NOTE: This article is part of a nine-part sequential narrative series on initiation practices in SA. Answer the question at the end of the article to continue with the narrative or view the full series at The Perilous Path To Manhood.
Siyanda Gadiso, 29, tried to take his own life three times after a botched circumcision in 2013.
Then, aged 23, he went to Mfizweni initiation school near Lusikisiki, where he was circumcised with 14 other boys, and where he knew neither his ikhankatha (traditional nurse) nor his ingcibi (traditional surgeon).
“I was left unattended for more than eight days. I could not urinate but other initiates kept telling me everything would be alright. When my ikhankatha finally arrived after eight days, he told my uncle when he enquired that I was in good condition,” he said.
Gadiso said when his uncle finally visited him at the initiation school and saw what was happening, he suggested he be taken to hospital but the traditional nurse refused, saying he would be arrested and fined because he was unregistered.
I woke up after three days and my penis was cut off. I was told doctors and nurses tried everything to save it, but it was either they amputate or let me dieSiyanda Gadiso
“My uncle saw my situation was worsening so he took me by force to St Elizabeth Hospital in Lusikisiki. I woke up after three days and my penis was cut off. I was told doctors and nurses tried everything to save it, but it was either they amputate or let me die,” he said.
After two successful penile reconstruction surgeries in July last year, Gadiso now feels like a man again. He is one of 50 men who have undergone penile reconstruction at Nelson Mandela Academic Hospital in Mthatha, at a cost of about R20m to the provincial health department.
“I had given up on life. I just wanted to die. But now after the surgeries I’m looking forward to life,” he said.
Gadiso has started a small construction business in his village outside Port St Johns, where he builds rondavels and driveways for villagers.
Gadiso and the 49 other amputees from the Mthatha area were helped by the Gugulethu E Sirayi Foundation which put them in touch with a group of specialists led by urologist Dr Raymond Campbell. Sirayi, who started his eponymous foundation, said some victims needed to wait more than 10 years for reconstruction.
Another who has been helped is Mputhumi Ncanywa, 37, whose penis was reconstructed in May, 11 years after it was amputated.
I had given up on life. I just wanted to die. But now after the surgeries I’m looking forward to lifeSiyanda Gadiso
Nelson Mandela Academic Hospital urologist Dr Mbuyiselo Madiba said each procedure costs up to R500,000, depending on the reconstruction. The hospital worked with the provincial and national health departments on the programme.
“Our province has embraced this initiative. We have even ring-fenced some of the male medical circumcision budget for this programme. I have about 12 urologists who are trained and are ready to help,” Madiba said.
Madiba, an advocate of medical male circumcision instead of traditional circumcision, which he said would help stem the death toll, said he has formed a team which includes psychologists to work with Campbell and his team.
“After surgeries, we conduct home visits as part of the after care,” Madiba said.
Campbell said when they conducted the first reconstructive surgery it was met with scepticism.
“Unlike a penis transplant, which costs less and depends on a donor, reconstruction takes muscles and skin grafts from the patient’s thigh or arm,” he said.
Campbell describes all boys who had lost their penises through botched circumcisions as “silent victims”.
“More emphasis is placed on the boys who have died. Amputees die in silence. They are tagged as factory faults by their peers. Depression kicks in. They are told the fault lay with them when they seek help. Even though I might not have statistics, many have taken their own lives,” he says.
More emphasis is placed on the boys who have died. Amputees die in silence. They are tagged as factory faults by their peersDr Raymond Campbell
Campbell said most traditional surgeons are not properly trained to conduct circumcisions and called for more funds to be made available, to allow this work to continue. He and his team of plastic surgeons, Dr Johannes Krietzieger and Dr Liana Volkwyn, volunteer their time for free.
“The clinics are run by the urology and plastic surgery teams stationed at the Nelson Mandela Academic Hospital, so this saves a huge amount of money,” Campbell said.
In December 2014, SA was the first country to perform a penile transplant, performed at the Tygerberg Hospital in Cape Town by the head of urology at Stellenbosch University, Prof Andre van der Merwe. A second was done in April 2017.
At one stage, there were more than 10 men on the waiting list.
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