Monday, December 31, 2012

EASTERN CAPE: 300 botched circumcisions

SABC
December 22, 2012

E Cape gets cash boost to curb initiation deaths

In July this year, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape (SABC)
Government has allocated R20 million to the Eastern Cape Health Department to curb the deaths of initiates and ensure safe circumcisions. Seventeen boys have died due to botched circumcisions since the start of the circumcision season.
Eastern Cape Health and officials from Pretoria met in Bhisho to discuss strategies to tackle circumcision-related deaths in the province.
Eastern Cape Health Department spokesperson, Sizwe Kupelo says: "The discussions were held in Bhisho and it transpired that the department is allocated R20 million to deal with circumcision and ensure safe circumcision in the Eastern Cape."
In July this year, initiate deaths rocketed to the alarming figure of 42 in the Eastern Cape while other provinces like Limpopo and Free State had much lower figures of four and five respectively. [Cold comfort to their families.]
More than 300 initiates were admitted to hospitals across the Eastern Cape this season due to botched circumcisions or complications resulting from failure to carry out medical check-ups before going to the bush. [It is unclear how prior checkups prevent botched circumcisions.]
In South Africa, traditionally performed circumcision is still largely influenced by culture as [o]pposed to Western circumcision at a hospital. [Actually, Western circumcision at a hospital is largely influenced by culture - our culture.] It is performed routinely on boys from infancy to adolescence to initiate them into manhood. Although other South African ethnic groups practice the ritual, it is mostly associated with the Xhosa culture. According to the history of the Xhosa people, one has to be circumcised to be considered a "man".
Circumcision is performed by traditional "teachers" or "principals" who run the initiation school, often in the bush where boys spend two or more weeks undergoing all the rituals. However there have been reports that no anesthetic is used, therefore hygiene becomes crucial.
The leaders performing the procedure use "razors" or knives that are reportedly not sterilised and can be used to circumcise the entire group of initiates. [- greatly increasing the risk of HIV transmission.]

Tuesday, December 25, 2012

SYDNEY: Imam condems female "mutilation" defends "circumcision"

The Australian
December 24, 2012

Female circumcision is a right, says imam


by Rachel Baxendale

A MUSLIM leader and outspoken opponent of female genital mutilation says female circumcision, which he defines as the partial removal of the clitoral hood, is not only an utterly distinct practice, but the "divinely ordained right of a woman" under Islam.

Sydney-based Al-Ghazzali Centre for Islamic Sciences and Human Development founder and president, Imam Afroz Ali, appeared on the ABC's 7:30 program in October, condemning female genital mutilation and saying he had been told by community members of its occurrence in Australia.

(Registration required for more)

JAKARTA: Govt told to stop female circumcision

The Jakarta Post
December 23, 2012

Govt told to stop female circumcision


As the United Nations has adopted a resolution urging member states to ban female genital mutilation, the government has been told it has no choice but to revoke a Health Ministry regulation issued in 2010 that condones female circumcision.

National Commission on Violence against Women (Komnas Perempuan) deputy chairwoman Masruchah said that the 2010 ministerial regulation runs counter to the UN resolution because it legalizes a practice that is harmful to the sexual and reproductive health of women.

The UN General Assembly unanimously approved the resolution, which is not legally binding, on Thursday, urging its 193 member states to enforce legislation that prohibits female genital circumcision.

The 2010 Health Ministry regulation stipulates that female circumcision is allowed as long as it is performed by licensed doctors, nurses or midwives.

“We have consistently pushed the ministry to revoke that regulation because it abuses the reproductive rights of women. This practice stems from the erroneous interpretation of cultural and religious teachings,” Masruchah told The Jakarta Post.

Many Indonesians, she said, believed that female circumcision could control the sexual desires of girls.

Instead of providing health benefits, female genital mutilation can cause severe bleeding, urination problems and can lead to complications during childbirth, according to the World Health Organization (WHO).

The Health Ministry website claims that female circumcision, as stipulated in the regulation, cannot be categorized as female genital mutilation.

The regulation stipulates that “female circumcision is an action of incising the skin that covers the front part of clitoris, without harming the clitoris”.

The Indonesian Doctors Association chairman, Zaenal Abidin, said that the association would study the UN resolution and that they would issue a recommendation related to female circumcision.

“The association cannot make any recommendations unilaterally. We will involve religious scholars and communities in the deliberations. We will also study the suggestions from the WHO and international doctors’ associations,” he said.

...

Indonesian General Practitioners Association member Enrico Renaldi, who believes that female circumcision is unnecessary and harmful, said that medical practitioners in the country were facing challenges in preventing the practice.

“It is hard for doctors to be agents of change. There are strong pros and cons in the matter. Indonesians, particularly those in rural areas, see female circumcision as a necessity,” Enrico said.

Iffah Ainur Rochmah, the spokesperson for the Islamic group Hizbut Tahrir Indonesia (HTI), rebuffed the negative assumptions about female circumcision practices in Indonesia.

“This is a part of our culture rooted in Islamic teachings. The practice should be carried out through procedures that will not cause health implications,” she said.

Iffah called on the global community, including the UN, to not liken Islamic female circumcision with the unhygienic and inhumane practice of female genital mutilation.

She explained that Islam teachings regulated female circumcision as a minor incision of the skin that covers the front part of the clitoris.
...
Earlier story

Sunday, December 23, 2012

BERLIN: Majority oppose new circumcision law

Unternehmen-heute.de
22. Dezember 2012

Umfrage: Klare Mehrheit der Deutschen lehnt Beschneidungsgesetz ab

von Bernd Seeger
Berlin - Das vom Bundestag mit großer Mehrheit beschlossene Gesetz zur Beschneidung von Jungen wird von 70 Prozent der Deutschen abgelehnt. Das ergab eine repräsentative Umfrage des Instituts Infratest dimap im Auftrag des Vereins Mogis (Missbrauchsopfer gegen Internetsperren), die der Frankfurter Allgemeinen Sonntagszeitung vorliegt.
Nur 24 Prozent der Befragten hielten das Gesetz demnach für richtig. Es erlaubt - mit einigen Auflagen - die bestehende Beschneidungspraxis. Im Bundestag hatten sich Mitte des Monats 434 Abgeordnete für die Annahme des Gesetzes entschieden. Für die Meinungsumfrage wurden 1.000 Personen am 18. und 19. Dezember befragt.
Unternehmen-heute.de
December 22, 2012

Poll: Clear majority of Germans reject circumcision law

by Bernd Seeger
Berlin - An infant male circumcision law overwhelmingly adopted by the Bundestag is opposed by 70 percent of Germans. The findings of a representative survey by the institute Infratest dimap on behalf of the Mogis Association (abuse victims against Internet censorship) were presented in the Sunday edition of Frankfurter Allgemeinen.
Only 24 percent of respondents considered the law appropriate. It allows - with a few conditions - the existing practice of circumcision. In the Bundestag at the middle of the month 434 MPs had decided to pass the law. In the survey, 1,000 people were questioned on 18 and 19 December.
Earlier story

Saturday, December 22, 2012

EASTERN CAPE: Circumcision deaths resume: 15 this season

TimesLive (South Africa)
December 21, 2012

Eastern Cape officials to meet on circumcision deaths


by

Officials from the national department of health will meet with local leaders and officials on Friday to discuss the deaths of young boys after circumcision.

