Initiations: Bogus surgeons are the greatest problem – expert

As the school holidays coincide with the start of the winter initiation season, traditional health practitioner and founder of Mothong African Heritage Trust Foundation Dr Ephraim Mabena urges the law to take action against bogus traditional surgeons.

“The traditional industry itself needs to safeguard the traditional ways of doing things because bogus traditional healers are the biggest problem,” he said.

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Mabena believed the traditional way of doing things, such as circumcision, were governed by the philosophy of Ubuntu.

“Our practice is governed by the code of conduct. Going to a traditional school, you’ll be told the do’s and don’ts which are very important,” he said.

Free voluntary services

This came after the Gauteng department of health urged the public to take advantage of the free voluntary male medical circumcision (VMMC) services available at 46 public health sites across the province.

The department noted male circumcision reduced the risk of contracting HIV infection by 60%, a lower risk of sexually transmitted infections, a decreased risk of urinary tract infections and a reduced risk of penile cancer.

“It can prevent conditions such as phimosis (the inability to retract the foreskin), paraphimosis (swelling of the retracted foreskin) and balanitis (inflammation of the glans). It is also easier to clean the penis and improves hygiene,” it said.

According to Efua Prah, an associate professor in medical anthropology at the University of Johannesburg, medically supervised circumcision had a direct and measurable benefit to young people’s health.

Prah said the joint united nations programme on HIV/Aids and World Health Organisation-endorsed VMMC in 2007. She said the endorsement was made after studies demonstrated about 60% reduction in HIV infection among men who had been circumcised.

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“The benefits traditional practices have within society cannot be quantified and it is a difficult practice to measure and justify.

“Certainly, there are innumerable benefits that touch on the more psychosocial and cultural elements of societies’ growth and stability,” she said.

“What we do know regarding traditional male initiation practices is that young boys can suffer and, in many instances, die.”

Nokwanda Bokolo, from department of public health at the University of Fort Hare, alluded one major issue was the prevalence of illegal initiation schools, where “we have an inexperienced surgeon and inexperienced personnel taking care of initiates”.

“These conditions often lead to severe consequences, including reports of abuse such as bullying, physical violence and mental trauma,” she said.

“This goes against the tradition’s intent, which is to build young males into responsible men who gain respect in communities.”

Bokolo said the success of promoting VMMC depended on factors like accessibility, cultural acceptance and comprehensive health care services.

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The department said VMMC was also beneficial to females as it reduced the risk of HPV infection in men, reducing the risk of cervical cancer in their female partners.

“The public is warned not to go to unregistered or illegal initiation schools as leads to botched circumcisions,” the department said.

Mabena said circumcision was not only for preventing sexual transmitted diseases, but the differences were deeper.

“These reasons go beyond when it comes to traditional healing and indigenous ways of doing things. The reasons are from different traditional healing techniques and the modern way of doing things,” he said.