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News24 (South Africa)June 28, 2010

Circumcision toll rising

Cape Town ‐ The death toll in the Eastern Cape's winter circumcision season has risen to 39, the provincial healthdepartment said on Monday.

Spokesperson Sizwe Kupelo said the latest deaths had occurred in the Ntabankulu and Engcobo areas of Transkei and on

farms in the Chris Hani district, which includes Queenstown.

National Traditional Affairs Minister Sicelo Shiceka said at the weekend he was considering regulating initiation schoolsafter ongoing reports of youths dying at illegal schools.

His department was also seeking harsh sentencing for those found to be running illegal schools.

The Eastern Cape already has its own circumcision legislation, but prosecutions are sometimes hampered by a lack of co‐operation from communities and parents.

Kupelo said on Monday his department was sending an official to Mthatha in a bid to persuade municipal councillors tostop issuing death notices for victims of these il legal schools.

The notices allowed families to obtain death certificates from the department of home affairs, he said.

"These cannot be treated as natural deaths. These are all police cases, and there must be a post‐mortem on every one," hesaid.

"They (the councillors) should rather notify the police if any deaths are reported to them."

http://www.news24.com/SouthAfrica/News/Circumcision-toll-rises-to-39-20100628http://www.circumstitions.com/news/news36.htmlhttp://www.circumstitions.com/news/news38.htmlhttp://www.circumstitions.com/index.html#news


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City Press (South Africa)June 27, 2010

Cousins succumb to septic wounds

Loyiso Sidimba at lusikisiki

Cousins Xolile Mdingwa‐Ngobe and Wezile Ngobe died of botched circumcisions within 24 hours of each other after two

weeks at an initiation school in Lambasi vill age, Lusikisiki.Mdingwa‐Ngobe (26) was a carpentry, plumbing and bricklaying student at Ingwe FET College in Lusikisiki, while Ngobe(27) was unemployed. Their mothers are sisters.

Mourners at Mdingwa‐Ngobe’s funeral in Mgungudlovu on Saturday described him as quiet and peaceful.

Mdingwa‐Ngobe’s aunt had bought a colourful blanket for his graduation ceremony. At the funeral, the blanket was placednext to his coffin.

Distraught uncle Welcome Ngobe said he only found out about Wezile’s initiation from young men in his village.

“Mdingwa‐Ngobe told an uncle on his father’s side, but Wezile never told anyone,” he said. Wezile was buried at hismaternal home in Lambasi on Thursday.

He was only taken to the St Elizabeth Hospital on June 16 after his cousin Mdingwa‐Ngobe’s death that morning.

Wezile died the following morning at the hospital.

“Their wounds became septic,” Welcome said.

Their traditional nurses, despite seeing that the men had been improperly circumcised by an ingcibi known only asBhabholomhlehlo, kept them in their hut until it was too late to save their lives.

The other 10 initiates in their hut were all admitted to St Elizabeth Hospital with botched circumcisions.

Welcome wants government to declare the situation a disaster and to step in to assist the families of dead initiates. “We’vehad to take out loans for their funerals,” Welcome said.

flikr

June 27, 2010

New slogan at Gay Pride parade

http://www.flickr.com/photos/bats1234/4740017423/http://www.citypress.co.za/SouthAfrica/News/Cousins-succumb-to-septic-wounds-20100627


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June 16, 2010

HRW urges Kurds to ban female circumcision

ARBIL ‐ Human Rights Watch on Wednesday called on Iraqi Kurdish authorities to outlaw female circumcision in the face of growing evidence of use of the physically and emotionally damaging practice.

In a 73‐page report entitled: "‘They Took Me and Told Me Nothing': Female Genital Mutilation in Iraqi Kurdistan," the NewYork‐based watchdog recorded the experiences of 31 girls and women in four villages in northern Iraq's autonomousKurdish region.

...

The watchdog said that while there were no official figures, local research indicated that female c ircumcision waswidespread in the region and had affected a significant number of girls and women.


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"Female genital mutilation violates women's and children's rights, including their rights to life, health and bodily integrity,"said the watchdog's Middle East women's rights researcher, Nadya Khalife.

...

A 2007 regional justice ministry decree ordering the arrest and punishment of practitioners appeared never to have beenimplemented, and a proposed 2008 bill to outlaw the practice had never got beyond a preliminary vote of support in theregional parliament, the report said.

In early 2009, the regional health ministry drew up a strategy for eliminating the practice but later withdrew its supportwith the result that a public a wareness campaign was "inexplicably delayed", the watchdog added.

Female circumcision has traditionally been practised in Egypt, Sudan Yemen and parts of east Africa. It has been outlawedin a number of countries, most recently Uganda.

Jerusalem PostJune 25, 2010

Rehovot newborn saved after botched circumcision

By JUDY SIEGEL

Infant had lost a third of his blood.

Kaplan Medical Center doctors saved the life of a newborn baby who on Wednesday was seriously injured by a mohelduring his circumcision and lost a third of his blood.

Dr. Marius Guy, a senior urological surgeon, said that the eight‐day‐old baby from Rehovot was in serious condition withhis penis nearly disconnected at its base, causing massive blood l oss.

The Health Ministry was given full details by the hospital, but if was not clear whether the religious family was going to filea complaint against the mohel. The parents refused to allow Kaplan to release any information that might identifythemselves or the ritual circumcisor, the hospital spokesman said.

“In all my years as an urologist, I never encountered such a deep cut causing such extensive blood loss,” said Guy. The babyunderwent immediate surgery to stop the blood and later microsurgery to reattach the penis on Thursday. Skin wasremoved from the groin to replace damaged tissue. The baby is under observation in the pediatric intensive care unit, but

his life is not in danger.The mother said she opened the baby’s diaper and found a lot of blood.

“We called the mohel, who came and put pressure on the area,” s he said. “He accompanied us to the hospital.”

http://www.jpost.com/Israel/Article.aspx?id=179486


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The doctors said the foreskin had not been removed in the failed circumcision, but the cut was made on the borderbetween the penis, the scrotum and the abdomen. In addition, a large artery at the top of the penis was harmed in a waythat endangered his life.

[This suggests that the mohel was utterly incompetent ‐ yet the parents leave him free to strike again.]

The surgeons added that after a circumcision, parents must open the diaper and make sure the baby is not bleeding. If there is bleeding and the baby is not quiet, don’t hesitate to take him to a hospital emergency room, they said.

“Any bleeding in babies can put them quickly into shock and even endanger life,” one of the surgeons said.

The Times (Swaziland)June 24, 2010

PM wants all MPs to circumcise

By SIBONGILE SUKATI

LOBAMBA — Prime Minister Sibusiso Barnabas Dlamini yesterday said a roll call to check al l male parliamentarians if theywere circumcised should be conducted.

Dlamini preached to the Members of Parliament about the importance of getting circumcised and said all the legislatorsshould play their part in ensuring that the halved new infection rate for HIV/AIDS is achieved by 2015.

Swaziland

HIV Rates:Circumcised men 21.8%

Intact men 19.5%

Source: www.measuredhs.com

The PM was responding to a motion which was moved by Mafutseni MP Joseph Madonsela who said the PM should comeup with an action plan which parliamentarians can use i n the fight against HIV/AIDS.

The PM said there was a lot that the MPs had to learn and advised them that for starters they should be faithful to theirrespective partners.

Ensure

The PM told female MPs to also ensure that their partners were circumcised as they had access to tell whether their

http://www.measuredhs.com/countries/http://www.times.co.sz/index.php?news=17829


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partners were circumcised or not. He further said f emale MPs should ensure that every boy child in the family i ncludingnewly born babies were circumcised. He said the MPs had a big role to play in the fight against HIV/AIDS and said soon hewould ensure with the help of the National Emergency Response Council on HIV/AIDS (NERCHA) that he would bringforward to Parliament the action plan.

[There is no evidence whatsoever that circumcising babies offers any protection against HIV at all.]

The PM revealed that the American government had given the country E200 million [= USD 26,400,000] for thecircumcision campaign and said they had indicated that should more money be needed they were willing to provide it. Hesaid MPs should also be able to teach their constituents on the importance of taking anti‐ retrovirals (ARVs) and thePrevention of Mother to Child Transmission (PMTCT).

He said the circumcision campaign should also be preached in churches.

TimesLive (South Africa)June 24, 2010

East Cape circumcision death toll at 33

Yet another would‐be initiate has died at an ill egal circumcision school in the Eastern Cape, the province's healthdepartment said on Thursday.

The death brings the toll for this winter's circumcision season to 33.Department spokesman Sizwe Kupelo said on Thursday morning he was on his way to the village of Moyeni near Libode,where a youth had died only hours earlier.

