In South Africa, the tradition of young men going to the mountain for circumcision, particularly during winter, is deeply rooted in Xhosa culture.
This rite of passage is known as "Ukwaluka" and signifies the transition from boyhood to manhood. The practice is not just a physical act, but a culturally significant event that prepares young men to take on adult responsibilities and honours their heritage.
Winter, especially during the months of June and July, is the peak season for circumcision in many South African communities. There are several practical reasons for this timing.
The cooler temperatures reduce the risk of infections during the healing process, making it a safer period for the procedure.
Additionally, winter coincides with the school holidays, allowing young men to fully participate in the initiation rites without disrupting their education.
Circumcision plays a crucial role beyond its cultural significance. Numerous studies, including those endorsed by the World Health Organization (WHO) and UNAIDS, have shown that male circumcision can reduce the risk of heterosexual men acquiring HIV by approximately 60%.
This is particularly important in a country like South Africa, where HIV continues to be a significant public health challenge.
Right to Care, a health NGO running South Africa’s largest voluntary medical male circumcision (VMMC) programme, is advising men to get circumcised this winter.
The procedure, part of the country’s HIV prevention strategy, can reduce the risk of HIV transmission by up to 60%. Despite progress in fighting HIV, it remains a significant issue in South Africa.
Dr Khumbulani Moyo, the head of the VMMC programme at Right to Care, stated: “Winter is the peak season for circumcisions in South Africa.
“Our trained teams are ready at health facilities in Gauteng, Free State, Eastern Cape, Western Cape, Limpopo, Mpumalanga, North West, and KwaZulu-Natal to provide free, safe circumcisions. June, being Men’s Health Month, is an ideal time for men to get circumcised.”
Moyo added that for many men, undergoing circumcision was often their first experience with the public health system.
“Our teams are skilled in providing confidential care in a secure setting. The procedure is straightforward, with a quick recovery time. Men can return to regular activities within one to three days, and the wound fully heals in six weeks,” he explained.
HIV remains a substantial threat in South Africa, with the youth population being especially vulnerable. Health industry stakeholders, including government bodies and non-governmental organisations (NGOs), are constantly working to reduce the number of new HIV infections.
Circumcision programmes form a critical component of these efforts. Initiatives like the Medical Male Circumcision (MMC) campaign are designed to encourage and provide safe circumcision services, often integrating traditional practices with medical oversight to ensure the well-being of participants.
A recent survey by the Human Sciences Research Council shows that HIV is hitting young people and women in South Africa the hardest.
The Sixth SA National HIV Prevalence, Incidence, and Behaviour Survey found that KwaZulu-Natal has the highest HIV rates, with Mpumalanga, Free State, Eastern Cape, North West, Gauteng, Limpopo, Northern Cape and Western Cape, following.
Moyo stressed the importance of circumcision for men's health.
"Circumcision is key for overall health. We offer comprehensive health checks before the procedure, including tests for HIV, STIs, TB, blood pressure, and diabetes."
Moyo highlighted that they also provide individual and group counselling. "For men at high risk of HIV, we recommend PrEP (Pre-Exposure Prophylaxis) as part of our full HIV prevention plan," he added.
The integration of traditional circumcision practices with modern medical approaches is vital. It helps in gaining community acceptance and ensures that the health benefits are maximized while minimising risks.
Organisations often collaborate with traditional leaders and community members to educate about the benefits of circumcision, both culturally and in terms of health. This collaboration is crucial for overcoming resistance and ensuring widespread adoption of the practice.
Medical circumcision is done under local anaesthetic and takes only 30 minutes. Besides the anaesthetic injection before the procedure, there is very little pain.
“Your healthcare worker will tell you everything you need to know, including how to care for your wound,” said Moyo.
Concerns about circumcision affecting sexual function or pleasure are common, but Moyo stressed that medically performed circumcisions, done in sterile conditions, do not impact sexual performance or enjoyment.
"You just need to avoid sex and masturbation during the six-week healing period”.
Beyond its cultural importance, circumcision is a key strategy in reducing HIV infections, playing a pivotal role in the nation’s public health initiatives. Right to Care has performed over 1.5 million safe circumcisions since 2012.
∎ To find out more about free medical circumcision or to make an appointment, call or send a “please call me” to the Right to Care circumcision call centre on 082 808 6152.