The department will meet with the Eastern Cape MEC for health Sicelo Gqobana, the Eastern Cape House of Traditional Leaders and local government departments in Bhisho, said provincial health spokesman Sizwe Kupelo.

This meeting follows the death of a boy in Mzimvubu this week.

He was the 15th boy to die as a result of a botched circumcision this season. [Apart from his death, how was his circumcision different from one that wasn't "botched"?]

In June, a total of 49 boys died while undergoing initiation in the mountains.

"The national department of health is expected to present a plan to the province and then there will be discussions that will seek to bring an end to the problem," Kupelo said.

UNITED NATIONS: Call for a world-wide ban on female cutting

CBS News (AP)
December 20, 2012

U.N. seeks a global ban on female circumcision


UNITED NATIONS The U.N. General Assembly unanimously approved a resolution Thursday calling for a global ban on female genital mutilation, a centuries-old practice stemming from the belief that circumcising girls controls women's sexuality and enhances fertility.

It has also been linked to religious and cultural practices, although Muslim and Christian leaders have spoken out against it.

Although not legally binding, General Assembly resolutions reflect international concerns and carry moral and political weight.

The U.N. said in 2010 that about 70 million girls and women had undergone the procedure, and the World Health Organization said about 6,000 girls were circumcised every day.

The resolution, cosponsored by over 100 countries and adopted by consensus, calls the practice harmful and a serious threat to the psychological, sexual and reproductive health of women and girls.

It calls on the U.N.'s 193 member states to condemn the practice and launch education campaigns to eliminate it. It also urges all countries to enact and enforce legislation to prohibit the practice and to end impunity for violators.

According to Amnesty International, female genital mutilation is commonplace in 28 countries in Africa as well as in Yemen, Iraq, Malaysia, Indonesia and among certain ethnic groups in South America, but it is also a worldwide concern because it is also practiced by immigrants in diaspora communities.

Amnesty International's U.N. representative Jose Luis Diaz called the resolution "a first" for the General Assembly and an important moment for campaigners against "this grotesque practice."

NEW YORK: Metzitzah non-warning defended as freedom of speech

Not telling parents about the risks of sucking penises is freedom of speech now?

The New York Times
December 18, 2012

Lawyer Says Ritual Circumcision Is Protected Activity


by Russ Buettner

A lawyer for Orthodox Jewish groups asked a federal judge on Tuesday to throw out a New York City regulation requiring parents to sign a consent form before their infant sons undergo a form of Jewish ritual circumcision in which the circumciser uses his mouth to remove blood from the incision.

The lawyer, Shay Dvoretzky, said the practice, which is prevalent in parts of the ultra-Orthodox community, is a constitutionally protected religious activity. He said that requiring ritual circumcisers, known collectively as mohelim, to be involved in conveying the city’s perspective on the procedure would infringe upon their rights of free speech.

“That lies at the heart of First Amendment protection,” Mr. Dvoretzky said.

But a lawyer for the city argued that the regulation was necessary and that the practice most likely caused 11 herpes infections in infants between 2004 and 2011. Two of the infected babies died; at least two others suffered brain damage.

“The health department is not looking at the religion in determining what to do about this conduct,” said Michelle L. Goldberg-Cahn, a lawyer for the city. “The city is looking at the conduct.”

The Orthodox groups, including Agudath Israel of America and the Central Rabbinical Congress, sued the city in October to block the regulation, which was approved by the New York City Board of Health in September but is suspended until a ruling is issued in this case. The groups say that the procedure is safe and that the city has not definitively linked infections to the practice.

Infectious disease experts, several of whom filed briefs in support of the regulation, widely agree that the oral contact, known in Hebrew as metzitzah b’peh, creates a risk of transmission of herpes that can be deadly to infants because of their underdeveloped immune systems.

On Tuesday, Judge Naomi Reice Buchwald, of Federal District Court in Manhattan, heard oral arguments in the case, one that pits the sanctity of ancient religious rituals against the rigors of both modern medicine and secular government regulation [but not, so far, human rights]. She said her decision would come within a few weeks.

Her sharpest inquiries were directed at Mr. Dvoretzky, the lawyer for the Orthodox groups.

She raised a hypothetical situation in which a single religious group amputates left pinkie fingers at birth, and asked Mr. Dvoretzky whether the city would have the authority to regulate the activity. He said it would depend upon whether the practice caused immediate, serious harm. [Does anyone seriously argue that it wouldn't?]

Judge Buchwald also said there was a direct comparison to consent requirements placed on physicians when they perform a circumcision.

Mr. Dvoretzky called that an “apples and oranges” comparison, because a physician would not perform a metzitzah b’peh.

“Wait a second,” Judge Buchwald interrupted. “They can’t perform any circumcision without consent. It’s a surgery.” [She's on the brink of Getting It. Whose consent, when it is unnecessary surgery.]

Mr. Dvoretzky said the city should undertake a broad education campaign, to prevent all infant herpes infections.

But Judge Buchwald said such a campaign would have little impact, because the risk of infections is medically well-known.

Friday, December 14, 2012

MANCHESTER: Nurse guilty of manslaughter after circumcision death

BBC
December 14, 2012

Grace Adeleye guilty of killing baby in botched circumcision


A nurse has been found guilty of manslaughter after causing a baby's death by botching his circumcision.

Grace Adeleye, 67, carried out the procedure on four-week-old Goodluck Caubergs at an address in Chadderton, Oldham, in April 2010.

The boy bled to death before he could reach hospital the following day.

Adeleye was found guilty of manslaughter by gross negligence at Manchester Crown Court.

The nurse, who denied the charge, had told the jury she had done "more than 1,000" circumcision operations without incident. [So much for "Make sure the doctor who does it is experienced"!]

The court heard that Adeleye and Goodluck's parents were from Nigeria, where the circumcision of newborns is the tradition for Christian families.

Adeleye, of Sarnia Court, Salford, was paid £100 to do the operation.

The jury was told that she carried out the procedure using a pair of scissors, forceps and olive oil and without anaesthetic.

She had claimed there had been "no problem" when she left the infant and that his parents had been pleased with the operation.

However, the court heard that when Goodluck's parents had changed his nappy several hours later, they had found a large amount of blood and phoned Adeleye, who had told them to re-dress the wound.

Goodluck's parents called an ambulance the following morning and he was taken to the Royal Oldham Hospital, where he died a short time later.

A spokesman for NHS Oldham said had the family gone to the hospital and asked for a circumcision, "they would have been advised to go to an approved practitioner who would have charged £100, the same as Grace Adeleye".

Following the guilty verdict, Adeleye was bailed while pre-sentencing reports are prepared.

The Crown Prosecution Service's Jane Wragg said the case "was not about the rights or wrongs of circumcision [yet if he hadn't been circumcised, he would still be alive], but the grossly negligent way in which the procedure was undertaken".

"Goodluck Caubergs was a healthy little boy whose tragic death was wholly unnecessary," she said.

"Goodluck died because the standard of care taken by Grace Adeleye in carrying out the circumcision fell far below the standard that should be applied.

Earlier story

BERLIN: Bundestag legalises circumcision, 100 oppose

Reuters
December 12, 2012

Germany passes law to protect circumcision after outcry


by Madeline Chambers


Protesters against circumcision, Berlin 12-12-12 Protestors in front of the Brandenburg Gate, Berlin
REUTERS-Pawel Kopczynski

(Reuters) - German politicians passed a law on Wednesday to protect the right to circumcise infant boys in a show of support for Muslims and Jews angered by a local court ban on the practice in May.