"What is upsetting is that last week, we went there and the villagers hid these boys away. Now they are calling us when thisboy is dead," he said.

"It's very upsetting and unnecessary, because we could have saved this boy."

...

IOL News (South Africa)

June 24, 2010

Nightmare drags on for circumcision victims

http://www.iol.co.za/index.php?from=rss_South%20Africa&set_id=1&click_id=13%20&art_id=nw20100623222447385C802856http://www.timeslive.co.za/local/article517347.ece/East-Cape-circumcision-death-toll-at-33


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The winter circumcision death toll in the Eastern Cape has reached 32, the provincial health department said onWednesday.

News of the deaths came as traditional leaders sought to extend a moratorium on circumcision to the whole of Pondoland.

Department spokesperson Sizwe Kupelo said two would‐be initiates died on Thursday, one at Machibi village near Port StJohns, and the other in the Lusikisiki area.

...

At St Barnabas Hospital in Libode, one of the rescued youths had been urinating when his gangrenous penis dropped off ,Kupelo said.

At Nelson Mandela Academic Hospital in Mthatha, doctors had performed more than a dozen partial penis amputationssince the weekend, to remove gangrenous tissue.

Doctors at St Elizabeth's in Lusikisiki had performed two full amputations this week.

...

Kupelo said other departments needed to get involved, because it was not just a health issue.

WoodTVJune 22, 2010

Did circumciser have more victims?

Kent County detective says yes

By Marc Thompson

SPARTA, Mich. (WOOD) ‐ The Sparta man who posed as a doctor and performed an adult circumcision illegally in his homemay have more victims, one investigator believes.

On June 9, Thomas Heugel was sentenced to five years probation after pleading guilty in April to one count of unauthorized practice of a health profession; a felony that could have carri ed a four‐year prison sentence.

The investigator in that case ‐‐ Detective Ed Kolakowski, of the Kent County Sheriff's Department ‐‐ always suspectedthere were more victims, he said Tuesday.

24 Hour News 8 obtained a copy of a police report from 1999 where a young man accused Heugel of criminal sexualconduct.

Sheriff's investigators wanted to add those charges to this most recent case, but the statute of limitations had r un out.

http://www.woodtv.com/dpp/news/local/kent_county/Did-circumciser-have-more-victims


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Cases such as these are important, investigators said, because they show a pattern of indecent behavior.

In 1999, Heugel was a supervisor for a work detail program. Young offenders would be assigned to his care to complete jobs in the community, instead of serving jail time.

In a police report, one of the offenders accused Heugel of touching him inappropriately. He says Heugel invited him back tohis house and offered him a massage.

Heugel made comments about his pubic hair, grabbed his penis and said he had a good circumcision that wasn't cut backtoo far, the man alleged. The case was classified as fourth‐degree criminal sexual c onduct.

"It appears there were no charges filed in that complaint," Kolakowski said.

He came across the 1999 report and wanted to add it to his case, but was told because the CSC was f ourth‐degree and notfirst, the statute of limitations had expired.

Kolakowski was looking for ‐‐ and stil l believes ‐‐ Heugel has other victims.

...

Earlier story.

AllAfica.comJune 22, 2010

South Africa: Controversial Plastic Clamp Used to Circumcise Men

Kerry Cullinan

KwaZulu‐Natal's health department is using a plastic device in its mass male circumcision drive that speeds up theprocedure but has significant side‐effects in adult men.

Doctors who spoke anonymously to Health‐e, expressed concern about the department's use of the Tara Klamp (TK), adisposable device designed to stay on the penis for around seven days until it falls off with the foreskin.

A small trial of young men in Orange Farm found that those circumcised with the Malaysian‐developed TK were far morelikely to report bleeding and swelling than those circumcised with forceps.

The trial involved 69 men, 35 of whom were cir cumcised with the TK and 34 with forceps, and was published in the SAMedical Journal in March 2009.

Almost 40 percent of those circumcised with the TK reported "adverse effects" including infection, delayed wound healing,swelling and problems with penis appearance while only three percent of those circumcised with forceps reported anyproblems.

http://allafrica.com/stories/201006220477.htmlhttp://-/?-


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This prompted lead researcher Dr Emmanual Lagarde and colleagues to conclude: "Given the high rate of adverse events inthis study and the low number of available studies, we strongly caution against the use of the TK for young adults, and werecommend careful evaluation of the procedure when performed on children."

[Why do children get less protection than adults? ]

The World Health Organisation (WHO) has advised caution when using any devices to circumcise men.

"Currently, WHO does not recommend any devices for circumcision among adult or young men," according to theorganisation's circumcision guidelines.

"WHO encourages further research on promising devices to assess their safety, effectiveness and acceptability. The

surgical approaches used in the randomized controlled trials (the forceps‐guided and sleeve resection methods) have beenshown to be safe, effective and acceptable."

After a significant delay in responding to queries, during which time the province's first "circumcision weekend" was held,departmental spokesperson Chris Maxon said that while the WHO "provides guidance to member countries", countries"may use their discretion to utilise methods that might not be a pproved by the WHO but are beneficial to theircommunities".

"It is not the fact that WHO does not approve the Tara clamp but the fact i s they do not have enough data on the use of thedevice at a mass scale, which is what KZN will provide at a later stage," said Maxon

"The use of the Tara clamp in KZN will be used under strict protocols which will include training and supervision by thesurgeon that has been identified by the province."

However, Dr Francois Venter, head of the SA HIV Clinicians Society said: "Good local and published data suggests that theTara Klamp is more dangerous than WHO recommended methods. We have precious few HIV prevention interventionsavailable to us. I do not understand why KZN would be using this device, when we have safer alternatives, especially whereunsafe circumcision has been roundly condemned by the national Department of Health."

Currently, the device is being sold wholesale for R99 and Health‐e was unable to confirm rumours that the Malaysiancompany planned to open a manufacturing plant i n the province.

The province has embarked on a mass male circumcision drive as circumcised men have a far lower c hance of getting HIVthan uncircumcised men.

Times Live (South Africa)

June 21, 2010

Pondoland circumcision death toll rises

http://www.timeslive.co.za/local/article513331.ece/Pondoland-circumcisionhttp://www.circumstitions.com/HIV.html


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Twenty‐eight initiates have died in circumcision schools in the Pondoland area since June 5, the Eastern Cape healthdepartment says.

"We've lost six more boys in eNgcobo, Libode, Qumbu and Tsolo over the weekend," department spokesman Sizwe Kupelotold Sapa.

Two died when their initiation school in eNgcobo caught fire on Friday, while the four died in botched circumcisions.

The department suspended the winter circumcision season following a meeting with chiefs, traditional healers, surgeonsand residents in the Pondoland area.

"In other areas initiations have been running smoothly without incidents. The reason for this crisis here is that boys who

were circumcised last year are now running these initiation schools."In the region there were 77 legal initiation schools, but "fly‐by‐night" ones were responsible for the deaths.

Since the beginning of June, 14 boys have had their genitals mutilated and hundreds were recovering in hospitals.

Hospitals in the area, Kupelo said, were under pressure to deal with the sharp rise in botched circumcisions.

Oh, suspend them altogether!

news24 (South Africa)June 18, 2010

22 die, circumcisions suspended

East London ‐ Traditional circumcisions were suspended in the Pondoland area on Friday after the death toll followingbotched circumcisions rose to 22, the Eastern Cape health department said.

The decision to suspend the circumcisions for this season was taken at a meeting between health MEC Phumulo Masuale,traditional healers, surgeons and community members in the Lusikisiki area.

"Those who attended the meeting were in agreement... this will allow us to intervene and to deal with those boys who arealready in the mountain," said department spokesperson Sizwe Kupelo.

Teams comprising doctors, police officers, traditional healers and surgeons would be dispatched to various posts to assessthe boys.

Hospitals in the area were under pressure to deal with the sharp rise in botched circumcisions. This contributed to the

decision to put a hold on the procedure.

Circumcision courts

http://www.news24.com/SouthAfrica/News/22-die-circumcisions-suspended-20100618


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...

Kupelo said the department was seeking meetings with the police, justice department and the National ProsecutingAuthority to discuss the possibility of setting up special circumcision courts

BernamaJune 9, 2010

72 Per Cent Of Aids/HIV Sufferers In Malaysia Are Muslims ‐ AIDS Council

KUALA TERENGGANU, June 9 (Bernama) ‐‐ More than 70 per cent of the 87,710 HIV/AIDS sufferers in the country areMuslims, Malaysian AIDS Council vice‐president Datuk Zaman Khan said on Wednesday.

[ 60.4% of the population of Malaysia is Muslim, the remainder Buddhist, Christian, Hindu, and Chinese religions. Virtually all Muslim men are circumcised, virtually none of the others are.]

