SOUTH AFRICA: Another botch

Cape Times
March 6, 2016

Op left teen without tip of penis

by Zelda Venter
PRETORIA: It was meant to be a routine circumcision, but the procedure left a Pretoria teenager without the tip of his penis.

His mother had taken him to the Soshanguve Community Health Care Clinic on May 2, 2014 for the circumcision. The mother said when they arrived, her 16-year-old son was taken to a room where a doctor was to perform the procedure. However, the doctor mistakenly amputated the tip of the penis during the operation.

Thereafter, the tip was placed on ice in a plastic bag and taken to the Dr George Mukhari Academic Hospital, along with the boy. There doctors tried to reattach the tip without success.

The botched circumcision has resulted in a R1.1 million [$US72, 180] damages claim against the Gauteng MEC for Health.

The teenager’s mother, who is unemployed and lives in North West, instituted the R1.1m damages claim in the high court of Pretoria on behalf of her son.

According to the mother, it took three months for the private part to heal and doctors have told the boy that it is still too early to do reconstructive surgery.

The series of operations required will cost around R150 000 [$US9,840], the court heard.

The mother is blaming the doctor for her son’s deformity, saying the doctor was negligent.

She also charges that had the reaction been quicker, and the tip of the penis placed on ice and delivered to another hospital sooner, it was possible it could have been reattached. She said the doctor took his time in placing the penis tip on ice and arranging for her son to be taken to hospital.

If the tip and her son were rushed to hospital, his private part could have been saved, she said. Aside from the disfiguration, the boy suffered severe psychological shock and trauma, and had lost out on one of the “amenities” of life. She claimed R380 000 for his future medical expenses and R600 000 for trauma.

His lawyer, Greyling Erasmus, said the matter had been postponed to a date still to be determined.

SOUTH AFRICA: 43 circumcision deaths

Genital cutting claims lives of 43...

IOL
18 December 2015

Heat claims lives of three initiates

by Patsy Beangstrom
Northern Cape - Three initiates have died in the Northern Cape as a result of heat exhaustion since the start of the summer initiation season in November.

The death toll from botched circumcisions has risen to 43 nationwide.

Xhanti Teki, media liaison officer of the provincial Department of Co-operative Governance, Human Settlement and Traditional Affairs, on Thursday confirmed the three deaths of initiates in the Northern Cape due to heat exhaustion which he attributed to the soaring heat conditions.

...The department further stated on Thursday that an interdict has been sought against an illegal initiation school in Dithakong.

“The interdict was served to the respondent on December 11. The intention of championing the legal avenue is to clamp down on illegal initiation schools.”

Teki added that the Draft Northern Cape Initiation Bill, which will legally regulate the practice, was currently being processed and it was expected that it would be promulgated in 2016.

Newly appointed Minister of Co-operative Governance and Traditional Affairs, David van Rooyen, told reporters in Pretoria earlier this week that the death toll from initiation schools nationally had risen to 43 which he added was “totally unacceptable”.

The Eastern Cape reported 30 deaths, followed by the Free State (six), Northern Cape (three), Western Cape (two), Gauteng and North West (one each).

Van Rooyen said the circumcision ritual faces challenges which include abductions, kidnappings, and the mushrooming of illegal and unregistered schools.

“We are working with various stakeholders across various sectors to ensure that our young men can undergo this rite of passage in a safe manner,” the minister said.

... Between 2005 and 2015, more than 500 initiates have died while 300 have lost their manhood, official statistics show.
...

SOUTH AFRICA: Successful (?) penis penis transplant after botch

The Guardian
March 13, 2015

Man gets world's first successful penis transplant after botched circumcision

by David Smith in Johannesburg

A 21-year-old man in South Africa has received the world’s first successful penis transplant and accepts the organ as his own, doctors said on Friday.

The operation took a team of surgeons nine hours and has allowed the patient to become sexually active.

The man’s penis was amputated three years ago after a circumcision went wrong at a traditional initiation ceremony. The patient, who has not been named, received the new organ from a deceased donor on 11 December and has regained all functions.

Professor Andre van der Merwe, head of the urology division at Stellenbosch University, whose staff carried out the operation at Tygerberg hospital in Cape Town, said the recipient is doing “extremely well” both physically and psychologically.

“The patient accepted the penis as his own,” he told the eNews Channel Africa (eNCA). “He told me in no uncertain terms that the fact it belonged to somebody else is completely out of his mind and he’s moved on with this as his own penis. That’s absolutely the way we want it.”

...

“We repaired a small hole in his urethra, the pee pipe, last week so we could remove his catheter and just that induced an erection on the operating table. We were so surprised at that erection that he certainly is getting very good results for his transplant.”

Van der Merwe described the groundbreaking operation as “very, very difficult”. He told eNCA: “What we did was to manage the small blood vessels in the penis, which are really only a little bit more than a millimetre wide, to existing blood vessels in the abdomen that has come down, and we could connect that up.

“So many things could have gone wrong. Actually one of the blood vessels did clot up for a few hours. We could relieve the clot, thankfully.”

