THE DAILY DISPATCH, East London, Eastern Cape Province, South Africa,
Friday, 24 June, 2005.

Setting standards for safe practice of traditional circumcision

THE EASTERN Cape government passed the Application of Health Standards in Traditional Circumcision Act in 2001.

This law sets standards for the safe practice of traditional circumcision, and sets the rules for giving permission to carry out circumcisions and run circumcision schools.

In terms of the circumcision law, the Health MEC appoints at least one medical officer.

It's the medical officer's job to grant permission to circumcise or treat initiates, and to keep records about circumcisions. The medical officer is allowed access to any occasion where circumcisions are carried out or where initiates are treated.

Nobody may run a circumcision school without the written permission of the medical officer in their area.

Nobody, including the parents or guardians of initiates, may interfere with the medical officer or prevent him from doing his job.

The medical officer grants permission to experienced traditional surgeons to conduct circumcisions.

Nobody may circumcise an initiate without the written permission of the medical officer in that area.

Traditional surgeons who don't have the necessary experience must act under the supervision of an experienced traditional surgeon.

The medical officer must approve the type of instrument which will be used to carry out the circumcision.

Permission is not needed to treat an initiate in a hospital or by a medical doctor outside the traditional context.

Both the medical officer and the person applying to carry out circumcisions or to run a circumcision school must write their full names on the document asking for permission, they must both sign it and the date must be written on it.

The initiates may not be treated by anyone except a traditional nurse, a medical practitioner, the medical officer or anyone else authorised by the medical officer.

No initiate may treat another initiate.

Initiates must be at least 18 years old. If an initiate is younger than 21 years old, his parent or guardian must sign a consent form agreeing to allow him to be circumcised.

Anyone who breaks the circumcision law could be convicted of an offence and fined up to R1000 or sent to jail for up to six months. Anyone who runs a circumcision school or circumcises an initiate without permission, could be fined up to R10000 or jailed for up to 10 years.

For an initiate to get permission to be circumcised, he needs:

  • A birth certificate or identity document proving he is at least 18 years old, or at least 16 years old if his parents specifically request the initiation;
  • Consent from his parent or guardian if he is under 21;
  • A certificate from a medical doctor, confirming that he passed a pre-circumcision medical examination and is fit to be circumcised;
  • To find a traditional surgeon to carry out the circumcision who is known to his parents or guardian or family and who uses instruments which they approve of.

At the circumcision, the instruments used must be sterilised and the same instrument should not be used for more than one initiate.

If the traditional surgeon doesn't have enough instruments he should ask the medical officer for them.

The traditional surgeons and traditional nurses must co-operate with the medical officers.

At circumcision schools, the medical officer can inspect the school and the initiates whenever he feels necessary.

The initiates must, at least within the first eight days of the circumcision, be allowed by the traditional nurses to have a reasonable amount of water to drink to avoid dehydration.

The traditional nurses may not expose the initiates to any harmful situation or danger and must report any sign of illness among the initiates to the medical officer as soon as possible.

The traditional nurse must stay at the circumcision school all the time for the first eight days of the initiation process and, after that, must visit the initiates at least once a day until the end of the initiation.

The medical officer may prescribe any measure that may be needed for the good health of the initiates, which may include a departure from traditional methods.

Contact the Department of Health for more information or for details of the medical officers.

Circumcision problems can be reported on the department's toll free number 0800032364.

(File created 25 June 2005)