Intactivism News

April- June 2010

To more recent news

(More recent items first)

Earlier items


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 health department 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 schools after 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 to stop issuing death notices for victims of these illegal 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," he said.

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


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 village, 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 placed next 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 his maternal 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 as Bhabholomhlehlo, 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’ve had to take out loans for their funerals,” Welcome said.


June 27, 2010

New slogan at Gay Pride parade



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 New York-based watchdog recorded the experiences of 31 girls and women in four villages in northern Iraq's autonomous Kurdish region.


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

"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 been implemented, and a proposed 2008 bill to outlaw the practice had never got beyond a preliminary vote of support in the regional parliament, the report said.

In early 2009, the regional health ministry drew up a strategy for eliminating the practice but later withdrew its support with the result that a public awareness 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 outlawed in a number of countries, most recently Uganda.


Jerusalem Post
June 25, 2010

Rehovot newborn saved after botched circumcision


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 mohel during 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 with his penis nearly disconnected at its base, causing massive blood loss.

The Health Ministry was given full details by the hospital, but if was not clear whether the religious family was going to file a complaint against the mohel. The parents refused to allow Kaplan to release any information that might identify themselves 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 baby underwent immediate surgery to stop the blood and later microsurgery to reattach the penis on Thursday. Skin was removed 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,” she said. “He accompanied us to the hospital.”

The doctors said the foreskin had not been removed in the failed circumcision, but the cut was made on the border between the penis, the scrotum and the abdomen. In addition, a large artery at the top of the penis was harmed in a way that 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


LOBAMBA — Prime Minister Sibusiso Barnabas Dlamini yesterday said a roll call to check all male parliamentarians if they were circumcised should be conducted.

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


HIV Rates:

Circumcised men


Intact men


Source: www.measuredhs.com

The PM was responding to a motion which was moved by Mafutseni MP Joseph Madonsela who said the PM should come up with an action plan which parliamentarians can use in 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 their respective partners.


The PM told female MPs to also ensure that their partners were circumcised as they had access to tell whether their partners were circumcised or not. He further said female MPs should ensure that every boy child in the family including newly born babies were circumcised. He said the MPs had a big role to play in the fight against HIV/AIDS and said soon he would ensure with the help of the National Emergency Response Council on HIV/AIDS (NERCHA) that he would bring forward 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 the circumcision campaign and said they had indicated that should more money be needed they were willing to provide it. He said MPs should also be able to teach their constituents on the importance of taking anti- retrovirals (ARVs) and the Prevention 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 illegal circumcision school in the Eastern Cape, the province's health department 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 this boy 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

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

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 St Johns, 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 amputations since 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.


June 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 home may 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 carried a four-year prison sentence.

The investigator in that case -- Detective Ed Kolakowski, of the Kent County Sheriff's Department -- always suspected there 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 sexual conduct.

Sheriff's investigators wanted to add those charges to this most recent case, but the statute of limitations had run out. 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 to his 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 back too far, the man alleged. The case was classified as fourth-degree criminal sexual conduct.

"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 fourth-degree and not first, the statute of limitations had expired.

Kolakowski was looking for -- and still believes -- Heugel has other victims.


Earlier story.


June 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 the procedure 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), a disposable 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 more likely to report bleeding and swelling than those circumcised with forceps.

The trial involved 69 men, 35 of whom were circumcised with the TK and 34 with forceps, and was published in the SA Medical 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 any problems.

This prompted lead researcher Dr Emmanual Lagarde and colleagues to conclude: "Given the high rate of adverse events in this study and the low number of available studies, we strongly caution against the use of the TK for young adults, and we recommend 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 the organisation'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 been shown 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 approved by the WHO but are beneficial to their communities".

"It is not the fact that WHO does not approve the Tara clamp but the fact is they do not have enough data on the use of the device 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 the surgeon 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 the Tara Klamp is more dangerous than WHO recommended methods. We have precious few HIV prevention interventions available to us. I do not understand why KZN would be using this device, when we have safer alternatives, especially where unsafe 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 Malaysian company planned to open a manufacturing plant in the province.

The province has embarked on a mass male circumcision drive as circumcised men have a far lower chance of getting HIV than uncircumcised men.


Times Live (South Africa)
June 21, 2010

Pondoland circumcision death toll rises

Twenty-eight initiates have died in circumcision schools in the Pondoland area since June 5, the Eastern Cape health department says.

"We've lost six more boys in eNgcobo, Libode, Qumbu and Tsolo over the weekend," department spokesman Sizwe Kupelo told 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, surgeons and 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 following botched 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 are already in the mountain," said department spokesperson Sizwe Kupelo.

Teams comprising doctors, police officers, traditional healers and surgeons would be dispatched to various posts to assess the 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


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


June 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 are Muslims, 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 AIDS which 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 been attributed 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 News
June 18, 2010

Circumcisions kill 20 boys in South Africa

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

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

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

Circumcision is seen as a rite 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 medical circumcision 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, reports Sapa news agency.

"Four of the boys even need their genitals removed completely, as it could result in death if it's not. We are just waiting for consent 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 AAP was against it before they were for it, and now, after an outcry, they're against it again - Alice Dreger and Ellen Feder have been raising the alarm about "medical research" currently being conducted at Cornell University. A pediatric urologist at Cornell-Dix Poppas-has been operating on little girls with what he judges to be oversized clitorises, cutting away important clitoral tissues, and then stitching the glans to what remains of the shaft. Poppas claims that, unlike past clitoral-reduction procedures, 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 circumcision have been predictibly pooh-poohed, though both operations are to make the child's genitals conform to parental expectations of what is "normal" for their sex. Since these children had "ambiguous genitalia" some might grow up to identify as male and 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 Masilela

THE Swaziland National Blood Transfusion Service (SNBTS), the only service under the ministry of health responsible for the supply of blood and blood products, says circumcised individuals are among the target groups to make potential blood donors 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 hospital transfusion.

“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 criteria for people who may be considered for blood donation,” says the Head 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.”


HIV Rates:

Circumcised men


Intact men


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 have performed 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’. He stated that they were currently visiting in-school youth to request for blood donations.


“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 voluntarily donated 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 12 days, 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 they learnt 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 to get treatment.

"His is a sad case 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 his condition," 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 Mthatha where 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 the areas over the deaths.

Seven under-aged initiates were rescued from an illegal initiation school run by Mtshiyelwa Mtshayina Ndoda, a 55-year-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 close to 20 initiates died in his schools and 15 had their penises amputated."

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

Kupelo said the department was also seeking meetings with the police, justice department and the National Prosecuting Authority to discuss the prosecution of those contravening the Traditional Circumcision Act, which regulates the custom in the 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 continue illegally circumcising and killing these boys," Kupelo said.

Last year alone, 91 initiates died and hundreds were hospitalised in 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 the early hours of yesterday morning.