Therefore, he said, the celebration for this year's World AIDS Day would emphasise efforts to enhance the participation of and awareness on AIDS among Muslims.

He said what was more worrying a report by the United Nations General Assembly Special Session (UNGASS)on AIDSwhich stated that nine Malaysians were infected with the disease everyday.

Also of concern was the spread of the disease among women, from 9.5 per cent in 2000 to 20 per cent last year, he said

when speaking at a function to commemorate World AIDS Day here Tuesday night.He said that in 2000 the main cause of women being infected with HIV/AIDS was drug addiction, but lately, it had beenattributed to heterosexual sex (30 per cent).

This happened because of lack of concern and cooperation from the society to protect women from the disease, he added.

...

BBC NewsJune 18, 2010

Circumcisions kill 20 boys in South Africa

Twenty South African boys have died following botched circumcisions in the Eastern Cape Province.

http://news.bbc.co.uk/1/hi/world/africa/10350471.stmhttp://en.wikipedia.org/wiki/Malaysia#Religionhttp://webcache.googleusercontent.com/search?q=cache:Mc_sUtmcxnIJ:www.bernama.com/bernama/v5/newsgeneral.php%3Fid%3D504593+72+Per+Cent+Of+Aids/HIV+Sufferers+In+Malaysia+Are+Muslims+-+AIDS+Council&cd=2&hl=en&ct=clnk&gl=nz3


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"The deaths occurred over the past 12 days, with nine of them occurring over the past 24 hours," said a provincial healthspokesperson.

Some 60 boys have been rescued from 11 initiation schools which have since been closed.

Circumcision is seen as a r ite of passage into manhood in some South African communities.

The practice is common among the Xhosa and Ndebele communities.

However, Zulu King Goodwill Zwelithini wants it reintroduced among the Zulu people because of reports that medicalcircumcision can reduce the chances of getting HIV.

The rescued boys have been taken to the Nelson Mandela Academic Hospital in Mthatha.

"All 60 of them have septic wounds and are dehydrated," said Eastern Cape health spokesperson Sizwe Kupelo, reportsSapa news agency.

"Four of the boys even need their genitals removed completely, as it could result i n death if it's not. We ar e just waiting forconsent from their parents to perform the procedures."

...

The Stranger (Seattle)June 16, 2010

Female Genital Mutilation at Cornell University

Posted by Dan Savage

While the whole world was debating the American Academy of Pediatrics' position on "female genital cutting" ‐ the AAPwas against it before they were for i t, and now, after an outcry, they're against it again ‐ Alice Dreger and Ellen Feder havebeen raising the alarm about "medical research" currently being conducted at Cornell University. A pediatric urologist atCornell‐Dix Poppas‐has been operating on little girls with what he judges to be oversized clitorises, cutting away importantclitoral tissues, and then stitching the glans to what remains of the shaft. Poppas claims that, unlike past clitoral‐reductionprocedures, his procedure is "nerve sparing." ...

To the study

[The article has provoked widespread outrage, some of it based on the misapprehension that the insturment Poppas used to

measure clitoral sensitivity (a "biothesiometer") was a sexual vibrator ("massager"). All comparisons with male circumcisionhave been predictibly pooh‐poohed, though both operations are to make the child's genitals conform to parental expectationsof what is "normal" for their sex. Since these children had "ambiguous genitalia" some might grow up to identify as male and

http://www.thestranger.com/images/blogimages/2010/06/16/1276740688-yang_felsen_poppas_2007.pdfhttp://slog.thestranger.com/slog/archives/2010/06/16/female-genital-mutilation-at-cornell-university


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consider what was done to be unwanted penile reduction surgery, very much akin to circumcision.]

Recipe for an HIV tsunami

The Observer (Swaziland)June 17, 2010

Circumcised can still donate blood‐SNBTS

By Calsile MasilelaTHE Swaziland National Blood Transfusion Service (SNBTS), the only service under the ministry of health r esponsible forthe supply of blood and blood products, says circumcised individuals are among the target groups to make potential blooddonors in the era of HIV and AIDS.

This group is listed among the safe targets for people who can be considered to donate blood for use in hospitaltransfusion.

“We consider anyone who has taken the decision to circumcise as a person who has taken a stand to live a healthy lifestyle.“Living a healthy lifestyle is one of the selection cri teria for people who may be considered for blood donation,” says theHead of Clinical Laboratories and Blood Transfusion, Dr. Hosea Sukati.

[This is madness. There is ample evidence that some men choose to be circumcised so that they can give up using condoms.]

He said, “Apart from the decision to circumcise, we know that these individuals already know their HIV status, therefore,they are considered to be among the safe group for blood donation.”

Swaziland

HIV Rates:Circumcised men 21.8%

Intact men 19.5%

Source: www.measuredhs.com

He, however, indicated that they may be compelled to defer a potential blood donor for a certain period only if they haveperformed their circumcision outside of a credited health institution.

The SNBTS Donor Recruiter Khaya Mavuso encouraged circumcised blood donors to continue to share their ‘gift of life’. Hestated that they were currently visiting in‐school youth to request for blood donations.

http://www.measuredhs.com/countries/http://www.observer.org.sz/index.php?news=14149


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...

“As a blood bank, we do not provide HIV testing to the public.

[But do they test donations? According to this study, many developing countries don't .]

...

He further explained that World Blood Donor Day also provided an opportunity to celebrate those who have voluntarilydonated their blood.

...

Times Live (South Africa)June 17, 2010

EC circumcision: 13 dead in 12 days

Two more initiates have died in the Eastern Cape, bringing to 13 the number of circumcision‐related deaths in the past 12days, the provincial health department says.

A 16‐year‐old youth from Nxukhwebe village in Libode died on Wednesday night, spokesman Sizwe Kupelo told Sapa.

Officials from the department were raiding illegal initiation schools in the Port St Johns area on Wednesday when theylearnt of another death of an initiate that happened on Sunday night.

The teenager from Port St Johns' KwaQubuswayo village died on his way to hospital after his father arranged for him toget treatment.

"His is a sad c ase because he went for initiation without his parents' permission and because his father was not circumcised,he [the father] was not allowed into the initiation school.

"He had to depend on reports from traditional nurses about his son's health and it was too late when they told him of hiscondition," said Kupelo.

The teenager died on his way to hospital. A postmortem to determine the actual cause of his death was expected soon.

Meanwhile, Health MEC Phumulo Masuale was on Thursday visiting the Nelson Mandela Academic Hospital in Mthathawhere a number of boys were facing penile amputation.

He would also visit illegal initiation schools in Mthatha, Libode and Lusikisiki, before meeting traditional leaders in theareas over the deaths.

Seven under‐aged initiates were rescued from an illegal initiation school run by Mtshiyelwa Mtshayina Ndoda, a 55‐year‐

http://www.timeslive.co.za/local/article507006.ece/EC-circumcision--13-dead-in-12-dayshttp://www.aidsreviews.com/files/2001_3_1_24_35.pdf


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old unregistered traditional surgeon who had been arrested several times for the offence.

"He was recently given a three‐year suspended sentence but he continued doing the same thing. In the past five years closeto 20 initiates died in his schools and 15 had their penises amputated."

Ndoda has a pending case of operating an illegal initiation s chool which will be heard on July 22.

Kupelo said the department was also seeking meetings with the police, justice department and the National ProsecutingAuthority to discuss the prosecution of those contravening the Traditional Circumcision Act, which regulates the custom inthe province.

"The major problem is that parents are reluctant to prosecute illegal traditional surgeons who sometimes force their

children into circumcision at a very young age."We identify the perpetrators, but if parents are not willing to open cases against them, they are freed and continueillegally circumcising and killing these boys," Kupelo said.

Last year alone, 91 initiates died and hundreds were hospitalised i n the province.

Dispatch (South Africa)June 17, 2010

35 would‐be initiates rescued in Transkei

EASTERN Cape Health Department officials rescued 35 teenagers from illegal circumcision schools in the Transkei in theearly hours of yesterday morning.

...

Health Department spokesperson Sizwe Kupelo said ... designated medical offic ers accompanied by police invaded thearea yesterday, searching for illegal initiation schools.

He said they decided to visit the area after receiving a tip‐off about illegal initiation schools in the area.

“ We rescued 35 boys in Libode and took them to hospital for treatment,” he said

During the operation, which started at 3am, four illegal initiation schools were closed down.

“We have a number of initiates who are receiving treatment in our hospitals; there are four at St Elizabeth Hospital, four atBambisana Hospital, both in Lusikisiki; five at Mthatha General Hospital, all in a critical condition,” he said.

