Surgery partnership programme to rectify botched circumcisions

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Eight years of “a lot, a lot of pains” behind him, Nelson Gentsana is happy. “I can pee like any other man now,” the 23-year-old is quoted in a Mail & Guardian report as saying. Gentsana was the victim of a botched circumcision at an inititation school in the Eastern Cape in 2010.

The report says speaking in 2017 for a report on botched circumcisions at initiation schools, Gentsana recalled the “five or six months” he subsequently spent in hospital. “I was in severe pain. So much pain. I couldn’t feel my right leg. I couldn’t walk. Emotionally, I didn’t feel like a human being. I didn’t feel anything. Nothing at all.”

At the age of 16, he had to adapt to life “without my manhood” and having to use a catheter to urinate. His parents are dead and he lives in the Eastern Cape town of Lusikisiki with his brother and sister, both of whom were unemployed. “If we had something to offer him – some money to take him to hospital and get back his manhood – we would. But we struggle a lot for money. A lot,” said Gentsana’s uncle.

The report says Gentsana was identified as one of the province’s “high priority” botched circumcision survivors in need of reconstructive surgery. “I was very grateful,” said Gentsana. “But I was nervous. Too much nervous.”

The operations, which would ordinarily cost between R150,000 and R200,000 each, are done by a partnership between Nelson Mandela Academic Hospital and a Pretoria-based urologist, Dr Raymond Campbell. The Man and Boy Foundation identifies men in need of surgery. Campbell said the programme has been running for 18 months and, to date, has successfully operated on 25 young men.

But James Porter, a doctor at the Madwaleni Hospital in the Eastern Cape’s Mbashe district, said his hospital alone admitted an average of 10 boys weekly during the height of an initiation season, mostly for dehydration and septic wounds. And, the report says, with initiation season approaching, there will probably be more young men in need of reconstructive surgery.

In November last year, the Commission for the Protection and Promotion of the Rights of Cultural, Religious and Linguistic Communities released its report on the problems that lead to deaths and injuries at initiation schools. It found that the majority of initiates (79%) are in the Eastern Cape, where traditional initiation practices are favoured (63% of initiates) over hospital circumcisions (13%). “What is striking is that only 17% of initiates understood the risks associated with traditional circumcision without being seen by a doctor, while 67% did not have a clue about these risks,” it said.

The report says the commission’s investigation was undertaken in response to a “crisis threatening a cultural practice that has been conducted in African societies in South Africa and elsewhere from time immemorial”. “The recent problems – deaths, amputations, injuries, gangsters – occurring in male initiation schools have resulted in negative perceptions of the practice; perceptions which find expression in criticism directed at the initiation schools, especially that they represent an outdated cultural practice. Furthermore, the initiation schools are seen by many as death traps for young people,” the commission’s chair, Thoko Mkhwanazi-Xaluva, said.

She said the majority of initiation schools “run without incidents”. But the report said that the number of hospital admissions, deaths, injuries and penile amputations during initiation seasons could no longer be ignored. “The crisis – as it should be declared – warrants urgent attention by all South Africans concerned,” said the report.

“I always say, once there is a mortuary van and an ambulance, culture is no longer there. Culture collapses at that point and it is just a crime,” Mkhwanazi-Xaluva is quoted in the report as saying.

Since 2013, in a house in Lusikisiki, Gugulethu Sirayi has been counselling survivors of botched circumcisions. With little in the way of funding, he transports, feeds and counsels the young men for these monthly sessions using the little money he earns as a construction worker. The suicide rate is high among these young men. Sirayi said: “I just try and give them hope. So many of them think they’re nothing because they have lost their manhood.” Witnessing the success of Gentsana’s operation, he said, made him “very, very happy”.

According to the report, Campbell does these operations on a pro-bono basis and said “it is one of the most satisfying things I have undertaken as a doctor”. “With the boys we operate on, the stories are all really terrible. They are really in such a broken state. There is a real sense of hopelessness.”

Mkhwanazi-Xaluva said that, when the commission’s investigating team spoke to survivors of botched circumcisions, it became clear that “(they experience) trauma, trauma, trauma … every day of their lives”.

Having experienced that first-hand, Gentsana said: “Those people who do these things to us, they must look after the boys (in their care). I experienced those difficulties. I don’t want anyone to go through that. Nobody should go through that thing.”

Mail & Guardian report

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