Health Department spokesperson Sizwe Kupelo said ... designated medical officers accompanied by police invaded the area 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 at Bambisana 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 serious condition”, 12 were taken to St Barnabas Hospital in Ngqeleni and four to Nelson Mandela Academic Hospital in Mthatha.”


Nkosi Jongusapho Bokleni of Ngqeleni said the boys were dying because there was no proper running of the rite in the area.

“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 the past 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 Libode and 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 its wards," he said.


June 14, 2010

Leaders meet over circumcision deaths

Mthatha - Eastern Cape health MEC Phumulo Masuale will meet traditional leaders in the Mthatha area this week over circumcision-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 Mkhambathi villages, 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 then sped 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 24 initiates 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 costing 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 got involved to save the boys' lives and save the department a lot of money."

"We will continue to help, but call on traditional 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's Court 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 July 22.

Last year alone, 91 initiates died and hundreds were hospitalised in 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

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 school in NU 15 on Saturday after it was reported that an initiate 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 Post
June 13, 2010

Traditional Israeli brit mila technique ups infection risk


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

The long-time practice by Israeli ritual circumcisers (mohelim) of using gauze for as long as 26 hours to stop penile bleeding is 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, even outside a hospital or clinic, compared to the rate among Israeli males circumcised by a mohel. The difference, the authors suggested, was in the method used to stop the bleeding.... (called hemostasis in medical jargon), an aspect of brit mila that is not dictated by Jewish law. ... “The unique phenomenon of the high rate of UTI in male infants in Israel seems to be related 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 the recommendations in the journal articles and decide whether to ask the Religious Services Ministry to direct mohalim to change their hemostasis techniques.

The Shaare Zedek team studied the medical records of 449 newborns up to the age of four weeks who were brought with fever to the hospital’s pediatric emergency room between 1997 and 2006. All underwent urine cultures for UTIs, and the 290 with a positive culture had cultures taken of their cerebrospinal fluid. Their parents were asked if the infants had 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 the same age. Meningitis was found to be very rare.

Mohalim have already changed some of their methods out of health considerations . For example, they abandoned direct sucking 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.


Times Live (South Africa)
June 12, 2010

Destitute teen circumcised boys


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

The teen admitted to having used an unsterilised, home-made scalpel to circumcise youngsters for as little as R25 [$US 28.25].

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 last year after botched circumcisions.

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

The teen, who may not be named because he is a minor, has been summoned by elders to appear before a traditional council 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 school while doing grade 1. It's simple. When one of my friends 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."

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 a surgeon. 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" and blamed 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 to do this? Initiation is not about cutting tissue or foreskin. It's moving from being a boy to being a man, and helping a young man through this transition. He should have been arrested long ago."

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


Hub Pages
June 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 KwaZulu Natal to help combat HIV infections. So far 800 men have been circumcised aT the end of April. The premier said that the provincial government had set a target of circumcising 47,055 newborn boy and 186,703 males during 2010/11. Strong evidence 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. In Eshowe, according to premier Mkhize, his department and the United States Government's Presidential Emergency Plan for Aids Relief would hold the first male circumcision camp, for men between the ages of 14 and 25 years. ... [How many newborns have unprotected sex?]


June 10, 2010

Sparta man who performed illegal circumcision wants an apology

Grand Rapids, MI (WZZM) - A Sparta man sentenced to probation for performing a circumcision without a medical license says the Kent County sheriff owes him an apology.

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

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 Buth sentenced 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 be assaulting 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 trial and prosecutors never had an opportunity to present any evidence against Heugel.


Earlier story


Times Live (South Africa)
June 9, 2010

Three hospitalised with gangrenous penises

Three Transkei boys have been admitted to Mthatha's Nelson Mandela Academic Hospital with gangrenous penises following 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 a bid 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 area on Wednesday morning after he circumcised six other under-age youths.

Health department officials were on Wednesday afternoon preparing to rescue eight youths from an illegal circumcision school 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, was responsible 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 News
June 9, 2010

Circumcision girl's father wins custody


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 closed-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 and was 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 in 2006.

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

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, says the 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 thing at 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 an illegal 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 recognised schools.


June 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 other minor injuries to the penis during sex -- which may help explain why circumcision lowers the risk of HIV transmission from 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 two others in Uganda, South Africa and Kenya showed that circumcision can reduce a man's risk of HIV infection through heterosexual 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, circumcised men were 39 percent less likely than their uncircumcised 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, circumcision limits the virus' access to the body cells it targets. Another theory is that the thickened skin that forms around the circumcision 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 the past 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 saying they'd sustained a penile injury in the past six months. That decline, according to Mehta's team, is likely due to the general improvements both study groups showed in their sexual health practices -- including greater condom use and fewer sex partners.

[And the difference between those two figures is 11 percent. The reduction attributable to just going in the study - the Hawthorne effect - is three times the reduction attributable to circumcision.]

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 hour of 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.

[Or perhaps they should look harder for confounding factors - and an explanation for the extraordinarily high rate of penile injuries 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: Results From a Randomized Controlled Trial in Kisumu, Kenya.

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


PURPOSE: Injuries to the penis during intercourse represent a hypothesized mechanism by which uncircumcised men are at increased risk for HIV. There are no published, systematically collected data regarding mild penile coital trauma to our knowledge. We identified risks of self-reported penile coital injuries in men 18 to 24 years 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, and were defined as penis feels sore during sex, penis gets scratches, cuts or abrasions during sex, and skin of the penis bleeds after sex. Generalized estimating equation analysis estimated odds ratios for penile coital injuries.

RESULTS: From February 2002 to September 2005, 2,784 participants were randomized. 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 than for 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% CI 0.51-0.75) 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 and genital ulcers (p <0.05). Condom use, cleaning the penis soon after intercourse and being married/cohabiting were protective (p <0.05, each).

CONCLUSIONS: Self-reported penile coital injuries were common in these healthy young men. Circumcised men were at lower risk for coital injuries. Verifying penile coital injuries, the mechanism of acquisition and the association with HIV risk is needed.



June 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 tattoo on his hip.

The defense said the boy had been coached and was not a reliable 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 Lacy

The defense says the jury has to find Gonzalez and Gorman not guilty if they are not willing to convict a parent for piercing their 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 Daily
May 29, 2010

Politics disturbing Circumcision program in Zimbabwe

ZIMBABWE – HARARE – Donors are shunning to fund the national circumcision 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 involved 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, but we 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 first be implemented before they release their funds and we are very much worried by this development,” said the source who declined to be named.

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

Specialist Urologist and UZ college of Health Education Institute of Continuing Health Education Director Mr Christopher Samkange 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, that to reduce HIV prevalence from double digits to single digit, and for us [t]o achieve that we must circumcise 80% of the male 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 centers in 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 phase that have produced the 6000 males that have so far been circumcised. [6000 in 6 months in 5 centres is 1.2 men per working hour 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,”said Mr Samkange.

