Moving Mountains: The Move to Provide Safe Male Circumcision Services within Traditional Settings In South Africa

Traditional circumcision rituals are part of the rites of passage for many young boys into manhood. Traditional rites of passage are practices by various cultures in South Africa. In South Africa, thousands of young boys are circumcised in traditional initiation schools each year. Not all initiation schools practice the same circumcision procedure, with some schools only performing a partial circumcision.

A number of risks are incorporated with this journey to manhood. Sadly, many young boys die each year from botched or non-sterile circumcisions or dehydration during the circumcision ritual because they are denied water. There is no health screening before initiation takes, hence placing ill initiates, or those with chronic conditions, at risk of adverse events. Some initiates suffer genital mutilation or penile amputation as a result of untrained practitioners. In addition, where circumcisers use the same non-sterilised blade on all initiates these young men are placed at risk of contracting HIV or Hepatitis.

Despite improved relationships between the SA Government and initiation schools over the past five years, there remains a challenge with the number of illegal initiation schools cropping up across the country. In addition, deaths can occur at legal and illegal schools, as is evidenced by the fact that just this month at least seven young boys have died in the Eastern Cape. At present there is no national legislation governing the circumcision procedures that must be followed in these schools.

The Department of Health has set the target of 4.3 million Medical Male Circumcisions this year. Voluntary Medical Male Circumcision (VMMC) ensures a clinically safe procedure under regulated conditions. MMCs  provide as much as 76% reduction in risk of HIV acquisition on an individual level, with an average protective effect of an estimated 60 percent according to the World Health Organisation. The long-term impact of the choice of this procedure could be the prevention of more than 1 million new HIV infections by 2025.

Considering that traditional circumcision is not performed in accordance with the scientific medical approach, it translates that not all traditional circumcisions provide the same protective benefit against HIV and STI acquisition as the scientifically based MMC procedure does.

In efforts to assist traditional circumcising communities and to curb initiation deaths, JPS Africa has embarked upon an ambitious endeavour to skill traditional initiation schools and provide MMC within traditional settings. These activities are done in close collaboration with the Provincial Departments of Health and traditional initiation schools in Mpumalanga and the Eastern Cape. JPS Africa has provided on-site assistance and service delivery resulting in more than 4000 safe circumcisions being done within traditional settings.

Every man counts, and with high quality and consistent support, we are facilitating a safe passage of boys into manhood.




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