The ban - imposed on the grounds that circumcision amounted to "bodily harm" - triggered an emotional debate over the treatment of Jews and other religious minorities, a sensitive subject in a country still haunted by its Nazi past.

The outcry prompted Germany's centre-right government and opposition parties to draw up legislation confirming the practice was legal - overruling the decision by a court in the western city of Cologne.

The new law passed by an overwhelming majority in Bundestag lower house said the operation could be carried out, as long as parents were informed about the risks.

[Hardly "overwhelming" - the 100 votes against were considerably more than expected.]

German vote piechart, 434 for, 100 against, 46 abstained

[By party: Angela Merkel's CDU/CSU most toed her line; only among the Communsts did most vote to protect children:]

Voting in the Bundestag, 12/12/12 by party

Jewish groups welcomed the move.

"This vote and the strong commitment shown ... to protect this most integral practice of the Jewish religion is a strong message to our community for the continuation and flourishing of Jewish life in Germany," said Moshe Kantor, President of the European Jewish Congress.

Germany's Catholic Bishops Conference said it hoped the bill would help safeguard religious freedoms. No comment was immediately available from the country's Central Council of Muslims.

PAIN MINIMISED

The May ruling centered on the case of a Muslim boy who bled after the procedure [requiring surgery under general anaesthetic and 10 days in hospital] and the ban only applied to the area around Cologne.

But some doctors in other parts of Germany started refusing to carry out circumcisions, saying it was unclear whether they would face prosecution.

Under the new law, a doctor or trained expert must conduct the operation and children must endure as little pain as possible, which means an anesthetic should be used. The procedure cannot take place if there is any doubt about the child's health.

Justice Minister Sabine Leutheusser-Schnarrenberger said no other country in the world country had made the religious circumcision of boys an offence.

"In our modern and secular state, it is not the job of the state to interfere in children's' upbringing," she said. [Cutting what other body part off is "upbringing"?]

Child welfare group Deutsche Kinderhilfe disagreed, saying the government had "(pushed) through the legalization of the ritual of genital circumcision ... against the advice of child right campaigners and the medical profession." [And against German's Grundgesetz - Basic Law]

Thursday, December 13, 2012

SOUTH KOREA: Circumcision rate declining

7th Space
December 12, 2012

Decline in male circumcision in South Korea


by DaiSik Kim, Sung-Ae Koo and Myung-Geol Pang

To investigate the changing circumcision rate in South Korea in the last decade and to propose underlying causes for this change, in the context of the present fluctuating world-wide trends in circumcision.

Methods: From 2009 to 2011, 3,296 South Korean males (or their parents) aged 0-64 years were asked about their circumcision status, their age at circumcision, and their information level regarding circumcision. We employed non-probability sampling considering the sensitive questions on the study theme.

Results: Currently the age-standardized circumcision rate for South Korean males aged 14-29 is found to be 75.8%.

In an earlier study performed in 2002, the rate for the same age group was 86.3%. Of particular interest, males aged 14-16 show a circumcision rate of 56.4%, while the same age group 10 years ago displayed a much higher percentage, at 88.4%.

In addition, the extraordinarily high circumcision rate of 95.2% found 10 years ago for the 17-19 age group is now reduced to 74.4%. Interestingly, of the circumcised males, the percentage circumcised in the last decade was only 25.2%; i.e., the majority of the currently circumcised males had undergone the operation prior to 2002, indicating that the actual change in the last decade is far greater.

Consistent with this conjecture, the 2002 survey showed that the majority of circumcised males (75.7%) had undergone the operation in the decade prior to that point. Focusing on the flagship age group of 14-16, this drop suggests that, considering the population structure of Korean males, approximately one million fewer circumcision operations have been performed in the last decade relative to the case of non-decline.

This decline is strongly correlated with the information available through internet, newspapers, lectures, books, and television: within the circumcised population, both the patients and their parents had less prior knowledge regarding circumcision, other than information obtained from person to person by oral communication. Within the uncircumcised population, the prior knowledge was far greater, suggesting that information discouraging circumcision played an important role.

Conclusion: South Korean male circumcision is likely to be undergoing a steep decline.

The cause for this decline seems to be the increase in information available on the pros and cons of circumcision.

[Boys in South Korea are commonly circumcised in late childhood or early puberty. They have input into the decision that babies do not - the reason, cynics say, that circumcision advocates press for the operation to be performed in infancy.]

Monday, December 10, 2012

MALAYSIA: Health Ministry wants "medical" female cutting

ABC (Australia)
December 7, 2012

Malaysia storm over female circumcision


Audio: Activist Azrul Mohamad Khalib speaks to Connect Asia about female circumcision in Malaysia (ABC News)

Debate is raging in Malaysia over Muslim female genital mutilation as the country's health ministry reportedly develops guidelines to reclassify it as a medical practice.

In 2009, the Fatwa Committee of Malaysia's National Council of Islamic Religious Affairs ruled that "female circumcision", as it has become known, was obligatory for Muslims but if harmful must be avoided.

Human rights activist Azrul Mohamad Khalib has written a scathing commentary calling for abolition of the practice.

He says it has no religious or medical benefits.

But according to the results of a university survey the practice is widespread, with more than 90 per cent of Malay Muslim female respondents reporting they have been circumcised.

Azrul Mohamad Khalib told Radio Australia's Connect Asia: "It certainly is a surprising figure, really. The study involves more than 1,000 female respondents and when we look at it, around 90 per cent or so are Malay Muslims."

Disappointing
Azrul Mohamad Khalib is also communications and resource mobilisation adviser of the SPRINT project with the International Planned Parenthood Federation.

He said that to have anecdotal evidence "captured" in the study is really "both surprising and a little bit disappointing".

What about the suggestion that the health ministry may be about to register the practice?

He said: "One of the things I find quite alarming with regards to this development is that the Ministry of Health is actually depending on a fatwa, a religious opinion that was actually issued by the national fatwa council, in which they made it obligatory, or 'wajib', for all Muslim women to be circumcised.

"It seems that the Ministry of Health is now (instituting) that fatwa.

"So, in contrary to quite a number of best practices as well as a WHO (World Health Organisation) advisory, the Ministry of Health is taking steps now to sort of make it standardised, or medicalised, in such a way that it might be applied to all public health-care facilities."

At the moment the practice is carried out generally by traditional practitioners, as well as private health practitioners, the activist said.

"One of the things that those working on gender issues in Malaysia have come to realise is that a barrier when we deal with these sort of issues is the lack of awareness - the 'why' of such practices and how harmful it can be.

"Certainly when it comes to female circumcision, the position that has been taken is that if it does do no harm why not do it? Well . . . if there are no benefits to doing it, why do it?

"One of the first steps that we are trying to push out forward is that we are very much trying to spread awareness that such practices are unnecessary.

"They're not required by religion, they're not having any medical benefits whatsoever and certainly when we look at it it's strictly cultural in its entirety.

"But as you mentioned, it is going to be extremely hard if more than 90 per cent of the Malay Muslim population already practising it."

Saturday, December 8, 2012

MANCHESTER: "Discredited" method used to circumcise baby who died

Mancunian Matters
December 7, 2012

Nurse accused of killing Oldham baby in botched circumcision used 'discredited' procedure, court hears


by Lucy Kenderdine

A nurse accused of killing a four-week-old Oldham baby in a botched circumcision used a ‘relatively dangerous’ and ‘discredited’ procedure, a court heard today.

