Ethical dilemmas of circumcision school with reference to the Venda

Mahada, Livhuwani Paul (2004-03)

Thesis (MPhil)--Stellenbosch University, 2004.

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Thesis

ENGLISH ABSTRACT: Morbidity and mortality are national problems that affect a vast number of children and young adults each year in Circumcision Schools. The number of children who either get sick or die of traditional circumcision school is probably high. "In one study of penile mutilation practice (in 1990) of the Xhosa tribe of Southern Africa, 9 % of mutilated boys died: 52 % lost all or most of their penile shaft skin: 14 % developed severe infectious lesions: 10% lost their glans penis; and 5 % lost their entire penis. This represents only those boys who made it to the hospital," (Denniston and Milos, 1997: v). The problem is still the same and this could mean that the true complication statistics is likely to be much higher if the entire South Africa is taken into consideration. Although traditional circumcision was well intended, the recent spate of death puts it under threat. Besides, there are many other controversial acts that are taking place within the school itself. There are many illegal schools instituted by inexperienced traditional surgeons. The plight is further worsened by the commercialisation of the traditional institution. It is painful to note that the camps which were normally held in winter for children to heal faster are now also held in summer. The outmoded system of administration in this institution and the health hazards experienced, confronts parents, children and the entire community with a dilemma - a dilemma that warrants ethical reflection. The dilemma poses a serious challenge to the cultures that practice the traditional ritual of circumcision. Many of the advisers of this thesis agree (the likes of Prof. C.S. van der Waal, Prof G. Tangwa, Chief T.l Ramovha, Traditional healer Mashudu Dima and Dr D. Sidler) that we don't have to do away with the school as such, but that there is a need to either change and improve certain things in this school. Social change and medical awareness seem very important in this regard. The hurdle created by this dilemma, though daunting, can be overcome. We need education, cooperation, dialogue, rationality and true reflection on our culture to work this problem out. Until our children are safe from the threat of morbidity and mortality, no one is safe. I therefore think that many human errors could paint an unfavourable picture on the traditional Circumcision School, whereby creating ethical dilemmas. The ethical dilemma could be a starting point for critical reflection on culture and tradition with the hope for change and future progress. It is such a challenge that Circumcision Schools should face and which they urgently need.

AFRIKAANSE OPSOMMING: Ernstige beserings en 'n hoë dodetal in besnyding-skool is 'n nasionale probleem wat elke jaar talle kinders en jong volwassenes affekteer. Die getal kinders waarvan die gesondheid aangetas word of wat selfs sterf in dié tradisionele besnyding-skole is waarskynlik haag. "In one study of penile mutilation practice (in J 990) of the Xhosa tribe of Southern Africa, 9% of mutilated boys died: 52% lost all or most of their penile shaft skin: J4% died developed serious infectious lesions: J0% lost their glans penis; and 5% lost their entire penis. This represents only the boys who made it to hospital" (Denniston and Milos, 1997:v). Dié probleem bestaan voort, en dit mag beteken dat die ware ongevalle syfer veel hoër mag wees, sou die hele Suid Afrika in berekening gebring word. Alhoewel besnyding tradisioneel welbedoeld is, word dié praktyk nou bedreig deur die onlangse vlaag van sterftes. Daarbenewens is daar vele ander kontroversïele praktyke wat in dié skole self bedryf word. 'n Groot aantal van die skole is onwettig en word deur onervare tradisionele sjirurge bedryf. Dié problem word verder vererger deur die kommersialisering van dié tradisionele institusie. Dit is ook kommerwekkend om daarop te let dat waar dit gebruiklik was om dié kampe in die winter te hou - vir die sneller herstel van die kinders - hulle nou ook in die somer beslag neem. Die verouderde sisteem waarmee dié institusie se administrasie bedryf word, sowel as die gesondheids-gevare wat daarmee gepaard gaan, stelouers, kinders en die gemeenskap as geheel voor 'n dilemma - 'n dilemma wat etiese nadenke verg. Dié dilemma bied 'n ernstige uitdaging tot die kulture wat steeds die instelling van besnyding huldig. Soveel as sekere van die bydraes binne die vervolgende verhandeling (bv. Dié van Proff. c.S. De Waal, G. Tangwa, Hoofman T.J. Ramovha, Tradisionele heler Mashudu Dima en Dr. D. Sidler) saamstem dat daar nie ingeheel van die skole afgesien hoef te word nie, is daar wel 'n nood om sekere aspekte daarvan te hersien en verbeter. Sosiale verandering en 'n mediese perspektief is van groot belang hiertoe. Die struikelblok wat deur hierdie dilemma veroorsaak word - hoewel intimiderend - kán weloorkom word. Daar is 'n nood vir opvoeding, samewerking, dialoog, redelikheid en 'n ware nadenke oor ons kultuur om hierdie probleem die hoof te bied. Tot tyd en wylons kinders veilig staan van die dubbele gevare van besering en dood, is niemand veilig nie. Ek dink dus dat, terwyl verskeie etiese dilemma's ongunstige beeld skep van menslike foute, hulle ook vra om insigte rondom die menslike kultuur, en om hoop vir toekomstige vooruitgang. Dit is wat tradisionele besnyding-skole benodig.

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