If one assumes that traditional initiation and circumcision will continue to be a practice for the majority of boys, the Health Department should do more to promote the practice as adult-supervised and under the auspices of traditional cultural leaders. More must be done to prevent the unnecessary deaths and medical complications this province faces during each initiation season.

A change in attitude is necessary so that young men, who want to participate in the ritual, also have the freedom to choose either a medical- or traditional circumcision.

As we approach Heritage Day on September 24, one is again reminded of the cultural diversity of our Rainbow Nation. The Democratic Alliance wants to emphasize that it not only respects cultural practices and cultural diversity in SA, but will also do anything possible to protect it.

The easy solution would be to lay down legislation which would force all initiates to undergo medical circumcisions in clinics and hospitals and outlaw traditional circumcision. But that would only solve the clinical problem we are confronted with and not the far larger underlying problem.

A recent study and survey conducted in the Lusikisiki area by the Human Sciences Research Council and University of the Free State, found that the majority of initiates – up to 70 per cent of them – felt that they would be stigmatized if they should have chosen medical rather than traditional circumcision. It is also interesting to note that one in five initiates said the relationship between medical and traditionally circumcised men was hostile. It is therefore clear that traditional circumcision is not only preferred, but will continue to be so for many years to come.

However, this does not mean that the Department of Health cannot take the initiative to heal the relationship between those in favour of a medical procedure and traditional practices. Somehow the message should be conveyed that it is OK for young men to choose medical circumcision, and that these men will not be stigmatised. At least young men should have the freedom to choose.

Urbanisation has caused large numbers of boys to undergo circumcision in makeshift initiate schools in or close to cities, where traditional cultural leaders and supervision is sidelined.

It is the role of the Department of Health not merely to police the existing practices, but to rather promote the right, traditional and safe practices.

I believe the community and families must take pride and responsibility that standards maintained at these schools are kept at the highest possible levels.

While it is the Department’s role to communicate the correct information about circumcision to boys and their families, it is also the Department’s duty to communicate risk behaviour and to promote safe social practices.

The same Human Sciences Research Council study I quoted above, also found that nine out of ten boys were sexually active prior to circumcision and engaged in behaviour that increases their risk of HIV-infection.

Traditional initiation practices can be used as opportunities to drive and promote preventative behaviour. If boys by their thousands attend initiation schools every year, certainly the Department of Health should see this as the ideal place to spread the message of safe sexual practices?

The Department of Health, along with traditional leaders and communities should take hands to integrate safe sex education into circumcision schools. The opportunity is there and the chance to change behaviour is large. Focus-groups among initiates has already revealed that sexually active initiates, when asked about sex after circumcision, indicated they wished to abstain for a short period before resuming sexual activities with intended condom use being high.

This is an opportunity to save lives. Not only from botched circumcisions, but also from contracting HIV.

For further information, please contact Pine Pienaar, MPL on 082 446 1888

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