Grace Adeleye, 67, of Sarnia Court, Salford, denies manslaughter by gross negligence where 27-day-old Goodluck Caubergs died following the operation at his home.

The jury in Manchester Crown Court heard evidence from expert circumcision consultant Nigel Zoltie on the Nigerian religious ‘clamp and cut’ procedure used by Adeleye in the circumcision.

He said: “Bleeding is such a significant risk that it must be explained to the parents, particularly for the method used on Goodluck.”

Mr Zoltie added that the traditional method carries risks greater than others currently used and the procedure has largely been discredited by medical circles.

But he did argue that it whilst the instruments used by the defendant, artery forceps and surgical scissors, were not the ideal tools, if ‘used with skill’ they could do the job effectively and safely.

The prosecution also argued that the high risks and complications that can arise as a result of the procedure were not properly explained to the parents.

This could mean that full consent for the circumcision was not given as the parents did not fully understand what it entailed and how it would be done, the court were told.

Adeleye also did not get written consent from the parents to carry out the procedure as it is not customary to do so for community and religious circumcisions, the jury heard.

However she defended herself by saying that she discussed the risks with the parents before the procedure through a series of phone calls with the father on the day of the circumcision.

She said: “I explained everything to him and he told me he understood.”

Adeleye added that the fact that they had asked her to perform the circumcision was enough consent for community circumcisions and written consent was never given.

The court also heard evidence surrounding the aftercare of baby Goodluck and what information the parents were given regarding his safety.

Neither parent received written information on what to look out for in terms of complications after the procedure.

Adeleye said: “I told them they should watch out for bleeding and infection.”

The trial continues next week.

Earlier story

MANCHESTER: Nurse circumcised baby who died "culturally"

Manchester Evening News
December 5, 2012

Salford nurse accused of Oldham baby's manslaughter after 'botched' circumcision defends method


A nurse accused of the manslaughter of a four-week-old baby after a home circumcision said today she had carried out "more than a thousand" such procedures without a single problem.

Grace Adeleye, 67, performed the procedure on Goodluck Caubergs without anaesthetic and using only a pair of scissors, forceps and olive oil, Manchester Crown Court heard.

Goodluck was born on March 22, 2010, in Rochdale Infirmary and died on April 17, after bleeding to death the day after the circumcision, aged 27 days old.

The defendant is originally from Nigeria, where she qualified as a nurse and midwife, as [are] the youngster's parents, where the circumcision of newborns is the tradition for Christian families, the jury heard.

Mrs Adeleye said after praying before the operation, as is her custom, she used the traditional, Nigerian "clamp and cut" method, which she had used hundreds of times, without any pain-killers for the child.

And she told the jury when she left the boy with his parents, Sylvia Attiko and Olajunti Fatunla, there [were] no problems but [she] warned them to monitor closely any bleeding from the wound.

...

But today Mrs Adeleye, a mother-of-six told the jury she herself performed circumcisions on her two grandsons and carried out more than a thousand such ops while practising in Nigeria.

She said it was custom to have a naming ceremony for the child on the eighth day after birth then she would travel from church to church performing the operation.

And since coming to the UK in 2004, working as a state registered nurse in Litchfield, she had performed a further 20 home circumcisions.

None had required hospital treatment or suffered excessive bleeding.

Mrs Adeleye said she performed the same circumcision technique on Goodluck like the others.

"It's the cultural one in Nigeria. It's clamp and cut," she said.

Peter Wright QC, defending asked her: "Is there anaesthetic administered to the child before the procedure?"

"We don't usually, no," she replied.

"The culture, why we don't need anaesthetic, that's why we do it early in life. We believe if it's done early the pain is not as well as in an older child."

The prosecution claim Adeleye also failed in her duty of care to the child because the boy's parents knew nothing about the procedure or medical matters.

But the witness said she had discussed the procedure and what needed to be done with firstly the father then the mother separately,

"Mr Fatunla asked me , he told me about the procedure he wanted to do," the defendant told the jury.

"He said he has inquired amongst the Nigerians. That he wanted to do the cultural one."

She added: "He said he's scared of blood. He said he doesn't want to see blood."

Mrs Adeleye said she did not want to use "big medical words" so spoke to the father in their own Yoruba dialect from Nigeria - and stressed the boy must be monitored for bleeding from the wound.

The defendant said she questioned the parents about the health of mother and baby, sterilised the instruments she used and cleaned the boy's groin with TCP before the op began.

She used artery forceps to clamp the excess skin for one minute then used surgical scissors to "trim" the foreskin which only took a "few seconds," before gauze, vaseline and bandages were applied.

The skin was given to the boy's father, because Nigerian custom has it, that if it is discarded carelessly the boy will grow into a "promiscuous" man, the jury were told.

Mrs Adeleye said she remained at the house for one hour to monitor any bleeding before leaving.

She told the jury there was "no problem" with the parents thanking her and about to cook a meal before she left.

She told the jury they would hardly have been "dining and wining" if there had been complications with their son's op.

Proceeding

Earlier Story

AUSTRIA: Charges filed against circumcisors by victims

December 5, 2012

Charges brought against two religious circumcisers for the first time in Austria


Criminal charge: grievous bodily harm inflicted on at least 2000 babies and small children

(Vienna, 29 November 2012) – Charges are being brought against the community rabbi and mohel of the Jewish Religious Community in Vienna. The rabbi has stated himself that for religious reasons he has performed operations, where there was no medical indication, on the genitals of over 1000 male babies. The second accused is a general practitioner who runs a circumcision centre in Vienna and is specialized in ritual Islamic circumcision. He is also the president of the Islamic Religious Community in Vienna. On his website he proudly presents photos of circumcised children online. The doctor also faces charges by the disciplinary commission of the Chamber of Doctors. The rabbi will also be charged for violation of medical law.

Circumcision is a severe trauma for children

“The removal of the penis foreskin is a surgical operation on the physical integrity of the patient. In cases where there are no medical reasons, it is a matter of deliberate grievous bodily harm,” explains Anja Oberkofler, lawyer. Even nowadays the operation is often carried out without an anaesthetic and is extremely painful: babies have no protective mechanism and because of the shock often fall into a momentary coma. The circumcision ritual is often performed without any explanation and frequently also without any anaesthetic; for little boys aged between 6 and 8 this causes severe trauma. The foreskin is the most sensitive part of the penis and thus highly erogenous tissue. When it is removed the glans is covered by a layer of hard skin. This can result in the loss of sexual sensitivity and a limited ability to achieve an orgasm, as testified by many of those affected. Possible complications can occur after the operation such as bleeding or mutilation: according to current medical information the ratio is between 2 and 10 per cent.

Religiously motivated bodily harm is not per se exempt from punishment

A further reason for the charge: for an operation with such grave consequences it is necessary to gain the consent of the person concerned. This does not occur in the case of babies and children. As lawyer Oberkofler stated, “It is incomprehensible why religious approval to inflict grievous bodily harm should be exempt from punishment.” Austria has signed the UNO convention on the rights of children which contains a regulation concerning punishment for the circumcision of children due to religious reasons. The right of protection of bodily integrity is also anchored in the Charter of fundamental rights of the European Union. “The fundamental right of the child to have physical integrity ensured cannot be annulled by arguing for the religious freedom of the parents. The religious freedom of the parents in bringing up their children ends where grievous bodily harm inflicted on their child begins”, she says.