Immediately after the operation there was an “oozing” that led to bleeding, he continued. “We were dealing with infection and clot formation and bleeding. That was the most difficult thing initially.”

But the patient is “a very fit young man” and making “a good recovery”.

...the South African man and his partner are coping well, according to Van der Merwe. “Huge psychological effects. If you add an organ you make a ripple effect on somebody’s ego, you can even induce psychosis …

... bogus surgeons are blamed every year for numerous deaths and injuries, including gangrene caused by unsterilised blades. Experts estimate that around 250 lose their penises each year to medical complications.

“There is a greater need in South Africa for this type of procedure than elsewhere in the world,” Van der Merwe said in a statement. “For a young man of 18 or 19 years, the loss of his penis can be deeply traumatic. He doesn’t necessarily have the psychological capability to process this. There are even reports of suicide among these young men.” ...

But not so fast:

Forbes March 13, 2015 The Penis Transplant Is Not A Breakthrough Yet by Benjamin Davis The news of the first penile transplantation washed across Twitter  feeds this morning and the usual casually assertive statements were made. One of the surgeons involved in the operation even trumpeted the results as “a massive breakthrough” in a press release from his institution. Allow me to deflate the party somewhat on this “breakthrough.” As described, the surgeons sewed very small nerves and vessels together. This is done every day, in every hospital in the US (think vasectomy reversal). There is nothing surgically novel about sewing two ends of a urethra together or really small blood vessels either for that matter (remember that John Wayne Bobbitt’s severed penis was sewn back on relatively quickly). But long-term function is a different — and major –  issue. The penis in question has only been functioning for a few months. It is the long-term function that is important, particularly in light of the fact that rejection of transplanted organs often takes years, not months. Would the headlines be different if the patient loses his penis next month? Or if he develops a post-transplant lymphoproliferative disorder, which is commonly deadly? The good news: The patient appears to be doing well and has erections. ...  One media misconception laid to rest: If he had a 1 cm penis to begin with (as described) then his ability to orgasm and ejaculate were already preserved. It is the erection and urinary ability that is new. But similar, albeit perhaps more strident sentiments, were expressed when the first double-hand transplant and face transplant patients were announced. And how is that going? Well, I would say extremely slowly but with some limited success.... My larger concern for these patients is that most of these young men whom the operation could be helpful for are not living in medically accessible regions. As outlined by reports from the CRL Commission in South Africa, over 500,000 men were hospitalized from ritual circumcisions. Transplanting the penis was the easy part. Taking care of it will be the really hard part. Transplant patients need constant blood work, medication changes, biopsies, and exams (remember the first hand transplant patient refused to take his meds – and his hand was removed). For patient’s who live in remote areas of the world with limited medical care a penis transplant is not going to help and unlikely to be a common procedure in the future. Sorry. I wish I thought differently.

SOUTH AFRICA: Three arrested; youths in critical condition

South African Government
December 9, 2014

MEC Fikile Xasa on arrest of unlawful circumcision suspects

Three suspects arrested for unlawful circumcision
Cogta - MEC Fikile Xasa yesterday descended to the Mbizana Local Municipal area as part of monitoring the December traditional initiation season.

During his monitoring visit to traditional initiation schools, MEC Xasa pounced on two separate initiation schools and recued a total of 39 initiates in the Elurholweni village. Three suspects were arrested for kidnapping and unlawful circumcision. They are being held at the Mbizana Police Station.

“These were illegal schools that put the lives of our initiates at risk. We had no option rather to close them down and refer the initiates to the rescue centre in Port St Johns for further medical observation. As a caring government we want to save lives and put an end to the death of initiates,” said MEC Xasa.

None of the initiates had the required official documentation including letters from the local traditional leaders, no premedical examination and no parental consent to undergo the traditional initiation ritual. Their amabhoma were destroyed to prevent them being used as other illegal initiation schools.

The MEC was accompanied by members of the Traditional Initiation Forum (TIF), members of the SAPS, traditional leaders and government officials.

Some of the rescued initiates were in critical conditions hence given immediate medical attention by officials from the department of Health.

MEC Xasa encourages the community of Mbizana and other hot spot areas to work together through the establishment of TIF to end the deaths of initiates.

SOUTH AFRICA: Prepex device not suspended

Mail & Guardian (South Africa)
August 21, 2014

Department refutes political link to Israeli circumcision product approval

by Mia Malan, Amy Green
An Israeli male circumcision product has not been put on hold, says the South African health department.

The health department has denied media reports in a national newspaper last week that plans to introduce the non-surgical medical male circumcision device, PrePex, to the government’s medical male circumcision programme, have been put on hold because it’s an Israeli product.

According to the department’s medical male circumcision programme manager, Dayanund Loykissoonlal, no decision has been made yet. “The minister will make his decision on the basis of our research findings, which will be concluded in February 2015. We need to make sure that whatever device we implement in the country must be safe and effective for South Africans to use. It must do what it’s supposed to do – it must be effective for HIV prevention.”