Kupelo said another 16 initiates were in “a very s erious condition”, 12 were taken to St Barnabas Hospital in Ngqeleni andfour to Nelson Mandela Academic Hospital in Mthatha.”

http://www.dispatch.co.za/article.aspx?id=410631


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...

Nkosi Jongusapho Bokleni of Ngqeleni said the boys were dying because there was no proper running of the rite i n thearea.

“These young boys let unauthorised individuals who are also not familiar with the rite to circumcise them,” he said.

Bokleni said lack of discipline among the young boys was also a major problem.

“Since initiation is not part of our culture, these boys do not listen to us, they say they cannot listen to boys,” he said.

Bokleni said they had run out of ideas on how to deal with the continuous deaths in the area.

“This problem is getting worse each year,” he said.

...

IOL (South Africa)June 16, 2010

Nurses traumatised by circumcision cases

Another youth has died at a circumcision school in Mthatha, bringing to nine the number of initiation‐related deaths in thepast 10 days, the Eastern Cape Health Department said on Tuesday.

"It is a traumatic experience to see a young boy losing his genitals in one day. Our nurses are finding it hard to deal with,"said spokesperson Sizwe Kupelo. The latest death was on Monday.

...

He said that while the cause of death was still unknown, the teenager had been in an initiation school.

The health department was "extremely concerned" about the deaths and the high number of casualties involved.

On Tuesday, Kupelo said 32 youths between the ages of 10 and 16 had been admitted at St Barnabas hospital in Libodeand that four initiation schools had been closed down by the department.

"The hospital cannot admit more of these boys because there's no space in i ts wards," he said.

News24.comJune 14, 2010

http://www.news24.com/SouthAfrica/News/Leaders-meet-over-circumcision-deaths-20100614http://www.iol.co.za/index.php?set_id=1&click_id=13&art_id=nw20100615222255149C989140


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Leaders meet over circumcision deaths

Mthatha ‐ Eastern Cape health MEC Phumulo Masuale will meet traditional leaders in the Mthatha area this week overcircumcision‐related deaths, a spokesperson said on Monday.

Seven youths have died of botched circumcision in the past nine days, said departmental spokesperson Sizwe Kupelo.

The first was a youth from Mandela Park Village, in Mthatha, who died last Saturday.

The second died on Thursday at Godini Village near Libode. Three others died at KwaCele, Marhamzeni and Mkhambathivillages, outside Lusikisiki, on Saturday, while two more from Lusikisiki died on Sunday.

"One of the two initiates who died yesterday (Sunday) was allegedly dumped by a bakkie at his home. The bakkie thensped off," said Kupelo.

He said that while the cause of death was still unknown, the teenager had been in an initiation school.

The health department was "extremely concerned" about the deaths and the high number of casualties involved, with 24initiates in hospital, some of them since March.

91 died last year

"It costs the department over R1 000 a day to treat an initiate. It is c osting us millions of rands," said Kupelo.

The department worked day and night and over weekends, responding to complaints about young boys being circumcised.

"The department is not trying to co‐ordinate the ancient tradition, but instead of waiting for initiates to die, we gotinvolved to save the boys' lives and save the department a lot of money."

"We will continue to help, but call on tr aditional leaders and other custodians of the custom to do more," he said.

Meanwhile, an unregistered traditional surgeon, Mtshiyelwa Mtshayina Ndoda, 55, appeared in the Libode Magistrate'sCourt for illegally circumcising boys in the area.

He has illegally circumcised more than 300 boys, charging them R200 or a live chicken. His case was postponed until July22.

Last year alone, 91 initiates died and hundreds were hospitalised i n the province.

How many deaths will it take till we know that too many people have died?

Dispatch Now 24/7 (South Africa)

June 14, 2010

Initiate dies as circumcision season opens

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An teenage initiate has died at a circumcision school in Mdantsane over the weekend, as the season for young boys’passage to Xhosa manhood started off with schools closing last week, writes Bongani Fuzile.

Captain Leon Fortune said police were called to an initiation sc hool in NU 15 on Saturday after it was reported that aninitiate was getting sick.

“On arrival at his hut, he was already dead. The report is that he became sick and started vomiting,” said Fortune.

Police are investigating circumstances around his death.

...

Jerusalem PostJune 13, 2010

Traditional Israeli brit mila technique ups infection risk

By JUDY SIEGEL‐ITZKOVICH

J'lem doctors say employing different method to stanch bleeding could reduce complications.

The long‐time practice by Israeli ritual circ umcisers (mohelim) of using gauze for as long as 26 hours to stop penile bleedingis responsible for the significantly higher rate of urinary tract infections (UTIs) within a few weeks of the Jewish ritual.

According to pediatricians and infectious diseases experts at Jerusalem’s Shaare Zedek Hospital, by adopting a different,

yet simple medical technique for stanching the bleeding, many UTIs can be prevented.

...

Studies conducted abroad have showed that UTIs were infrequent when a physician performed the circumcision, evenoutside a hospital or clinic, compared to the rate among Israeli males circumcised by a mohel. The difference, the authorssuggested, was in the method used to stop the bleeding.... (called hemostasis in medical jargon), an aspect of brit mila thatis not dictated by Jewish law. ... “The unique phenomenon of the high rate of UTI in male infants in Israel s eems to berelated to the traditional technique of hemostasis. It is time to improve the practice of traditional circumcision.”

After being asked to comment, the Health Ministry told The Jerusalem Post it would seriously consider therecommendations in the journal articles and decide whether to ask the Religious Services Ministry to direct mohalim tochange their hemostasis techniques.

The Shaare Zedek team studied the medical records of 449 newborns up to the age of four weeks who were brought withfever to the hospital’s pediatric emergency room between 1997 and 2006. All underwent urine cultures for UTIs, and the290 with a positive culture had cultures taken of their cerebrospinal fluid. Their parents were asked if the infants had

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recently undergone circumcision and, if so, whether it had been performed by a non‐physician mohel.

After eight days of life, 24.7% of circumcised boys who had fever were found to have UTIs, compared to 8.4% of girls of thesame age. Meningitis was found to be very rare.

Mohalim have already changed some of their methods out of health considerations . For example, they abandoned directsucking by mouth of the bleeding organ [except in New York ] to avoid giving or getting hepatitis B or C, or HIV infections,and instead suck through an hourglass‐shaped glass tube in which cotton wool is inserted to prevent transmission of pathogens in either direction.


Destitute teen circumcised boys

By ZINE GEORGE

A boy has confessed to circumcising at least 35 youngsters after quitting school to perform the ritual i n exchange for cash.

The teen admitted to having used an unsterilised, home‐made scalpel to circumcise youngsters for as little as R25 [$US28.25].

Police arrested the 15‐year‐old, who lives with his unemployed mother at Mchonkco Village near Mthatha, last week.

Health officials were shocked to learn that he had started performing circumcisions at the age of 10 ‐ without any training.About 91 initiates died in the Eastern Cape las t year after botched circumcisions.

A spokesman for the provincial department of health, Sizwe Kupelo, said it was costing over R1000 a day to treat eachinitiate.

The teen, who may not be named because he is a minor, has been summoned by elders to appear before a traditionalcouncil at Ngqeleni. He faces a fine of one cow for illegally performing the ritual.

Tearing up, the boy told the Sunday Times: "I did it because I know I can do it. I used to practise on other boys at schoolwhile doing grade 1. It's simple. When one of my fri ends asked me to do it in 2005, I did it."

The boy, who was initiated himself in 2008, said there had been no "casualties" from his operations.

He started so young because: "I don't have a father. My mother is unemployed. I am the breadwinner at home. That's why I

dropped out of school in grade 2. I had to find a way to make a living.

"I wash my tools with water, and that's it. If I have to deal with more boys later, I just wipe it."

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His 28‐year‐old mother said: "I am a woman, and have nothing to do with initiation. I was not aware that my son was asurgeon. When I asked about the cash he brought home from time to time, he said he was helping other initiates."

Mthatha hospital complex's chief medical superintendent, Dr Mbuyiselo Madiba, condemned the teen "surgeon" andblamed the local community and traditional leaders.

"A traditional nurse must be known to the community and the chief. How can they allow a boy who should be at school todo this? Initiation is not about cutting tissue or foreskin. It's moving from being a boy to being a man, and helping a youngman through this transition. He should have been arrested long ago."

Police said the teen faced a charge of contravening the Circumcision Act.