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

Zimbabwe 2005-6

HIV Rates:

Circumcised men


Intact men


Source: Gisselquist table 7.4


May 29, 2010

Female genital cutting: not even a 'nick'

The American Academy of Pediatricians backs away from an ill-conceived move to relax its rules on the practice.

Late last month, 330 villages in Senegal held a ceremony to announce that they would end the practice of female genital cutting. That brought the number of Senegalese communities to abandon the practice to 4,229, and when the number reaches 5,000, complete eradication will be achieved. Similar pronunciations and celebrations are occurring in other countries — 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 all of a girl's clitoris and/or labia — historically done to prepare her for adulthood and marriage — is the result of years of work by local and international activists. Particularly noteworthy has been the success of the nonprofit Tostan, which means "breakthrough" in Wolof. The organization spends almost three years teaching villagers about health and human rights. Thus, when a community 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 the universal right to stewardship of one's body. And that understanding leads to other changes: As villagers learn about the health effects of childbearing, girls are less likely to be married off as children and more likely to go to school. And as women 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 water buffalo, suggesting last month that the ban on genital cutting in the United States be relaxed so that physicians could accommodate immigrant parents and "nick" the clitoris of young girls. A symbolic procedure performed stateside, the academy 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 was commendable, but this policy was potentially disastrous. First, when "minor" cutting has been embraced in Africa, it has often provided a cover for more severe cutting. Second, the purpose of genital cutting is to diminish or destroy female sexual 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 have been lost in translation; the new message to the Middle East and Africa would have been that American doctors will cut girls.

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


Sydney Morning Herald
May 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 Muslim girls 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 the American 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 a lot 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 doctors being 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 without medical 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 was suspected 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 way so 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 next month'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 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 violation of 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 operation going 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's members 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)


  • 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 or after circumcision, circumcision is not justifiable except on medical/therapeutic grounds. Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy 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 and psychological complications. The most common complications are bleeding, infections, meatus stenosis (narrowing of the urethra) and panic attacks. Partial or complete penis amputations 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 only be exposed to medical treatments if illness or abnormalities are present, or if it can be convincingly 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 autonomy and physical integrity.
  • The KNMG calls on (referring) doctors to explicitly inform parents/carers who are considering non-therapeutic circumcision for male minors of the risk of complications and the lack of convincing medical benefits. The fact that this is a medically non-essential intervention with a real risk of complications makes the quality of this advice particularly important. The doctor must then record the informed consent in the medical file.
  • The KNMG respects the deep religious, symbolic and cultural feelings that surround the practice 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 much as possible.
  • There are good reasons for a legal prohibition of non-therapeutic circumcision of male minors, as exists for female genital mutilation. However, the KNMG fears that a legal prohibition would result in the intervention being performed by non-medically qualified individuals in circumstances in which the quality of the intervention could not be sufficiently guaranteed. This could lead to more serious complications than is currently the case.
This viewpoint by the KNMG is jointly endorsed by the following scientific associations:
  • The Netherlands Society of General Practitioners
  • The Netherlands Society of Youth Healthcare Physicians
  • The Netherlands Association of Paediatric Surgeons
  • The Netherlands Association of Plastic Surgeons
  • The Netherlands Association for Paediatric Medicine
  • The Netherlands Urology Association
  • The 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


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). 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 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 is forbidden 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, 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 totally opposed 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 that this 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 medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.


The AAP's media release

June 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 Directors retired a recent policy statement on FGC and replaced it with another statement clearly denouncing the practice.

The original version, Ritual Genital Cutting of Female Minors, from the AAP Committee on Bioethics, was published in May Pediatrics and featured in AAP News (http://aapnews.aappublications.org/cgi/content/full/31/5/31). Updated from a 1998 version, the statement 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 countries 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 decline to perform them, even in the absence of any legal constraints. However, the ritual nick suggested by some pediatricians is not physically harmful and 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 from undergoing disfiguring and lifethreatening procedures in their native countries, and play a role in the eventual eradication of FGC. It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater 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 medically unnecessary procedure that alters the genitalia of female infants, girls, and adolescents.

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

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

The American Academy of Pediatrics (AAP) reaffirms its strong opposition to female genital cutting (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 is forbidden 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 protect the health and well-being of all children.

"The May 2010 statement aired some important controversies in the field about how to end these practices worldwide," said Dr. Palfrey. "Unfortunately, the discussion about the controversial '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 all forms of female genital cutting including the ritual nick," whether it is in the U.S. or elsewhere in the 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 worldwide awareness 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 cancer 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 could be sent to her home to give her a mild sedative "mixed with a soft drink such as Ribena". If this proved impossible, a consultant anaesthetist should 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 similar case. 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 sufficient capacity to make decisions about her own health. The case was brought by an unnamed NHS foundation trust, whose doctors 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.

Attempts to look more closely at the tumour using an MRI scan proved impossible as PS has both a phobia of hospitals and needles and is also claustrophobic, meaning she cannot lie still for a scan. After she refused to attend hospital several times, "the clinical team treating her has reluctantly come to the conclusion that special arrangements will need to be put in 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-up plan, 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 forcible unnecessary genital operations on children.]


New York Times
May 26, 2010

Doctors Reverse Stand on Circumcision


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 that doctors be given permission to perform a ceremonial pinprick or nick on girls if it would keep their families from sending them overseas for the full circumcision. Although the nick on a girl’s clitoris is illegal in the United States, the academy’s bioethics panel had noted it is practiced in some countries. The policy statement ignited a storm of criticism from opponents of female genital cutting. Dr. Judith S. Palfrey, president of the academy, said: “We’re saying don’t do it. Do everything 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 circumcision performed by a visiting physician at the house. It is reported by the press office of the Investigation Department UPC RF Republic 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 the way 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-call physicians. The preliminary cause of death boy was an allergic 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 village 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 circumcised, the provincial health department said.

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

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

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

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

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

He said the boys' parents would have to take the matter to the police for him to be arrested.

"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 concern 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 other matters.

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


WASHINGTON: The review by a prestigious US medical academy of its policy on female genital cutting has triggered a storm 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 its critics 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 the academy of deliberately softening its stance to avoid a double standard because it 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 previous opposition 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 argue that offering a form of ''ritualistic genital nick'' might help dissuade families from taking their daughters overseas where they 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, including Australia.

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

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 trust between hospitals and immigrant communities, save some girls from undergoing disfiguring and life-threatening procedures in their native countries, and play 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 was clear that just saying no was often inadequate.

''We had families explicitly tell [paediatricians] that if we did nothing they would take their kids back to Africa where they would not have control over how harmful a procedure was done,'' Dr Diekema said. ''What they needed was something that satisfied what they believed were the demands of their religion.''

The committee's concept of a nick was far les intrusive than infant male circumcision.

''[It] would remove no tissue, would not touch any significant organ but, rather [it] would be a small nick of the clitoral hood which is the equivalent of the male foreskin - nothing that would scar, nothing that would do damage,'' Dr Diekema said.