PrePex consists of an elastic band that compresses the foreskin, restricting blood supply until the foreskin dries and can be cut off after a week of the device being administered, without stitches, bleeding or anaesthetic.

Endorsed by WHO
Trade union Cosatu has called for a boycott of Israeli products and has voiced its objection to PrePex because of its Israeli origins. But Loykissoonlal says research results, and not politics, will determine the department’s decision on whether or not to introduce the device. PrePex was the first non-surgical male circumcision device to be endorsed or ‘prequalified’ by the World Health Organisation (WHO) in May 2013.

Research has shown that medical male circumcision – the removal of the entire foreskin of the penis – can [perhaps] reduce a male’s risk of contracting HIV through heterosexual sex by [up to] 60%.
South Africa first introduced medical male circumcision in 2010, and has since circumcised 1.4-million men. The government’s national strategic plan on HIV for 2012 to 2016 aims to have medically circumcised 80% of men between 15 and 49 – or 4.3-million men – by the end of the 2015/2016 financial year.

Modelling studies published in the medical journal Plos Med in 2011 showed that if South Africa reaches this target, more than 20% of new HIV infections – or one million could be averted by 2025. According to study projections, about five medical male circumcisions are needed to prevent a single case of HIV infection. [This "modelling" is all based on a total of 73 circumcised men who did not get HIV, while 64 did, out of 5,400 circumcised in three trials.]

South Africa is however not on track with reaching this target, and, is looking at ways to speed up the programme. The introduction of a non-surgical device, in addition to surgical procedures where doctors cut off the foreskin, is one such way.

PrePex is currently being tested in eight pilot sites in Gauteng, Mpumalanga and North West to test the feasibility of introducing the device as part of its medical circumcision campaign.

“We have completed the first phase of the research, in line with WHO recommendations, looking at the pilot implementation of the device. We still have the other two phases, the passive and active surveillance, left to do. Active surveillance is putting the device out there in the actual health settings and doing about 1 000. PrePex placements on clients and following them up rigorously. And passive is looking at another 9 000.”

Earlier story

AFRICA: 500,000 circumcision casualties in 8 years

Inside Man
August 20, 2014

Half a million boys killed and hospitalised by tribal circumcision

by by Glen Poole
Around half a million boys have been killed and hospitalised by circumcision in South Africa in the past eight years according to local reports, writes Glen Poole.

Research published by the Commission for the Promotion and Protection of the Rights of Cultural, Religious and Linguistic Communities (CRL) claims that more than 500,000 boys have ended up in hospital since 2008 after being subjected to traditional circumcision practices.

The South African media has also revealed that circumcision has killed more than 500 boys in the Eastern Cape region of the country in the past eight years, with the toll reaching 528 last month.

Traditional circumcision is seen as a rite of passage into manhood in some tribal communities. Boys face huge social and cultural pressure to take part in these dangerous rituals and males who haven’t been circumcised are not considered to be real men and face being ridiculed and ostracised.

Circumcision schools have become death traps
In the Eastern Cape of South Africa, boys attend initiation schools where they spend several weeks in the mountains during the circumcision season. “The initiation schools are seen by many as death traps for young people,” said the Reverend Dr Wesley Mabuza, Chair of CRL’s Rights Commission. “The South African society is being confronted with issues that force it to re-examine its ways of doing things”.

South Africa isn’t the only country where traditional circumcision practices are increasingly being recognised as a social problem. In Kenya, men from tribes who don’t practice circumcision are chased and rounded up by members of the Bukusu tribe and forcibly circumcised. Elsewhere, in Australia, the safety of ritual circumcision became a topic of public debate when three boys were airlifted to hospital after being injured in an aboriginal initiation ceremony.

Meanwhile the South Africa state is promoting circumcision as a weapon in the fight against HIV/AIDS and has set itself a goal of circumcising 4.3 million men and boys from 2010-2016. Both the ethics and efficacy of using circumcision to try and combat the disease have been heavily criticised but the state seems determined to hit its targets and is exploring the introduction of infant circumcision to help it reach its goals.

African boys killed by circumcision in UK
The social and cultural acceptance of male circumcision as a legitimate practice places boys in African families all over the world at risk. High profile incidents of African boys being subjected to forced circumcision in the UK include Goodluck Caubergs who died aged just 27 days old after being circumcised by a midwife and Angelo Ofori-Mintah who died aged 28 days old after being circumcised by a Rabbi. Last month we also reported the story of a trainee doctor who divorced her African-born husband after he had their son circumcised without her consent or knowledge.

Those campaigning against male circumcision in South Africa, like the group NOCIRC-SA are currently in a minority. Groups like CRL are not opposed to the ritual, but are focussed on reducing the obvious risks.

CRL Chairperson, Thoko Mkhwanazi-Xaluva said: “We cannot have mothers lose their boys up there and be told only when the other boys come back. At this rate [the practice] is going to die of natural causes because….people are scared of taking their kids to initiation schools.”