Hub PagesJune 12, 2010

South Africa And The 2010 World Cup: In The Eye Of The Storm 65

By ixwa

... In some of its breaking news, the Daily News has reported that "More than 800 men have been circumcised in KwaZuluNatal to help combat HIV infections. So far 800 men have been circumcised aT the end of April. The premier said that theprovincial government had set a target of circumcising 47,055 newborn boy and 186,703 males during 2010/11. Strongevidence from clinical trials in Orange Farm in Gauteng, Kenya and Uganda had demonstrated that circumcised males had

close to 60 percent less chance of acquiring HIV during [unprotected ] sexual intercourse than uncircumcised men. InEshowe, according to premier Mkhize, his department and the United States Government's Presidential Emergency Planfor Aids Relief would hold the firs t male circumcision camp, for men between the ages of 14 and 25 years. ... [How many newborns have unprotected sex? ]

WZZMJune 10, 2010

Sparta man who performed illegal circumcision wants an apology

Grand Rapids, MI (WZZM) ‐ A Sparta man sentenced to probation for performing a circ umcision without a medical licensesays the Kent County sheriff owes him an apology.

"The way the investigation was conducted was inappropriate," says 56 year old Thomas Heugel.

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Thomas Heugel admits he performed a circumcision on a 21 year old homeless man with a deformity.

"He begged me, 'Please, please help me'," says Heugel. "I decided that was the only thing that was going to cure it so I did."

Heugel, who says he is trained paramedic, says the patient is completely satisfied with the results.

...

Heugel pled guilty to one count of practicing medicine without a license. Kent County Circuit Court Judge George Buthsentenced him to 5 years probation.

[ Apparently his crime was pretending to be a doctor. Anyone may circumcise anyone.]

"The court is not placing you on any additional jail time," the judge told Heugel. "You have received sufficient punishment

because of the disgrace you have suffered."

During the investigation there were reports Heugel may be operating a circumcision clinic in his home. That he may beassaulting minors.

No supporting evidence from the detective on the case was ever presented in court.

...

Because he pled guilty to the single charge there was no tri al and prosecutors never had an opportunity to present anyevidence against Heugel.

...

Earlier story


Three hospitalised with gangrenous penises

Three Transkei boys have been admitted to Mthatha's Nelson Mandela Academic Hospital with gangrenous penisesfollowing illegal circumcisions, says the Eastern Cape health department.

The health department's spokesman Sizwe Kupelo said the boys, from the Ngqeleni area, would receive specialist care in abid to avoid amputation.

They were part of a group of six originally taken to Libode's St Barnabas Hospital.Kupelo said a 20‐year‐old man was arrested in the Libode ar ea on Wednesday morning after he circumcised six otherunder‐age youths.

H l h d ffi i l W d d f i i h h f ill l i i i

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Health department officials were on Wednesday afternoon preparing to rescue eight youths from an illegal circumcisionschool in the Ngqeleni area following information that they were ill.

Kupelo said it had emerged that a 14‐year‐old arrested last week for performing illegal circumcisions on his age‐mates, wasresponsible for previous botched operations that had already resulted in nine penis amputations.

The youth, who had been released from custody, was being dealt with under the newly‐implemented Child Care Act.

He is scheduled to appear before a traditional council on Thursday.

Gulf Daily NewsJune 9, 2010

Circumcision girl's father wins custody

By RASHA AL QAHTANI

A FATHER at the centre of a row about the circumcision of his five‐year‐old daughter was yesterday awarded custody of the child.

The girl's Bahraini mother, 28, was previously arrested after a six‐day hunt when she went into hiding with the youngster,to avoid having to hand her back to the Emirati following a custody visit.

She was released the following day and filed an official complaint against her ex‐husband, accusing him of performing

illegal circumcision on the child.Sharia Court judges yesterday refused mother's request to impose a travel ban to keep the girl in Bahrain, during a cl osed‐door session but awarded the father custody.

The father's lawyers earlier admitted that the girl had been circumcised, but said it was a tradition practised in the UAE andwas done legally by doctors.

...

The couple married in 2004 and their daughter was born the following year.

They divorced a year later and the father returned to the UAE with the child.

However, the mother then fought for legal custody of her daughter in Bahrain's courts, which granted her full custody in2006.

But the child's father also fi led a case in the UAE, where a court awarded him full custody in 2008, although the motherlater won visitation rights.

Th th l t ti h t d b ttl t th I l i Sh i t

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The mother now plans to continue her custody battle at the Islamic Sharia court.

...

TimeLive (South Africa)June 4, 2010

14yr old arrested for illegal circumcision

A 14‐year‐old boy was arrested in the Ngqeleni area of Transkei after performing illegal circumcisions on six youths, saysthe Eastern Cape health department.

He would be charged under the province's circumcision laws, spokesman Sizwe Kupelo said.

The six boys were the same age as he was.

"This boy, according to police, has been wanted for similar offences for the last three years, meaning he started this thingat ten [years of age]" Kupelo said.

"This really calls for community members, traditionalists, to re‐look at this thing, because it's no longer a customary ritual,it's something else: boys just doing as they wish."

He said the arrest came as the winter circumcision season got under way in the province.

Eleven illegally circumcised boys had been admitted to Libode's St Barnabas Hospital over the past two days.

Several of them had had to have botched circumcisions redone.

Health department officials were late on Friday on their way to Bhukwini village near Libode to rescue a group of boys at anillegal circumcision school who were reportedly sick, Kupelo said.

Every year scores of youths in the province are hospitalised, and a number [ 90 in 2009] die, after botched circumcisions.

The province's circumcision law provides that only boys older than 17 may be circumcised, and then only at recognisedschools.

ReutersJune 4, 2010

Circumcision may prevent sex‐related penis injuries

NEW YORK (Reuters Health) A new study finds that circumcised men appear less likely to sustain cuts abrasions and

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NEW YORK (Reuters Health) ‐ A new study finds that circumcised men appear less likely to sustain cuts, abrasions andother minor injuries to the penis during sex ‐‐ which may help explain why circumcision lowers the risk of HIV transmissionfrom heterosexual sex.

For the new study, researchers used data from an HIV clinical trial in Africa, where nearly 2,800 men between the ages of 18 and 24 were randomly assigned to undergo circumcision or remain uncircumcised. In 2005 and 2006, that trial and twoothers in Uganda, South Africa and Kenya showed that circumcision can reduce a man's risk of HIV infection throughheterosexual sex by up to 60 percent. [They never fail to mention that factoid, do they? ]

In the current study, the researchers found that, over two years, ci rcumcised men were 39 percent less likely than theiruncircumcised counterparts to report any type of penile injuries during sex.

This raises the possibility that lower injury risk is one reason that circumcision lowers the odds of HIV transmission,according to the researchers, led by Dr. Supriya D. Mehta of the University of Illinois at Chicago. [It also raises the possibility that circumcision makes men less likely to report (other) penile injury...]

Exactly why circumcision may protect against HIV during sex is unknown, Mehta and colleagues report in the Journal of Urology. There are a few theories: One is that, by reducing the amount of mucosal tissue exposed during sex, circumcisionlimits the virus' access to the body cells it targets. Another theory is that the thickened skin that forms around thecircumcision scar helps block HIV from gaining entry.

But there is also a possible role for mild penile injuries ‐‐ cuts, scratches and tears in the skin that could serve as a portal of entry for HIV. In some past studies, uncircumcised men have reported higher rates of such injuries than circumcised men.

At the outset of the current trial, 64 percent of the men said they had sustained some form of penile injury during sex in thepast six months ‐‐ most often general soreness, scratches, cuts or abrasions. Seventeen percent said they had bleeding.[Those figures are remarkably high ‐ did they control for dry sex ? ]

Six months into the trial, that rate was on the decline. By year two, 31 percent of circumcised men said they'd had a sex‐related penile injury in the past six months.

Men in the uncircumcised group also reported a reduction in injuries, though it was less significant ‐‐ with 42 percent sayingthey'd sustained a penile injury in the past six months. That decline, according to Mehta's team, is likely due to the generalimprovements both study groups showed in their sexual health practices ‐‐ including greater condom use and fewer sexpartners.

[ And the difference between those two figures is 11 percent. The reduction attributable to just going in the study ‐ theHawthorne effect ‐ is three times the reduction attributable to cir cumcision.]

Men who said they had had multiple sex partners in the past month were more likely to report sex‐related penile injuries

than those who had been monogamous. On the other hand, condom use and the habit of washing the penis within an hourof having sex were both linked to decreased risks of penile soreness and other injuries.

Further studies, Mehta's team writes, should look at the role penile injuries may play in the transmission of HIV or other

sexually transmitted diseases

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sexually transmitted diseases.

[Or perhaps they should look harder for confounding factors ‐ and an explanation for the extraordinarily high rate of penileinjuries in this sample.]

SOURCE: here%2810%2902988‐5/abs tract Journal of Urology, online May 17, 2010.

The study is

J Urol. 2010 May 16.

