HEADLINE:   Initiates bears fruit

PUBLICATION: Pretoria News

PAGE NUMBER: 10

AUTHOR:     Zubeida Jaffer

DATE:       2001-02-28 13:16:09

Doctor's fight for initiates bears fruit

Zubeida Jaffer

Own Correspondent

Cape Town - The fathers wait until nightfall. Then, with their sons by their side, they knock on her door, desperate for help. 

At first, Mamisa Chabula does not know what to do. It is 1989 and she has just set up her medical practice in Motherwell, a township in Port Elizabeth. The fathers are bringing their sons from the bush where the traditional circumcision rites have gone horribly wrong. 

"Oh - the septic wounds," says Dr Chabula. "I cannot forget the expressions of these young men." 

She decided to ask her brother to help remove the bandages and dressings around the genitals. A penis completely caked in yellow pus. Another shrivelled up, black, charcoal-like as a result of infection. Then the complete absence of genitalia. 

Every six months, young boys throughout the country attend circumcision or initiation school. In Port Elizabeth alone, about 15 000 boys are annually involved in this age-old rite of passage from boyhood to manhood.

Unlike the trend in Soweto where children are increasingly undergoing surgical circumcisions in hospital, this is rare in the Eastern Cape and most other provinces. 

During the last session in December last year, 11 initiates are known to have died in the Eastern Cape. Forty more were admitted to hospitals and one initiate had his penis amputated at the local provincial hospital.

Dr Chabula said in most cases the practitioners were not dressing the wounds properly. They were not using herbs and were not nursing the initiates. Dehydration and septicaemia were the main reasons for the deaths. 

She said she believed that some traditional practitioners knew what they were doing was wrong. Some were motivated by commercial interests - they were circumcising more boys so that they could be paid more and were not taking the time that had been taken in the past. 

As the patients queued up, she decided something had to be done. She talked to the traditional practitioners and encountered resistance. 

"I could see they were wondering whether I wanted to make money, to take their jobs away from them," she said. "Although they did not publicly agree with me, something told them that it was not right. They did not want to listen to me. I was a woman interfering in a man's world."  

After more than a year of talking, they slowly came round. 

"We could then together decide that the boys must be medically examined before the circumcision and that an association had to be formed," she said. 

The Motherwell Traditional Surgeons and Attendants Association became the backbone of a campaign, which continues to grow. 

It set up a register for all practitioners (iingcibi). Dr Chabula trained them in wound management and insisted on pre-medical examinations of all young boys. The iingcibi agreed to carry a registration card to prove their credentials. 

But then fathers and sons started arriving from other areas. She tried knocking on official doors in the city for help but had no luck. 

The breakthrough eventually came in 1999. Govan Mbeki, former deputy chairman of the Senate, advised her to take the local mayor to see the boys in hospital. 

"When the mayor saw the botched circumcisions, he said to me: 'Mama, is this the struggle we are letting you go through alone?' He was shocked." 

He immediately established an intervention committee, which included Dr Chabula and other local councillors. 

Dr Chabula was appointed as the Director of the Western District Council serving a large section of the Port Elizabeth community. This gave her the official platform to drive the campaign for controlled circumcision across several residential areas.

 "We have so far registered and trained 200 practitioners and plan to do more," she said. She and her colleagues also went on an aggressive radio drive to make people aware of the dangers they were facing. 

Now her work has won the support of the Eastern Cape provincial health department including the MEC for health, Bevan Gowanda.