Charge brought by victim of abuse and circumcision

The charge is being brought by Sepp Rothwangl, who was subject to sexual abuse in his childhood by a member of the church. “Nowadays I see it as my duty to ensure that children should not suffer physical and emotional harm because of religious privileges which go unpunished.” Rothwangl has also been instrumental in organizing the campaign against church privileges; signatures are at present being collected for this campaign. “I am totally against special rights for religious communities, because it should not be allowed to mutilate children’s sexual organs in the name of religion without being punished,” stated Rothwangl. “This is where civil society and the rule of law have to intervene.” The campaign against church privileges is therefore also in favour of bringing the current criminal charges.

Afflicted persons break their silence

The second person bringing charges is Cahit Kaya, who was circumcised as a child according to Islamic ritual. “I would have liked to have had the freedom myself to decide whether I would be circumcised or not”, says Kaya today. “But without my consent, without any information and without any preparation on the part of the doctor nor on the part of my parents, I was circumcised in a state hospital in Vorarlberg. Many Moslems suffer a great deal from the sexual consequences of their circumcision and are ashamed to have been a victim of this operation. If they do indeed talk about it, then only in their very closest circle of friends. This silence finally has to be broken.”

www.kirchen-privilegien.at

www.beschneidungsdebatte.info

WASHINGTON: PEPFAR targets babies

PEPFAR
November 30, 2012

PEPFAR now explicitly targetting infants


In its "PEPFAR Blueprint: Creating an AIDS-free Generation" the meaning of the word "Voluntary" seems to have been forgotten.

Action Step: Increase the number of males who are circumcised for the prevention of HIV....
10. Build the capacity of partner governments to begin planning for and financing an integrated, long-term early infant male circumcision (EIMC) program as the adult V[oluntary ]M[edical ]M[ale ]C[ircumcision] program is being scaled-up. PEPFAR’s financial support is prioritized to the adult VMMC program. However, once the adult program has progressed sufficiently, PEPFAR funds may be used to support EIMC activities. (p 23)

[There is no evidence that infant circumcision has any effect on HIV transmission]

Wednesday, December 5, 2012

BERLIN: Paediatric Association condemns circumcision law

Gesetzentwurf der Bundesregierung
November 27, 2012

German Pediatric Society roundly condemns infant circumcision.


Dr.Wolfram Hartmann, President of the Professional Association of Child and Youth Doctors in Germany, spoke on November 26, 2012 to the Bundestag committee considering the Government's "Draft law on the scope of child's care regulations at a circumcision of the male child" and the draft law of MPs Marlene Rupprecht, Katja Dörner, Diana Golze, Caren Marks, Rolf Schwanitz, other MPs: "Draft law on the scope of the child's care and the rights of the male child at a circumcision "

The Association opposes the first, which sets conditions for the performance of child circumcision, but no limit on who may do it, and supports the second, which sets a minimum age of 14, with informed consent.

Dr Hartmann told the committee

This statement is coordinated with the German Academy for Child and Youth Medicine (DAKJ), the umbrella organization of all pediatric associations in Germany (German Society for Child and youth medicine DGKJ, Professional Association of the Child and Youth doctors, German Society for social pediatrics and youth medicine DGSPJ), to which other organizations are co-opted (see also . I also refer to the statement of the Germany Society for Child Surgery) on that subject.

From a medical point of view, there is no reason to remove the intact foreskin of under-aged boys not capable of giving consent. In pre-school age, it is also very rare to have a true medical indication to remove (circumcise) the foreskin. At this age, the foreskin (prepuce) is physiologically more or less strongly fastened to the glans. Attempts to pull back the immature and adhered foreskin often cause inflammations and painful fissures.

"The male foreskin is part of the dermal organ and fulfills an important role in protecting the very delicate glans. ...

The repeatedly-quoted statement of the AAP contradicts earlier statements by the same organization, without being able to refer to new scientific evidence. The AAP statement has meanwhile been considered scientifically untenable by almost all pediatric societies and associations worldwide.

... The American lawyers association for children's rights, Attorneys for the Rights of the Child also criticized the AAP statement in a letter to the Pediatrics magazine [Which was not published there, but was published here]. It [says the AAP policy] contains errors and inconsistencies and violates both the AAP's own statements regarding bioethics, and several civil and criminal law regulations in the USA.

The WHO recommendations for prophylactic circumcisions only refers to mature, sexually active men in countries with low hygienic standards and is not suitable to justify the prophylactic circumcision of under-aged boys not capable to give consent. ...

.... The government's current draft law on the scope of child's care regulations at a circumcision of the male child unwillingly opens the door for demands to legalize the circumcision of girls.

MANCHESTER: Midwife tried for circumcision death

BBC
November 27, 2012

Manchester baby boy 'bled to death after circumcision'


A four-week-old boy "bled to death" after a home circumcision carried out by a nurse, a court has heard.

Goodluck Caubergs died the day after nurse Grace Adeleye carried out the procedure without anaesthetic, Manchester Crown Court was told.

The jury heard the 66-year-old only used scissors, forceps and olive oil at an address in Chadderton, Greater Manchester in April 2010.

Mrs Adeleye denies manslaughter by gross negligence.

The court heard the medic and Goodluck's parents are originally from Nigeria, where the circumcision of newborns is the tradition for Christian families.

'Dangers ignored'

Mrs Adeleye, of Sarnia Court, Salford, was paid £100 to do the operation, the court was told.

It is alleged the defendant, who is also a midwife, left a "ragged" wound that bled and her post-operative care was inadequate.

The family home, where the procedure took place, is a mile and a half from Royal Oldham Hospital.

Adrian Darbishire QC, opening the case for the prosecution, told the jury: "The allegation essentially here is that the care she provided in the course of tha t procedure was so bad that not only did it cause the death of that young baby wholly unnecessarily, but it amounted to gross negligence and a crime."

The court heard up to three children a month are admitted to the Royal Manchester Children's Hospital because of bleeding after home-based circumcisions - a danger the nurse should have been aware of.

Mrs Adeleye went to Goodluck's home on 16 April 2010, telling his mother to fetch some olive oil and a bowl of warm water and stripping the baby to his vest, the jury was told.

'No pain relief'

The defendant brought her "instruments" out of her handbag and dipped a pair of scissors into the water in a kidney dish.

She carried out the procedure with no anaesthetic or local pain relief before cleaning the wound with cotton wool and applied a bandage, the court heard.

Between 30 and 40 minutes after surgery, Mrs Adeleye left without making any proper checks on the patient, Mr Darbishire said.

Later, the parents found the bandage had come off the wound and there was blood in Goodluck's nappy. [US: diaper]

Mr Darbishire said even a small amount of blood loss is dangerous and the loss of just one sixth of a pint of blood can be fatal for a newborn.

A post-mortem examination revealed Goodluck's death was caused by a loss of blood.

The trial continues.

Monday, November 26, 2012

ZIMBABWE: Men don't want to be circumcised

NewsDay (Zimbabwe)
November 24, 2012

Men fear circumcision


By Pamela Mhlanga
THE male circumcision programme that was launched in 2009 has only seen 10% of the targeted 1,2 million men by 2015 being circumcised, a government official said yesterday.

The programme’s national coordinator in the Health and Child Welfare ministry, Sinokuthemba Xaba, was speaking during the opening of a voluntary medical male circumcision clinic in Bulawayo’s Lobengula suburb.

He said most males feared getting circumcised due to a number of factors.

“More and more men have heard about the benefits of male circumcision, but have various concerns that prevent them from getting circumcised,” Xaba said.

