UGLY CIRCUMCISION RITUAL TREND IN SOUTH AFRICA

Uchenna Anozie,
Nigeria

Male circumcision (from Latin circumcidere, meaning "to cut around") is the surgical removal of the foreskin (prepuce) from the human penis. In a typical procedure, the foreskin is opened and then separated from the glans after inspection.

This procedure is obtainable in many races of the world and it was on biblical record that circumcision is a sign of covenant between the Israelites and Yahweh. Apart from the Jews other races practice this, especially African races.In the western world circumcision is done at childhood and done medically with anaesthesia in some cases, this medical procedure is safe and sound without any negative impact, and in fact recent discoveries show that circumcised males stand a reduced risk of contracting HIV than the uncircumcised.

Other sources confirmed that women prefer men with circumcised penis than the uncircumcised penis, reason being that the uncircumcised penis has an ugly aesthetic view and often very pointed, well there is no theory that proves to us which penis is better.

It will interest us to know that various races round the world see circumcision as a ritual but today I am going to focus on South Africa where this ritual of male circumcision is taken serious and it is becoming a public health concern because  lot of lives have been lost in this ritual performances while some males have permanently lost their penis or are still battling with a rotten penis due to acquired infections associated with their procedure of circumcision. Also HIV has been a great concern because unsterilized instruments are used during these rituals.

According to inquirerdotnet, Agence France-Presse. Monday, July 8th, 2013. Botched circumcisions killed 30 young men and landed almost 300 more in hospital during traditional initiation rites in a South African province, the health department said Sunday.

The 30 deaths in rural Eastern Cape province occurred during the annual season when young males undergo a rite of passage into manhood.

Ten other youths were hospitalized after being rescued from a forest on Sunday, said provincial health department spokesman SizweKupelo in a statement.

“The ten initiates’ private parts are rotten. They are badly damaged. Their condition is scary,” he said.

A further 293 young men were undergoing hospital treatment for dehydration, gangrene and septic wounds, Kupelo added.

Some had lost their genitals.

Teenagers from ethnic Xhosa, Sotho and Ndebele groups typically spend around a month in secluded bush or mountains areas for their initiation to manhood.

This includes a circumcision as well as lessons on masculine courage and discipline.

Traditional surgeons perform the procedure in the bush, sometimes with unsterilized instruments or lacking in technique.

Botched circumcisions leading to penis amputations and deaths are an annual tragedy.

In May around 34 deaths in two other provinces were reported.

Needless giving more history on these sad events, it has been a regular occurrence in South Africa but the question is what can we do about this public health problem, this is an ugly trend and yet we need to respect people’s culture and tradition.

We public health activists should do our best to convince the south African government to carry out a strong advocacy on safer ways of practicing this circumcision ritual, it will be better off if these males are circumcised as children, not waiting till the grow up to 16 years and above. Also if medical practitioners are involved in the procedure with anaesthesia and sterilized instruments being used, then we can encourage this ritual, but these traditional surgeons are endangering people lives, young and promising fellows. It has been reported severally that people witch hunt their enemies during these ritual by doing a bad procedure on the children of their presumed enemies.

Let us spread this campaign and who knows the South African government might have the political will to face this ugly ritual trend.

Mahila Mandals: Case Studies from Mumbai, India

Sarah Simpson, University of Medicine & Dentistry of New Jersey, MPH-Epidemiology Candidate

Home to more than 18 million people, India’s most populous city, Mumbai, continues to be an attraction for millions looking for a better life for themselves and their families. Migrants from different parts of India, religions and cultures end up in the crowded slum communities around Mumbai. This past winter I had the opportunity to learn about urban health issues in these slum communities along with 20 other students from around the US and the world for three weeks at the Tata Institute of Social Sciences (TISS) in Mumbai.

My project group and I sped around town in rickshaws, trudged through sludge, and dust to study urban health issues in the slum areas of Shivaji Nagar.  Located in the M Ward and home to some of the largest slums in India, about 600,000 people live in this area, which is located near the Deonar dumping ground, a man-made mountain of debris and trash. The health of the urban poor is complicated by many issues ranging from waterborne illnesses to infectious and communicable diseases, and when compounded by inadequate nutrition and overcrowded and poorly constructed living conditions makes for a dire situation for millions of people.

During our first day, we were introduced to the “Mahila Mandals” or women’s groups there are instrumental to addressing these public health issues.  Parts of Shivaji Nagar are plotted slum areas recognized by the government; however they have minimal access to facilities and services provided by the Brihanmumbai Municipal Corporation (BMC). Imagine sharing 28 bathroom stalls (14 for men, 14 for women) with 1,000 other people and as you can imagine they quickly become unsanitary. The breakdown of government services has lead to the organization of community based organizations such as Mahila Mandals.

Instead of using a needs-based or problems-focused approach which would highlight only the worse aspects of a community, we decided to highlight the community’s assets by writing a case study using SWOT (Strengths, Weakness, Opportunities and Threats) Analysis to help us investigate how to best utilize these important community assets. We interviewed 6 Mahila Mandal groups consisting of some registered and unregistered groups and varying in size and number of members.  We concluded that not only do the Mahila Mandals work to solve issues with sanitation, but they also promote immunization of children, maternal and child health education and resolve domestic violence issues. However, their impact is limited mostly due to funding and support from the local community.

At the end of our study, we recommended that the government provide more funding and implement community-based participatory research programs which would allow the communities to identify, support, and mobilize existing resources to create a shared vision of change and encourage greater creativity in solving community issues.² Community organizations like these groups and community engagement are important for continued public health and social change. Further research is needed on how to best utilize these valuable community assets.

Our internship presentation can be found at: http://prezi.com/i0lbgveimbyc/copy-of-indian-urban-slums/

References:

1. Mili, D. Migration and Healthcare Access to Healthcare Services by Migrants Settled in Shivaji Nagar Slum of Mumbai, India. TheHealth 2011; 2(3): 82-85