Draped in bull intestines, Oscar Wafula prepares for "the cut."
BUNGOMA DISTRICT, KENYA -- Oscar Wafula, 13, is recuperating after undergoing the cultural circumcision rite many boys in his village have begun to avoid.
Born in the Bungoma district of western Kenya, Wafula is the first-born in a family of five. He is one of the lucky initiates who successfully underwent the cultural male circumcision rite this August, a marker of the transition from childhood to adulthood. A member of the Bukusu community, a sub-tribe of the larger Luhya who believe in traditional male circumcision as a marker of manhood, Oscar’s father, Martin Wekesa, says it would have been considered cowardice if his son would have opted for medical circumcision.
The “traditional circumcisers,” who practice the rite with homemade knives and no anesthetic, are considered to have special powers handed down from generation to generation, but have no medical training. In Kenya’s western districts, some suggest that as many as 40 percent of the young men who opt for cultural circumcision end up in the hospital with a host of complications, including the loss of the entire penis. But with little corroborating data, the acutal impact it impossible to determine.
But despite the risks and the frequency with which young men here seek hospital treatment after the rite, the practice, which dates back to late 17th century, remains an important community ritual that celebrates a boy coming of age. Research, however, suggests that cultural circumcision is a major factor in the transmission of HIV/AIDS here. New data suggests that one out of every eight initiates becomes HIV infected during the rite.
The Shame of Pain
Cultural male circumcision is common within the Luhya tribe. Many communities in the Bungoma district have held on to the practice, while others have recently abandoned it in favor of medical circumcision. Here, boys between the ages of 10 and 14 face what is known as “the cut” in August of every even year. Most clans perform the rite on as many as 10 young men on a single day with the same tools.
Usually, initiates undergo rigorous preparations as they gear up for their big day -- a day when they subject their naked bodies to villagers carrying crude instruments. Viewers sit ready to laugh and jeer if any of the initiates display signs of pain. A boy who cries out will bring shame to his family and will be ostracized from taking part in important community activities in the future.
Preparations for Wafula’s circumcision rite started in early July, when he and other initiates gathered together each night to rehearse for their big day. Rehearsals included learning how to use a special musical instrument called a chinyimba, which is worn around the wrist and produces a ngo ngo sound. Initiates are expected to play them vigorously and keep rhythm during the circumcision rite.
On that eve of the rite, each maternal uncle slaughters a bull and crowns part of the intestines around his neck. Call likhoni, the ritual cements the unity between maternal and paternal relatives. For the whole night before the rite both men and women dance and sing songs to mock and tease the initiates. One song translates to, “Don’t be a woman. Stand up tomorrow and show what a man you are by withstanding the knife. Otherwise, who will you marry?”
Early on the morning of the big day, the likhoni is removed and the initiates, usually 10 per clan group, are led to a special place in the wilderness where their naked bodies are smeared in cold mud to numb the nerves. Then, they are led back to the village. Using a crude knife, the circumciser jumps on the approaching initiates one by one at a lightning speed and once done, whistles and runs off. Women and girls then ululate and come out to witness their man, singing songs of praise for his bravery during the cut. Each circumcision, performed at great speeds, is done with the same knife.
Advocates say the speed at which the circumciser is expected to perform the cut is what leads to most complications and as many as 40 percent of the initiates are transported to hospital after the rite. The high number of injuries and concerns over the use of the same knife in regions that have high HIV/AIDS rates is slowly forcing a cultural shift, as many parents do not want their sons to engage in the now controversial circumcision rite.
The Link Between the Circumcision Rite and HIV
Many parents say they are torn between being the custodians of their culture and considering the health risks associated with the traditional cut. The National AIDS Control Program in Kenya estimates that more than 20,000 young boys from Bukusu community underwent the traditional cut this year; a number that is much lower than in the 1990s, when hospital circumcision was unheard of for most tribes.
While new science suggests that male circumcision could be one way to fight HIV infection by up to 60 percent during heterosexual intercourse, the cultural circumcision rite remains an HIV risk due to the communal ceremony. The 2007 UNAIDS and World Health Organization, WHO, report on HIV recommended male circumcision as one element of cutting down new HIV infections, but new data suggests that the practice of cultural circumcision is increasing HIV infection rates.
Joseph Masafu is a 90-year-old traditional herbalist. He says he was 10 when he received his cultural circumcision. During the rite, he recalls sharing the same knife with 15 other boys from his clan. In those days, he says, they did not give a second thought to sharing a knife. But today, such a practice poses significant health risks.
A polygamist father of 37 children and a staunch custodian of culture, Masafu says the emergence of AIDS as such a deadly disease has forced him to circumcise his own children and grandchildren even though he has “no special hereditary powers” as is the case with most traditional circumcisers.
“Old age brings its own wisdom and since I cannot imagine taking my children and grandchildren to hospital for circumcision, because it is a total betrayal to culture, I do it myself,” he says. He adds that he does not have to worry about HIV or other infections to the family because he has crafted many knives for the job. “Besides, I use special herbs to sterilize these knives and therefore make them safe,” he says.
Clans Begin to Embrace Changing Rituals
While not everyone feels equipped to circumcise their children at home, many parents are opting for alternative practices. In western Kenya, several organizations have stepped in to sensitize communities on the importance of safe and hygienic circumcision. Action in the Community Environment, ACE Africa, provides information about safe and hygienic circumcision to tribes here. According to Augustine Wasonga, executive director, a survey on the ground indicates one out of every eight initiates becomes HIV infected during the rite. Though his claims could not be verified as other recent statistics do not exist.
Working closely with the government and other partners, he says his organization has been involved in counseling and providing information on the benefits of voluntary male medical circumcision. “The major challenge has been to change the mindset of these youngsters who believe that the traditional cut elevates them to stardom, that it makes them ‘real’ men,” he says. Wasonga says this mindset also encourages risky behavior after the rite. “These boys end up engaging in irresponsible teenage sexual engagements that puts them at a risk again,” he says.
This year, statistics from ACE Africa suggest that they have helped more than 800 boys from poor communities access safe medical circumcision in the Bungoma district. “We also managed to train over 500 traditional circumcisers on the need for ‘One man, One knife,’ to cut down new HIV infections,” says Wasonga. He says he is optimistic that counseling young boys and families on the risks of cultural circumcision will help cut down new HIV infections by 2015.