“Males have questions like; what if something goes wrong?

“Will the wound heal? Where will my foreskin go? These are some of the fears that we hear every day from men who are considering going for the procedure.”

...

Xaba also said the ministry wanted to expand male circumcision services to all districts nationwide.

...

Xaba said government was still a long way from reaching its target of having 1,2 million men circumcised by 2015.

...

LONDON: Plan to prosecute more for female cutting

The Voice
November 23, 2012

MP welcomes improved laws on female circumcision


There are currently no prosecutions on female genital mutilation

LABOUR POLITICIAN Diane Abbott fully supports an action plan that will be published on improving prosecutions for female genital mutilation (FGM).

Director of Public Prosecutions (DPP) Keir Starmer QC is publishing his action plan on improving prosecutions for FGM following his round table meeting with experts in September.

FGM has been a specific criminal offence in England and Wales since 1985, but no prosecutions have ever been brought.

In September, a round table meeting on prosecuting cases of FGM with more than 30 interested and expert parties was hosted by the DPP at the Crown Prosecution Service (CPS) Headquarters in London, including the Association of Chief Police Officers, individual police forces, Members of Parliament, medical professionals, the NSPCC and other third sector organisations.

Speaking on how to tackle FGM, Abbott said: “I really welcome this. The issue has lurked in the shadows for too long, and I think it’s got to be brought into mainstream consciousness more.

“About 20,000 children in England and Wales are deemed "at risk" every year. The situation is similar in France, yet whereas some 100 parents and practitioners of this have been convicted in France, there has never been a single prosecution in the UK.”

Abbott continued: “I think many of the people who are affected by this are voiceless and unprotected, and we’ve got to do more to understand it.”

The DPP has established a steering group to oversee the progress on the action points ahead of his next FGM prosecution round table in summer 2013.

Starmer said: “It’s critical that everything possible is done to ensure we bring the people who commit these offences against young girls and women to justice and this action plan is a major step in the right direction.

“Everyone who can play a part in stopping FGM – from the doctor with a suspicion that an offence has been committed and the police officer investigating the initial complaint to the prosecutor taking a charging decision – needs to know what to do to improve detection rates, strengthen investigations and, for the part of the CPS, to start getting these offenders into court.

“I am determined that the CPS should play a key role in ensuring that the impunity with which these offenders have acted will end.”

The action points include gathering more robust data on allegations of FGM, so the scale of the problem can be gauged.

Friday, November 23, 2012

INDIA: 7-year-old castrated in botched circumcision, fighting for life

The Times of India
November 23, 2012

7-year-old loses genitals after circumcision, fighting for life


By Rajendra Sharma
ALWAR: A seven-year-old boy is battling for life after a circumcision surgery went horribly wrong at a private hospital in Alwar on Thursday. The boy's genitals had to be cut off in an attempt to save his life, said sources. An FIR has been lodged against the hospital authorities after the relatives of the boy created a ruckus.

The boy, Imran, was admitted to Sania hospital in Alwar town on November 10 for circumcision. According to sources, after the operation, some equipment was used to prevent bleeding. However, electric current accidentally passed into his private parts and the boy suffered serious injury. [In other words, they used monopole electrocautery and cooked his penis from the inside. This is malpractice.] On November 13, the boy was referred to a private hospital in Jaipur. After investigating the case, the doctors in Jaipur advised the boy's relatives to remove his genitals as it was necessary to save his life. The operation was conducted and his genitals were removed. Three days after the operation, the boy was again admitted to Sania hospital in Alwar.

The boy is now fighting for life while his relatives are protesting outside the hospital in Alwar.

Imran's grandfather Ayub Khan said: "The circumcision was carried out by Dr Tayyab Khan, a physician at Sania Hospital. He is not a surgeon. The licence of the hospital should be cancelled for carelessness."

Imran's uncle Fakruddin Khan said that the operation was to be completed in just 30 minutes but the doctors took four hours. "Two days after the circumcision, the doctors advised us to take the boy to Jaipur. When we took the boy to Jaipur, the doctors there immediately informed us that the boy's private parts were completely damaged and his genitals had to be removed. After operation, we tried to admit the boy in different hospitals but no hospital admitted him. The last option for us was Sania hospital. So we brought him here back after his genitals were removed in Jaipur."

However, denying the allegation, Dr Tayyab Khan said the circumcision was carried out by a surgeon Hariram Gupta. He said it was just an accident. [Just? Should the parents be relieved he wasn't castrated deliberately?]

Former minister Nasru Khan also reached the spot to calm down the situation but all his efforts went in vain. Nasru Khan and the protestors were involved in a heated argument at the spot. The protestors alleged that he was taking the side of the hospital.

The hospital administration assured the relatives of the boy that the hospital would bear the expenses of the boy's treatment. [His life is ruined. How will they treat that?]

BERLIN: Bundestag begins debating legal circumcision

DeutcheWelle
November 22, 2012

German parliament debates circumcision law


By Kay-Alexander Scholz
Germany's parliament has started debating a draft law on infant male circumcision. The government wants legal security for Muslim and Jewish traditions in Germany.

In May 2012, a Cologne court ruled that the circumcision of a young boy on religious grounds amounted to grievous bodily harm and therefore illegal.

...

The draft law foresees amending the German Civil Code by article 1631d, which is to be dedicated entirely to male infant circumcision. The operation would be legal if it is carried out according to "appropriate medical procedures" and does not endanger the child's health, for instance in the case of a hemophiliac. Persons other than doctors who are trained in the art of circumcision, such as Jewish mohels, will be allowed to practice the rite during the first six months of a child's life.

...

The Bundestag, or lower house of parliament, began its discussion on the legislation on Thursday (22.11.2012). An alternative draft law handed in by a group of opposition left-wing lawmakers was also on the agenda. They propose that parents should have to wait until their son is 14 so he can give informed consent for the procedure. After all, they argue, circumcision involves a grave operation in which the "foreskin is amputated."

This draft takes into account criticism by children's protection organizations and the Association of Pediatricians, which approved of the Cologne court's ruling. In this scenario, circumcision on the eighth day after birth, as is Jewish custom, would be impossible.

The Bundestag Legal Committee is scheduled to examine the medical risks circumcision entails at a hearing on November 26.

...
Earlier story

UNITED NATIONS: Circumcision not important in preventing HIV

November 20, 2012

New H.I.V. Cases Falling in Some Poor Nations, but Treatment Still Lags


By Donald G. McNeil

New infections with H.I.V. have dropped by half in the past decade in 25 poor and middle-income countries, many of them in Africa, the continent hardest hit by AIDS, the United Nations said Tuesday.

The greatest success has been in preventing mothers from infecting their babies, but focusing testing and treatment on high-risk groups like gay men, prostitutes and drug addicts has also paid dividends, said Michel Sidibé, the executive director of the agency U.N.AIDS.

“We are moving from despair to hope,” he said.

Despite the good news from those countries, the agency’s annual report showed that globally, progress is steady but slow. By the usual measure of whether the fight against AIDS is being won, it is still being lost: 2.5 million people became infected last year, while only 1.4 million received lifesaving treatment for the first time.

“There has been tremendous progress over the last decade, but we’re still not at the tipping point,” said Mitchell Warren, the executive director of AVAC, an advocacy group for AIDS prevention. “And the big issue, sadly, is money.”