He said the ethical rationale for such a suggestion was ''harm minimisation''.

''My feeling is that this certainly would not increase in any way more harmful procedures … It could only decrease them. I don't think you're going to have families who currently do nothing suddenly wanting the procedure. The only thing you would see is a flow of families who would otherwise get a more dangerous [procedure] moving towards one that doesn't harm their girl.''

He said some Western physicians working in Africa believed a ritualistic ''nick'' had been used to satisfy parents wanting the procedure for their daughters. He said the academy meant to speak ''to all paediatricians, including those in countries where this hadn't been precluded by a law''.


The British Medical Journal (full text requires subscription)
May 13, 2010

UK colleges criticise "compromise" in US guidance on female genital mutilation

Zosia Kmietowicz

Two UK Royal Colleges have raised concerns about guidance issued by American paediatricians on female genital mutilation in which they suggest that doctors could offer families "a ritual nick as a possible compromise to avoid greater harm."

The Royal College of Obstetricians and Gynaecologists and the Royal College of Paediatrics and Child Health say in a statement that, "To suggest that a qualified medical practitioner is involved in this practice as a ‘compromise’ does not make it less brutal and has the danger of giving legitimacy to FGM [female genital mutilation]. Two wrongs do not make a right. The main objective for all civilised societies has to be the complete eradication of an unacceptable practice."


"Female genital mutilation is in itself a ritual practice and to suggest that another ritual ‘nick’ replaces the FGM does not change the simple fact that pre-pubescent girls in some societies are expected to go through a violent and painful procedure which will scar them for the rest of their lives. For clinicians in any country, the act of engaging in any ritual female genital cutting, no matter how token, will make them complicit in continuing the practice of FGM."


May 16, 2010

Teens held for illegal circumcisions

Johannesburg - Two teenage boys were arrested after they allegedly illegally circumcised five others at Libode, Eastern Cape department of health said on Sunday.

Spokesperson Sizwe Kupelo said the two, both aged 15, were arrested at Dalaguba village on Saturday by a joint team from the department and police.

"They circumcised five boys under the age of 17 and two others circumcised one another. The seven were taken to hospital in a stable condition."

Kupelo said the department was concerned about the illegal circumcision because last year over 90 boys died due to illegal circumcision.



Open Congress
April 26, 2010

Bill introduced to protect girls from travel for FGC

HR 5137 IH


2d Session

H. R. 5137

To amend title 18, United States Code, to provide penalties for transporting minors in foreign commerce for the purposes of female genital mutilation.


April 26, 2010

Mr. CROWLEY (for himself and Mrs. BONO MACK) introduced the following bill; which was referred to the Committee on the Judiciary


To amend title 18, United States Code, to provide penalties for transporting minors in foreign commerce for the purposes of female genital mutilation.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


This Act may be cited as the ‘Girls Protection Act of 2010’.


Section 116 of title 18, United States Code, is amended by adding at the end the following:

‘(d) Whoever, being a United States citizen or alien admitted for permanent residence in the United States, knowingly transports a person in foreign commerce for the purpose of conduct with regard to that person that would be a violation of subsection (a) if the conduct occurred within the United States, or attempts to do so, shall be fined under this title or imprisoned not more than 5 years, or both.’.


L A Times
May 1, 2010

Alice Miller dies at 87; psychoanalyst explored effects of child abuse

By Elaine Woo

Alice Miller, a Swiss-trained psychoanalyst who won a wide American audience with provocative books about the pervasiveness of child abuse and its legacy of physical and emotional suffering, has died. She was 87.


Miller was concerned about a spectrum of behaviors ranging from sexual and physical abuse — which, by her definition, included spanking and circumcision — to neglect, humiliation and other forms of emotional cruelty. ...

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


Peninsula Daily News (WASHINGTON)
May 13, 2010

Man who used branding iron on kids found not guilty of one assault count; mistrial on other count

PORT ANGELES — The jury deciding the fate of a Sequim man accused of assaulting two of his children by burning initials into their skin with a hot branding iron found him not guilty of second-degree assault this afternoon.

The jury is deadlocked on a lesser charge of fourth-degree assault. Superior Court Judge Brooke Taylor declared a mistrial on that count.

Earlier report:

By Paul Gottlieb

PORT ANGELES -- A Clallam County jury will begin deciding at 9 a.m. today if Mark J. Seamands of Sequim should be convicted of assault for branding his two teenage sons like cattle as "a family thing."

Testimony and closing arguments concluded late Tuesday in the two-day Superior Court trial.

It could end with Seamands, 39, being sentenced for up to 12 to 14 months for branding "SK" -- for "Seamands Kids" -- on the chest of his then-13-year-old son and the arm of his then-15-year-old son.

He branded them on Nov. 25, 2008, after they asked him to do it, the father and both boys testified.

'Asked to be branded'
"I asked to be branded," the younger son, now 15, testified Tuesday.

He wanted to be branded, he said, "because I was going to be part of this family my whole life."

On the same day, a friend branded "SK" on the arm of the father with the same red-hot branding iron, according to the father's testimony.

The father also branded his then-18-year-old daughter.

In closing arguments, Lawyer Loren Oakley of the county Public Defender's Office, who is representing Seamands, did not dispute that Seamands branded his children.

Oakley compared the branding to circumcision.

He said there was no evidence of criminal intent and claimed the boys were not "disfigured."

"This is a case about different strokes for different folks," Oakley said.

Presenting a starkly different view, Deputy Prosecuting Attorney John Troberg said despite the sons' willingness to be branded, Seamands "didn't do his job as a parent" and acted irresponsibly by putting them under risk of infection and scarring them.

"In this state, we do not let minor children be branded like livestock," Troberg said.

Seamands, who in testimony called branding "a family thing" and the brand "a family brand," is charged with two counts of second-degree assault-domestic violence. ...

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


May 6, 2010

Group Backs Ritual 'Nick' as Female Circumcision Option


In a controversial change to a longstanding policy concerning the practice of female circumcision in some African and Asian cultures, the American Academy of Pediatrics is suggesting that American doctors be given permission to perform a ceremonial pinprick or “nick” on girls from these cultures if it would keep their families from sending them overseas for the full circumcision. Related

The academy’s committee on bioethics, in a policy statement last week, said some pediatricians had suggested that current federal law, which “makes criminal any nonmedical procedure performed on the genitals” of a girl in the United States, has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation.

“It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm,” the group said.

But some opponents of female genital mutilation, or F.G.M., denounced the statement.

“I am sure the academy had only good intentions, but what their recommendation has done is only create confusion about whether F.G.M. is acceptable in any form, and it is the wrong step forward on how best to protect young women and girls,” said Representative Joseph Crowley, Democrat of New York, who recently introduced a bill to toughen federal law by making it a crime to take a girl overseas to be circumcised. “F.G.M. serves no medical purpose, and it is rightfully banned in the U.S.

