One Sunday morning, the boy wasn't at home and neither his grandmother nor uncle knew where he was. When he came home that afternoon, his pants were covered in blood and he had a slip of paper in his pocket stating that he had been circumcised at the local regional hospital along with some post-operative instructions. The boy said that the school principal had loaded about 14 boys into a school bus and taken them all to be circumcised! No consent was taken from the parents or caregivers of these boys. In fact, they were not even informed and no HIV counselling and testing was done as part of the circumcision. Worse even, the child in question is immunosuppressed because he's failing treatment on ARVs, so his potential for complications is much higher. One hopes that the strictest sterile conditions were adhered to as any cross-contamination of instruments or equipment would result in the other children being exposed to his multi drug-resistant strain of HIV.
Cases like this one occur every day. There are very many ethical issues in this case alone. Deeply unethical practices surrounding VMMC are happening, in South Africa, every day.