Circumcision and Reduced Risk of Self‐Reported Penile Coital Injuries: ResultsFrom a Randomized Controlled Trial in Kisumu, Kenya.

Mehta SD, Krieger JN, Agot K, Moses S , Ndinya‐Achola JO, Parker C, Bailey RC .

Abstract

PURPOSE: Injuries to the penis during intercourse represent a hypothesizedmechanism by which uncircumcised men are at increased risk f or HIV. There are nopublished, systematically collected data regarding mild penile coital trauma to ourknowledge. We identified risks of self‐reported penile coital injuries in men 18 to 24years old in a randomized trial of circumcision to prevent HIV in Kisumu, Kenya.

MATERIALS AND METHODS: Each participant underwent standardized interview,medical history and physical examination at baseline, and 6, 12, 18 and 24 months

after enrollment. Self‐reported penile coital injuries were assessed at each visit, andwere defined as penis feels sore during sex, penis gets scratches, cuts or abrasionsduring sex, and skin of the penis bleeds after sex. Generalized estimating equationanalysis estimated odds ratios for penile coital injuries.

RESULTS: From February 2002 to September 2005, 2,784 participants wererandomized. At baseline 1,775 (64.4%) men reported any coital injury including 1,313(47.6%) soreness, 1,328 (48.2%) scratches, abrasions or cuts and 461 (16.7%)bleeding. On multivariable analysis coital injury risk was lower for circumcised thanfor uncircumcised men with soreness (OR 0.71, 95% CI 0.64‐0.80),scratches/abrasions/cuts (OR 0.52, 95% CI 0.46‐0.59), bleeding (OR 0.62, 95% CI0.51‐0.75) and any coital injury (OR 0.61, 95% CI 0.54‐0.68). Other significant risks

included increasing age, multiple recent sex partners, HSV‐2 seropositivity andgenital ulcers (p


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CONCLUSIONS: Self reported penile coital injuries were common in these healthyyoung men. Circumcised men were at lower risk for c oital injuries. Verifying penilecoital injuries, the mechanism of acquisition and the as sociation with HIV risk isneeded.

KMPH NewsJune 3, 2010

Deliberating Begins in 7‐year‐old Boy Tattooed Case

by: Caryn Kochergen

A jury has begun deliberating the fate of two men accused of tattooing a 7–year–old boy.

Both sides of the case made closing arguments Wednesday.

The boy testified that his father, Enrique Gonzalez held him down, while co–defendant Travis Gorman put a bulldog tattooon his hip.

The defense said the boy had been coached and was not a r eliable witness.

"John Doe has never changed from what he stated from the very beginning of this case, from day one. That his father held

him down and he was forcibly given the tattoo by Travis Gorman," said prosecuting attorney, William LacyThe defense says the jury has to find Gonzalez and Gorman not guilty if they are not willing to convict a parent for piercingtheir kids' ear or getting them circumcised. [Indeed, because a tattoo is less of a modification than circumcision]

If the two are convicted of aggravated mayhem, they face life in prison.

Earlier story

Zim DailyMay 29, 2010

Politics disturbing Circumcision program in Zimbabwe

ZIMBABWE – HARARE – Donors are shunning to fund the national circ umcision program with the government suspending

the national roll out of the program to August when it hopes things would have changed politically, a senior official

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the national roll out of the program to August when it hopes things would have changed politically, a senior officialinvolved in the circumcision pilot program has revealed.

“We were supposed to have rolled out the program nationally some few weeks ago after successful first pilot project, butwe had to postpone it because of financial constrains.

Initially the donors had promised to fund the program but they have since said the Global Political Agreement should firstbe implemented before they release their funds and we are very much worried by this development,” said the source whodeclined to be named.

Officials in the Ministry of Health and HIV & AIDS researchers said 6000 males have been circumcised in the pilot projectwhich was carried out in six months.

Specialist Urologist and UZ college of Health Education Institute of Continuing Health Education Director Mr ChristopherSamkange said circumcision has proved to be applicable in Zimbabwe.

“We have carried out a practical model that has proved that male circumcision has the impact that we are aiming to, thatto reduce HIV prevalence from double digits to single digit, and for us [t]o achieve that we must ci rcumcise 80% of themale population in the country. [NB. They have not actually studied the effect of circumcision on HIV transmission ‐ if any ‐themselves.]

“We carried out a feasibility study that showed us that the circumcision operations can be done and we set up five centersin the country which we have used as a model to how best it can be done and it is in these five centers in the pilot phasethat have produced the 6000 males that have so far been circumcised. [6000 in 6 months in 5 centres is 1.2 men per workinghour per centre ‐ the staff weren't exactly run off their feet.]

“We have now learnt on how best we can done the operations and now rolling out a national circumcision programe,”saidMr Samkange.

The country’s HIV prevalence is currently at 13.7% and HIV & AIDS specialists say circumcision in societies which practicevaginal sex reduces the prevalence to a single digit.

Zimbabwe 2005‐6

HIV Rates:Circumcised men 20%

Intact men 19%

Source: Gisselquist table 7.4

LATimes

May 29, 2010

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y 9,

Female genital cutting: not even a 'nick'

The American Academy of Pediatricians backs away from an il l‐conceived move to relax its rules on the practice.

Late last month, 330 villages in Senegal held a c eremony to announce that they would end the practice of female genitalcutting. That brought the number of Senegalese communities to abandon the practice to 4,229, and when the numberreaches 5,000, complete eradication will be achieved. Similar pronunciations and celebrations are occurring in othercountries — in Gambia and Somalia, and in Mauritania, where on Tuesday 78 villages participated.

The growing movement to end the ancient practice of slicing off part or al l of a girl's clitoris and/or labia — historical ly doneto prepare her for adulthood and marriage — is the result of years of work by local and international activists. Particularlynoteworthy has been the success of the nonprofit Tostan, which means "breakthrough" in Wolof. The organization spendsalmost three years teaching villagers about health and human rights. Thus, when a c ommunity opts to end genital cutting,it is generally because of a recognition that cutting not only endangers girls' physical well‐being but runs counter to theuniversal right to stewardship of one's body. And that understanding leads to other changes: As villagers learn about thehealth effects of childbearing, girls are less likely to be married off as children and more likely to go to school. And aswomen become better educated, they are more likely to participate in the economy and open businesses.

Into this delicate international effort, the American Academy of Pediatricians blundered with all the finesse of a waterbuffalo, suggesting last month that the ban on genital cutting in the United States be relaxed so that physicians couldaccommodate immigrant parents and "nick" the clitoris of young girls. A symbolic procedure performed stateside, theacademy maintained, might spare a girl a brutal experience outside the country.

The outcry against such a misguided proposal was immediate. That doctors wanted to save girls from greater harm wascommendable, but this policy was potentially disastrous. First, when "minor" cutting has been embraced in Afri ca, it hasoften provided a cover for more severe cutting. Second, the purpose of genital cutting is to diminish or destroy femalesexual desire; it is the first step toward a girl's subjugation to family honor, to a father's authority and a husband's mastery.Even a symbolic nick is a violation of a girl's human rights. And lastly, fine distinctions about "nicking" could easily havebeen lost in translation; the new message to the Middle East and Africa would have been that American doctors will cutgirls.

Thursday, the academy retracted the proposal and reaffirmed its opposition to all forms of female genital cutting. Wecommend it for heeding the pleas of activists in the field and women who have survived being cut. Pediatricians have animportant role to play as well, but it is to explain to parents why cutting is forbidden here — detailing the health problems itcreates for girls and emphasizing the legal consequences parents face by having it done to their daughters.

Sydney Morning Herald

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y y gMay 28, 2010

Doctors don't support 'ritual nicking'

The college for Australia's obstetricians and gynaecologists says it does not support the "ritual nicking" of young Muslimgirls and anyone suspected of performing such genital mutilation should be reported to authorities.

Dr Ted Weaver, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists(RANZCOG), said media reports suggesting the college would review its policy were the result of a misquote.

He said the issue was likely to be discussed at a meeting next month, triggered by recent announcements made by theAmerican Academy of Pediatrics, but a policy shift was not on the agenda.

"The college does not support ‐ does not ‐ support female genital mutilation, full‐stop," Dr Weaver told AAP on Friday.

"This ritual nicking, as it has been called, has been put forward as a way of satisfying cultural sensitivities without making alot of difference to a woman's genitalia but we do not support that either."

The US paediatrics body released a new policy last month, and retracted it this week, which raised the idea of doctorsbeing able to prick or nick a girl's clitoral skin in order to satisfy cultural requirements in some Muslim communities.

The procedure ‐ not dissimilar to an ear‐piercing ‐ was proposed as a safer alternative to ceremonial cutting done withoutmedical supervision and which could result in broader damage and, potentially, a loss of sexual sensitivity.