Georganne Chapin, executive director of an advocacy group called Intact America, said she was “astonished that a group of intelligent people did not see the utter slippery slope that we put physicians on” with the new policy statement. “How much blood will parents be satisfied with?” ...

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

A version of this article appeared in print on May 7, 2010, on page A16 of the New York edition.


, 2010

FGM: The Pharaonic rite that's a hard habit to break

Norhan Elhakeem

Aswan--In a nation where UNICEF estimates 96 percent of all married women have undergone some form of female genital mutilation (FGM), Aswan's official declaration against the practice earlier this week, marked by First Lady Suzanne Mubarak's two-day visit to the southern governorate, was one that has human rights and women's rights groups cheering--and gearing up for more action.

But while various units within the Egyptian government--whose Health and Population Ministry banned all forms of female genital cutting in 2007--and numerous non-governmental organizations and civil and human rights groups have all taken a clear stand against the continued practice of FGM across the country and are working toward eliminating it, on the ground and especially in villages, Aswan's declaration means very little.

"All these people, they can say and do whatever they want," says Nabawiya Abdel Hamid. "These are our traditions, and they're impossible to change." ...

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


New Vision (Kampala)
May 4, 2010

War against female circumcision hits snag

By Catherine Bekunda

EFFORTS to end female genital mutilation have hit a snag after the Government failed to provide sh400m for compensating the practitioners.

The money is meant for start up capital for over 400 promoters of the practice, said labour state minister Emmanuel Otaala.

“The ministry is proposing to compensate them with sh1m each for the lost income as a result of eliminating the practice,” Otaala explained.

“These people are also looking for survival. Since the female genital mutilation Act was passed, they have been out of business.”



Al Hdhod
May 5, 2010

African states push for UN ban on female circumcision

DAKAR- Lawmakers from 27 African countries gathered in Dakar on Monday for a two-day conference to push for a UN ban on female genital mutilation as a breach of human rights.

International activists joined envoys from the United Nations and African Union in Senegal to "promote the adoption of a resolution that explicitly bans female genital mutilation as a practice that is contrary to human rights."

The cutting or removal of young girls' and women's clitoris and/or labia affects some 120 to 140 million women in 28 countries, mostly in Africa and the Middle East, according to the World Health Organisation.

Often carried out for deep-seated religious or cultural reasons, it can lead to infection, urinary tract problems, mental trauma, sterility or complications during childbirth, and in some cases fatal haemorrhaging. In Africa, around 91 million girls aged nine and under have undergone the practice, with three million operated on each year, the UN population fund's envoy Rose Gkuba told the conference.

"Now is the time to move forwards with a specific resolution at the United Nations that can give a new boost, a new hope to activists, governments and lawmakers," Italian Senate deputy leader and campaigner Emma Bonino said.

"There is no miracle solution," she told the conference. "Only a complex strategy that needs to be implemented."

The African Union's envoy Yetunda Teriba stressed that the West had a role to play in combating genital mutilations.

"Migrants have exported the practice," she said. "Although most of the victims are in Africa, the problem is growing in Europe among migrant and refugee communities."

But Senegal's parliament speaker Mamadou Seck said the key to fighting genital mutilation was "education and persuasion, to convince but not coerce."

Senegal is one of 19 African countries that have banned the practice and its Families Minister Ndeye Khady Diop said a nationwide campaign between 2000 and 2005 managed to reduce the number of mutilations by over 70 percent. Dakar is preparing to launch a second campaign that hopes to eradicate the practice completely by 2015, she said.


April 30, 2010

Forward condemns AAP's policy on FGC

FORWARD Condemns the American Academy of Pediatrics' amended policy on Female Genital Mutilation (FGM), which suggests conducting ritual nick of genitals as "compromise".

On 26 April 2010 the American Academy of Pediatrics (AAP) released a revised "Policy Statement - Ritual Genital Cutting of Female Minors" which significantly weakens their commitment to health and well being of infants and children. The AAP is endangering rights of young girls at risk of FGM by suggesting the performance of Type IV* FGM as 'a possible compromise to avoid greater harm'. FGM, in all its forms, is a violation of human rights and poses immediate and long-term health consequences to girls and women.

FORWARD is deeply concerned at this weakening of policy on FGM and is calling on the AAP to revert to its caveat free 1998 policy statement that 'opposes all forms of female genital mutilation'.

"All forms of FGM are a clear breach of a girl's human rights and this practice should not be perpetuated by health professionals, whose duty is to care and protect the girl. FGM carried out by medical professionals gives a legitimate and acceptable face to a practice which damages women's and girls' reproductive, sexual and psychological health. Performing FGM in sterile conditions does not alleviate the long-term effects of FGM and international bodies such as the World Health Organisation have consistently opposed such a move," states FORWARD's Executive Director, Naana Otoo-Oyortey.

The AAP has downgraded its recommendation to 'oppose all forms of Female Genital Mutilation', as stated in the 1998 recommendations, to 'oppose all forms of Female Genital Cutting (FGC) that pose risk of physical or psychological harm'. It has qualified the recommendation that 'its members actively seek to dissuade families from carrying out FGM', by now applying it only to 'harmful forms of FGC'. Most seriously, it has also erased altogether the 1998 recommendation that 'its members decline to perform any medically unnecessary procedure that alters the genitalia of female infants, girls, and adolescents'.

In effect, the new AAP policy promotes changes in US federal and state laws that would 'enable pediatricians to reach out to families by offering a ritual nick' for example 'pricking or incising the clitoral skin to satisfy cultural requirements'.

FORWARD is an African Diaspora women's campaign and support charity. Its work responds to the need to safeguard dignity and advance the sexual and reproductive health and human rights of African women and girls. It works with individuals, communities and organizations to transform harmful practices and improve the quality of life of vulnerable girls and women.

FORWARD envisions a world where women and girls live in dignity, are healthy and have choices and equal opportunities to fulfil their potential.

*The World Health Organisation identifies the following four types of FGM: a.. Type I: Excision of the prepuce, with or without excision of part or the entire clitoris (clitoridectomy). b.. Type II: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). c.. Type III: Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulations). d.. Type IV: All other harmful procedures to the female genitalia for no medical purposes, for example: pricking, piercing, incising, scraping and cauterisation


If he was perfect, why cut part off?

April 28, 2010

World Exclusive: Meet Sandra Bullock's Baby Boy!

... "He's just perfect, I can't even describe him any other way," Bullock reveals exclusively in the new issue of PEOPLE, announcing that she is the proud mother of Louis Bardo Bullock, a 3½-month-old boy, born in New Orleans. "It's like he's always been a part of our lives."

Hollywood Life
April 28, 2010

Sandra's Shocking Favorite Moment With New Baby Louis - You'll Never Believe What It Is!

As strange it may sound, her favorite expeirence [sic] was baby Louis Bardo Bullock’s secret bris, a Jewish circumcision ceremony.

