Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Experiences of Nurses in Caring for Circumcised Initiates Admitted to Hospital with Complications

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Experiences of Nurses in Caring for Circumcised Initiates Admitted to Hospital with Complications

Article excerpt

INTRODUCTION

South Africa is a country with a diverse racial population with groups of different beliefs and practices. All these cultural groups have a constitutional right to practise and preserve their cultures (Constitution of South Africa, Act 108, 1996). The circumcision of boys in preparation for manhood is a common practice in many African cultural groups. The performance of and participation in this ritual gives the young men a feeling of satisfaction and belonging. Research has shown that circumcision has medical benefi ts as well. A study conducted in Kenya revealed that circumcision can reduce the risk of HIV-1 infection (Agot, Ndinya-Achola, Kreiss, & Weiss, 2004, p. 158). Another study, in Botswana, found that circumcision was becoming increasingly popular in that country. It was also found, based on clinical trials, that circumcision might be an acceptable option as an HIV prevention strategy among sexually active people (Kebaabetswe et al., 2003, p. 214). Circumcision is undoubtedly benefi cial in reducing the risk of HIV infection and other sexually transmitted diseases.

The ritual of circumcision is a highly valued practice, especially among black South African cultural groups. It is believed to potentially develop boys into men. In South Africa, this practice is most common among ethnic groups such as Xhosas, Northern and Southern Sothos, Southern and Northern Ndebeles, Vendas and Tsongas. However, there are variations even between local cultural groups in the way the ritual is conducted. For example, the Southern Ndebele group spends three to four months in seclusion whereas the Northern Sotho group spends only four to six weeks. The ritual is also common among other cultures, including Western cultures, varying again with regards to the processes involved and the signifi cance attached to it.

In South Africa, traditionally, the ritual is performed in the mountains or in the veld, away from the initiates' homes. One of the reasons for this is that circumcision is not only about cutting the foreskin, but also an opportunity to educate the young men about the life skills relating to manhood. The initiates spend up to four weeks in the mountains; they could stay even longer if not yet properly healed. During that period the boys are taught about issues such as respect for one's elders, how to treat women and how to protect and take care of one's family. The lessons are given by the elders and traditional circumcision nurses (Bottom, Mavundla, & Toth, 2009, p. 29). Initiation normally takes place during the winter months in order to reduce the risk of sepsis. Despite this, many circumcision operations develop complications which could lead to lifelong health problems and even death. In July 2002, it was reported that 14 initiates had died in South Africa and that more than 100 initiates had been treated in hospitals, most with septic wounds (The Times of India, 2002). In 2003, 20 youths were reported to have died from botched circumcisions in the Eastern Cape and another 100 had been injured, some as a result of having been severely beaten during the initiation (Dempster, 2006). In 2005, 12 boys died and 100 were hospitalised. Some of the initiates suffered the loss of their sexual organs (Staff Writers, 2006). In 2006, an 18-year-old youth from Makhubeni village in the Eastern Cape was admitted to a hospital in the area after losing part of his penis following an unsuccessful circumcision. At the time, the death toll was reported to be 16 while more than 300 initiates had been admitted to hospital with complications (Zuzile, 2006, p. 4).

BACKGROUND AND PROBLEM STATEMENT

African cultures that practise circumcision dictate that the initiates are not to be touched or even seen by women before the completion of the initiation. The rationale for secluding initiates from women is to promote and facilitate the healing process. The belief is that contact with women may lead to excitement and penile erection which may delay the healing (Mbito & Malia, 2009, p. …

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