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Medically assisted circumcision: a safer option for initiation rites


Culturally sensitive integration of medical circumcision could avert adverse effects at traditional male initiation rites

In many traditional cultures, male initiation rites involve circumcision practices that can sometimes result in medical complications. In a recent incident in the Northern Territory, three young men required airlifting from their Borroloola initiation site to Darwin for medical assistance.1 The risk of permanent harm and potentially fatal outcomes could be decreased if safer options were available during initiation ceremonies. In this article, we report that it is possible to provide safe circumcision at male initiation rites.

In December 2013, a traditional initiation ceremony was conducted in Drekikier District, East Sepik Province, Papua New Guinea (PNG). During the 4-week ceremony, circumcision, considered vital for transition from boyhood to manhood, is conducted in the first week. Previously, young initiates suffered excruciating pain and severe blood loss when a carved cassowary bone was used to cut the penis and foreskin. On this occasion, at the invitation of community leaders, a medical team assembled at the site to provide safe male circumcision for 34 initiates.

The team consisted of a medical officer, two community health workers, an HIV counsellor and the provincial HIV response coordinator. Consistent with local cultural traditions, the entire…