Though Sandra Bullock and her family had to be super secretive about the adoption of baby Louis Bardo Bullock, they did manage to share one special experience together — a private circumcision! “You have never seen adults more panicked about what was about to happen to their son, but the celebration and the amount of love we felt and the pride in the little man whom we love so, so much became the greatest moment I have ever had in my life,” she tells People. Wow… we never thought we’d get all misty-eyed over a circumcision, but Sandra just makes it sound so beautiful. [They should have asked Louis.]

Of course, there is one curious thing Sandra says about her son’s procedure. It wasn’t just a standard doctor-performed circumcision — it was a full-on Jewish bris!

“A friend of ours helped arrange for a bris at the house, because we couldn’t go [to a hospital for the procedure]” Sandra tells People. “The mohel [a person trained in the practice] came to us.”

It is surprising that Sandra opted to have a bris, considering neither she nor her soon-to-be-ex-husband Jesse James are Jewish ...

[If only one parent needs to consent, and an adopted child has, in effect, four parents, his chance of remaining intact falls to one in 16 even if they all toss coins.]



The Local
April 29, 2010

Doctors refuse to perform circumcisions

Doctors in western Sweden are refusing to carry out the circumcision of boys, despite clearance by elected officials to carry out the procedure for non-medical reasons.

The Västra Götaland region is obliged to procure healthcare for at least 300 operations each year among Jewish and Muslim families, according to the Göteborgs-Posten (GP) local daily.

"Now we have to go out and find someone who is willing to perform the operations. The doctors' sector council (Sektorsrådet) have said no to these procedures. We respect the doctors' position," said Lars-Göran Moberg, head of the region's healthcare committee to GP. [If they respect the doctors' position, they won't look for anyone else to do it.]

Paediatric surgeon John Westfelt can see no possibility for doctors within the public healthcare system to perform the operations.

"We have de-prioritised several other measures to help sick children, such as surgery on tight foreskins for medical reasons. And obviously we can not carry out these operations without sacrificing something else."


AAP now lets its doctors perform female genital cutting - even though that is illegal

PEDIATRICS (doi:10.1542/peds.2010-0187)
April 26, 2010

Policy Statement-Ritual Genital Cutting of Female Minors


The traditional custom of ritual cutting and alteration of the genitalia of female infants, children, and adolescents, referred to as female genital mutilation or female genital cutting (FGC) [or female circumcision. Does the AAP want that expression not just disused, but forgotten?], persists primarily in Africa and among certain communities in the Middle East and Asia. Immigrants in the United States from areas in which FGC is common may have daughters who have undergone a ritual genital procedure or may request that such a procedure be performed by a physician. The American Academy of Pediatrics believes that pediatricians and pediatric surgical specialists should be aware that this practice has life-threatening health risks for children and women.[How long before the American Academy of Pediatrics acknowledges that pediatricians and pediatric surgical specialists should be aware that circumcision has life-threatening health risks for children and men?] The American Academy of Pediatrics opposes all types of female genital cutting that pose risks of physical or psychological harm, counsels its members not to perform such procedures, recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC, and urges its members to provide patients and their parents with compassionate education about the harms of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters. [To read these recommendations, you wouldn't know that even "non-harmful forms" of FGC are illegal.]



The American Academy of Pediatrics:

The American Academy of Pediatrics:

1. Opposes all forms of FGC that pose risks of physical or psychologicalharm. 1. Opposes all forms of female genital mutilation (FGM).
2. Encourages its members to become informed about FGC and its complications and to be able to recognize physical signs of FGC.
3 Recommends that its members actively seek to dissuade families from carrying out harmful forms of FGC. 2. Recommends that its members actively seek to dissuade families from carrying out FGM.
4. Recommends that its members provide patients and their parents with compassionate education about the physical harms and psychological risks of FGC while remaining sensitive to the cultural and religious reasons that motivate parents to seek this procedure for their daughters. 3. Recommends that its members provide patients and their parents with compassionate education about the physical harms and psychological risks of FGM.
4. Recommends that its members decline to perform any medically unnecessary procedure that alters the genitalia of female infants, girls, and adolescents.

[The old recommendation 4 is gone completely - doctors are no longer even recommended to decline to perform all FGC, only "the harmful forms". The human right to genital autonomy is completely lacking - who may decide whether genital cutting is physically or psychologically harmful but the girl herself? Isn't the very fact of being held down and having part of your genitals cut off psychologically (if not physically) harmful?

Here is the AAP's article announcing the policy, with no mention of a 'ritual nick' or that the 1998 recommendation No 4 had been deleted.


Culture shock

AAP opposes ritual genital cutting of female minors, recommends cultural sensitivity

Alyson Sulaski Wyckoff Associate Editor

Almost 15 years ago, a U.S. hospital serving a large immigrant population cared for patients whose home country in Africa practiced female genital cutting (FGC). When the physicians and nurses in obstetrical practice asked the pregnant Somalian women about to give birth whether they would like their newborns circumcised if they were boys, the women answered, "yes, and the girls, too."

This startled the hospital workers but raised awareness of the complexities of dealing with immigrants accustomed to such practices. Some Somalian mothers suggested the hospital allow doctors to perform a symbolic or "ritual nick" procedure to save the daughters from being sent back to their home countries where they would be forced to endure a much more severe and dangerous procedure. The doctors who supported the suggestion knew it also could prevent the families from hiring a local traditional practitioner to carry out the request.

However, a public outcry at that time against any form of FGC, as well as new federal legislation banning it, caused the hospital to drop the idea.

While seemingly far-removed from the concerns of most U.S. physicians, the custom does impact pediatric practice here. In areas of the United States where immigrant families have relocated from countries where FGC is customary — Somalia as well as Sudan, Ethiopia and Eritrea, among others — some parents continue to ask pediatric specialists to perform the procedures.

More pediatricians also are encountering patients who have undergone FGC.

Ritual Genital Cutting of Female Minors (Pediatrics 2010;125:1088-1093 ) states that the Academy opposes all types of FGC that pose risks of physical or psychological harm.

The updated policy statement reminds AAP members of the life-threatening health risks for females who are subjected to FGC, counsels them not to perform such procedures and recommends they try to sensitively persuade families of the potentially life-threatening complications involved.

The tone of the updated statement is more culturally sensitive and dialogue-focused, according to author Dena S. Davis, J.D., Ph.D., a former member of the AAP Committee on Bioethics. Language that is condemning or condescending doesn’t help physicians "start a conversation," Dr. Davis said.

For example, the more neutral term "female genital cutting" is used instead of "female genital mutilation" (title of the 1998 statement) in part because it may help doctors and health educators broach the subject with families who don’t view the procedure as mutilation.

In fact, the statement says pediatricians should remain sensitive to the complex cultural and religious reasons that motivate parents to seek FGC for their daughters. Parents often are unaware of the harmful consequences.

