Its a traditional custom in the Philippines for boys when they reach puberty. If your arent circumcised you get teased. Some people go through it as a medical procedure while others do it through a ritual method. The ritual method usually uses a specialist(mananule).
"However, in rural areas, there are "specialists" who do the "traditional pukpok under the tree, near the river" to perform the same procedure. Before the pukpok, the manunule or pukpok asks the one to be circumcised to chew guava tops. The manunule then uses a sharpened labaja or barber's knife to cut the foreskin. The manunule then places the boy's chewed guava tops on the genital as a way of medication. The "new man," as they are usually called, then jumps into the river for cleansing. Jumping into the river would then constrict the blood vessels and stop the bleeding of the wound. Though it is unsanitary, the procedure is accepted and has been practiced for decades in rural areas."