Circumcision+in+Bukusu+Tribe,+Kenya

= = =Circumcision in the Bukusu Tribe = toc by Gaby Marantz

Overview of the Bukusu
The Bukusu are a Luhya tribe of Bantu speaking people. They dwell primarily in the Bungoma county of Kenya along some of the southern parts of the country's border with Uganda (Marck, 1997). The majority of the population lives in rural areas. Most religious members of the tribe are either Catholic or Protestant. The Bukusu people have a long history of compulsory circumcision. The rate of male circumcision among the their tribe is about 80%, compared to 66%, which is the average circumcision rate in Sub-Saharan Africa ( Egesah, Wanyama, & Muange, 2014).

The process of the circumcision ceremony
Male circumcision among the Bukusu is a highly involved and meaningful ritual. The ceremonies take place every other year in August, early enough that the participants, who are primarily adolescent boys ages 12-16 (Bailey, Egesah, & Rosenberg, 2008), can return to school in the fall. There are three overall stages to the circumcision rites: preparation and operation, healing and seclusion, and final coming out feast and festivities (Marck, 1997).

The week preceding the circumcision operation is characterized by songs of courage, dancing, and feasting among the initiates and their families (Egesah, Wanyama, & Muange, 2014). The day before the ceremony, an initiate will visit his uncle who adorns him with a necklace of made of bull meat (Ondeko, 2013). The ceremony continues with a night of drinking beer at the initiate's father's house (Marck, 1997; Ondeko, 2013). In the middle of the night or early in the morning before dawn, the adolescents go down to the river to numb their bodies in the cold water and be smeared with mud (Khamis, 2014; Ondeko 2013). They then return to their fathers' houses to await the operator, who circumcises them at dawn in front of a crowd of onlookers (Khamis, 2014; Ondeko, 2013).

The adolescents continue to stand outside after being circumcised until their fathers come and give them gifts and weapons (Marck, 1997). Afterwards they walk backwards into their homes, symbolizing turning away from their childhoods, and begin a period of seclusion for healing and instruction on how to be an adult man in the community. (Ondeko, 2013). The group of adolescents circumcised in one year together form an age grade, a social grouping that indicates seniority and status (Marck, 1997).

Significance of the ceremony
From the perspective of structural functionalism, circumcision for the Bukusu is an important part of the creation perpetuation of social relationship rules in the tribe. The ritual defines and is indicative of gender and familial roles. For instance, participation in the ceremony is restricted almost exclusively to men, and the place of women is primarily as that of post-cut caregiver or sexual object (Egesah, Wanyama, & Muange, 2014; Marck 1997). Additionally, the circumcision ritual is an important aspect of certain family relationships such as those between the initiate and his father and uncles, as well as the wider social relationships of the age-grade of the initiates and of their fathers (Marck, 1997).

Looking at the circumcision rites through the lens of symbolic anthropology also shows its broader cultural significance. The ceremony is a rite of passage from boyhood to adulthood, through which adolescents are supposed to prove their preparedness for facing the challenges of being adult men (Egesah, Wanyama, & Muange, 2014). It is of utmost important that they exhibit stoic bravery and courage throughout the process, including the actual circumcision which is done without any anesthesia ( Khamis, 2014; <span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">Ondeko, 2013). Egesah, Wanyama, and Muange (2014) explain that “circumcision is a process by which the traditional norm of initiation through lessons about roles, functions and community expectations especially for production and reproduction pass to a young man as they change from childhood to adulthood” (p. 282). The ceremony initiates adolescent boys in a masculinity that is courageous, violent, and the agent of productivity and reproductivity.

<span style="color: #222222; font-family: 'Times New Roman',Times,serif; font-size: 14pt;">Transition from traditional to clinical
<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">Despite the long history and significance of traditional circumcision among the Bukusu tribe, it is becoming slightly less prevalent as more boys and families opt for operations in clinical settings instead. Generally speaking, being an uncircumcised adult man carries with it far too much social stigma for many people to do away with the practice altogether, however an increasing portion of the population no longer wishes to participate in the traditional ritual. Egesah, Wanyama, and Muange (2014) outline four main reasons why this is the case.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;"> **Education**. Most parents wanted their sons to be circumcised before starting secondary school so as to avoid the humiliation associated with being uncircumcised upon making that transition (Egesah, Wanyama, & Muange, 2014). Additionally, parents who valued education more highly were more likely to choose a clinical circumcision which is associated with less involved procedures and a shorter recovery period than traditional ceremonies (Egesah, Wanyama, & Muange, 2014). Because of this clinical procedures are typically less disruptive to the boy's schooling.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;"> **Cost**. Circumcisions are expensive. The cost of food, beer, gifts, fees, bedding, wound care, cloth, etc. for a traditional ritual is about four times as much as the cost of the materials required for a clinical circumcision (Egesah, Wanyama, & Muange, 2014). For a family living in poverty, the traditional route might just not be possible.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">**Religion**. The people who opt for traditional circumcision typically have no strong religious affiliation and do not view religion as having any important influence on their lives and traditional decisions because it is not an aspect of Bukusu culture (Egesah, Wanyama, & Muange, 2014). However, some members of the tribe ascribe to Christianity, which preaches against many aspects of traditional African beliefs and practices including circumcision (Egesah, Wanyama, & Muange, 2014). These families choose clinical circumcision for their sons in order to avoid the (from a Christian perspective) immoral, ritualistic ceremonies while also avoiding the social stigma of being uncircumcised.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">**Health**. The final major factor influencing Bukusu parents' decision to circumcise their sons traditionally or in a clinic is their beliefs about the health risks involved in the operation. Those who express low levels of health-related concerns are more likely to choose ritual circumcision (Egesah, Wanyama, & Muange, 2014). Parents who chose clinical circumcision expressed a fear of HIV infection through shared blades, a fear of tetanus infections from unsanitary tools and conditions, a desire for faster healing, and concern about other complications resulting from a botched procedure (Egesah, Wanyama, & Muange, 2014).