FGC persists today mainly in Africa, the Middle East and some Asian communities, with about 4.5 million procedures performed each year on girls 4 to 10 years old. Sometimes it’s done on infants or postponed for females until just before marriage.

Typically, a local village practitioner, lay person or midwife performs FGC for payment — without anesthesia — and by using a variety of crude instruments. In developed countries, physicians might be enlisted to do the procedure under sterile conditions with anesthesia.

The policy statement includes illustrations of four main types of FGC; type 3, infibulation, is most severe and involves sewing together the labia so the vaginal opening is about the size of a pencil.

Among the consequences of FGC are hemorrhage, shock secondary to blood loss or pain, local infection and failure to heal, septicemia, tetanus, trauma to adjacent structures and urinary retention. Infibulation is associated with long-term gynecologic or urinary track problems, infertility and painful intercourse; a pelvic exam or vaginal childbirth presents significant challenges.

FGC has been documented in people of many religions, including Christians, Muslims and Jews. Among those who practice FGC, there is a perception that it is obligatory or at least encouraged by the religious tradition, which may not be the case. The statement avoids criticizing those who believe the ritual is important for religious reasons.

In their counseling, pediatricians should explain female genital anatomy and function, and be prepared to discuss why male genital alteration is practiced routinely in this country but female genital alteration is condemned and is illegal if the female is younger than 18.

Protection of the physical and mental health of girls should be the overriding concern of the health care community, the statement says.

Published on June 1, 2010, doi:aapnews.20100601-2* © 2010 American Academy of Pediatrics (requires subscription)

More analysis on the AAP-FGC page.]


International Coalition for Genital Integrity
April 26, 2010

Infant circumcision causes 100 deaths each year in US

A new study published yesterday in Thymos: Journal of Boyhood Studies estimates that more than 100 baby boys die from circumcision complications each year, including from anesthesia reaction, stroke, hemorrhage, and infection. Because infant circumcision is elective, all of these deaths are avoidable.

The International Coalition for Genital Integrity applauds that, for the first time, a rational attempt has been made to estimate the scale of the problem, and is simultaneously appalled by how many baby boys needlessly die each year in the United States.

The study concluded: “These boys died because physicians have been either complicit or duplicitous, and because parents ignorantly said ‘Yes,’ or lacked the courage to say ‘No.’” And called the deaths “an unrecognized sacrifice of innocents.”

The study found that approximately 117 neonatal (first 28 days after birth) circumcision-related deaths occur annually in the United States, one out of every 77 male neonatal deaths. The study also identified reasons why accurate data on these deaths are not available, some of the obstacles to preventing these deaths, and some solutions to overcome them.

Previous studies estimated the death rate as low as two per year to as many as 230. The study collected data from hospital records and government sources to attempt to provide a more accurate magnitude of the problem.

To put this in perspective, about 44 neonatal boys die each year from suffocation, and 8 from auto accidents. About 115 neonatal boys die annually from SIDS, nearly the same as from circumcision.

To the abstract.


The Guardian
April 21, 2010

Leaving baby to cry could damage brain development, parenting guru claims

Neurobiologists say high levels of stress hormone cortisol are 'toxic' to the developing brain, according to Penelope Leach

Leaving a distressed baby to cry on a regular basis could be damaging to the developing brain, according to parenting guru Penelope Leach, whose new book will be seen as a head-on confrontation with the tough-love approach of baby experts such as Gina Ford, who say parents should "train" their infants by allowing them to cry themselves to sleep.

In the latest salvo in the baby wars, Leach brings science to her aid, which she says has progressed remarkably in recent years. Using saliva swab tests, scientists have been able to measure high levels of the stress hormone cortisol in distraught babies whose cries elicit no response from parent or carer. Neurobiologists say, according to Leach, that high cortisol levels are "toxic" to the developing brain. [e.g. De Bellis et al.]

"It is not an opinion but a fact that it's potentially damaging to leave babies to cry. Now we know that, why risk it?" Leach says in her book, The Essential First Year – What Babies Need Parents to Know. ...

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

"We found that in our own child-care research. We followed 1,200 mother and baby pairs from birth to state school. We were surprised to find that differences in child care do not make nearly as much difference as we expected them to. What makes more difference is the carer's responsiveness."


[Circumcision produces an increase in plasma cortisol: Anand KJ, Hickey PR. Pain and its effects in the human neonate and fetus. N Engl J Med. 1987; 317(21):1321-9.]


Helsingin Sanomat (Helsinki)
Aprill 15, 2010

Legislation on circumcision stalled

Mother fined for having son circumcised

Proposed legislation on non-medical circumcisions has not progressed even though a bill on the matter has been under preparation for nearly a decade. There are no plans to put forward a proposal on the matter during the current government term, which runs out next year.
  The Ministry of Social Affairs and Health recommended in 2003 that circumcisions should be allowed as a part of public health care, but this has not happened.
  An estimated 200 boys are circumcised in Finland each year for religious reasons.

None of Finland’s university hospitals perform circumcisions for non-medical reasons, and the willingness of private doctors to do the procedure has declined.
  As a result, some parents are sending their sons abroad for the procedure, or have the operation done in Finland by someone who is not a doctor.

Helsinki District Court on Tuesday sentenced a mother to a fine for incitement to assault for having her six-month old son circumcised.
  In the summer of 2008 the woman had hired a person who claimed to be a surgeon to perform the circumcision. No credentials were shown, and the boy had to be hospitalised the next day for bleeding.
  Earlier in the spring, the parents of another boy were fined in a similar case. The circumcision, which led to complications, was performed by a rabbi who was brought in from Britain.

In both cases the court applied a precedent set by the Finnish Supreme Court in 2008.
  In its ruling the Supreme Court decided that a religiously mandated circumcision of a Muslim boy was not illegal, because it was made in a proper medical fashion. According to the decision, banning all circumcisions would violate the constitutional guarantee of privacy in family life and freedom of religion. [Do these guarantees apply to any other contested parental practices, such as corporal punishment or child marriage?]
  However, the decision does not answer the controversial questions of whether or not doctors are obliged to perform circumcisions, or how they should be paid for. It is hoped that new legislation might clarify these issues.
  “If a law were to come, its key content would be that the procedure could be done only by doctors. Individual doctors would be allowed to refuse”, says director Eija Koivuranta of the Ministry of Social Affairs and Health.

Religiously mandated non-medical circumcisions are mainly performed on Jewish and Muslim boys.
  In Judaism, a ritual circumcision must be performed by a mohel, who is trained in the procedure according to Jewish tradition. In Finland nearly all mohels are also doctors, although Jewish law does not require them to have formal medical training.
  “We feel that it is not necessary to pass a law according to which someone who performs a circumcision should be a doctor”, says Dan Kantor, a spokesman for the Helsinki Jewish Congregation.
  Finland’s Islamic Council is in favour of passing a law on circumcisions.
  “If a family cannot afford a private doctor, it should be possible to perform the procedure in the public sector, or financial assistance should be provided. Otherwise circumcisions might be performed in conditions that are not safe for children”, says the council’s information officer Isra Lehtinen. [This argument carries no weight when the children involved are girls.]

