In response to the devastating loss of approximately 1 219 initiates during the traditional circumcision season between 1995 and 2023 in the Eastern Cape, WSU researchers have turned a spotlight on the critical socioeconomic determinants preventing these high mortality and morbidity rates.
The overall findings of this study revealed that poverty, unemployment, illegal actions to gain money, and the overvalued quest to attain social respect are the leading socioeconomic determinants that affects negatively with the resultant health crisis of traditional male circumcision practice.
This is highlighted by WSU researcher Prof Mbuyiselo Douglas and Prof Charles Hongoro in their paper titled: “The Consideration of Socioeconomic Determinants in Prevention of Traditional Male Circumcision Deaths and Complications.”
“During the era of oppression, the oppressors permitted black people to maintain their traditions as long as they stayed in power. However, at the dawn of democracy, poverty driven by unemployment became widespread. It was during this time that young men, seeing an opportunity, chose to become untrained traditional surgeons, leading to the tragic increase in deaths among initiates” said Douglas.
Douglas added that among AmaXhosa people in the EC, circumcision is practiced as a male initiation rite of passage, used as a transition from boyhood (ubukhwenkwe) to manhood (ubudoda) and this is tradition is pride and honour to them because this is where initiates are educated to be good and responsible leaders to their families and the community at large.
“However, we cannot discard how the initiation schools have changed now, initiates take health risks for cheaper practices. Illegal traditional surgeons are not registered and their prices are lower than prices of registered traditional surgeons,” said Douglas.
He added that llegal traditional nurses introduce smoking of dagga and drinking of alcohol to initiates, telling them that they will not feel the pain, those who refuse are emotionally abused and beaten up in the initiation school.
“During data collection, participants proposed that the government could implement a system to cover the costs for boys who cannot afford the services of legal and registered traditional surgeons. Instead of allocating funds to unwanted medical circumcisions, the government could direct these resources towards paying registered traditional circumcision surgeons who practice safe male circumcision. This approach could incentivise them to circumcise boys who are unable to pay the R500 fee,” said Douglas.
The participants also suggested that the Life Orientation syllabus offered at school should incorporate circumcision health sessions to empower the boys.
“Currently, WSU is leading an initiative of an implementation health promotion programme targeting schoolboys in the Eastern Cape to empower them on prevention of circumcision deaths, illegal and negative behavioural determinants affecting them,” said Douglas.
The initiative is a mutual response from Cooperate Governance and Traditional Affairs (COGTA) and relevant stakeholders for WSU and other universities in the Eastern Cape to design a consolidated syllabus for schoolboys as a contribution to a collaborative intervention.
By Anita Roji