Monday, May 4, 2015

SWAZILAND: More "Circumcise and Conquer" clients at HIV clinics

The Swazi Observer
April 30, 2015

Soka Uncobe got more men on HIV services

by Winile Mavuso
WHILE most HIV positive Swazis do not enroll for pre-ART services because they feel well and don’t see the need to go to the clinic, the Soka Uncobe Male Circumcision campaign ran in 2011-12 saw more men enrolling for HIV care services.

This is contained in a study conducted by ICAP in 2011-2012 with support from the Centre for Disease Control (CDC) and the President’s Emergency Plan For AIDS Relief (PEPFAR). The study was presented to stakeholders during a breakfast meeting at Mountain Inn yesterday.

The objective of the study was to evaluate whether key linkage procedures were implemented in accordance with the new set of standard operating procedures on linkage and retention (National SOP) introduced by the ministry of health. The study explored early enrollment and retention in HIV care among clients newly diagnosed with HIV from two HTC settings (home- and MC-based HTC), as well as finding client, clinic and SOP characteristics that might be associated with early enrollment and retention in care.

Hence, the National SOP was implemented in the Soka Uncobe Male Circumcision campaign during which testing was facility based and the Swaziland HIV Incidence Measurement Survey (SHIMS) during which testing was home based.

HIV testing was a requirement for men to get circumcised and those who took up the services also got to know their HIV status. According to the study, from 13 Soka Uncobe sites visited, it was found that many MC files of HIV positive clients included completed readiness assessment forms.

“Interestingly, although similar enrolment rates were observed between study-gender groups overall and within 18 months of diagnosis, proportionally, more Soka than SHIMS clients enrolled in HIV care within three to six months,” reads part of the document.

This could be attributed to the fact that many Soka sites were co-located at HIV care facilities, hence clients were easily linked to expert client counselors.

[Or could this be because more Soca Uncobe ("Circumcise and Conquer") clients got HIV?]
Earlier story

Sunday, May 3, 2015

UGANDA: Cutting men does increase the HIV risk to women

April 29, 2015

Male Circumcision Curbs HIV Spread but Risk of Transmission High While Wound Heals
Real news: Male Genital Cutting INCREASES Risk To Women

by Bidita Debnath
While circumcision reduces the risk of human immunodeficiency virus (HIV) transmission by infected men [that has NOT been established], there is actually a possible increased risk of infecting female sexual partners while the circumcision wounds heal, warns a new research.

The World Health Organization (WHO) recommends male circumcision (the surgical removal of foreskin from the penis) [for consenting adults] which reduces HIV acquisition by 50-60%. [They have to include their mantra.]
"There is a window of a few weeks after circumcision when the risk that an HIV-infected man could transmit the virus to a female partner actually increases," said the study's first author Aaron Tobian, associate professor of pathology at the Johns Hopkins University School of Medicine. "During that time, more HIV-infected men are shedding the virus, and on average they are shedding greater amounts of it, than before circumcision," he noted.

However, scientists report that a new study of HIV-infected men in Uganda has identified a temporary, but potentially troublesome unintended consequence of the procedure: a possible increased risk of infecting female sexual partners while the circumcision wounds heal.

[See the weasel-words and euphemisms: infecting more women with HIV is exactly contrary to what this whole campaign is supposed to be about.] 

The study examined 223 HIV-positive Ugandan men who were medically circumcised. Circumcision reduced the number of HIV-positive men who were shedding the virus more than five-fold over the long term, but it had the opposite effect in the weeks right after the surgery. Case by case, the likelihood of HIV transmission from a newly-circumcised man to his female partner is less than one-tenth of one percent, the researchers estimated.

But with the WHO seeking to circumcise nearly 29 million men, the study projects that this small increase could add up to 17,000 new infections among female partners of newly circumcised HIV-infected men.

"Although we're counseling men not to have sexual intercourse while their wounds are healing, we know that they are," Tobian said.

The solution, he says, may lie in another one of the study's findings. "If the men are on anti-retroviral drugs, this reduces the risk of their shedding the virus by about 90%," he pointed out. The study was published in the journal PLOS Medicine.

