Traditionalists resist the call for a cleaner cut

For thousands of young men in western Kenya and eastern Uganda, the month of August heralds the season during which they pass from childhood to manhood through the traditional ritual of circumcision.



"Here you are no man if you are not cut," said Lucas Wanyama, a traditional circumciser among the Tiriki people of western Kenya. "Only those who are brave enough to face the knife are men worth talking about."



Wanyama still uses traditional instruments to remove the boys' foreskins, and one knife to circumcise several boys. He has heard of HIV and is aware of how it spreads, but insists his methods are safe.



"They can't get AIDS because I treat these knives; I heat them in very hot charcoal before I cut the boys so they can't be infected," he said.



Dangers



According to Walter Obiero, clinical manager at western Kenya's Nyanza Reproductive Health Society, using one knife is just one of the risky practices associated with traditional circumcision. “The kinds of ordinary knives used in traditional circumcision leave huge wounds and the technique doesn't ensure uniform healing," he said.



"The initiates engage in sex before they are healed, which puts them at high risk of getting infected," Obiero noted. "This is the greatest danger."



A 2007 study carried out in Western Kenya's Bungoma District among the Bukusu people found that men circumcised traditionally experienced twice as many complications as those circumcised medically. Complications delay healing and when combined with premature sexual activity, place young men at even higher risk of HIV.



The Nyanza Reproductive Health Society has set up parallel medical male circumcision in areas where the circumcision season is ongoing. Men receive counselling both before and after the procedure about the dangers of engaging in sex too soon and risky sexual behaviour, but the traditional method remains more popular a nd people who opt for the medical method ar e perceived as cowardly.

Taking my son to the hospital means I want to bring up a coward. If he can withstand the hot knife, then he is a man

Blending medical and traditional practices



In some parts of Kenya, traditional circumcisers have been trained in medical male circumcision and given a “safe circumcision kit” that includes several blades, gloves and antiseptic.



However, government policy stating that male circumcision must be done by a trained health professional has made it difficult to integrate traditional circumcision into the formal healthcare system.



According to Peter Cherutich, head of prevention at the National AIDS and Sexually Transmitted Infections Control Programme, deeply rooted beliefs mean communities have been reluctant to embrace medical circumcision.



"People who circumcise traditionally have cultural beliefs… and it would be difficult to change them at once, but we have started [talking] with these communities, [telling them] they can be circumcised medically but to go on with the traditional ceremonies that accompany the process," he told IRIN/PlusNews.



However, it will take some convincing to persuade men such as Onesmus Eshitemi, a father of three, whose son has just undergone traditional circumcision, to abandon centuries of tradition.



"Taking my son to the hospital means I want to bring up a coward," he said. "If he can withstand the hot knife, then he is a man."



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