Safeguarding brit milah in South Africa

NICOLA MILTZ

“I pray no other child will ever endure what my child has had to go through,” she said this week, “It is soothing to know that a regulatory board is in place that will make sure that something like what happened to my boy, never happens again in this country.”

The Regulatory Board of Brit Milah in South Africa, has just launched a full regulatory framework coinciding with a digitally interactive website which deals with every aspect of the brit milah procedure.

Chairman of the Board, Dr Richard Friedland said: “This is a very interactive website – the first of its kind in the world – and we encourage all new parents to actively engage with us digitally. They will get a response from a member of the Board within 24 hours. It is a work-in-progress, so we welcome all comments and suggestions.”

The Board was established by Chief Rabbi Warren Goldstein and the Beth Din, following a commission of enquiry into this failed circumcision, which has seen the toddler in and out of doctors’ rooms ever since he was eight days old. Since the board was established last year, a huge amount of work has been done to formulate a set of regulations governing the entire brit milah process. Until this time, there were no regulations in place.

“This is an historic moment for us,” said Rabbi Goldstein, “The Board is an ongoing governance structure. It will oversee the maintenance of the highest international standards of good governance, safety, hygiene and halacha.”

In trying to make sense of what happened to her boy, the mother said her baby’s accident was the spark that ignited the authorities to put these very important measures in place.

It is now incumbent on all mohelim in South Africa to be fully registered and accredited with the Board, which is chaired by Friedland, CEO of Netcare. A list of the mohelim and their contact details is available on the site and parents are encouraged to use only the ones listed.

Fellow Board members include advocate Nathan Segal, Rabbi Dr Pinhas Zekry, Rabbi Anton Klein from the Beth Din, specialist trauma surgeon Dr Reuven Jacks and Dr Joseph Spitzer.

Each of the country’s seven registered and approved mohelim, including four in Johannesburg and three in Cape Town, have been subjected to a strict accreditation process, including the requirement to produce things like a police clearance certificate, documentation proving they are not on the sexual offenders register, make known their HIV status and show they do not have Hepatitis B.

What’s more, mohelim are required to take part in yearly continued education workshops and be subjected to annual inspection.  

The Regulatory Board is in the process of accrediting these mohelim, in terms of its latest guidelines, policies and procedures, and expects to complete this process by this December.

Dr Spitzer, one of the world’s foremost authorities on circumcision, was brought out to South Africa to help set up the Board and its website.

Speaking after the launch of the website, Dr Spitzer said: “The Regulatory Board is responsible for ensuring the highest standards of care and safety for all infants undergoing a brit milah and ensuring that it is conducted according to strict halachic principles. The interactive website is a world first and the UK is inches behind.”

The Board is responsible for the development of standardised guidelines, policies and procedures to ensure the highest standards of safety are maintained. It must ensure the appropriate registration, accreditation and continuing education of practicing mohelim; and maintain all records of brit milahs performed in South Africa. The Board also has the authority to fully investigate any concerns or complaints raised and to recommend and institute appropriate remedial action.

Said Friedland: “The website’s information will be helpful in guiding and advising parents as to the regulatory framework that now governs Orthodox Jewish circumcision.”

According to Rabbi Goldstein, all mohelim have been given the opportunity to have their say on the guidelines. “We have the buy-in from all the mohelim,” he said.

According to the site:

• All mohelim have to adhere to the highest standards of brit milah and ensure that the safety and wellbeing of the baby are paramount, while ensuring the procedure is completed according to the precise halachic requirements.
• A mohel will not have any contact with a baby, nor undertake any procedure if he is ill.
• A mohel must be in good health and stop practising where there is a change in his own health which might affect performance or pose a risk to the baby.
• A mohel should offer clear, consistent verbal and ideally written information and advice throughout all stages of the circumcision process. This should include the risks of any complications, bleeding and surgical site infections, what is done to reduce them and if complications occur, how they are best managed.
• A mohel must obtain written, informed consent from parents before performing the circumcision. The consent form can be downloaded from the site.
• The mohel must keep notes relating to all encounters with the baby or family including a record that written consent for the procedure was obtained. He will also complete an electronic registration and procedure document, which will be submitted to the Beth Din.
• The mohel must respect the confidentiality of the family and must not share any medical information he may receive, without the express consent of the baby’s parents unless this disclosure is in the best interests of the baby.
• If a mohel is concerned that a child is at risk of abuse or neglect, he must inform the medical officer of the Regulatory Board in the first instance for advice on how to escalate this concern.

The site also deals with the most frequently asked questions including: Will the mohel use an anaesthetic? How long does the procedure take? How is the procedure performed? How dangerous is a brit milah?

What, if any infections, could my son contract? What do I do in the event of excessive bleeding? How long will it take for the pain to subside?

The website is www.britmilahsa.co.za