Some regions, like Southern Africa and the Caribbean, are doing particularly well, while others, like Eastern Europe, Central Asia and the Middle East, are not. Globally, new infections are down 22 percent from 2001, when there were 3.2 million. Among newborns, they fell 40 percent, to 330,000 from 550,000.

The two most important financial forces in the fight, the multinational Global Fund for AIDS, Tuberculosis and Malaria and the domestic President’s Emergency Plan for AIDS Relief, were both created in the early 2000s and last year provided most of the $16.8 billion spent on the disease. But the need will soon be $24 billion a year, the groups said.

“Where is that money going to come from?” Mr. Warren asked.

The number of people living with H.I.V. rose to a new high of 34 million in 2011, while the number of deaths from AIDS was 1.7 million, down from a peak of 2.3 million in 2005. As more people get life-sustaining antiretroviral treatment, the number of people living with H.I.V. grows.

Globally, the number of people on antiretroviral drugs reached 8 million, up from 6.6 million in 2010. However, an additional 7 million are sick enough to need them. The situation is worse for children; 72 percent of those needing pediatric antiretrovirals do not get them.

New infections fell most drastically since 2001 in Southern Africa — by 71 percent in Botswana, 58 percent in Zambia and 41 percent in South Africa, which has the world’s biggest epidemic.

But countries with drops greater than 50 percent were as geographically diverse as Barbados, Cambodia, the Dominican Republic, Ethiopia, India and Papua New Guinea. [...where circumcision is not prevalent.]

The most important factor, Mr. Sidibé said, was not nationwide billboard campaigns to get people to use condoms or abstain from sex. Nor was it male circumcision, a practice becoming more common in Africa.

Rather, it was focusing treatment on high-risk groups. While saving babies is always politically popular, saving gay men, drug addicts and prostitutes is not, so presidents and religious leaders often had to be persuaded to help them. Much of Mr. Sidibé’s nearly four years in his post has been spent doing just that.

Many leaders are now taking “a more targeted, pragmatic approach,” he said, and are “not blocking people from services because of their status.”

Fast-growing epidemics are often found in countries that criminalize behavior. For example, homosexuality is illegal in many Muslim countries in the Middle East and North Africa, so gay and bisexual men, who get many of the new infections, cannot admit being at risk. The epidemics in Eastern Europe and Central Asia are driven by heroin, and in those countries, methadone treatment is sometimes illegal.

Getting people on antiretroviral drugs makes them 96 percent less likely to infect others, studies have found, so treating growing numbers of people with AIDS has also helped prevent new infections.

Ethiopia’s recruitment of 35,000 community health workers, who teach young people how to protect themselves, has also aided in prevention.

...

Mr. Warren’s organization said in a report on Tuesday that the arsenal of prevention methods had expanded greatly since the days when the choice was abstain from sex, be faithful or use condoms. Male circumcision, which cuts infection risk by about 60 percent [They can never resist saying that, with ever increasing certainty, can they? Or failing to mention it is only from women to men?], a daily prophylactic pill for the uninfected and vaginal microbicides for women are in use or on the horizon, and countries need to use the ones suited to their epidemics, the report concluded.

OTTAWA: DIY Circumciser loses his appeal

The Calgary Herald
November 16, 2012

Father who circumcised his son on the kitchen floor loses high court appeal


OTTAWA - The Supreme Court of Canada has abruptly dismissed the appeal of a British Columbia man who tried to circumcise his four-year-old son on his kitchen floor with a carpet-cutting blade.

The boy needed corrective surgery to repair the damage from the botched procedure.

In a 7-0 ruling from the bench, the justices left intact a Court of Appeal ruling convicting the man of aggravated assault and assault with a weapon.

The man, identified only as DJW, was convicted at trial in October 2009 of criminal negligence causing bodily harm and acquitted on the two assault charges.

The appeal court restored convictions on the assault counts and stayed the negligence charge, conditional on the conviction for aggravated assault.

The man's appeal to the Supreme Court sought to have the assault charges thrown out again, but the justices dismissed the case from the bench, saying their reasons would be available in 48 hours.

The original trial was told the man felt his religious beliefs required that his son be circumcised. Doctors advised him to wait until the child was older and stronger before performing the procedure.

In its factum on the case, the Crown dismissed the religious reasoning.

"This is a case about child abuse," the Crown argued. "This is not a case about the applicant's religious freedom or circumcision generally." [But how do the material circumstances of the operation bear on the man's religious freedom or circumcision generally? If he had done it "properly" would it no longer be child abuse? How does this differ except in detail from Dr Andrew Freedman of the AAP Task Force on Circumcision, who circumcised his own son on his parents' kitchen table?]

DJW's lawyer argued that the man took safety precautions, including extensive research on the topic of circumcision.

"The appellant's actions were performed with reasonable cause ... and without intent to assault or in any way harm his son," the factum said.

The trial judge found the kitchen was not a sanitary place for a surgical procedure [Someone should tell Dr Freedman], that the blade used wasn't as sharp as a surgical instrument and it was inappropriate to use a veterinary product to try and staunch the bleeding from the boy's partly severed foreskin.

DJW's religious background was as a Jehovah's Witness, although he was "disfellowshipped" by his family and the church. The Crown said his religious education and associations later led him to believe that male circumcision was a covenant with God.

He attempted to circumcise himself in 2005 and could not stop the bleeding. He had to go to an emergency room where a doctor sutured the wound.

His name is under a publication ban to protect the child's identity.

Earlier story

OTTAWA: DIY Circumciser to be heard by top court

Canada.com
November 15, 2012

Top court hears botched home circumcision case Friday


By Natalie Stechyson
OTTAWA — The Supreme Court of Canada will hear on Friday the dramatic case of a B.C. father who, for religious reasons, tried to circumcise his four-year-old son on his kitchen floor with a carpet blade and a blood coagulant meant for horses.

Among the many issues the court will have to consider is the meaning of criminal negligence, and whether religious beliefs can go into the determination of what is reasonable behaviour, said Carissima Mathen, a law professor at the University of Ottawa.

“When you have something like this where, on an objective basis, the benefits of this procedure are mixed, and it seems like the primary motivation for circumcising your son is cultural or religious, are those beliefs something that we should factor into whether this a reasonable thing for someone to have done?” Mathen said.

“It raises questions such as why is it, in fact, that we permit infant circumcision?

A trial judge found that over the years after his son’s birth, the father known only as D.J.W. decided to “make things right with God” by following the laws of Moses, according to court documents. This included circumcision.

The trial judge found that D.J.W. had consulted with two rabbis and four physicians, and had asked several doctors to perform his son’s circumcision. None would do it because the boy would have required a general anesthetic, which could not be justified for a child so young.

In 2007, after giving his son some homemade honey wine, D.J.W. attempted to circumcise the boy on the kitchen floor, according to court documents, wounding him in the process.

The boy later had to have corrective surgery.

D.J.W. was found guilty in 2009 of criminal negligence causing bodily harm, but was acquitted of two other charges. The B.C. Court of Appeal stayed the conviction and upped the charge to aggravated assault and assault with a weapon.

In delving into the case, the top court will also look at whether the injury D.J.W. inflicted was a “wound” and if the blade he used on his son, known only as D.J., can be considered a “weapon,” said Marie-France Major, a partner at Ottawa’s Supreme Advocacy LLP.

D.J.W. is seeking an acquittal, maintaining that the trial judge was wrong to convict him of criminal negligence, but right to acquit him of aggravated assault and assault with a weapon, according to court documents.