[But if the men are known to be HIV-positive, WHY CUT THEM? It is TOO LATE. This just underlines how this whole campaign is not about preventing the spread of HIV/AIDS, but promoting the spread of male cutting.]
Source: IANS
[Wawer et al. started to find this six years ago, but they cut that study short "for futility" - it didn't find benefit - before it could be confirmed.]

LOS ANGELES: Lawsuit against Mogen clamp maker

And about time too!

Law 360
April 22, 2015

Circumcision Clamp Makers Sued Over Amputated Penis

by Y. Peter Kang
Los Angeles (April 22, 2015, 4:00 PM ET) -- Companies associated with the production of a clamp used in performing circumcisions were hit with a product liability suit in Pennsylvania state court on Wednesday alleging that the medical instrument's poor design led to the amputation of the tip of an infant's penis.

California resident Victoria Hoekstra, the mother of a minor child, filed the suit against Misdom-Frank Corp. and related entities Sklar Corp. and Medco Group Inc., accusing the Pennsylvania-based companies of negligence and product liability in connection with the partial amputation of her week-old infant's penis in 2010 in what was supposed to be a routine circumcision procedure, according to the complaint.

Hoekstra says that the companies' product, known as a Mogen clamp, has a design defect that does not provide any protection for the head of the penis, unlike other circumcision clamps, and contains a second defect that does not allow for the doctor to be able to visualize the head of the penis when applying the scalpel to the foreskin.

These design defects "are well known and have long been identified and published in medical literature," according to the complaint.

"The Mogen clamp, unlike other circumcision devices, has a long history of penile amputations," Hoekstra alleges. "Defendants have misrepresented the efficacy and safety of their Mogen clamp through various means and media, actively and intentionally misleading the medical community, patients and the public at large."

[The Mogen Company went out of business in 2012 after losing two lawsuits to the value of $18.3 million. A subsequent suit was worth $4.6 million.]

Hoekstra says that her son has sustained permanent injury and will require future corrective surgeries and brings claims for strict liability, negligence and breach of warranty against the companies, seeking more than $50,000 in damages.

An attorney for the plaintiff told Law360 on Wednesday that the clamp should be pulled from the market.

"Circumcision is an ancient ritual that has been performed safely for centuries without incident [BS!]," said co-lead counsel Daniel Balaban of Los Angeles-based Balaban & Spielberger. "This case is about a defective product that has left our client mutilated and maimed. This dangerous device should be pulled off the market or fixed before another infant is harmed."


--Editing by Stephen Berg.

KENYA: 30 boys cut by force

How is this not sexual abuse?

Daily Nation (Kenya)
April 22, 2015

Anxiety in Eldoret after NGO ‘forcibly’ circumcises 30 boys

by Copperfield Lagat
Anxiety has gripped Eldoret in Uasin Gishu after an estimated 30 children were forcibly circumcised by a non-governmental organization based in Kisumu and which has a clinic in Eldoret.

The Impact Research Development Organisation is alleged to have performed the circumcision on the school-going children last week in various parts of Eldoret, when learners came home for the April holiday.

The mood was tense Wednesday evening at Kapsoya Estate as mothers wailed uncontrollably after realising that their sons, some as young as six years old, were circumcised by the organisation without their consent.

Lucy Ekwong said she had gone to town but did not find her two sons upon arriving home in the evening.

She would later find out that they were nursing pains at a Sudanese neighbour’s house.

“I had gone to town but when I came back in the evening, my two children, aged six and eight were in my neighbour’s house.

“The young one said they were offered sweets and taken to a clinic in Langas where many boys were circumcised,” the bitter mother said.

“I was shocked but immediately took up to caring for them. I later talked to a police officer who denied knowing of such an activity.

“I am so confused because the surgery itself is not according to the requirements of the Kalenjin traditions.

“My people in the village, upon learning of that, are accusing me of doing it on my sons,” said Ms Ekwong.

Some of the children were from the South Sudan Nuer community which does not perform circumcision on their boys.

The community regards the act of circumcision as a taboo and anyone conducting it is banished.
Only two children, who were from Islamic Center, were Kalenjins while close to 30 others were those from South Sudan.

A Sudanese national, Madol Anyief said: “Our Dinka Bor community does not perform circumcision. Anyone who is circumcised is banished and disowned.