SOUTH AFRICA: "Circumcising Men Cuts HIV Risk Among Women" - study

MedPage Today
July 26, 2014

Circumcising Men Cuts HIV Risk Among Women

by Michael Smith

Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
[That hasn't stopped the media from splashing it everywhere - as here - as headline news.]

MELBOURNE, Australia -- The HIV-preventing benefits of circumcision were not just restricted to men, researchers said.

In a region of South Africa where HIV prevalence is high, women whose only sexual partners were circumcised had a significantly lower prevalence of HIV, according to Kevin Jean, PhD, of the French National Institute for Health and Medical research in Villejuif, France, and colleagues.

Moreover, a mathematical model suggested that the incidence of HIV among those women was also lower than among women whose partners included uncircumcised men, Jean reported at the International AIDS Conference here.

The finding -- the first evidence that women also benefit -- is a "compelling argument" to speed up the roll-out of voluntary male circumcision in Africa, Jean argued.

[No mention of the Wawer study in Uganda, which suggested that circumcising men INcreases the risk to women.]
 
Three randomized trials have shown that men who are circumcised are at lower risk of acquiring HIV, including one in the Orange Farm township of South Africa.

Researchers have since demonstrated that a free program of voluntary circumcision could be widely accepted among men in the region, leading to lower HIV prevalence among circumcised men.

But the missing piece of the puzzle has been what happens to women when men are circumcised and the prevalence of HIV drops, as has happened in Orange Farm, a township of about 110,000 adults near Johannesburg.

[So this sample was also taken in Orange Farm. How many of the same men were used? Over-testing the same sample leads to less reliable data. The fact that ALL the studies claiming benefits emerge from the same three sites, and the same cluster of researchers, is increasingly suspicious.]

To find out, Jean and colleagues surveyed a total of 4,538 sexually active women, ages 15-49, in three waves, in 2007, 2010, and 2012.

Participants were asked about their age, ethnic group, occupation, age at first sexual intercourse, alcohol consumption, education, number of lifetime partners, and consistent condom use.

They also were asked about the circumcision status of their partners, and the researchers took a blood sample to analyze HIV prevalence in the cohort, Jean said.

Among the 1,363 women who reported only having had circumcised partners, the HIV prevalence was 22.4%, compared with 36.6% among the remaining 3,175.

[This is quite a loose association - women's HIV status vs her reporting of remembering ever had an intact partner. It can be confounded by faulty memory, lack of interest or misidentification.]

Mathematical modeling from the observed age-specific prevalence rates yielded estimated incidence, Jean said. Although the researchers have also measured new HIV cases in the cohort, that data is still being analyzed, he said.

The analysis showed that incidence among women who only had circumcised partners was 0.032 cases per person-year, compared with 0.039 per person-year among the remaining women.

[So circumcision reduces the risk by 0.006 cases per person-year? That's hardly impressive, even if true.]

The numbers yielded an incidence rate ratio of 0.83 and a risk reduction of 16.9% for the women who only had circumcised partners, Jean said. When the analysis was restricted to women 15 through 29, the risk reduction was 20.3%, he added.

[Data-mining.]

The study extends previous research on circumcision in the region, commented Stefano Vella, MD, of the Istituto Superiore di Sanita in Rome, and a former president of the International AIDS Society.

Evidence is mounting that multiple prevention measures will be needed to slow the HIV/AIDS pandemic, he said, and circumcision seems likely to play an important role since it has been shown to offer partial protection for men.

The evidence that the procedure also reduces the risk of HIV among women is of "paramount importance," he told reporters.

...

EASTERN CAPE: Pigs stolen, owner abused for being intact

New Age (South Africa)
July 17, 2014

‘Initiation school teachers stole my pigs’

by Montsho Matlala
A subsistence pig farmer yesterday decried the police’s failure to make an arrest after 20 of his pigs were allegedly stolen by a group of people from a local cultural initiation camp in Jane Furse, Limpopo.

Mafole Machika, 57, told The New Age yesterday that cultural initiation camp teachers from Ga-Phaahla village stole his pigs on May 23.

“The mob – armed with sticks, knobkerries, axes and pangas – stormed my yard undressed to their waists,” he said. “They took my 20 pigs while shouting that I was a worthless man who had not been culturally circumcised.”

Machika said the young men also swore at him in front of his grandchildren.
“And the police officers in Nebo were disgusting,” he said.

“The station commander told me that it was the traditional law of the land that I be treated that way because I was leshoboro (uncircumcised). Even now nobody has been arrested and my pigs are gone.”

Machika also claimed the two senior police officers who ridiculed him were friends of the local traditional leader.

“All I want is justice. Every year during cultural initiation rituals, gangs of boys and men insult me about my private parts.

“Three years ago I even sent my two sons to the cultural initiation school and they have graduated,” the pig farmer said.

“My sin is that I didn’t go to the mountains? But why are so many men in the village who did not go there not harassed?”

Provincial police spokesperson Col Ronel Otto confirmed the incident. “At this stage, I still have to find out more details and I will make a comment soon,” Otto said.

