and medicalisation rates across birth cohorts and ethnic groups. Additionally, the study delves into data from the Kisii community, where FGC medicalisation is particularly high, to examine the association between medicalisation and a mother’s social position, as she is typically the primary decision-maker regarding the practice. Findings reveal that the coexisting trends of decreasing prevalence and increasing medicalisation exhibit significant ethnic variation. Among the Kisii, greater wealth is associated with higher odds of a medicalised cut compared to a traditional cut, while higher education and media use are linked to higher odds of not undergoing cutting at all compared to a medicalised cut. Our findings nuance the international community’s premise that the medicalisation of FGC hinders the eradication of the practice.

Children are Losing Lives in the Name of Culture: The Health Impacts of Initiation Schools in South Africa

Background: On an annual basis, young boys lose their lives due to circumcisions performed at initiation schools across South Africa. Some of the initiates lose their manhood as a result of amputations and all these acts are done in the name of culture. Over the last few years, there have been more media reports in South Africa about improper traditional circumcisions coupled with poor health outcomes causing deaths of children admitted at initiation schools. Aims: This article explores the health impacts of traditional initiation schools in South Africa. Methods: This review followed desktop approach through utilization of secondary data. Systematic quantitative review technique was used to collect data. To get a better understanding of the context under investigation, desktop analysis was employed using the five steps of the data analysis process. Results: The themes identified in this study include challenges associated with the practice in relation to children's rights, ethical conflicts between traditional initiation practices and public health, commercialization of initiation schools, and complications associated with circumcision at initiation schools. Conclusion: There is insufficient enforcement of the laws and a lack of public knowledge regarding the impact of initiation on children. Even though South Africa's national and local governments have made significant attempts to control the initiation practices and uphold children's rights, significant law enforcement is still required to shield children from unsafe cultural customs. In addition to the ineffective execution of existing rules and regulations, the traditional initiation sector is burdened by a lack of direct, continuous, and efficient supervision of the operations of initiation schools. Received: 7 February 2024, Reviewed: 11 March 2024, Revised: 29 March 2024, Accepted: 16 April 2024.

INTERROGATING THE PERSISTENCE OF FEMALE GENITAL MUTILATION IN ILORIN, KWARA STATE, 2000-2020

Female genital mutilation is also known as female genital cutting and female circumcision which comprises all procedures involving a partial or total removal of the external female genitalia either for cultural or other non-therapeutic reasons. FGM is a sensitive topic and issue because it cuts across several cultures and needs to be addressed with great care, without affecting people’s feelings as it touches on other people’s cultures. The practice is, therefore, still deeply entrenched in the Nigerian society. Despite efforts to raise awareness of FGM’s medical complications through governmental and non-governmental organizations, the practice persists in some communities, and this makes one ponder on the factors that seem to preserve the practice. This paper using both primary and secondary sources of historical research methodology assesses the socio-cultural and religious factors that contributed to the continuous practice of female genital mutilation in Ilorin despite the international condemnation. In Nigeria, the South-south (77 percent) has the highest incidence of Female Genital Mutilation among adult women, followed by the South-east (68 percent), and the South-west (65 percent). However, it was only lightly practised in the North, surprisingly leaning toward a more extreme form. At the national level, 41 percent of adult women have had Female Genital Mutilation typically carried out by a traditional circumciser using a blade. There was a significant relationship between the persistence of the practice of FGM and social structures, cultural, and religious beliefs. The study shows that the continuous practice of female genital mutilation in Ilorin is not due to ignorance, but a longstanding tradition and religious belief.

Phimosis in Adults: Narrative Review of the New Available Devices and the Standard Treatments.

Phimosis is the inability to completely retract the foreskin and expose the glans. The treatment of phimosis varies depending on the age of the patient and the severity of the disease; a great number of conservative or surgical treatments are currently available. To provide the first review summarizing the available options for the treatment of adult phimosis. A PubMed, Cochrane and Embase search for peer-reviewed studies, published between January 2001 and December 2022 was performed using the search terms "phimosis AND treatment". A total of 288 publications were initially identified through database searching. Thirty manuscripts were ultimately eligible for inclusion in this review. Conservative treatment is an option. and it includes topical steroid application and the new medical silicon tubes (Phimostop™) application for gentle prepuce dilation. Concerning the surgical approach, the gold-standard treatment is represented by circumcision in which tissue synthesis after prepuce removal can be also obtained with barbed sutures, fibrin glues or staples. Laser circumcision seems to be providing superior outcomes in terms of operative time and postoperative complication rate when compared to the traditional one. Several techniques of preputioplasty and use of in situ devices (which crush the foreskin and simultaneously create haemostasis) have been also described. These in situ devices seem feasible, safe and effective in treating phimosis while they also reduce the operative time when compared to traditional circumcision. Patient satisfaction rates, complications and impact on sexual function of the main surgical treatments are presented. Many conservative and surgical treatments are available for the treatment of adult phimosis. The choice of the right treatment depends on the grade of phimosis, results, complications, and cost-effectiveness.

