Unnecessary surgical procedures or traditional practices?

Circumcision for Samoan boys could be described as a tradition and in fact, almost a rite of passage. 

In fact in some circumstances, it has also been described as shameful if a male has not been circumcised.

And in Tonga, Niue and Tikopia, it is also very much an accepted practice.

Not so in New Zealand where it is reported that public hospitals will no longer circumcise boys on request and Polynesian families are often forced to seek a sympathetic G.P. who will perform the operation.

One of the reasons given for the medical profession refusing to carry out this operation is because of the belief “that children should be protected from permanent bodily alteration inflicted on them without their consent in the name of culture, religion, profit, or parental preference. Under accepted bioethical principles, parents can consent to surgery on behalf of a child only if it is necessary to protect the child’s life or health. “Routine” circumcision fails this test because it painfully and permanently removes a normal and healthy part of a boy’s penis, does not protect the child’s life or health, and in fact creates new risks. Removing the foreskin is no more justified than removing a finger or any other healthy body part.”

So perhaps this is one of the reasons for the high cost of overseas operations ($1,000) quoted by Dr. Tagaloa Robert Thomsen, the A.C.E.O. of Health Service Performance and Quality Assurance. (see front page story)

Dr Tagaloa was commenting on the news story of a medical student at the National University of Samoa who had been carrying out this procedure for 70 tala as opposed to the 150 tala charged by local doctors. 

Another reason many doctors in the Western world are against the procedure is because removing part of a baby’s or child’s penis is painful, risky, and harmful. Many circumcisions are performed with no analgesic, they say, but even when pain control is employed, the pain is not eliminated. 

“As with any surgery, complications can and do occur with circumcision. These include infection, abnormal bleeding, removal of too much skin, loss of all or part of the glans, urinary problems, and even death. All circumcisions result in the loss of the foreskin and its functions, and leave a scar.”

The fact that the operation can lead to complications is something Dr Tagaloa strongly agrees with.

“Circumcision is a surgical procedure and if not done properly, can lead to major complications including death. This is why circumcisions can only be performed by a registered, medical doctor and not by anyone else; not by a nurse; nor a medical student.”

So having said that the procedure should be not done by anyone other than a doctor, and having also argued that doctors are available in rural areas at least on a weekly basis as well as in Apia, we are left with the question of cost. 

For families with several male children, limited wages and other extenuating factors, the offer of an operation costing just half of the going rate would possibly be hard to turn down. 

However the fact that an unregistered person has been performing these procedures is cause for concern whether or not parents have laid charges.

The reasons for their refusal to do so may be varied including privacy issues for their child or children and the shame of not checking the ‘doctor’s’ credentials. 

What may hopefully come out of this whole incident is the opportunity to look at this tradition, as we from time to time with other traditions and to weigh up whether the risks and reasons still make this viable today.

Given that in other parts of Africa, female circumcision is also still practiced, those who are vociferously adamant about gender equality and equal rights for women, may be very happy in this case not to want everything a man gets. 

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