British Medical Journal, Volume 313 Number 7058, Page 647,
September 14,1996.

Botched circumcisions lead to arrest for murder

       Police in South Africa have arrested a traditional "surgeon" and charged him with murder after the deaths of four Xhosa initiates in Lusikisi, a small village in the Eastern Cape province last month. More than 60 others were admitted to hospital with septic wounds after the botched circumcisions. Around 26 of the young men, aged about 18 years, had plastic and reconstructive surgery on their penises by teams of doctors flown into the region. The project was funded by the South African Red Cross. The young men will be given psychological help.

       The disaster has led to a debate among the country's health experts, lawmakers, and guardians of local traditions. The Eastern Cape's government has appointed a team to look into the ritual and propose legislation to deal with the problem. In the same region last year there were 34 deaths, 12 penis mutilations, and 743 initiates admitted to hospital for septic wounds.

       Until this year's disaster there had been a move towards using Western medical and more hygienic methods for the practice, including the use of scalpels instead of assegais (spears). Some local hospitals have started a programme to examine the young men before they enter the initiation schools, and a code of conduct was agreed in 1991 on how to carry out the rites. At the end of that year there had been no casualties among those who had passed through the more sterile hands of the "surgeons" who had adhered to the code.

       These moves have not found favour with all local chiefs, and at least one group has rejected the Westernisation of the circumcision schools. The debate extended into a censorship row, too, when King Mayisha II of the Ndzundza Mabhoko tribe complained to the Broadcasting Complaints Commission of South Africa about the handling of circumcision by the state run South African Broadcasting Corporation. After an incident in which 50 men had a botched circumcision the broadcasting corporation stated that of 10 callers to a programme on the issue most were in favour of maintaining the practice of circumcision but called for qualified medical practitioners to investigate health standards at the initiation schools to minimise deaths and mutilations. The king complained that gross damage was being done to a culture that was the pride of the nation. His complaint was not upheld.

-PAT SIDLEY, health journalist, Johannesburg

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(File revised 06 August 2001)

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