Of all the health risks associated with being crucified tetanus infection is not the first that springs to mind. But the Filipino government has issued a health warning to devotees who re-enact the Crucifixion every Good Friday advising them to get a Tetanus jab before being nailed to the cross.

In a move aimed at cure rather than prevention the Department of Health has strongly advised devout Catholics to get a vaccination before taking part in crucifixion ceremonies to prevent infection.

Francisco Duque, Health Secretary, said devotees should “have shots of gamma globulin or anti-tetanus…The six-inch nails they use for crucifixion must be thoroughly sterilised." Mr Duque added that participants should also take antibiotics while their wounds heal. He said it was hard to discourage "flagellants from whipping their own flesh, the best penitents can do is ensure that their whips are well-maintained."

Each Good Friday in ceremonies throughout the country men dress in white robes and flagellate themselves with glass-tipped paddles and bamboo whips, in penitence for their sins before being nailed to a cross with six inch nails.

The Church frowns on the custom and this year the Catholic Bishop Conference of the Philippines has sought to dissuade people from taking part in the ceremonies which have become something of a tourist attraction.

Sebastian Horsley, an oil painter, was the first Westerner to take part in the Karabrio. He felt that it would be valuable for him to experience that level of pain, for artistic rather than religious reasons.

Ruben Enaje, a Filipino carpenter has taken part in the festival every year since 1988 to show his gratitude to God for saving him when he fell out of a window.