“It is said these people were going around saying the government has directed circumcision but we have later been assured that the county has no such programme,” Anyief said, adding that she did not question much because she was a foreigner and feared for her life.

According to reports corroborated by the circumcised boys, sweets were used by people who were in cars to lure them.

One of them said they were more than a hundred only that some were hiding in their homes.
Uasin Gishu County’s Chief Officer for Health Mr Silas Boit said the revelation came during a normal supervision at Kapsoya Health Centre on Tuesday when they met a young boy who was walking in pain.

“We asked further and we were told that there was a forceful circumcision that the NGO had conducted. The boy had a urinal retention complication due to the surgery,” Mr Boit said.
The health officer said they went round the estate and got over 30 other boys in pain in their various homes.

Some who were suspected to be developing infections were referred to Moi Teaching and Referral Hospital for medication.

Mr Boit said police and the county officials managed to arrest three officers from the NGO who were booked at Kapsoya Police Post.

Mr Boit said: “We were shocked after realising that the car in which the suspects had been arrested was released and was going around collecting the boys to ferry them to hospital,” Boit said.

He added that the OCS had promised to take the suspects to court.

Meanwhile, parents have been urged to keep a close watch on their children.

OXFORD, ENGLAND: Babies feel pain "like adults"

Science Daily
April 21, 2015

Babies feel pain 'like adults': Most babies not given pain meds for surgery

The brains of babies 'light up' in a very similar way to adults when exposed to the same painful stimulus, a pioneering Oxford University brain scanning study has discovered. It suggests that babies experience pain much like adults.

The study looked at 10 healthy infants aged between one and six days old and 10 healthy adults aged 23-36 years. Infants were recruited from the John Radcliffe Hospital, Oxford (UK) and adult volunteers were Oxford University staff or students.

During the research babies, accompanied by parents and clinical staff, were placed in a Magnetic Resonance Imaging (MRI) scanner where they usually fell asleep. MRI scans were then taken of the babies' brains as they were 'poked' on the bottom of their feet with a special retracting rod creating a sensation 'like being poked with a pencil' -- mild enough that it did not wake them up. These scans were then compared with brain scans of adults exposed to the same pain stimulus.

The researchers found that 18 of the 20 brain regions active in adults experiencing pain were active in babies. Scans also showed that babies' brains had the same response to a weak 'poke' (of force 128mN) as adults did to a stimulus four times as strong (512mN). The findings suggest that not only do babies experience pain much like adults but that they also have a much lower pain threshold.
The research was funded by the Wellcome Trust and is reported in the journal eLife.

'Up until recently people didn't think it was possible to study pain in babies using MRI because, unlike adults, they don't keep still in the scanner!' said Dr Rebeccah Slater of Oxford University's Department of Paediatrics, lead author of the report. 'However, as babies that are less than a week old are more docile than older babies, we found that their parents were able to get them to fall asleep inside a scanner so that, for the first time, we could study pain in the infant brain using MRI.

'This is particularly important when it comes to pain: obviously babies can't tell us about their experience of pain and it is difficult to infer pain from visual observations. In fact some people have argued that babies' brains are not developed enough for them to really 'feel' pain, any reaction being just a reflex -- our study provides the first really strong evidence that this is not the case.'

The researchers say that it is now possible to see pain 'happening' inside the infant brain and it looks a lot like pain in adults.

As recently as the 1980s it was common practice for babies to be given neuromuscular blocks but no pain relief medication during surgery. In 2014 a review of neonatal pain management practice in intensive care highlighted that although such infants experience an average of 11 painful procedures per day 60% of babies do not receive any kind of pain medication.

'Thousands of babies across the UK undergo painful procedures every day but there are often no local pain management guidelines to help clinicians. Our study suggests that not only do babies experience pain but they may be more sensitive to it than adults,' said Dr Slater. 'We have to think that if we would provide pain relief for an older child undergoing a procedure then we should look at giving pain relief to an infant undergoing a similar procedure.'

Dr Slater added: 'Recent studies in adults have shown that it is possible to detect a neurological signature of pain using MRI. In the future we hope to develop similar systems to detect the 'pain signature' in babies' brains: this could enable us to test different pain relief treatments and see what would be most effective for this vulnerable population who can't speak for themselves.'

