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Narratives about the dual utilisation of indigenous knowledge systems and health based practices in the success of traditional male circumcision (ulwaluko) in the Eastern Cape Province of South Africa

Using a narrative approach and a postcolonial theoretical framework, in particular the notion of hybridity, the goal of this research is to locate the practice of the Eastern Cape AmaXhosa male circumcision, normally known as Traditional Male Circumcision (TMC) within recent developments in health affairs. Of importance in this scenario is the permeation of “western” based circumcision methods such as Voluntary Medical Male Circumcision (VMMC) within the geo-political space of TMC. Bhabha’s theory of hybridity is going to play a critical role in this effort. The research methodology is that of an endogenous and explorative nature. For practical reasons so to enable comparisons of the successful integration of TMC with “western” health-based systems of knowledge, two districts have been chosen as data collection sites. One is in the Sarah Baartman district (Makhanda) and one is in the Oliver Tambo district (Ngquza Hill). Purposive sampling is going to be utilized. The use of in-depth interviews will play a fundamental role. Narrative-inducive methods will be essential. For data analysis, thematic narrative analysis will be used.

As indicated by the 2008 World Health Organization report, TMC is an ancient custom that has its roots in amaXhosa knowledge systems. With colonization, these practices have been changed, adapted or altered (World Health Organization, 2008; Deacon and Thomson, 2012; Gogela, 2017). With the infusion of “western” understanding of gender, development into adulthood, and health, various of the customs (eg. wearing particular clothing when initiation is complete) have changed. And yet, as a traditional practice, TMC stands as a symbol of anti-colonial practice, and the knowledge thereof is fiercely guarded (World Health Organization, 2008; Deacon and Thomson, 2012). Dispute, however, surfaces in the question of health, particularly where there are initiate deaths (Mavundla et al., 2009; Prusente et al. 2019;  Mpateni and Kang’ethe, 2020).

“Western” medical systems are touted by some as superior to traditional surgeons in ensuring and maintaining health, particularly with regard to circumcision. What is called medical male circumcision (MMC) is regarded as less risky than TMC. As circumcision is seen as more than a health issue (attached as it is to the transition of manhood), those who practice it may see the inroads of “western” medicine as jeopardizing or undermining traditional knowledge systems. Still, there are areas in which the integration of “western” medical knowledge and traditional practices is viewed as a success (Mavundla et al. 2009; Nwanze and Mash, 2012; Prusente et al. 2019; Mpateni and Kang’ethe, 2020).    

Although a number of studies on TMC have been conducted, there is a scarcity of research that investigates the combination of AmaXhosa traditional and “western” methods in the success of traditional male circumcision. Of the few that have been conducted, authors have identified a need for more in-depth studies of this nature. As Prusente et al. (2019:2) argue, “review of the existing MC policies in order to enable the integration of MMC and TMC is urgently required”.  There is also much need for the research to be conducted by black, young researchers who, though drawing from their own personal experiences can adopt both an insider and outsider approach.

Researchers

Sithembele Xhegwana

Last Modified: Thu, 17 Sep 2020 13:37:41 SAST