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August 2002

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Kenya

Traditional circumcision a health hazard

By Eric Maino

The widely practiced tradition of circumcising boys is now seen as a threat to life. The use of the same circumcision knife to operate on several initiates has increased the chances of transmitting viruses, including HIV.

August is circumcision season in Bukusuland, which covers mainly the Western Kenyan districts of Bungoma and Trans-Nzoia. The circumcision of boys is at the centre-stage of every debate in villages here. Young boys aged between 12 and 14 years are bracing themselves to undergo one of the most respected and popular occasions. "About 8,000 boys from the community are ready for the 'cut'," discloses 70-year-old Masinde Wanyama, a member of a Bukusu council of elders from Naitiri, Bungoma district. "But, unlike the previous years where we used to perform the rite traditionally, most boys, this time round will go to hospital for the operation," he adds.

This new development is a contravention of norms, but Masinde continues to explain: "We have to weigh between culture and survival. There is the AIDS scourge threatening to wipe out the whole generation, we are told that our style of rites passage is one way of transmitting the virus. If we subject our children to risk who will perpetuate our generation?"

The change of culture might make Mango Mukhurarwa, the Bukusu ancestor who bravely brought circumcision to the community, turn in his grave at the caves of Mount Elgon, a volcanic mountain at the border of Kenya and Uganda. He might be feeling disrespected as people fail to embrace his gift to the community.

There is a captivating true story of how the ancestor risked his life by bravely killing a terror serpent (eyabebe) in the early 1800s to qualify for the initiation from the Sabaot ethnic group.

The serpent was unleashing untold mischief in the community by swallowing alive animals and people. Then one day Mukhurarwa, the great hunter who persistently wanted to be circumcised by the Sabaots - the Bukusu had not started circumcision - was challenged to kill the serpent in return for the "cut."

To slice a long story short, Mango, with his sharp machete, accomplished his assignment and was, at 1pm that very day under the fierce tropical sun, circumcised by a woman, as the overjoyed Sabaots ululated and sang praise songs. From then, the Bukusu is said to have possessed the gift of circumcision and have carried on with it diligently for decades.

The Bukusu style of circumcision has been very controversial, dismissed by Christianity and other religions as being wicked. The evening before a boy is to be initiated is packed with action. There is excessive consumption of traditional liquor and hard drugs such as marijuana, as people sing and dance.

"On the eve of the cut," observes 30-year-old John Barasa, a catechist at a local Catholic church in Nzoia village, Lugari district, "apart from consuming the brew prepared under poor hygienic conditions, women socialise freely with men. Even married women commit infidelity on this day because culture allows," he notes sadly.

The repercussion, Barasa discloses, is the increase in AIDS cases, family separations, and early pregnancies, resulting in high dropout rates. In a given season at the village, at least 20-school going girls get pregnant, reveals the catechist, a trend he describes as alarming.

The young boy, who stays in the deep night's cold without wearing a shirt, blows a whistle, and knocks two metal pieces with sisal whiskers at the end (Chinyimba) to rhythmically hit iron bangles worn on the hand. As a test of him withstanding the blade the following morning, he is abused and wiped, while others go an extra mile to place hot iron metal on his toe nails.

As though that is not enough, very early in the morning the initiate is circumcised naked in the presence of the entire society; the knife used for one can be used for even 10 others! "This is hazardous," notes Dr. Dickson Otieno of Namabale Hospital Bungoma district. He adds: "During that process, the same knife is stained with blood. When used on another boy, chances are high that some viruses including HIV, could be easily transmitted."

Otieno says a team of medical experts, assisted by social change crusaders, has been tirelessly traversing the entire community, preaching about the dangers of the circumcision ceremony. He expresses optimism that quite a good number of parents and boys have heeded the call. These efforts have been beefed up by consistent intervention by the Catholic and other churches; many boys opt for hospital circumcision. "There it's safe and in case of any emergency the doctor is ready for assistance," says 45-year-old Simiyu Sitanda, from Namanjalala, Trans-Nzoia district. His 13-year-old boy, Amos Sitanda was operated on at a hospital at the onset of this season.

"I'll never agree to be circumcised in the tradition style," vowed 14-year-old Bethwel Wanjala. "The whole process is out-dated and with the era of AIDS its possible to get infected since only one knife is used for a mass of boys." Wanjala is among 50 other boys from Naitiri village who got a two-day training on the dangers of traditional circumcision. He now educates other boys at Naitiri Primary School where he is a pupil.

Risks of HIV/AIDS aside, sometimes the circumciser may miss the target, endangering the boy's life. Dr. Otieno gets terrified at the thought of this. "In a season we get over 50 cases where the knife has chopped the artery leading to acute bleeding, some cases are mild while others are critical." Sinoko location administrative chief, Tabuka Siakama, also stages a campaign against home circumcision. He has on many occasions at public meetings implored parents and their sons to discard the old tradition. "Culture is nice, but we cannot take chances with a culture that has implications to our health," the chief has been telling his residents.

Boys cut at the hospital have the advantage of wound dressing and medical review by the doctor. Should complications develop, the attending clinical officer is always handy. Many boys consider the hospital operation as being trendy, and very few would actually prefer to go the traditional way. The traditional method, termed as gruesome and full of inhuman and degrading treatment, has attracted the wrath of human rights activists and the intervention of the government. Most government officials working in the region have always beseeched the community to change. Interestingly, the change has never been controversial and there is no strong opposition from traditionalists, as it would have been expected!

A Bukusu boy previously could not be considered a man if he did not pass through the customary ritual. The "uncultured" boy was always sidelined and regarded as a coward. However, for most boys today, the reverse is true: go it the tradition way and you will be called "uncivilized" and "barbaric." Never has modernity raided the African culture the way it has done to the Bukusu's circumcision. In this case, it is for the better.

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