"That's a decision for the Americans. Our view at the moment is that we are opposed to it," Dr Weaver said.

He said he was not aware of any doctors in Australia that were performing ritual nicking, though anyone who wassuspected of doing so should be reported to authorities.

"Child protection legislation is about stopping these sorts of things happening ... all of the states have legislated in this wayso it is illegal in Australia," Dr Weaver said.

"At this stage, the college has no intention of changing its position on female genital mutilation."

RANZCOG secretary Gino Pecoraro is reported in News Ltd newspapers as saying the practise would be discussed at nextmonth's Women's Health Committee meeting.

Reuters Life!May 27, 2010

Dutch doctors' group calls for circumcision ban

AMSTERDAM ‐ The Royal Dutch Medical Association on Thursday suggested a possible ban on elective circumcisions for

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young boys, saying they were medically unnecessary and violated children's rights.

The 161‐year‐old organization, which represents more than 46,000 doctors and students, called the procedure "a violationof the integrity of the body."

The group, known by its Dutch initials KNMG, proposed a dialogue between doctors and religious groups on the issue.

Most non‐therapeutic circumcisions in the Netherlands are performed on religious grounds. In the capital of Amsterdam,parents seeking circumcisions for elective reasons are often referred to a small clinic in a heavily Muslim neighborhood.

"KNMG sees good reasons for a legal ban on non‐therapeutic circumcisions, but fears that this will lead to the operationgoing underground," it said in a statement.

In a column on the KNMG's website, chairman Arie Nieuwenhuijzen Kruseman said some 80 percent of the group'smembers agreed circumcision should be discouraged.

According to a 2007 World Health Organization report, some 30 percent of men worldwide are circumcised.

(Reporting by Ben Berkowitz, editing by Paul Casciato)

KNMG homepage (Dutch) (English translation)

Conclusion

There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene. Partly in the light of the complications which can arise during orafter circumcision, circumcision is not justifiable except on medical/therapeutic grounds.Insofar as there are medical benefits, such a s a possibly reduced risk of HIV infection, it isreasonable to put off circumcision until the age at which such a risk i s relevant and theboy himself can decide about the intervention, or can opt for any available alternatives.Contrary to what is often thought, circumcision entails the risk of medical andpsychological complications. The most common complications are bleeding, infections,meatus stenosis (narrowing of the urethra) and panic attacks. Partial or complete penisamputations as a result of complications following circumcisions have also been reported,as have psychological problems as a result of the circumcision.Non‐therapeutic circumcision of male minors is contrary to the rule that minors may onlybe exposed to medical treatments if illness or abnormalities are present, or if it can beconvincingly demonstrated that the medical intervention is in the interest of the child, as

in the case of vaccinations.Non‐therapeutic circumcision of male minors conflicts with the child's right to autonomyand physical integrity.

The KNMG calls on (referring) doctors to explicitly inform parents/carers who are

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considering non‐therapeutic circumcision for male minors of the risk of complications andthe lack of convincing medical benefits. The fact that this is a medically non‐essentialintervention with a real risk of complications makes the qual ity of this advice particularlyimportant. The doctor must then record the informed consent in the medical file.The KNMG respects the deep religious, symbolic and cultural feelings that surround thepractice of nontherapeutic circumcision. The KNMG calls for a dialogue between doctors'organisations, experts and the religious groups concerned in order to put the issue of non‐therapeutic circumcision of male minors on the agenda and ultimately restrict it as muchas possible.

There are good reasons for a legal prohibition of non‐therapeutic circumcision of maleminors, as exists for female genital mutilation. However, the KNMG fears that a legalprohibition would result in the intervention being performed by non‐medically qualifiedindividuals in circumstances in which the quality of the intervention could not besufficiently guaranteed. This could lead to more serious complications than is currentlythe case.

This viewpoint by the KNMG is jointly endorsed by the following scientific associations:

The Netherlands Society of General PractitionersThe Netherlands Society of Youth Healthcare PhysiciansThe Netherlands Association of Paediatric Surgeons

The Netherlands Association of Plastic SurgeonsThe Netherlands Association for Paediatric MedicineThe Netherlands Urology AssociationThe Netherlands Surgeons’ Association

To a pdf of the full policy in English To a pdf of the media release in English Reactions in the British Medical Journal

AAP

May 27, 2010

American Academy of Pediatrics Withdraws Policy Statement on Female Genital Cutting

CHICAGO: The American Academy of Pediatrics (AAP) has retired its 2010 policy statement on female genital cutting(FGC) Th AAP B d f Di h d h f ll i AAP li FGC

http://www.aap.org/advocacy/releases/fgc-may27-2010.htmhttp://www.bmj.com/content/340/bmj.c2987.short/replyhttp://www.circumstitions.com/Docs/KNMG-pr.pdfhttp://www.circumstitions.com/Docs/KNMG-policy.pdf


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(FGC). The AAP Board of Directors has approved the following as AAP policy on FGC:

"The AAP reaffirms its strong opposition to FGC and counsels its members not to perform such procedures. As typicallypracticed, FGC can be life‐threatening. Little girls who escape death are still vulnerable to sterility, infection, andpsychological trauma.

"The AAP does not endorse the practice of offering a 'clitoral nick.' This minimal pinprick is forbidden under federal law andthe AAP does not recommend it to its members.

"The AAP is steadfast in its goal of protecting all young girls from the harms of FGC."

AAP President Judith S. Palfrey, MD, FAAP, said, "Our intention is not to endorse any form of female genital cutting or

mutilation. We retracted the policy because it is important that the world health community understands the AAP is totallyopposed to all forms of female genital cutting, both here in the U.S. and anywhere else in the world.

"The AAP's goal is to protect the health and well‐being of all children," Dr. Palfrey said. "One good thing to emerge is thatthis discussion has shone a bright light on this issue and raised the world's awareness about this harm to young women."

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medicalsubspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children,adolescents and young adults.

The AAP's media release

AAPJune 1, 2010

Academy clarifies position denouncing all forms of female genital cutting

By Alison Sulaski Wyckoff Associate Editor, Pediatrics

Reaffirming its strong opposition to female genital cutting (FGC), the AAP Board of Directorsretired a recent policy statement on FGC and replaced it with another statement clearlydenouncing the practice.

The original version, Ritual Genital Cutting of Female Minors, from the AAP Committee onBioethics, was published in May Pediatrics and featured i n AAP News(http://aapnews.aappublications.org/cgi/content/full/31/5/31). Updated from a 1998 version, thestatement detailed the health risks of FGC, provided historical perspective and urged members

to counsel families not to have such procedures performed.

However, confusion ensued when a few sentences were mistakenly interpreted as endorsing a

milder version of FGC for some immigrant girls who could be returned to their home countriesf f f th ti

http://aapnews.aappublications.org/cgi/content/full/31/5/31http://aapnews.aappublications.org/


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for more severe forms of the practice.

Here are the few sentences that were "mistakenly interpreted":

Most forms of FGC are decidedly harmful, and pediatricians should declineto perform them, even in the absence of any legal constraints. However,the ritual nick suggested by some pediatricians is not physically harmfuland is much less extensive than routine newborn male genital cutting.There is reason to believe that offering such a compromise may build trust

between hospitals and immigrant communities, save some girls fromundergoing disfiguring and lifethreatening procedures in their nativecountries, and play a role in the eventual eradication of FGC. It might bemore effective if federal and state laws enabled pediatricians to reach outto families by offering a ritual nick as a possible compromise to avoidgreater harm

There was also the deletion of this passage from the 1999 policy:

The American Academy of Pediatricians ...

4. Recommends that its members decline to perform any medicallyunnecessary procedure that alters the genitalia of female infants, girls, andadolescents.

The controversy ignited wide discussion via telephone calls, letters and blog posts from all overthe map.

On May 27, after hearing from members and others, the AAP Board of Directors and leadersresponded by retiring the statement and replacing it with the following:

The American Academy of Pediatrics (AAP) reaffirms its strong opposition to female genitalcutting (FGC) and counsels its members not to perform such procedures. As typically practiced,FGC can be life‐threatening. Little girls who escape death are still vulnerable to sterility,infection and psychological trauma.

The AAP does not endorse the practice of offering a "clitoral nick." This minimal pinprick isforbidden under federal law and the AAP does not recommend it to its members.

The AAP is steadfast in its goal of protecting all young girls from the harms of FGC.

AAP President Judith S. Palfrey, M.D., FAAP, emphasized that the Academy's goal is to protectthe health and well being of all children


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the health and well‐being of all children.

