The traditional Bukusu circumcision rite, Imbalu, is facing a modern test as families increasingly opt for hospital-based procedures over the age-old ceremonies in Bungoma County.

• Approximately 20-28 boys undergo voluntary male circumcision daily at Bungoma Children's Hospital, a private facility.
• While traditional circumcisers (Ngaribas) prepare initiates with age-old rituals, health professionals advocate for medical procedures citing safety and hygiene.
• Concerns are also raised about the pollution and neglect of sacred springs traditionally used for the rituals.