The Finnish Medical Association feels that no law authorising circumcisions should be passed, and that public health care should not be obliged to perform the procedures.
  This view is echoed by Harry Lindahl, thinks that non-medical circumcisions for underage boys should be illegal.
  “I think that it would be fine to wait until a boy turns 18, when he can decide for himself”, Lindahl notes.


April 13, 2010

MALAWI: Clinics dispel male circumcision myths

LILONGWE, 13 April 2010 (PlusNews) - Male circumcision (MC), which can reduce HIV among men by up to 60 percent, is controversial in Malawi and government has yet to implement mass male circumcision. But a chain of private clinics has rolled out the measure with some surprising results.

Banja La Mtsogolo (BLM) – Future Family in the local Chichewa language - a private family planning organization, rolled out the procedure at its network of 30 national clinics in 2009 and is the only organization offering it as part of an HIV prevention package.

The UN World Health Organization recommends circumcision and Malawi's National HIV Prevention Strategy 2009-2013 acknowledges its role, but falls short of outlining a clear policy.

Brendan Hayes, the head of BLM, admitted that MC has been a hard sell.

"In Malawi, you've got very big differences in the HIV epidemic from north to south and those differences don’t correlate to differences in circumcision prevalence. High prevalence rates are in the southern part of the country, which is also where we have the most circumcision ... but you're still only talking about one in three men," he told IRIN/PlusNews.

"These differences aren't totally inexplicable but I think it's made people more cautious about moving forward with male circumcision."

Confusion and controversy
Southern Malawi has a large migrant labour population and an HIV prevalence rate of about 18 percent, accounting for almost 70 percent of the country's HIV infections, according to government figures. Circumcision is culturally less prominent in northern Malawi, where prevalence rates are also lower.


HIV Rates:

Circumcised men


Intact men


Source: www.measuredhs.com

The mismatch between HIV prevalence and traditional circumcision rates has raised doubts among some high-level health officials, most notably Principal Secretary for HIV and AIDS within the Presidency, Dr Mary Shawa. [or Shaba]

Earlier this year, Shawa argued in local newspapers that she had not yet been presented with enough clinical evidence on MC, and its efficacy was questionable given high HIV prevalence rates among traditionally circumcising populations in the south.

Shawa also questioned the acceptability of the practice among ethnic groups that did not perform the procedure.



Men in a hurry not to get circumcised...

IOL News
April 12, 2010

Lunch break circumcision is a snip

By Kanina Foss

Joburg men can now get circumcised during their lunch breaks. The snip that saves lives is done at the ZuziMpilo Medical Centre in the CBD. It takes just one hour and costs R400.


The clinic started offering circumcision in mid-February. It has received calls from all over the country, but it has circumcised only about 12 men. [That's one circumcision every five days.]

Martinson hopes that numbers will increase in winter when traditional initiations take place and demand for circumcisions increases.


The R400 fee barely covers basic costs, and is subsidised by the US government, which funds the centre. Martinson said GPs charged about R700 and urologists at private hospitals about R2 000.

One of the reasons the centre's services may be slow to take off is that the government hasn't issued any major call for circumcision. [Or perhaps because men have considered it and said, "Not on your life!"]

According to Martinson, this is because public hospitals don't have the capacity to deal with large numbers of people requesting circumcisions.



Africa OnLine
(April 12, 2010)

Female circumcision banned

Kampala, Uganda - A Ugandan official says that parliament has passed a bill banning female genital mutilation.

Uganda’s Minister of Ethics and Integrity James Nsaba Buturo said that the new law, passed without opposition late on Thursday, could give offenders a life sentence.

Female genital mutilation, also known as female circumcision, is practised mostly in northeastern Uganda on more than 3 000 girls each December.

The practice involves the removal of a girl’s clitoris or other genital parts at a young age. Critics say it can lead to complications during childbirth and eliminates any pleasure for women during sex.

Female circumcision is illegal in more than a dozen African countries, although laws are rarely enforced. - Sapa-AP


6 Minutes (Australia)
April 12, 2010

Circumcision benefits not seen in Australia

[Falsly implying there are benefits. How about "Circumcision doubles NSU risk"?]

by Michael Woodhead

Circumcision does not seem to be justified in the Australian context because it has no protective effects against STIs and does not reduce sexual difficulties, a major new study has found.

A questionnaire survey of almost 4300 men carried out by researchers from La Trobe University in Victoria and the University of NSW found that circumcision was unrelated to STI risk overall, but appeared to increase the risk of non-specific urethritis [actually, to more than double the risk, with high significance] and reduce the risk of penile candidiasis.

Rates of HIV and syphilis were so low that it was not possible to conclude whether circumcision has any protective against these STIs, the study authors say in the Australia and NZ Journal of Public Health (34: 160) this month.

They say findings from a previous Australian survey that showed higher rates of sexual difficulties among uncircumcised men had been used in support of the procedure. However, the new study showed no such differences. In particular, there were no difference seen between circumcised and uncircumcised men in the over 50s age group, where previously uncircumcised men had previously [sic] been shown to have higher rates of difficulty maintaining an erection and having pain during intercourse.

“At the population level, circumcision appears to have minimal protective effects on sexual health in the Australian context,” concludes study author Dr Juliet Richters.


NOCIRC-SA (The National Organisation of Circumcision Information Resource Centres - South Africa)
April 1, 2010 (genuine)

South African boys get better protection

Amendments to the South African Children's Rights Act posted today make it harder for boys to be circumcised for frivolous reasons.

The changes require informed consent of both parents, and the boy if he is old enough, and the signature of the circumciser, to be kept on record until the boy is 21 - old enough to sue if he is not satisfied with the outcome.

From today, the Child Care Act is repealed and all sections of the Children's Act as amended come into operation. The proclamation has been signed by the Deputy President.

The Act provides:

Social, cultural and religious practices

12. (1) Every child has the right not to be subjected to social, cultural and religious practices which are detrimental to his or her well-being.

(3) Genital mutilation or the circumcision of female children is prohibited.

... (8) Circumcision of male children under the age of 16 is prohibited, except when
(a) circumcision is performed for religious purposes in accordance with the practices of the religion concerned and in the manner prescribed; or
(b) circumcision is performed for medical reasons on the recommendation of a medical practitioner.

(9) Circumcision of male children older than 16 may only be performed
(a) if the child has given consent to the circumcision in the prescribed manner;
(b) after proper counselling of the child; and
(c) in the manner prescribed.

(10) Taking into consideration the child['s age, maturity and stage of development, every male child has the right to refuse circumcision.

Consent forms have to be kept until the child is 21 years old.

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