South African Men Queue for Penis Transplant

By Che Ambe

“Frequently you would smell rotting when they were walking past. I spend many hours cleaning their wounds, trying to insert urinary catheters in their botched penis, battling to explain to 17-year-olds that they had lost their manhood”. These words capture the exasperation of Dutch doctor, Dingeman Rijken, as he continues to battle dangerous traditional circumcision practices that devastate lives of young male South Africans every year.(warning: Article include some sensitive images)

Last December, surgeons in South Africa conducted the first ever successful penis transplant on a South African man who three years earlier lost all but a 1cm stump of his penis following a bungled circumcision. The organ was harvested from a brain-dead patient. To claim success, the recipient had to stand up to urinate as the flubbed circumcision usually mutilate their penises such that they principally sit to urinate. Secondly, have normal sensual feeling and sexual intercourse when they want, and lastly be able to conceive with their partner.

The South African recipient was one of the many South African men whose penises are amputated yearly during age-old traditional circumcision rituals, usually under unhygienic and crude conditions. When Urologist Prof. Andre’ Van der Merwe, called a press conference last Friday, June 12, 2015, it was to confirm the attainment of the outlined goals. The beneficiary of the penis transplant’s wife was 4 months pregnant.

Young male South Africans ready for the “uwaluko” ritual

It was a job well done for the surgical team at the Tyderberg Hospital in Cape Town, and their patient who had put his adopted weapon of mass reproduction (penis) into efficient use. The News of the success prompted phone calls from many penisless South Africans for a similar procedure. About 250 young men in South Africa lose their penises each year due to brutal initiation and rite of passage into manhood rituals, mostly conducted by the Xhosa in a ceremony called “uwaluko”. For Prof. Merwe, the greatest challenge now is getting organ donors.

The ancient practice which takes place in the remote hills and valleys of the Eastern Cape usually involves a traditional surgeon called “ingcibi” severing the foreskin with a spear. The skin is then attached to the initiate’s blanket. During the isolation process which normally lasts for about a month, the initiate is painted with clay and provided with herbal concoctions as drinks. Certain foods are forbidden as well. It culminate in a downstream bath. Thereafter, the candidate’s belongings and hut in which the ritual is performed are incinerated. The initiate is then given a new blanket and called “amakwala” or new man.  Nelson Mandela described the process in his autobiography as a “kind of spiritual preparation for the trials of manhood”.

Some of Dr.Dingeman’s Patients

Many initiation schools in South Africa are controlled, but others are unregulated with spurious doctors operating with unsterilized equipment. Several of the young men usually 10-15, come out of the process battered leading to deaths, amputations and loss of manhood. Attempts at calling for better monitoring have often met with stiff resistance from traditional leaders (doctors), and politicians, benefitting from the practice. Initiates usually pay about $21 (250 Rands), including drinks, food, and home-coming ceremonies. Appalled by the abuse and inaction, Dr. Dingeman Rijkeu, in 2013 set up a site called “uwaluko” aimed at revealing  “the dark secrets of the ritual”.

Despite threats and summons from South African traditional doctors for breaking traditional taboos, by showing graphic pictures, which are supposed to be secret, his crusade for reform of the tradition is in full course.  Calls for the site to be shut down have equally failed. The South African Film and Publication Board though restricted the site to children under 13, ruled it as beneficial for educative and scientific purposes.

Annually the WHO estimates that 30% of men globally are circumcised secularly, religiously and traditionally (as symbols of cultural identity). Conclusive evidence the organization says now confirms that circumcision under hygienic conditions reduces risk of HIV/Aids infection.