House of Traditional Leaders chairperson Kgosi Malesela Dikgale has condemned the incident and called on traditional leaders to help victims of harassment by cultural initiation school “fanatics”.

“Any form of harassment is not a part of our culture. Some of the pillars of cultural initiation is respect for everyone and integrity,” Dikgale said.

SOUTH AFRICA: Circumcision death toll 23

IOL News
July 3, 2014

Initiation death toll at 23

Johannesburg - Twenty-three initiates have died since the start of the winter initiation season because of botched circumcisions and 104 others have been admitted to hospitals for related injuries, Deputy Traditional Affairs Minister Obed Bapela said on Thursday.

“It is saddening to report the increased number of initiates who have lost their lives to 23,” he said in a statement.

“This is despite all the efforts we have made.”

Nineteen of the deceased were from the Eastern Cape, three from Mpumalanga, and one from the Western Cape.

Bapela said the 104 others were admitted for dehydration, septic circumcision, gangrene, and other related injuries.

He sent his condolences to the affected families and said government condemned illegal circumcision schools.

“The rite of passage is not a licence for abuse of the initiates but a process that is ushering these young men to adulthood and a cultural practice that needs to be respected,” said Bapela. [Why should it be respected when it ushers them to death or emasculation?]

“The ministry of co-operative governance and traditional affairs continues to call on all members of the community to report any illegal initiation schools to the police.”

EASTERN CAPE: Circumcision death toll 13

Eye Witness News (South Africa)
July 1, 2014

EC initiate death toll rises

by Shamiela Fisher (ed. Gadeeja Abbas)
CAPE TOWN - At least 13 boys have died since the start of the winter initiation season, the Eastern Cape Health Department said on Tuesday.

Officials say hospitals are also overcrowded with severely ill initiates seeking medical assistance.
Early on Tuesday, an initiate in Mthatha died as a result of a botched circumcision.

The department's Sizwe Kupelo urged police and the Nationa Prosecuting Authority to bring criminal charges against the perpetrators.

We have se aside R20 million [$US 1,860,550] for the situation. We are concerned and are asking locals to help get the situation under control."

SOUTH AFRICA: 11 circumcision deaths so far this season

AP via CTV News (Canada)
June 26, 2014

Botched circumcision rituals in South Africa kill 11 young men

JOHANNESBURG, South Africa - The South African government says 11 young men have died so far this year in botched circumcision rituals that have killed hundreds in past years.

The government said in a statement Thursday that seven of the deaths in the current initiation season happened in South Africa's Eastern Cape province.

The ministry is urging traditional leaders to work with state medical experts to prevent deaths, some of which are due to dehydration and septic shock. It also says owners of illegal initiation schools should be arrested and prosecuted.

The circumcision ceremonies are meant to usher youths into manhood. Initiations are mostly practiced by the Xhosa tribe in eastern South Africa.

SOUTH AFRICA: 486 circumcision deaths in 6 years, nearly 0.5M hospitalised

City Press (South Africa)
June 24, 2014

486 die as greedy traditional surgeons run initiate schools 'like spaza shops'

[A spaza shop is an informal convenience shop business in South Africa, usually run from home. They also serve the purpose of supplementing household incomes of the owners, selling everyday small household items.]

by Zinhle Mapumulo
Close to 490 boys have died in initiation schools in three provinces in the past six years and a further 455 628 were hospitalised because of circumcision-related complications, an investigation has revealed.

These findings are contained in a report, released by the Commission for the Protection and Promotion of the Rights of Cultural, Religious and Linguistic Communities in Joburg today.

The report, titled Public Hearings on Initiation Schools in SA shows that boys as young as 12 died of dehydration, septicaemia, gangrene, kidney failure and assault during initiation.

The investigation focused on three provinces – the Eastern Cape, Mpumalanga and Limpopo – where traditional circumcision is an important cultural practice.

The Eastern Cape had the highest number of deaths between 2008 and 2013 – at 401. Mpumalanga followed, with 67 deaths and Limpopo recorded 18 deaths.

Many of the deaths recorded in the Eastern Cape happened in 2009 (91) and last year, when 83 boys died. Mpumalanga also saw a spike during the same years. In 2009, the province recorded 15 deaths and last year the figure shot up to 42.

Commission chairperson Thoko Mkhwanazi-Xaluva said the probe revealed a number of factors that led to the increase in the number of initiate deaths, but the biggest was the commercialisation of the practice by bogus surgeons.

“Many of the illegal [traditional] surgeons are not trained and have no idea what they are doing,” she said.

“All they care about is money. To them, the practice is like running a spaza shop. They mushroom during the circumcision seasons, make money and go underground after that.”

JOHANNESBURG: Man seeks redress for botch

Daily Sun (South Africa)
June 11, 2014

Justice for my 4-5!

(June 11 2014) - He had the circumcision because his wife kept fighting with him to do it. But the operation was a mess, and now his wife is fighting with him because of his damaged penis.
NOT ONLY COULD HE LOSE HIS 4-5, BUT HIS WIFE HAS MOVED OUT OF THE HOUSE AS WELL.

