It was supposed to an exciting chapter in his life, the start of his journey to manhood. He and his friends were looking forward to it and counted down the days until they left.
But that excitement soon led to excruciating pain and misery so profound Sihle Mlungu found himself plotting his death. And the reason is becoming all too familiar in South Africa.
A botched circumcision – in Sihle’s case at an initiation school in Lusikisiki in the Eastern Cape – resulted in his penis being surgically removed and plunged the 16-year-old into the depths of despair.
“I thought of diving off a cliff and falling on the rocks,” he says. “Sometimes I wished a car would run over me, but I wasn’t brave enough to go through with these things.”
The young man’s life changed when he met Gugulethu Sirayi, the founder of the Gugulethu Sirayi Foundation, a support programme that helps initiates who have suffered botched circumcisions.
Gugulethu arranged for Sihle to have penile reconstruction, an operation where fat, skin, tissue and nerves were harvested from his forearm and thigh to rebuild his penis. The surgery takes between nine and 12 hours.
Gugulethu, a former community health worker, started his foundation after finding out that initiates who’d suffered botched circumcisions were returned to their communities without any form of support. Since 2010 he’s been arranging counselling sessions and resources to help initiates get additional treatment or surgery to help them lead normal lives.
“Botched circumcision is a devastating issue which has a severe effect on these young men,” Gugulethu says.
“They go to initiation school believing they will return as respected members of their communities because they are no longer boys – but they are not prepared psychologically or mentally for the fact that things can go wrong. It becomes a huge setback for them.”
A step in the right direction
The foundation has since 2010 helped 11 initiates get penile surgery, while another 50 are undergoing counselling ahead of their operations. This is being done together with the Eastern Cape health department, which has now entered into partnerships with local urologists and plastic surgeons.
“They’re going to help us with penis reconstructions,” says Collen Konitshwe of the department’s medical male circumcision programme.
There are over a thousand boys living without penises in the Eastern Cape alone, according to Nkululeko Nxesi of the Community Development Foundation of South Africa.
“This is creating havoc in communities because these boys become depressed or sometimes violent. Surgical reconstruction is a huge step in the right direction,” Nxesi says.
The challenge with transplants
Surgical reconstruction is seen as a better option than penile transplant. Although there is often a good chance of success with a transplant, a shortage of donors means only four penises are available for transplant each year.
Sihle went to the initiation school without his family’s permission. At the time his mother, Veliswa Mlungu, was in Stanger in KwaZulu-Natal, where she works on a farm.
She was devastated when she learnt what had happened to her son. “I was very upset he went without my permission, and then I had to care for him. He is my firstborn and I was hoping he would study and start working, so I can stop working on the farms,” Veliswa says.
Sihle says he and his friends realized something wasn’t right at the initiation school when certain rituals weren’t performed.
“There are muthi rituals that need to take place before you bring initiates together, and the surgeon who was responsible for it didn’t do them and we started getting sick,” he says.
Two of his friends died in hospital after being circumcised, he says.
“I was worried, I thought, ‘I’ll end up dead too’. When I got over the fear of death I was in terrible pain.”
At the hospital doctors told him his penis had to be removed as it had been damaged beyond repair.
“Nothing could be done. I lost my penis like that. “I felt like I had lost everything. I thought about committing suicide – that felt like it would be my only way out.”
That hospital experience was so traumatic for Sihle he didn’t want to go to Pretoria for the penile reconstruction surgery in 2016, Gugulethu says.
“I struggled to get him to the doctors. He was afraid the same thing would happen there. I went to fetch him physically, saying: ‘Sihle, the bus [ for Pretoria] is leaving now’. Eish, he was not happy . . .
“But after the operation, he told me, ‘I never thought this thing was going to be done so easy’.”
“It was nice, nice. I never felt any pain,” recalls Sihle, who spent three months in hospital. “I’m still free from the pain. I can do everything a man with a normal penis can do. I have a girlfriend and I’m sexually engaged with her.”