"The May 2010 statement aired some important controversies in the field about how to endthese practices worldwide," said Dr. Palfrey. "Unfortunately, the discussion about thecontroversial 'ritual nick' led to confusion and misinterpretation of our policy."

She said the Academy published the clarification to reaffirm that the Academy is "opposed to allforms of female genital cutting including the ritual nick," whether it is in the U.S. or elsewhere inthe world.

The practice of FGC is widespread, with 4 to 5 million girls being subjected each year to

dangerous procedures, according to Dr. Palfrey. She said the discussion has increased worldwideawareness about this issue.

Earlier story

May 26, 2010

Doctors allowed to forcibly operate on woman with phobia of hospitals

Court rules 55‐year‐old woman with learning difficulties can be coercively sedated in order to have life‐saving cancer

surgery

A high court judge today gave doctors permission to forcibly sedate a woman who has a phobia of hospitals at her home,so that she can be taken for ca ncer surgery against her will.

The highly unusual judgement by Sir Nicholas Wall, head of the court's family division, said that if the 55‐year‐old woman,who has a significant learning difficulty, continued to refuse treatment, then an ambulance crew c ould be sent to her hometo give her a mild sedative "mixed with a soft drink such as Ribena". If this proved impossible, a consultant anaesthetistshould be on hand so the woman could be forcibly injected with a faster‐acting drug, ketamine.

The decision was praised by the learning disability charity, Mencap, which said it had never previously heard of a similarcase. David Congdon, head of campaigns, praised the judge for making "a very difficult decision".

Sitting in the court of protection, the judge said that the woman, identified in the ruling only as PS, lacked suffici ent

capacity to make decisions about her own health. The case was brought by an unnamed NHS foundation trust, whosedoctors believe PS will die if she does not have an operation to remove her ovaries and fallopian tubes.

Evidence presented to Wall said PS was diagnosed last year with uterine cancer, which was slow growing but would,without surgery ultimately spread and kill her

http://-/?-


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without surgery, ultimately spread and kill her.

Attempts to look more closely at the tumour using an MRI scan proved impossible as PS has both a phobia of hospitals andneedles and is also claustrophobic, meaning she cannot lie still for a scan. After she r efused to attend hospital severaltimes, "the clinical team treating her has reluctantly come to the conclusion that special arrangements will need to be putin place both to ensure that she has the operation and that she remains in hospital for her post‐operative recovery", the

judgment said. While "every effort" would be made to avoid forcibly sedating PS, this was seen as a necessary back‐upplan, the judge said. After the operation, she will remain drugged to make sure she does not flee. ...

(to the rest ‐ if this link fails, contact us)

[The care taken in reaching this decision and the life‐saving nature of the operation put it into sharp contrast with forcibleunnecessary genital operations on children.]

New York TimesMay 26, 2010

Doctors Reverse Stand on Circumcision

By PAM BELLUCK

The American Academy of Pediatrics has reversed its decision last month regarding the practice of female circumcision by

immigrants from some African, Middle Eastern and Asian cultures. The academy had suggested in a policy statement thatdoctors be given permission to perform a ceremonial pinprick or nick on girls if it would keep their families from sendingthem overseas for the full circumcision. Although the nick on a girl’s clitoris is illegal in the United States, the academy’sbioethics panel had noted it is practiced in some countries. The policy statement ignited a storm of criticism fromopponents of female genital cutting. Dr. Judith S. Palfrey, president of the academy, said: “We’re saying don’t do it. Doeverything that you can to support that family in this tough time, but don’t be pulled into the procedure.”

Earlier story

news reporter (Russia)May 26, 2010

In Tatarstan, the five‐year child died after circumcision

The investigating authorities of Tatarstan started checking into the death of five year old boy after a circumcisionperformed by a visiting physician at the house It is reported by the press office of the Investigation Department UPC RF

http://bmpost.com/9438.htmlhttp://-/?-http://www.nytimes.com/2010/05/27/health/27brfs-DOCTORSREVER_BRF.html?emc=mailto:hugh%7BAT%7Dbuzz.net.nz?Subject=http://www.circumstitions.com/news/news37.html


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performed by a visiting physician at the house. It is reported by the press office of the Investigation Department UPC RFRepublic of Tatarstan.

It was reported that a child who lived in the village Yudin inside Kazan, died the evening of May 22 in an ambulance on theway to hospital. According to the staff of the ambulance, the boy fainted after the removal of the foreskin of the penis –circumcised. The procedure was performed on the house surgeon, clinic number 19 of the Kirov district of Kazan.

According to the UPC, after surgery the child had convulsions and died despite resuscitation performed arrived on‐callphysicians. The preliminary cause of death boy was an all ergic reaction to pain medication.

A similar case was reported in Tatarstan in July 2008. After the traditional Muslim ritual at the Children’s Republican

Hospital, died four years old boy from the vill age of New Salman Alkeevskogo region of Tatarstan. The cause of death of the child has an allergic reaction to medication for anesthesia.

May 23, 2010

25 boys rescued after illegal circumcision

Twenty‐five Eastern Cape initiates have been rescued and taken to hospital after they were illegally circ umcised, theprovincial health department said.

"They were circumcised yesterday [Saturday] and on preliminary examination, it was clear that they needed to see adoctor," said spokesman Sizwe Kupelo.

The boys, aged between 12 and 15, were taken from Nkanga Village in Libode to St Barnabas Hospital on Sundayafternoon.

The traditional surgeon who illegally circumcised the boys, Ndonda Mtshayina, had been arrested several times for theoffence.

He was first given a suspended sentence of three years by an Eastern Cape court but continued with the illegalcircumcisions.

"He spent the whole of 2008 in jail after a second sentence was imposed on him. He was banned from practising but he stillcontinues," said Kupelo.

He said the boys' parents would have to take the matter to the police for him to be ar rested."Sometimes these illegal surgeons get away with murder because parents tend to stop attending court proceedings once

their children are healed.

"This is really a c oncern for us because we spend a lot of government funds on these boys when all this can be avoided "


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This is really a c oncern for us because we spend a lot of government funds on these boys when all this can be avoided.

Kupelo said the department spent about R1000 a day for each boy in hospital, money he said should be used for othermatters.

The department would soon send a delegation to the king of Western Pondoland to discuss Mtshayina.

"He is a problem," said Kupelo.

Sydney Morning Herald

May 22, 2010

Support for female circumcision stirs controversy in US

SIMON MANN

WASHINGTON: The review by a prestigious US medical academy of its policy on female genital cutting has triggered astorm of protest from lobbyists, women's groups and feminist bloggers.

The Academy of American Paediatrics has been accused of sanctioning child abuse and of behaving unethically. Among itscritics are many US medical practitioners.

''Have you all gone nuts?'' one paediatrican demanded of the academy's bio‐ethics committee in a website exchange.

''Just a little female circumcision? There's no reason to do this procedure and to condone any form of it is not acceptable.''Intact America, a non‐profit group that campaigns against all forms of circumcision ‐ male and female ‐ accused theacademy of deliberately softening its stance to avoid a double standard because i t tolerates male circumcision.

''This is gender equity run amok,'' claimed the group's founder, Georganne Chapin.

The offence was not caused by the committee's final recommendations, which endorsed the academy's previousopposition to female genital cutting, last reviewed in 2007.

Rather, the outrage was invoked by the committee admitting in its report the quandary of some paediatricians who arguethat offering a form of ''ritualis tic genital nick'' might help dissuade families from taking their daughters overseas wherethey would be more likely to undergo life‐endangering surgery and mutilation.

The bio‐ethics committee noted the sensitivities surrounding the issue and explicitly said it was not advocating surgery in

the US. Female genital cutting has been outlawed in the US since 1996 and is illegal in many Western countries, includingAustralia.

Coincidentally, two members of Congress last month introduced a bill which would make i t illegal for anyone to take girlsout of the US for the purpose of genital cutting.

http://www.smh.com.au/world/support-for-female-circumcision-stirs-controversy-in-us-20100521-w1uz.html


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p p g g

The committee stressed the need for doctors to counsel parents on the dangers of female cutting, especially in the case of more extreme surgery in which the entire clitoris and some, or all, of the labia minora are removed.

However, it raised the prospect of tokenistic surgery.

''There is reason to believe that offering such a compromise [of a 'nick'] may build tr ust between hospitals and immigrantcommunities, save some girls from undergoing disfiguring and life‐threatening procedures in their native countries, andplay a role in the eventual eradication of [female cutting],'' wrote the committee, which includes three women ethicists.

The chairman of the committee, Dr Doug Diekema, a Seattle paediatrician and bio‐ethicist, told the Herald most

paediatricians in the US would never have faced the dilemma recounted by the committee.But in areas with large numbers of east Africans ‐ in Seattle and Minnesota, for example ‐ it wa

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