SNIP/TUCK: Circumcision in the Philippines



In our country, circumcision is not done solely for medical purposes. Circumcision has been a part of our cultural norm; that every boy in his puberty years is expected to undergo. Pretty strange? Not so in our country. You see, circumcision has been a ritual, a rite of passage if you may, that boys have to go through during the said life stage. It is a cultural belief in the Philippines that the transition from boy to manhood is not thoroughly fulfilled without circumcision. 

Failure to undergo this traditional Filipino custom will most likely result to mockery and ridicule from peers and relatives. Those who are not yet circumcised will be called supot (intact prepuce) and will be looked down by those who are done with the procedure. If one reaches high school uncircumcised, he will be considered weird and abnormal. Those that reach the early adult years uncircumcised are considered "old" for the procedure. If one does not have a deep understanding and knowledge of the Filipino culture, this would be considered a low form of bullying.

CIRCUMCISION SEASON

In the Philippines, there is a so-called circumcision season and these are the months of April-May, or the summer months. These months are when the kids are on a school break; so, after the circumcision, the kids can rest at home without having to miss school during the healing process. It is during the said months when "Operation Tuli" (mass circumcision) in different hospitals and health clinics are conducted. Hundreds of crying, screaming, and on-the-verge-of-fainting boys would line up to undergo this procedure.

THE FILIPINO CUTS

Circumcision in the Philippines is done in two ways - the surgical circumcision and the traditional circumcision or "Pukpok" (vigorous blow or hammering).

Surgical Circumcision

The newer, more modern, and universally accepted method is the surgical circumcision. The surgical circumcision is favored by those who live in the urban areas where hospitals and clinics are more accessible. It is the circumcision of choice by urban folks who are more modernized and have been educated enough regarding this type of circumcision.

There are two techniques used for surgical circumcision - dorsal slit and sleeve techniques. The dorsal slit is the technique of choice for those with conditions such as phimosis (tight foreskin) and paraphimosis (un-retractable foreskin). The foreskin is pulled back over the glans before circumcision. A vertical cut down the center of the foreskin is made.  The slit is made up to the base of the the penis crown and the skin excised  . Multiple stitching follows using absorbable sutures. Of course, all of these are done after the injection of a local anesthetic. 

The sleeve technique on the other hand presents a more aesthetically pleasing penis. Circular cuts are made on the penile shaft that reveals a gap. The remaining foreskin are then pulled together and stitched up.This technique is said to be more intricate than the dorsal slit technique. This method is suitable for older boys and adults. 

Traditional Circumcision or "Pukpok"

This method has caused a bit of controversy over the years given the nature of the procedure itself. Many have argued that the traditional circumcision or "pukpok" is a form of genital mutilation and abuse. This method is done in the very rural areas of the country.

Boys would line up to go to the local "circumciser" for this traditional circumcision or "pukpok". It is favored that this procedure be done near a river, lake, or sea because the boys will be asked to submerged half of their bodies (from waist down) in the water to soften the penile skin before going under the knife. They will also be asked to chew guava leaves to be used for later. The foreskin is placed on top of a piece of wood called "lukaw". A razor (labaha) is then placed on top of the foreskin. The foreskin detaches after a few swift hammering. The boy will then be asked to spit the chewed guava leaves on the wound to control the bleeding.

I am not certain if this method is still being practiced up to this day although there have been reports that it still is.

FILIPINO CIRCUMCISION MYTHS

It will make one taller: Most of those who get circumcised do grow taller and the reason for such is that those who get circumcised are the boys who are in their growth spurt years. These are boys in the 10-16 age brackets. They are in the stage where physical changes happen like rapid increase in height. Circumcision has nothing to do with that.

It will make a penis bigger: Circumcision is subtraction and not addition. Part of a penis is excised. It will actually do the opposite if not successfully done. So, no, there's no solid fact that circumcision can make a penis bigger.

The uncircumcised will have a hard time getting someone pregnant: 
A lot of factors (sperm and structural abnormalities, genetic disorders, etc.)  are involved in not getting someone pregnant except for being uncircumcised.

YOU'RE THE MAN!

"Binata ka na!" (You're now a man!), are the first words you'd normally hear once the procedure is over. After the healing is complete and the boy's free from all physical pain that the procedure has brought him, he will then walk tall and with a smug like expression on his face for becoming a whole new man.

Be it a thousand years tradition or not, circumcision is a choice - unless it is medically indicated. It is a choice by the one getting circumcised and not merely what one's culture dictates. The boys should be informed regarding the advantages and disadvantages of circumcision first. Those who choose not to go with it should never be mocked. Lastly, traditional circumcision or "pukpok" should be eradicated...completely! Not only is the practice not safe, unsterile, and brutal, it can hurt the boys psychologically as well.


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Photo Credit:  www.reuters.com

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