The sad businessman (30) from Germiston, east of Joburg was perfectly happy with his sex life, but his pregnant wife wasn't. She said it would make sex for her much better if he went to the clinic to have a circumcision done.

But if he didn't do it, she said, he would be without a wife. In the end the man agreed, so he went to the Johannesburg Men's Clinic on 21 May. He paid R750 [$US 69.75] and went home the same day.
"I was not in any pain. I had a bandage wrapped around my penis and I couldn't see the cut," he said. But a few days later his wound became very painful and he took off the bandage.

"I could not believe my eyes," he said. "My foreskin had been cut off and it had been stitched back on again!" He immediately went back to the clinic but says they refused to give him the name of the doctor who did the operation. The man came to South Africa from Rwanda during the war in that country without being circumcised. "Last year I visited my family and they told me I had to be circumcised by a traditional healer. I ended up crying and telling my parents I was old and I was afraid things would go wrong," he said. "Then my wife started complaining. She said real men were circumcised." He said he couldn't sleep and he hadn't gone to work.

"My wife has taken our seven-year-old son and left the house. They are living in our other house in Vanderbijlpark," he said. "I am worried they may never come back."

The man is sleeping in the Wendy House outside so he doesn't disturb the other people in the house. "I have made peace with the fact that I may lose my penis. I am even prepared to fly to England to have it removed," he said. "But when I come back, that doctor will suffer." Clinic spokesman, Phumlani Dladla confirmed the doctor who did the operation made a mistake. It appears the patient had a lot of excess skin and the doctor didn't cut off enough.

Then he realised his mistake and cut off some more, but this time he cut off too much and sewed some skin back on again. He said the man may not have followed the doctor's instructions and that is why he ended up with a septic penis. [Yes, blame the victim.] "We have offered to do a second operation to rectify that," said Dladla. "We are willing to fix the problem if the man co-operates." "We know it will hurt but the problem will be fixed." The man has lodged a complaint against the doctor with the Health Professional Council of South Africa, which requested the name and practice number of the doctor.

EASTERN CAPE: Nine boys lose penises in botched circumcisions

Times Live (Soth Africa)
February 14, 2014

At least 9 penis amputations after traditional circumcision

by Katharine Child
Initiates who needed medical attention during the traditional circumcision season were often stigmatised by their communities.

Some men in the Eastern Cape who developed infections refused to go to hospitals and some had parents who prevented them from accessing medical treatment.

This is according to the Eastern Cape and Mpumalanga departments of health that recently reported back to parliament on the 2013 circumcision deaths.

Despite interventions by health officials, this happened:

• 43 people died in the Eastern Cape from circumcisions last year;
• Nine had their penis amputated;
• There were 31 botched circumcision deaths in Mpumalanga;

In the Eastern Cape, the biggest loss of life was caused by infected penises, leading to septicaemia.
Dr Dingeman Rijken, who had worked in Pondoland , Eastern Cape, said traditional leaders were not interested in working with doctors . After meetings with them, chiefs spread messages that medical circumcision was bad.

A traditional nurse was successful in setting up three centralised circumcision schools in Western Pondoland in December. Negotiations to improve the situation in Eastern Pondoland fell flat.

EASTERN CAPE: Doctor who showed botched circumcisions defended, attacked

The New Age (South Africa)
January 29, 2014

'Ban traditional circumcision'

by Sithandiwe Velaphi
A world renowned medico, Dr Robert WM Frater, has come out in support of a website [NSFW] set up by a former Eastern Cape-based state doctor that has exposed irregularities on circumcision in the province.

Frater, who operates in South Africa and England, said he first observed irregularities in the custom in the late 1940s when he visited the Eastern Cape at the time that he was still a medical student. [And he's done nothing about it for more than sixty years?]

Dr Dingeman Rijken, a Dutch doctor who worked at the department of health’s Holy Cross Hospital in Flagstaff in the Eastern Cape, set up a website to expose malpractices in traditional circumcision.
Rijken did this after 43 boys died last month due to botched circumcisions.

A total of 39 boys died in June last year, bringing the number of boys who died in 2013 to 82.

Frater said: “There are complications severe enough to cause death and when Dr Dingeman Rijken documented these on the web.”

The chairperson of the Eastern Cape House of Traditional Leaders, Chief Ngangomhlaba Matanzima, said Rijken had undermined the people of the province and their customs.

“It is clear that he would like Dr Rijken to cease his efforts to help.”

Frater is of the view that traditional circumcision should be aborted and replaced by medical circumcision. [Why replaced at all?]

“The time has come to start the process of removing traditional circumcision as part of the initiation rite,” he said.

The Film and Publication Board (FPB), which apparently called Rijken to come and explain reasons for setting up the website following a complaint from the Community Development Foundation of South Africa, said although the website was harmful to children under the age of 13, it was also educative.

“The website contains material which may be very disturbing and harmful to children [under the age of 13].

However it must be borne in mind that even though the website contains graphic images, it is a bona fide scientific publication with great educative value.

