Category Archives: Botched Circumcision

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South Africa: 4 year olds child dies after hospital circumcision

Johannesburg – “They killed my child.” These were the pained words of a Germiston father whose son had to be taken off life support on Wednesday evening after he was declared brain dead by two surgeons following a medical circumcision operation a week ago.

Reggie Mokalapa, 39, took his four-year-old son, Gugulethu, to Medicross Germiston for what doctors had assured him would be a “less than two-hour” procedure last Tuesday.

On Sunday, monitors showed that Gugulethu’s brain was not responding, and on Monday he was declared brain dead.

On Wednesday, a second doctor confirmed that Gugulethu was brain dead and the family elected for doctors to take him off life support.

“We are always advised to circumcise our children young, and we did this so that he’d be okay in future. Unfortunately, we took him to a slaughterhouse,” said Mokalapa.
 
 
 
 
Rest in Peace, Gugulethu.
 
Please, let’s stop cutting minors.
 
WHO, PEFPAR, Bill and Melinda Gates Foundation, UNAIDS, please stop cutting minors.

patrick_izimba

Safe Male Medical Circumcision in Uganda results in penile amputation

Circumcision, like every other surgery, carries some risks. The problem is when promoters argue for a surgery without medical indication and minimizing every risk in order to entice the patients to undergo the procedure.

As we know, the West is currently promoting VMMC (voluntary male medical circumcision, safe male medical circumcision) in some countries of Africa as part of the package for HIV prevention. A lot of emphasis has been set on reducing the costs of the procedure by looking for new methods (such as the PREPEX, the TaraKlamp, the Shang Ring) and trying to perform the procedure without the need for a surgeon, with minimally trained personnel.

Of course this is going to lead to complications, such as what happened to Patrick Izimba in Uganda, reported on July 16th of 2013. Patrick Izimba was enticed by one of the signs offering safe male medical circumcision, and what followed is every man’s nightmare. His penis suffered gangrene and was transferred to a specialist. Plastic surgery will be used to reconstruct his penis, but he won’t be able to have sex.

When you promote mass circumcision, these events are bound to happen. Yet, this the the message that circumcision promoters are sending to Africa:

Check out the explicit manifesto on their page: “Importance of establishing circumcision as a social norm is stressed“. It’s not about health, it’s not about preventing a disease, it’s about creating a social norm.

Let’s quickly visit the WHO’s manual for male circumcision with anesthesia, and on page 16 let’s check the listed risks:

Risks
As for any surgical procedure, there are risks associated with
circumcision. While the benefits of circumcision may be wide-ranging
and long-term, any problems generally occur during or soon after the
procedure. They include:

•pain;
•bleeding;
•haematoma (formation of a blood clot under the skin);
•infection at the site of the circumcision;
•increased sensitivity of the glans penis for the first few months
after the procedure;
•irritation of the glans;
•meatitis (inflammation of the opening of the urethra);
•injury to the penis; 
•adverse reaction to the anaesthetic used during the circumcision.

These complications are rare when circumcision is performed by well
trained, adequately equipped, experienced health care personnel, and
are usually easily and rapidly resolved. Data from controlled trials
show that fewer than 1 in 50 procedures result in complications.

Did I miss loss of the penis? Or is the loss of the penis darkly lumped into “injury to the penis”? When considering the reality of a man who just lost his sexual organ, does it make sense that these complications are rare and easily and rapidly resolved?

The news article about Patrick Izimba mentions anesthesia as possible cause of the gangrene. The WHO’s manual on male circumcision with anesthesia indicates:

“Lidocaine with epinephrine must not be used because there is a risk of constriction of the blood vessels to the whole penis, which can cause gangrene and loss of the penis”. 

Is this what happened? Was he told that gangrene and loss of the penis were possible risks of the procedure? If not, his consent was not informed consent.

