Intended for healthcare professionals

News Roundup [abridged Versions Appear In The Paper Journal]

Botched circumcisions kill 14 boys in a month

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7558.62-d (Published 06 July 2006) Cite this as: BMJ 2006;333:62
  1. Pat Sidley
  1. Johannesburg

    Fourteen boys have died as a result of botched circumcisions in the past month in the Eastern Cape province of South Africa.

    Hundreds more boys have been maimed and mutilated in the same process which takes place annually at “circumcision schools,” usually conducted in the bush, away from towns and villages. In South Africa, in many groups, boys are circumcised between puberty and adulthood, and it marks the ritualised passing from boyhood to manhood.

    In the past few years, however, this “circumcision season” has been marred by untrained and bogus traditional surgeons trying to make money but whose technique lacks expertise and hygiene.

    The provincial department of health says that 243 deaths and 216 genital amputations from circumcisions were recorded between 1995 and 2004. Last year there were more than 20 deaths.

    Laws and regulations in the Eastern Cape were passed in the hope of controlling the practice and ensuring hygienic conditions. Traditional surgeons have to be officially recognised and register with the department. They are trained to practice hygienically and to sterilise equipment, and they are required to call for help as soon as anything goes wrong.

    Surgeons caught running initiation schools without authority can be sent to prison, and they get severe sentences if they are found to be responsible for deaths or maiming.

    The Eastern Cape is a desperately poor area with large amounts of unemployment and hunger, and people set up unauthorised operations to enable them to earn money or food.

    One of the unfortunate side effects is that unhygienic circumcision spreads HIV/AIDS. This is ironic given that several studies in the country seem to show that circumcised men are less likely to contract the virus than those who are not circumcised.

    In the Limpopo province, much further north and close to the border with Zimbabwe, where several other tribes live, similar problems of botched circumcisions occur. This year so far, however, there have been no deaths in the region, but there have been instances of unregistered initiation schools and children under 9 years old submitting themselves for circumcisions without parental consent, according to Sefogole Makgeru of the House of Traditional Leaders.

    A spokesman for the Eastern Cape health authorities, Sizwe Kupelo, told the Independent online news service, “Young boys are dying like flies.”

    Boys often die of infection, gangrene, or sepsis, he said. They steal chickens to pay for the circumcision, carried out by these untrained bogus surgeons. According to Mr Kupelo, the boys form a queue and the surgeon, using the same knife or spear, will move down the queue performing the operation, without washing or sterilising the implement between boys.

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