Counsel for D.J.W. will argue that the man’s actions were performed with “reasonable care” and without intent to harm his son.

The Crown will argue that this is a case about child abuse, not D.J.W.’s freedom of religion or even about circumcision.

[“The result,” according to court documents submitted by the Crown, was “the foreskin on D.J.’s penis stuck out like two arms.] “D.J. was not circumcised. He was disfigured,” the Crown’s factum reads.

A decision from Friday’s case is not expected for some time.

Earlier story

GARRISON, NY: Western media hype female cutting

The Science Codex
November 13, 2012

Western media coverage of female genital surgeries in Africa 'hyperbolic' and 'one sided'


There is widespread condemnation of female genital surgeries and it is considered a form of mutilation and a violation of human rights, but an international advisory group argues that poor understanding and unfair characterizations of the practice are not really helping. In a public policy statement in the Hastings Center Report, the Public Policy Advisory Network on Female Genital Surgeries in Africa, a group that includes doctors, anthropologists, legal scholars, and feminists, argues that media coverage of the practice is hyperbolic and one sided, "painting the now familiar portrait of African female genital surgeries as savage, horrifying, harmful, misogynist, abusive, and socially unjust."

The advisory network's statement takes no position on whether the practice should continue, but aims to "move the coverage of the topic from an over-heated, ideologically charged, and one-sided story about 'mutilation,' morbidity, and patriarchal oppression to a real, evidence-based policy debate governed by the standards of critical reason and fact checking."

Three commentaries responding to the article, written by three bioethicists and an obstetrician-gynecologist, also appear in the journal.

Female genital surgery – a neutral [no, positive] term used by the advisory network instead of other terms, such as female genital cutting [really neutral] and female circumcision – has been condemned as a violation of the human rights of girls and women by a wide range of experts and organizations, including the World Health Organization and the United Nations. In several African countries, including Egypt, Guinea, Sierra Leone, and Somalia, more than 90 percent of women ages 15 to 49 have undergone such surgeries.

["Surgery" today implies
  • a professional operator
  • surgical instruments
  • sterile conditions

These are seldom fulfilled in tribal or much of ritual genital cutting. Here is (Muslim, male) genital cutting where the gloveless operator handles money (0:54) and bystanders are heard coughing during the course of the operation:


Is that "surgery"?]

In its statement, the advisory network focuses mainly on two types of female genital surgery, which they state comprise 90 percent of procedures in Africa. These practices involve reducing the clitoral hood and tissue and reducing or eliminating the labia and the clitoris. A third type, referred to as infibulation or sealing, involves narrowing the vaginal opening with stitches or some other sealing method. [Actually three types, each radically different from the others. Only the first may be considered minimal.]

The authors put forth seven facts that they hope will change the scope of media coverage and lead to a better understanding of the cultural complexities underlying female genital cutting:

  • Medical research has found that a high percentage of women who have had genital surgery "have rich sexual lives, including desire, arousal, orgasm, and satisfaction, and their frequency of sexual activity is not reduced."
  • Reproductive health and medical complications linked to female genital surgery happen infrequently.
  • Those who value female genital surgery view it as aesthetic enhancement, not mutilation.
  • In almost all societies where female genital surgery is performed, male genital surgery also takes place. [Since the Pokot people of Kenya resuumed male cutting, "almost all" has become "all".] Broadly speaking, then, such societies "are not singling out females as targets of punishment, sexual deprivation, or humiliation." [No, they're equal opportunity oppressors.]
  • The link between patriarchy and female genital surgery is unfounded. Almost no patriarchal societies adhere to the practice and, at the same time, the practice is not customary in the world's most sexually restrictive societies. [Islamic societies are not patriarchal?]
  • Women manage and control female genital surgery in Africa and the practice "should not be blamed on men or on patriarchy." Ironically, the authors contend, groups that fight against female genital surgery weaken the power of women.
  • An influential WHO study about the "deadly consequences" of female genital surgery is the subject of criticism that has not been adequately publicized. The reported evidence does not support sensational media claims about female genital surgery as a cause of perinatal and maternal mortality during birth

The authors outline the following seven policy implications:

  • The media, activists and policy-makers must "cease using violent and preemptive rhetoric" that paints a sensational image of African parents mutilating their daughters and damaging their reproductive and sexual health.
  • It should be acknowledged that female genital surgery is not unique to African women; the authors liken it to "genital piercings on college campuses" and "vaginal rejuvenations requested by some Western women." [But for the crucial issue of informed consent by the person being cut]
  • Advocates fighting for safe, hospital-based female genital surgery should be given a voice in public policy forums.
  • "Zero tolerance" slogans promoted by anti-mutilation groups are counterproductive. Not only do they limit thoughtful, respectful dialogue, but they can make genital surgery more dangerous by driving the practice underground.
  • Legislation and regulations that criminalize female genital surgery for adult women are discriminatory, because they deny women's autonomy "to choose what makes them happy with their own bodies."
  • Studies of genital surgery should be multidisciplinary, and there should be support for a network linking researchers and advocates who have diverse points of view.
  • Women and girls who have undergone genital surgery as children and are now living in countries where the practice is nonexistent or illegal should not be subjected to discourse that stigmatizes them or teaches them to expect sexual dysfunction. Such discourse "may provoke what could be called 'psychological mutilation,'" potentially compromising the development of a normal and healthy psychosexual life. [Hyperbole. Actual cutting is not mutilation while purely mental action is?]

While agreeing with the international network's call for accurate information about female genital surgery and its criticisms of inflammatory language, three commentaries disagree with the policy advisory statement.

Ruth Macklin, a bioethicist and professor in the department of epidemiology and population health at the Albert Einstein College of Medicine of Yeshiva University, takes issue with its depiction of the facts and points to crucial information that is missing from the statement, including numerous statements and resolutions by the International Federation of Gynecology and Obstetrics opposing the performance of female genital cutting and opposing any efforts to medicalize the procedure, and studies documenting significant harm to women who have undergone the procedure, as well as a change in attitude among younger women in countries where the prevalence of female genital cutting is high.

In another commentary, Nikola Biller-Andorno, director of the Institute of Biomedical Ethics at the University of Zurich, and Verina Wild, the institute's deputy director, argue that enough evidence now exists to define the conditions under which female genital cutting is morally unacceptable. They state that it would be unimaginable to conduct a randomized, controlled trial of the practice or to undertake long-term cohort studies, because such research would in fact condone female genital cutting. "Requiring more data before committing to a stance against clearly unacceptable forms of female genital cutting is not a proof of neutrality," they conclude. "It means failing to protect a very vulnerable population." The authors also call into question the Advisory Network's depiction of women's autonomy, suggesting instead that women may be compelled to undergo female genital cutting, because they cannot deviate from their local customs and social structures.

In the third commentary, Dr. Nawal M. Nour, an obstetrician-gynecologist and director of the African Women's Health Center (AWHC) at the Brigham and Women's Hospital in Boston, writes that her patients have endured both major and minor long-term complications from female genital cutting. Nour also states her concern that the Advisory Network's presentation of data is biased. For example, she writes that the statement that "a high percentage of women have rich sexual lives" would be more plausible if "high" were changed to "some." Nour cites a large meta-analysis showing that "women who had undergone genital cutting were more likely to report dyspareunia, no sexual desire, and less sexual satisfaction." "Speaking as both an African woman and an obstetrician-gynecologist," she writes, "I hope that this practice ends during my lifetime."