Genital Condyloma in a 2-Year-Old Child Secondary to Circumcision: A Case Report

Accumulated condylomas are exophytic tumors with a warty and hyperkeratosic surface due to the Human papillomavirus (HPV). Its prevalence in children is difficult to estimate due to limitations in epidemiological data. Its recurrent character is found in 30% of patients. Its management is very complex in children because of skin fragility. Circumcision is an operation consisting of the removal of part of the foreskin. This practice is done either with a simple knife or a pair of non-aseptic scissors which can be a source of contamination including HPV (Condyloma). Traditional circumcision does not seem to be reported in the literature as a mode of contamination. We report a case of genital condyloma in a child 2 years after circumcision. This is a 2-year-old male with no medical history but with a surgical history of circumcision that was brought by his parents in dermatological consultation for papular lesions accumulated on the penis. At the interrogation, we found the notion of recent circumcision performed by a tradithérapeute. The physical examination finds a good general condition. Dermatological examination reveals on the glans of multiple papules, exophitic, with warty and hyperkeratotic surface, of normal skin color. Furthermore, the physical examination of both parents was normal. The diagnosis of accumulated condyloma secondary to probable circumcision was retained before the clinical appearance of the lesions. Two electrocoagulation sessions spaced one month apart under local anesthesia were the treatment with a favorable evolution.

Substantial but spatially heterogeneous progress in male circumcision for HIV prevention in South Africa

BackgroundVoluntary medical male circumcision (VMMC) reduces the risk of male HIV acquisition by 60%. Programmes to provide VMMCs for HIV prevention have been introduced in sub-Saharan African countries with high HIV burden. Traditional circumcision is also a long-standing male coming-of-age ritual, but practices vary considerably across populations. Accurate estimates of circumcision coverage by age, type, and time at subnational levels are required for planning and delivering VMMCs to meet targets and evaluating their impacts on HIV incidence.MethodsWe developed a Bayesian competing risks time-to-event model to produce region-age-time-type specific probabilities and coverage of male circumcision with probabilistic uncertainty. The model jointly synthesises data from household surveys and health system data on the number of VMMCs conducted. We demonstrated the model using data from five household surveys and VMMC programme data to produce estimates of circumcision coverage for 52 districts in South Africa between 2008 and 2019.ResultsNationally, in 2008, 24.1% (95% CI: 23.4–24.8%) of men aged 15–49 were traditionally circumcised and 19.4% (18.9–20.0%) were medically circumcised. Between 2010 and 2019, 4.25 million VMMCs were conducted. Circumcision coverage among men aged 15–49 increased to 64.0% (63.2–64.9%) and medical circumcision coverage to 42% (41.3–43.0%). Circumcision coverage varied widely across districts, ranging from 13.4 to 86.3%. The average age of traditional circumcision ranged between 13 and 19 years, depending on local cultural practices.ConclusionSouth Africa has made substantial, but heterogeneous, progress towards increasing medical circumcision coverage. Detailed subnational information on coverage and practices can guide programmes to identify unmet need to achieve national and international targets.

Adolescent Experience in Performing Sifon Tradition (PostCircumcision Sex) in the Village of Fatumonas- Middle Amfoang, East Nusa Tenggara

Adolescence is a transition period from childhood to adulthood, with many physical and psychological changes. Physical changes in adolescents are marked by signs of primary sex and symptoms of secondary sex, and psychological changes are characterised by emotional changes and changes in intelligence. The purpose of this study was to explore the experience of adolescents in performing Sifon circumcision. The qualitative research method has an exploratory design and a phenomenological approach. The primary informants were adolescents aged 17-24 with a Sifon circumcision. Supporting informants are Sifon circumcision shamans—data collection techniques through in-depth interviews and observation. Data analysis used phenomenological analysis techniques. The research was conducted from June to August 2023. The research was born in Fatumonas, Central Amfoang, Kupang Regency. The results of the study showed that adolescents perform traditional circumcision without being disturbed or ridiculed by friends so that the face does not look old on both the man and his wife, lack of confidence in doctor's circumcision because it is not neat, and has become a tradition that cannot be lost. Adolescents also do Sifon because they fear the genitals will die / not function. Communication, Information and Education (IEC) regarding reproductive health and free sex language must be carried out on an ongoing basis so that adolescents can be aware and do not have a wrong understanding of Sifon circumcision.