Page 148 of the manual also states indicates:

Worsening wound infection with signs of gangrene. A rare risk
of genital surgery is infection with multiple bacteria, causing
progressive skin loss. In this situation, the blood supply is cut off,
and the skin becomes necrotic and turns completely black. This
condition is known as Fournier’s gangrene (synergistic gangrene
or necrotizing fasciitis) and is more common in men who have
diabetes. Any man with signs of spreading infection or black
gangrenous skin should be urgently transferred to a referral
centre. At the referral centre, it is usually necessary to give a
general anaesthetic and remove all the dead skin

And while we are in page 148 of the manual, let us wonder if men are advised about the possible late sexual complications, or are they reassured that their sexual function won’t be impacted? Page 148-149 describes late complications such as:

In the long term, the client may complain of:

• decreased sensitivity of the glans;

• oversensitivity of the glans;

• unsightly circumcision wounds, ragged scars or other cosmetic
concerns;

• persistent adhesions at the corona and inclusion cysts. These
problems can be avoided if the foreskin is fully retracted during the
operation and all adhesions carefully divided;

• discomfort during erection from the scrotal being skin pulled up the
shaft of the penis and a tight scrotal sac. This can result from
removal of too much skin during the circumcision. These problems
can be avoided by careful preoperative marking of the incision
lines.

• torsion (misalignment) of the skin of the penile shaft. This can be
avoided by taking care during the operation to align the midline
raphe with the frenulum.

Is this the new social norm? Males with unsensitive glans, unsightly scars and uncomfortable erections when the scrotum is pulled up by the penis because it doesn’t have enough skin to accommodate a normal erection? Is this the American gift to Africa? Are we transferring the American wound?

Appendix 6.2 of the WHO’s Manual shows a sample consent form for a minor. The consent form does not list the risks and complications of circumcision. It merely states that the parents were counseled on the existing risks. Without a written record, how are they to ensure that providers won’t be lying about the complications and exaggerating the benefits, when their expressed intention is to establish circumcision as a social norm?

Background

Gangrene and loss of penis is a frequent complication of traditional African circumcisions, due to the risk of infections and terrible conditions in which the procedure is usually carried. However, loss of the penis also occurs in sterile conditions. It happened in 2012 to a man in China, 2 weeks before his wedding.  In 2008 a man in Kentucky had his penis removed without consent during a circumcision because the doctor found a cancerous tumor; the man sued on grounds that he should have been waken up and given information prior to the amputation, and yet the court sided with the doctor as the consent form enables the doctor to perform any other procedure deemed necessary. And of course there is the well known case of David Reimer, who lost his penis while being circumcised as a baby, was raised as a girl until his teenage years, was reverted (breast reduction, penile reconstruction…), and committed suicide at 39 years.

Circumcision for HIV prevention remains nothing but speculation about a protective effect, with no proven causal reason. The African studies have been challenged by scientists and general public, but for some reason the UNAIDS and the WHO continue to promote circumcision as part of the HIV prevention package without stopping to think critically, sponsored by PEPFAR and the Bill & Melinda Gates Foundation.

Boy (3 years old?) suffers partial amputation of the glans during circumcision in Morocco

A boy loses 20% of his glans during a circumcision. The boy cries in horrible pain.

This video may have been posted by the parents, who wrote:

l’assassin est docteur BOUHDI FOUAD Bd Fida à casablanca et le complice Docteur FAYSSAL LAZRAK de clinique ATFAL Oasis à casa: le premier a causé la coupure pendant la circonciosion et a mis des sutures en fermant carrément le canal d’urtine et le 2ème a refusé de délivrer le compte rendu avant et après opération qu’il a effectué sur mon enfant pour sauver le fonctionnement d’urine

(the murderer is Dr. Fouad BOUHDI Bd Fida in Casablanca and the accomplice Doctor FAYSSAL LAZRAK clinical Atfal Oasis casa: the first caused the break for the circumcision and put sutures closing outright the urinary channel and a second refused to issue a report before and after the operation he performed on my child to allow urination)

The video was posted May 18th, 2013.

From the description, the procedure was performed at Clinique Atfal, in Casablanca, Morocco. http://www.blanee.com/etablissements/clinique-atfal-Casablanca

Partial and total amputation of the glans is one of the “low incidence high severity” complications of circumcision, one which leaves life long complications. EVERY CIRCUMCISION exposes the child to this risk, even if with a low incidence.

Not only is the boy traumatized, but he may have problems with urination and sex for the rest of his life.

My heart breaks for this boy.

More information (Arabic): http://hespress.com/societe/79020.html

More documented severe complications of circumcision: http://circleaks.org/index.php?title=Documented_Severe_Complications_of_Circumcision