The website highlights the malice that bedevils this rich cultural practice,” the board said.
Matanzima said there was “nothing educative” about the website.

He blamed the FPB for not doing what it was supposed to do – which was to shut it down.
“Is exposing manhood an education? These are kids belonging to the community. Even if there was consent from them, this is damaging.”

“We as custodians of this custom have not authorised this doctor to do what he has done.”

“We as black people respect other people’s cultures even if there are wrongdoings.”

Earlier story

EASTERN CAPE: Doctor blows whistle on botched circumcisions

Shooting the messenger...

Dispatch Online (South Africa)
January 11, 2014

Outrage over graphic circumcision website

by Bongani Fuzile and Zwanga Mukuthu
A WEBSITE set up by a controversial Dutch doctor showing graphic images of mutilated and infected penises of Eastern Cape initiates has caused outrage among traditional leaders in the province.

Dr Dingeman Rijken, a former employee of the Eastern Cape department of health, said he set the website up “for the world to see”.

Rijken said this was a last-ditch effort to show traditional leaders and local communities that initiation was not just a ritual, but in many cases resulted in genital mutilation that had led to the death of hundreds of young boys, while thousands have had their penises amputated or disfigured.

Rijken said he had on numerous occasions requested that initiates undergo medical circumcision but “weak” traditional leaders had shown no interest.

Instead, circumcision was being carried out by traditional surgeons who were sometimes incompetent or did not use sterilised equipment.

Speaking to the Saturday Dispatch this week and referring to traditional leaders, Rijken said the “self-proclaimed custodians of the ritual” called numerous meetings to discuss the death of initiates but there were never any solutions.

“Why do we sustain a ritual that slaughters boys in their prime or physically and mentally scars many others for life?” he asked.

“Many have lost their manhood while hundreds have suffered penile amputation. These deaths were avoidable. If the weak traditional leaders continue to do this, many innocent lives will be lost. These leaders need to wake up,” he said.

But the doctor’s website has come in for criticism from several quarters and he has been accused of exposing a sacred initiation custom to the world.

Over 200 graphic images on the website show close-ups of penises infected with gangrene and skin-loss while others show botched circumcisions. [NSFW - disturbing]

Rijken said he had permission to publish the pictures from the initiates concerned. “I took those pictures because I was given consent by those involved, including the initiates themselves,” he said.

But Eastern Cape House of Traditional Leaders deputy chairman Prince Zolile Burns-Ncamashe said it was “disgusting” that a foreign national could “undermine” the country’s customs. [Disgusting customs need to be undermined.]

“If I had the power I would send officials to arrest this doctor immediately,” Burns-Ncamashe said.

Nkululeko Nxesi of the Community Development Foundation of South Africa, an NGO that runs initiation rescue centres, said the website was an embarrassment to the AmaXhosa nation. [It certainly is, but not in the way they want to think.]

“This [the website] will undermine the work that is being done by traditional leaders and government and us,” Nxesi said. “He [Rijken] should respect the cultural principles and processes of this nation. This embarrassing thing he has done assumes that there is nothing being done to curb this.”

Rijken is no stranger to controversy. He worked at Flagstaff’s Holy Cross Hospital and last year released a training manual to assist in the ritual. However, it was not well received as it carried a picture of an initiate being circumcised.

Rijken said that from 1995 until now, 819 boys had lost their lives undergoing the rite, while thousands had been left mutilated.

On the website he said many of the initiates huts are built in secluded locations and centralised initiation schools were needed.

Health department spokesman, Sizwe Kupelo said the department had distanced itself from Rijken, as he was a former employee.

Kupelo said it was suspected that the pictures may have been taken at a time when Rijken was in the department’s employ. “The department will investigate and may report the doctor to the Health Professions Council [of SA] if he is found to have violated the patients’ rights by publishing the pictures,” Kupelo said.

Rijken is due to leave for Malawi, where he will start work at a local hospital, within a few weeks.
He said boys would continue to die unless medically trained personnel carried out circumcisions. [Or genital cutting stopped.]

The website – www.ulwaluko.co.za – contains graphic images.

Earlier story

EASTERN CAPE: 1000 circumcision deaths in 10 years

SABC (South Africa)
December 27, 2013

Burnt initiates taken to hospital

Three initiates who were burnt at an initiation school in Matatiele in the Eastern Cape have been taken to hospital. They were burnt after their makeshift hut caught fire.

Health Department spokesperson, Sizwe Kupelo, says an ambulance was dispatched after reports of a fire at the initiation school.

However, earlier reports indicated that when the ambulance arrived at the school, the initiates' handler refused to release them into the care of the medics.

...

Meanwhile, a 21-year-old traditional nurse has been arrested for allegedly beating up initiates in Lusikisiki in the Eastern Cape.

...

Police report that 30 people have died so far in the Eastern Cape after botched circumcisions.

The deaths have sparked a premature closure of Eastern Cape summer circumcision season. They are expected to be closed mid-January due to the continuous mushrooming of illegal initiation schools.