<span style="color: #222222; font-family: 'Times New Roman',Times,serif; font-size: 14pt;">Recommendations for cross-cultural work
<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">The academic literature available on the tradition of circumcision not just among the Bukusu but in all of Africa as a whole comments most on this health-related piece. Circumcision is correlated with lower rates of HIV transmission, particularly in the case of female-male transmission (Bailey, Egesah, & Rosenberg, 2008; Westercamp & Bailey, 2006). Because of this significant health benefit, a lot of effort has been put into getting non-circumcising communities to adopt the practice (Bailey, Egesah, & Rosenberg, 2008; Westercamp & Bailey, 2006). However, in order for circumcision to be an effective medical intervention, it is also necessary to improve the conditions around circumcision in the communities who already do it in order to make the procedure actually safe and healthy (Bailey, Egesah, & Rosenberg, 2008; Westercamp & Bailey, 2006). Both traditional and clinical settings are associated with high rates of complication and adverse affects (25% vs 1.7%) (Bailey, Egesah, & Rosenberg, 2008). There is a need for better trained staff, sterile supplies, and more hygienic settings for the medical procedures (Bailey, Egesah, & Rosenberg, 2008). Egesah, Wanyama, and Muange (2014) reported the story of an adolescent who nearly died as a result of his clinical circumcision because the circumciser had had no training and the overall conditions were unsanitary.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;"> Achieving better conditions for clinical circumcisions seems primarily to be a matter of resources. However, Bailey, Egesah, and Rosenberg (2008) also stress the importance of improving conditions for traditional circumcisions, which would be a more difficult task. They suggest, for instance, that “...educational programmes might be developed to encourage parents and young men to seek circumcision at earlier ages, before onset of sexual activity. This may avert more HIV infections and have the added advantage of reducing adverse events” (Bailey, Egesah, & Rosenberg, 2008, p. 674). In order for such an educational intervention to be effective, it would need to take into account the traditional and cultural significance of circumcision for the Bukusu. For this tribe, circumcision is a rite of passage; it initiates boys into adult masculinity. All aspects of the traditional ceremony, from the age of the initiates to the physical setting of the actual circumcision, are backed by generations of meaning. Any educational work done in this community around circumcision and HIV would have to sensitively work with the cultural norms.

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">References
<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">1. Bailey, R. C., Egesah, O., & Rosenberg, S. (2008). Male circumcision for HIV prevention: A prospective study of complications in clinical and traditional settings in Bungoma, Kenya. //Bulletin of the World Health Organization//, //86//(9), 669–677. doi: 10.2471/BLT.08.051482

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;"> 2. Egesah, O. B., Wanyama, M., & Muange, V. (2014). The relevance of intangible cultural heritage in modern times: Evidence from Babukusu male circumcision. //Sociology and Anthropology//, //2//(7), 273–283. []

<span style="font-family: Times New Roman,serif;"> 3. Marck, J. (1997). Aspects of male circumcision in subequatorial African culture history*. //Health Transition Review//, //7//(Supplement), 337–359. Retrieved from []

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">4. Khamis, N. (2014, November 24). Becoming a man [Web log post]. Retrieved from []

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">5. Ondeko, G. (2013, May 31). Bukusucircumcision ceremony [Web log post]. Retrieved from []

<span style="color: #222222; font-family: 'Times New Roman',serif; font-size: 12pt;">6. Westercamp, N., & Bailey, R. C. (2006). Acceptability of male circumcision for prevention of HIV/AIDS in Sub-Saharan Africa: A review. //AIDS and Behavior//, //11//(3), 341–355. http://doi.org/ [|10.1007/s10461-006-9169-4]