Circumcision during Ramadan carries risks
By Mohand Ouali for Magharebia in Algiers – 28/08/11
In Algeria, Ramadan is a popular time to have boys circumcised. But the delicate operation can result in accidents or injuries to children if performed by inadequately trained medical staff.
Although circumcisions can be performed at any time of the year, many Algerians choose to have their children circumcised during Ramadan, especially on the 27th day of the month, which has particular religious significance (Laylat al-Qadr or the Night of Destiny).
Many organisations, public institutions and companies arrange collective circumcision ceremonies during the holy month as a gesture of support for families. However, when collective operations are performed at improperly equipped facilities, injuries often result.
"There are nurses, general practitioners and even paediatricians who carry out these operations despite having no right to do so," said Dr Mourad Zaoui, who works at a hospital in Kolea, Blida province. "This is a surgical procedure that should be performed by a surgeon."
He explained that bleeding, infections and injuries resulting from surgical mishaps are the most common problems.
"I witnessed the death of a child from post-circumcision bleeding," he said, adding that in other cases, damage caused by botched circumcisions can be repaired. "In most cases, the child will certainly experience psychological trauma, but that is all."
"There are still some areas where there is no oversight, and this increases the risk of accidents," Dr Zaoui said. He also noted that there are no national statistics indicating the frequency of mishaps.
"Yes, accidents are frequent when circumcisions are performed. For instance, two boys were maimed when they were circumcised in mid-July in the town of Tenes," a medical source told Magharebia.
Another doctor in the town said that one child was maimed during a collective circumcision ceremony held by a charity last year. The child, who was later found to suffer from haemophilia, was circumcised by a nurse and was hospitalised due to bleeding. The nurse was suspended and legal proceedings filed against him.
The Algerian health ministry has taken steps in recent years to reduce the risk of injury, including issuing new safety recommendations for doctors.
The Social Action Department (DAS) in Algiers announced August 1st that it would offer circumcisions to a thousand boys during the holy month in partnership with the health ministry.
In Constantine, Abdelkader Nouar, the secretary-general of the Souboul el Kheirat office with the religious affairs ministry, has announced that around 500 boys from needy families will be circumcised during Ramadan. This gesture of solidarity will end on the eve of Eid al-Fitr. Nouar mosque committees have received numerous requests for circumcisions from impoverished families who cannot afford to pay private doctors for the procedure, which usually costs around 4,500 dinars (43 euros).
In early August, the daily newspaper La Tribune launched an initiative called "Together, let's put a smile on children's faces". The aim of the charity event was to arrange collective circumcision ceremonies for 120 orphans and needy children.
However, these mass circumcisions pose the greatest risk of accidents, according to authorities. In an August 4th statement, the health ministry said circumcisions "may only be performed by surgeons at a healthcare facility (public or private) where all of the safety measures necessary to ensure the success of this surgical procedure are in place".
The regulations aim to protect children and "prevent any repeat of the painful accidents that have transformed acts of faith and joy into acts of mourning". The guidelines have been in force since 2006, when the health minister issued instructions in wake of a tragedy in El Khroub that left several boys maimed.
Authorities hope to minimise the risks and offer protection to children by preventing accidents, the main causes of which are poor hygiene and incompetence. Since the 2006 incident, pre-operative assessments and general check-ups have been mandatory for all children prior to circumcision.
Subscribe to our newsletter and get Magharebia's latest articles delivered to your inbox.