The habit of performing circumcision on
the male newborn is one that has been carried out through the ages. It
means the removal of the male foreskin, in part or wholly so that the
penis is substantially exposed. It is perhaps the most common surgical
operation performed around the world and it is certainly the most common
operation performed in the male newborn. It is almost universally
practised in West Africa and in the Middle East. It has many faithful
adherents among the great religions of Christianity and Islam.
Many of these adherents trace their
practices to the time of Abraham when he was instructed to remove the
fore-skin of the male offspring of his generation on the eighth day of
life as a kind of covenant. Anthropologists, however, are of the opinion
that the practice even predated that era with circumcision being used
as a mark of the slaves in the palaces of the pharaohs. Other historians
say the original practice began among the Negro population of West
Africa. Whatever are the facts of the matter, circumcision is a widely
practised exercise which has recently fallen into immense controversies
in the affluent Western nations.
MALE CIRCUMCISION...
MALE CIRCUMCISION...
In the main, it is an essentially
cultural and social obligation in most parts of Africa with some ethnic
groups even performing this task as part of elaborate tribal ceremonies.
This is particularly true of the Maasai of East Africa and the Xhosa of
South Africa. In such a scenario, complications inevitably arise with
the tragic consequences of permanent deformity, disease and loss. In
those communities, the very act of undergoing circumcision is seen as a
necessary rite of passage into manhood. In some parts of the world,
especially in Western Europe and North America, there was the loud cry
that this was an unnecessary operation essentially being performed
without the consent of the infant. In Africa, many would argue that this
is stretching the concept of freedom too far.
There are some medical conditions that
also make circumcision necessary and these are recurrent infection
involving the glans of the penis and causing a problem called balanitis.
Circumcision takes away this malady. The other reason for performing a
circumcision is known as phimosis which means that the foreskin around
the glans of the penis becomes so tight that the glans can usually not
be freed without immense discomfort.
The last 15 to 20 years has seen a
torrent of information which now proves that circumcision is a valuable
tool in combating the HIV pandemic. The uncircumcised male has a prepuce
which is similar to the lining of the mouth. It is lined by a mucus
membrane which is vulnerable to injury and infection. It is thought that
the HIV virus finds it a lot easier to penetrate this membrane and get
into the body to cause disease. When an individual is circumcised,
however, healing occurs by bringing skin together from the adjacent cut
surfaces having excised the mucus lining. This skin is toughened by
keratin, the usual substance that makes our skin impermeable and this is
what thus protects the individual from HIV/AIDS. As a result of this
evidence, circumcision is now seen as an important part of the struggle
against this disease.
This has led to increasingly bold
attempts by various governments in the Southern African region to
promote the health benefits of circumcision and emphasise the evidence
that it helps men resist infection by the HIV virus provided the skin of
the penis is unbroken. In Africa, this is of particular importance
because most new infections with the HIV virus are obtained through
heterosexual relationships.
Various tools or devices have been
devised for carrying out this procedure over a long period of time. Not
one of them is perfect. However, all of them can be deployed safely once
they are used by good hands. They can be deployed in hospitals or in
clinics or in health centres. It can easily be performed by doctors or
nurses and other health care workers specifically trained for this
purpose in some resource-poor countries. The practice may be hospital
based or as is often the case in some other countries, may be done as a
domiciliary practice by nurses and Jews. Even with the modern methods of
circumcision, complications can often occur. In trained hands, these
are quickly rectified before something unpleasant happens.
When circumcision is performed by those
who should not be doing it, such as auxiliary nurses, nursing aides,
theatre attendants and hospital porters; the problems which frequently
follow are immense. The risk of bleeding after the procedure is common
and may be severe enough to require a blood transfusion. Sometimes,
infection is a major problem and it may pursue a prolonged course with
significant loss of function resulting. Sometimes, the penis itself is
amputated and sometimes, the wrong application of devices could lead to
gangrene of the glans. Obviously, this is a nightmare for parents and a
semblance of normality can only be restored following several
reconstructive operations which are expensive and emotionally
exhausting. This is a problem that is seen fairly commonly in hospitals
around the country.
In other climes where circumcision is
performed as part of an elaborate ceremony, death is a frequent
occurrence often from bleeding but also from infection and even tetanus.
It is thus important to not look at this procedure as though it were
one of those routine things; it assumes a major importance when
sometimes goes awry. This is the frequent repercussion of having it done
with an untrained hand.
The other inconvenience which
circumcision removes is the frequent need to clean an uncircumcised
penis. The prepuce which folds upon the penis usually keeps a sticky
white substance under its hood. This attracts bacteria and can lead to
recurrent infections if it is not consciously cleaned on a regular
basis. This may be convenient for an adult carry out with ease but would
be a challenge for a child whose parents have to find the presence of
mind to clean it always.
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