A COMPARISON OF BEHAVIOUR AND MORALITY BETWEEN YESTERYEARS’ AND CONTEMPORARY INITIATES: THE CASE OF 2022 CALA AND MDANTSANE STUDY

This article compared the behaviour of yesteryear’s initiates and the contemporary ones in Cala and Mdantsane. This study aimed to explore the policy differences informing TMC in yesteryears and those in the contemporary epoch; to identify the similarities and differences between the behaviour of the two sets of initiates; and to establish the environmental factors motivating the behaviour of initiates. The exploratory and descriptive designs were used. One‑on‑one interviews with the guidance of an interview guide to facilitate interviews. The findings revealed that the yesteryears’ initiates behaved meticulously compared to those of contemporary epoch; embracement of chastity by the yesteryears’ initiates; contemporary initiates displayed wicked behaviours post initiation; the contemporary initiates’ behaviours influenced by illusionary interpretation of rights and tenets of development; Contemporary initiates entrenching culture of abusing substances. Government should ensure that traditional male circumcision achieves its objective. Training for traditional attendants; and hosting cultural events for cultural resuscitation.

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

Analisis Hukum Islam terhadap Tradisi Makkatte Khitan Anak Perempuan Bugis

The Makatte' Tradition of Circumcision for Bugis Girls is a traditional practice that has long been an important part of the culture of the Bugis community in Indonesia. This tradition is believed to be an obligation for all women approaching their teenage years. The aim of this research is to find out the Makatte' traditional law carried out in South Sulawesi from an Islamic legal perspective. The research method used is the normative analysis method, namely investigating facts using Al-Qur'an and hadith reasoning, applicable regulations, and maqāṣid al-syarī'ah theory. The results of this research show that in society, the makatte' tradition has five meanings: as a sign of Islam, custom or culture, a symbol of maturity, cleanliness and health, as well as religious teachings and advice. When this teaching was adopted by the community, the community believed that the series of processions had become a responsibility. Then for those who don't implement it, this will have an impact on social impacts. The Koran does not speak clearly about circumcision for either men or women. Meanwhile, the Hadith, which is the second source after the Al-Quran in Islam, speaks very little about circumcision, so it is interpreted and given the impression of only the approval of the Prophet. Islam as a natural religion certainly upholds natural values. Therefore, Islam prioritizes nobility, purity and cleanliness and perfects all aspects of life.&#x0D;

Role of Traditional Circumcision in Formation of Masculine Gender Identity in Selected Communities in Africa

Traditional circumcision is considered an important rite of passage that marks the transition from boyhood to manhood. It is often seen as a way to initiate young males into adult society and convey societal expectations of masculinity. Based on the Ubuntu philosophy, the study employed a qualitative exploratory design and semi-structured interviews that were analyzed using thematic decomposition analysis. The study purposively sampled 30 respondents from Bukusu (Kenya), Aembu (Kenya) and Lemba (Zimbabwe). Data was collected through in-depth interviews and analyzed thematically. Findings revealed that traditional circumcision of men served as a mechanism for imparting societal values, beliefs, and responsibilities to young boys, reinforcing cultural norms and expectations of masculinity. Through this process, boys were educated about their roles and responsibilities within their specific community, which may include aspects such as being a provider for their families, protecting their communities, and upholding cultural traditions. This study recommends engagement in respectful dialogue and collaboration between western perspectives and African communities for a better understanding of the cultural significance of circumcision while addressing health and safety concerns.

Newspaper Coverage of Violence Related to Initiation and Traditional Male Circumcision in South Africa.

This study reports evidence of violence related to initiation and traditional male circumcision (ITMC) in South Africa. Our study conducted a search of the newspaper databases Newsbank and News24 from January 1, 2016, to August 31, 2023, and carried out a content analysis of newspaper articles that referenced violence in South African newspapers. Our initial search yielded 1796 articles; after screening for relevance and duplicates, 41 articles published in 16 South African newspapers and one online source were included in the analysis of the data. Most articles (41%) were published in 2016. Five major types of violence were identified at three unique stages of the ITMC process: (1) bullying; (2) mental and emotional abuse; (3) neglect; (4) physical violence; and (5) gender-based violence. At the pre-initiation stage, the articles reported that boys were forced, abducted, and trafficked into the initiation schools. While at the initiation schools, various forms of bullying, beating, fighting, slapping, assaulting, torturing, burning, neglecting, and physical, mental, and emotional abuse were reported. At the post-initiation stage, physical violence and mental abuse were reported. We noted that some articles reported violence prevention efforts during ITMC. Future research should examine readers' reception of newspaper information about violence associated with ITMC and their awareness of prevention measures. Our findings have implications for public health policy, including the Customary Initiation Act, which provides for the protection of life, the prevention of injuries, and the prevention of all forms of abuse that initiates may be subjected to as a result of initiation practices.

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.