By SOSTHENES PAULO MWITA, 30th December 2011 @ 11:00, Total Comments: 0, Hits: 1382
THE removal of the foreskin of young boys for, cultural, religious, medical or other reasons has been a controversial issue all over the world since time immemorial. Most tribal settings in rural Tanzania have their boys, not babies, circumcised as a compelling cultural imperative.
I hail from Mara Region where the Wasimbiti circumcise their boys mostly between the ages of 15 and 18. Here, circumcision of male babies is virtually unknown. Circumcisions are not ommon among the Wajaluo, Wahaya and Wasukuma of Mara, Kagera and Mwanza regions respectively. I must mention at the outset, however, that this discussion mainly centres on the circumcision of male babies and young boys.
Female circumcision, which is commonly referred to as female genital mutilation (FGM), is a horrendous ritual that I dislike. I will discuss it briefly later. Now, let us look at why circumcision may be carried out on boys and occasionally, on male babies. Let us see what the procedure involves. In short, circumcision of boys is an operation in which the foreskin is
removed from the penis.
The foreskin is the small flap of skin at the tip that can usually be pulled back over the end of the penis. Some people believe that the foreskin is redundant and that it gets in the way of good hygiene. I also believe so and support male circumcision wholeheartedly. However, some people believe that the foreskin is a “very sensitive” and vital part of the male anatomy that should not be removed.
Well, circumcision is done for a variety of reasons depending on cultural rituals, religious beliefs or hygienic stands. Among the Wasimbiti, male circumcision is a compulsory passing from childhood to adulthood. In some religions, such as Islam, it is a mandatory ritual that has to do with spiritual purity. And, as I have already said, in some cultures the ritual is done for reasons that appear to impinge on hygiene.
Circumcision may be done when the foreskin is narrowed or tight and cannot be pulled back. Other medical reasons for circumcision include recurrent attacks of infection under the foreskin know in medical parlance as balanitis. There is also an unusual condition that tends to affect adult men called balanitis xerotica obliterans.
Tiny patches of lymph glands on the underside of the foreskin may process infectious organisms including HIV/AIDS, helping them to enter the body. Recent research has suggested that circumcision may help to reduce the risk of contracting HIV/AIDS. In urban Tanzania, circumcision is occasionally performed on babies aged between a few days to a few months but the practice does not have state backing.
I must point out here that there is no compelling medical reason for circumcision. In Britain, for example, the operation is no longer routinely performed on healthy children. In fact, fewer than one in ten British teenage boys has been circumcised. In Africa , however, the ritual is widely practiced. Circumcision is a painful operation. With small babies, local anaesthetic may be sufficient and this avoids the risks of a general anaesthetic.
Local anaesthetic is a numbing medicine that can be injected at the base of the penis or in the shaft. In some cases local anaesthetic may be applied as a cream. In older children or in very rare adult cases, circumcision is best performed with the child completely asleep under general anaesthetic. Healing, in normal circumstances, takes up to seven days. Dissolving stitches (that do not need to be removed) are usually used. Simple pain relief medical drugs, such as paracetamol should be given regularly after the surgery.
Occasionally, there may be complications after the operation, including infection and scarring. Parents or care givers should be vigilant for these and get advice immediately if problems develop. In male babies the foreskin is lightly attached to the penis underneath it, much like the skin on an orange. It normally comes free over the course of the first few years of life.
By this analogy the foreskin can be readily separated from the main body of the penis at the start of a circumcision. A variety of methods are used to remove the foreskin and the amount eliminated can also vary depending on technique and culture. The Maasai leave it hanging at the base. Circumcision is one of the most common cultural or medical procedures in the world, with 25 operations performed every minute worldwide.
It is also one of the oldest and the simplest. The fact, that it continues to be popular, must mean there are good virtues in it. Now let us look briefly at what female genital mutilation (FGM) involves and what the state and the World Health Organization (WHO) think about it. FGM involves the removal of the clitoris by cutting with a sharp blade across the high-pressure clitoral artery.
This procedure is likely to cause life-threatening haemorrgage if carried out without competent surgical control. In the event of massive haemorrhage, serious collapse or sudden death may occur. Major blood loss can result in longterm anaemia. With infants (a practice that is uncommon) the incisor or “ngariba” uses fingernails to cut off the baby’s nascent clitoris.
The rite is conducted clandestinely under a shroud of secrecy. The incisor wanders casually into the baby’s home and works in dim light. The procedure, normally carried out on girls is performed with crude homemade knives, pairs of scissors, scalpels and pieces of glass or razor blades. There is often additional unintended damage to the labia minora due to crude tools, poor light or septic conditions.
Infection, due to unhygienic conditions, and the use of crude, unsterilised tools, is a likely consequence. Infection can also be contracted due to the application of traditional herbs used for healing the wound. These often come in the form of crushed tree leaves or roots.
The procedure is usually carried out by elderly village women who have been specially designated for this task or by traditional birth attendants. In urban centres affluent families prefer eliciting the services of health personnel such as midwives and doctors.
However, the Tanzanian government and the WHO have consistently condemned the medicalization of both circumcision and FGM. The WHO sees the practices as unnecessary as they are likely to carry serious, potentially dangerous complications. In Tanzania FGM has been banned.
In rural Tanzania FGM may not cross many minds as a public health hazard that warrants condemnation as it bears nasty physical, sexual and psychological consequences. In fact, incisors that carry out FGM on infants must be stark raving mad.
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