The Eastern Pondoland area of the Eastern Cape is notorious for its bogus circumcision schools. In the past 10 years, about 1 000 boys have died in the province and many others have lost their private parts.

Earlier story

DURBAN: Six circumcisions botched - without parents' consent

IoL News
October 20, 2013

R3m claim for six 'botched' circumcisions

by Amanda Khoza
Durban - The parents of six boys from Dassenhoek who were allegedly circumcised without consent are suing New Start clinic for R3 million [$US 305,000] in damages.

The clinic, which is managed by Society for Family Health and Thatenda Health Care, is a partnership with the Department of Health. It runs six male circumcision centres in KwaZulu-Natal, Gauteng and Mpumalanga.

In May, the Sunday Tribune reported that parents of 19 boys, aged 11 to 19, from Dassenhoek, near Mariannhill, laid charges against New Start over circumcisions.

Some of the boys experienced post-operative complications, swelling or bleeding of the penis or infected wounds. A case of assault with grievous bodily harm was opened.

...

The boys were picked up in groups by a man in a vehicle bearing the New Start logo from April to May.

...

Busisiwe Ntiga, 29, was at work when her 11-year-son was circumcised. She alleges the KZN Department of Health offered them money for their silence.

“One official told us we can be paid before the matter goes any further. They tried to silence us with money but we refused,” said Ntiga.

The KZN Department of Health has failed to respond.

Attorney Naheem Rehman, for the parents, said: “In terms of the Children’s Act, consent is required by a health practitioner before undertaking any procedure. Circumcision of children under the age of 16 is strictly prohibited unless it is done for medical or religious purposes. Any one who contravenes this law faces a 10-year jail sentence or will be fined.”

He said the Society for Family Health had until this week to respond to the letter of demand or summons would be issued.

Director of the society’s South African branch, Scott Billy, said the organisation had not received the letter and they were not aware of the claim.

However, the Sunday Tribune has seen a copy of a registered letter signed on behalf of New Start clinic acknowledging the letter of demand.

...

The July edition of the KZN Health Bulletin boasted more than 239 000 KZN men had been successfully circumcised since 2010, with not a single death or botched procedure – even though the Sunday Tribune highlighted the case of the Dassenhoek boys.

...

Meanwhile, Wentzell Ngidi, 26, the fast food employee from Umlazi whose entire skin was removed from his penis during a botched circumcision on September 21, is recovering at St Aidan’s Hospital and awaiting plastic surgery.

“I am still in a lot of pain,” said Ngidi this week.

...

JOHANNESBURG: 4yo boy dies after hospital circumcision

IoL News (South Africa)
August 16, 2013

Child dies after circumcision at hospital

by Vuyo Mkize

Johannesburg - “They killed my child.” These were the pained words of a Germiston father whose son had to be taken off life support on Wednesday evening after he was declared brain dead by two surgeons following a medical circumcision operation a week ago.

Reggie Mokalapa, 39, took his four-year-old son, Gugulethu, to Medicross Germiston for what doctors had assured him would be a “less than two-hour” procedure last Tuesday.

... Mokalapa went to wait outside in their car and, minutes later, his wife Wilhemina joined him.

... An hour later, Wilhemina asked the sister on duty to wake their son as Mokalapa needed to get to work.

“It was at that point they realised he wasn’t breathing,” Mokalapa said.

“His heart had stopped.

“It took them a while to resuscitate him, around 10 to 15 minutes, but eventually his heart started beating again.”

Gugulethu was then transferred to Netcare Sunward Park Hospital, where the attending doctor expressed extreme concern over his condition.

... doctors needed to cool Gugulethu’s body so that if there was any injury to the brain, it did not spread further.

“They did that over four days, and on the fourth day, they started warming him up.... On Sunday, monitors showed that Gugulethu’s brain was not responding, and on Monday he was declared brain dead.

On Wednesday, a second doctor confirmed that Gugulethu was brain dead and the family elected for doctors to take him off life support.

“We are always advised to circumcise our children young, and we did this so that he’d be okay in future. Unfortunately, we took him to a slaughterhouse,” said Mokalapa.

He added that all he wanted from Medicross was acknowledgement of what they did wrong.... Medicross director Dr Oelie van Schalkwyk on Thursday said the doctors and staff at the Germiston centre were “devastated” by what happened to Gugulethu.

“Gugulethu was admitted to Netcare Garden City Hospital after complications following his procedure, and everything humanly possible had been done by the doctors and nurses at Germiston medical centre to assist him.

“We are unable to speculate on the possible factors which may have contributed until it has been fully investigated and conclusively established precisely what transpired.

...

SOUTH AFRICA: Nearly 80 circumcision deaths

BBC
July 20, 2013

When circumcision can mean death in South Africa

Nearly 80 boys and young men have died this year in South Africa from injuries sustained during ritual circumcision.

This has led to renewed calls for more effective regulation of the so-called “traditional surgeons” who carry out the procedure.

The lure of financial gain has resulted in an increase in illegal initiation schools in rural areas.

BBC Africa’s Nomsa Maseko reports from the Eastern Cape.

Earlier story