Health workers fear return of brutal ritual

An edict by the king of the Zulus to bring back circumcision for millions of teenage boys is causing alarm in South Africa, amid record numbers of deaths from the traditional manhood ritual.

Tomorrow, at a meeting called in Durban by the Government of KwaZulu-Natal, traditional leaders in the province will outline how they wish to implement King Goodwill Zwelithini's decision to reintroduce circumcision 200 years after it was scrapped by King Shaka.

But health officials working with South Africa's second largest tribe, the Xhosa - who never gave up the practice - say the move could put millions of lives at risk.

"We have had a disastrous year, with 80 deaths, including two suicides," said Sizwe Kupela, a Xhosa who is health spokesman for the Eastern Cape.

Each year, 50,000 Xhosa boys descend on the vast province to undergo the secretive ritual - including circumcision by a "traditional surgeon" and one month's seclusion in nakedness.

"We see horrific cases of rotting penises, septicaemia and inadvertent castrations," he said. "Others die from dehydration and hypothermia. HIV is spread because the same knife is used on large groups of boys. My personal view is that if the Zulus go back to circumcision, they must do it the Western way, in hospital."

Last weekend, wrapped in a blanket, 19-year-old Andile Ngcolomba ended his month in seclusion by walking off the aloe-covered slopes of Peddie into his mother's impoverished village in Qamini Location.

He remembered very little about the visit he received in his mountain shelter in December from the traditional surgeon: "He arrives covered in clay and animal pelts. He is so ugly you don't want to look at him. I never even saw the knife. You just black out. When you wake up, it is done, and there is some powder there to help the healing. I did not sleep for seven nights for the pain."

During his time "on the mountain", Ngcolomba and other initiates in adjacent shelters received visits every other day from an ikangata (teacher), Mazinyanwana Mkhongi. The teacher, in his 70s, said: "My role is to check that the wound is healing and to explain the duties and responsibilities of a man. He must be able to survive in the wild, fight, but also resolve conflicts."

Ngcolomba, a schoolboy who lives with his mother and elder sister in the Cape township of Khayelitsha, had been convinced of the merits of initiation before enduring it.

After enduring the process, he was more convinced than ever of its virtues: "To us Xhosas, circumcision is what makes you a man. All my friends are doing it. Without it you are inkwenkwe - a boy - and you are not allowed to mix with men. Hospital circumcision does not count. You are not a man unless you have survived what I went through. No man can be a leader without it. To me, now, President Jacob Zuma is a boy because he is an uncircumcised Zulu."

Former presidents Nelson Mandela and Thabo Mbeki and Archbishop Desmond Tutu are all circumcised Xhosas. Whenever prominent South African figures misbehave, Xhosa title-tattle centres on whether they have been circumcised. Xhosas frequently denigrate Julius Malema - the outspoken leader of the African National Congress Youth League - because he is an uncircumcised Zulu. In 2008, ANC politician Fikile Mbalula succumbed to peer pressure and, aged 37, entered an initiation school. He later became deputy minister of police.

King Zwelithini claims to be reintroducing circumcision for Zulu boys because there is evidence that the practice sharply reduces HIV transmission. But with a Zulu president in power, it is likely that the king is equally motivated by a desire to bolster his nation.

Critics of initiation say traditional leaders have failed to update their teachings from the times when the ritual was put in place to select and grade warriors. Despite undergoing government training courses, teachers largely do not address burning South African concerns such as HIV prevention or sexual violence. The tradition also places a tremendous financial burden on poor families. Goats, blankets and bottles of Viceroy brandy and Smirnoff vodka must be bought. After initiation, a young man must be bought a suit and cap and must throw away his entire wardrobe, including underwear, shoes and even the mobile phone, school uniform and school bag from his boyhood.

Aids campaigner Vuyiseka Dubula is concerned that thousands more lives could be put in danger.But she added: "Most new incidences of HIV are among women. Initiation should be about education, including respecting women. I am a Xhosa woman and I know the initiates are taught how to use their power, not how to control it. If this could be changed, while not alienating the traditional leaders, we could see a new generation of men emerge, circumcised and more responsible."

FIGHTING HIV

LONDON - A key factor in the decision by King Goodwill Zwelithini to bring back circumcision has been the disproportionate impact of HIV on the Zulu people.

"Bacteria can linger under the foreskin and the resulting infections can make glands more susceptible to the transmission of HIV," says Tim Oliver, an emeritus professor at the London School of Medicine. "Statistics indicate that circumcision has helped to halt the spread of HIV in southern Africa."

Other health benefits linked to circumcision include improved rates in penile, cervical and - possibly - prostate cancer. In people of Jewish or Arabian origin, who traditionally circumcise their boys and young men, rates of the first two diseases are generally very low.

But the connection between circumcision and disease prevention is not straightforward.

"Studies that have compared disease rates in circumcised and uncircumcised men have not fully teased out the possible roles of other variables," says Oliver. "Instead of circumcising males, it may be just as effective - or even more so - to provide good sexual education and make sure fresh water is available to communities so that good hygiene can be practised."

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