GHANA: Girl banished for refusing genital cutting

MyJoy online
April 16, 2015

13-year-old girl banished for refusing to undergo circumcision

Despite efforts to combat the cultural practice of Female Genital Mutilation (FGM) in Ghana, reports indicate that some traditional leaders in some districts of the Brong-Ahafo Region are still encouraging it.

According to The Chronicle newspaper, some communities in the Tain and Banda districts of Brong-Ahafo indicates that the cruel act against girls is still ongoing under the charade of custom.

The daily newspaper reported in its April 16, 2015 issue that a 13-year-old pupil of the Brohani D/A Primary School security has been banished from Brohani in the Tain District by the queen mother for reporting to police an attempt to mutilate her genital.

Read the rest of the story as published in the newspaper below:
Narrating her ordeal to The Chronicle, the 13 year old pupil who is currently seeking refuge at the expense of a Good Samaritan at Nsawkaw said she was lined up with another girl waiting to have their genitals mutilated.

After hearing the cry of the other girl, who underwent the cruel act, she fled and went to inform her teacher, who subsequently reported the issue to the Girl Child Coordinator of the Tain District Directorate of the Ghana Education Service (GES), Ms. Comfort Maanu.

Ms. Comfort Maanu, together with the girl and the teacher, reported the case to the Department of Social Welfare, and subsequently, a formal complaint was lodged with the Nsawkaw Police, which led to the arrest of the alleged perpetrators, including the Queenmother of Brohani, a relative of the girl, and the executor of the FGM.

After the arrest of the three, the Nsawkaw Police referred the case to the Domestic Violence and Victim Support Unit (DOVVSU) of the Ghana Police Service in Wenchi and the alleged perpetrators have since been released on bail.

The Queenmother of Brohani is alleged to have threatened to have the girl killed anytime she steps foot in the community, a threat which has frightened the girl compelling her to seek refuge with a Good Samaritan at Nsawkaw.

Sources at the Department of Social Welfare and Community Development in the Tain District has hinted The Chronicle that some opinion leaders of the community, including politicians in the District, have been pushing for the case not to be sent to court, and hence, after almost two months of the incident, the matter has not been to court.

When the Deputy Regional DOVVSU Officer, ASP Setina Aboagye, was contacted, she said the regional office was yet to ascertain the case.

According to ASP Setina Aboagye, she would personally go to Nsawkaw on Friday, April 17, 2015, to follow up the matter.

However, investigations by The Chronicle has revealed that Brohani is the hub of FMG in the Tain and Banda districts, where young girls are sent for the practice to be undertaken, under the supervision of the Queenmother, hence the urgent need for the Ministry of Gender, Children and Social Protection to intervene.

FLORIDA: Injunction against 4 1/2 year old's genital cutting

WSBTV (Florida)
April 14, 2015

Woman filed federal suit to block son’s circumcision

by Jane Musgrave WEST PALM BEACH —
A Boynton Beach, Florida, woman who went into hiding with her 4 1/2-year-old son rather than abide by a judge’s order to have him circumcised has filed a lawsuit in federal court, claiming a forced circumcision would violate her son’s constitutional rights.

In the lawsuit filed Monday in U.S. District Court, Heather Hironimus claims there is no medical justification to circumcise her son, identified as C.R.N.H., and many legal and medical reasons not to do it.

“(The) application of Florida law to impose unnecessary, elective, cosmetic circumcision upon C.R.N.H. at the age of 4 1/2 years old for no religious reason violates (the boy’s) fundamental right to privacy and bodily integrity secured by the due process clause of the 14th Amendment to the United States,” her attorney Thomas Hunker wrote.

Hunker also claims the circumcision, sought by the boy’s father, constitutes “assault, aggravated assault, battery and aggravated battery.” It would cause irreparable psychological damage and provide few health benefits, Hunker says in the suit to be heard by U.S. District Judge Kenneth Marra.

Heather Hironimus, 30, and her son have been in hiding since last month when Palm Beach County Circuit Judge Jeffrey Gillen ordered her to bring her son to court to turn him over to the boy’s father, Dennis Nebus. When she didn’t appear at the hearing, Gillen signed a warrant for her arrest.

The federal lawsuit is the latest volley Hironimus has fired in the long-running legal fight to block the circumcision.

Three months after the boy was born in 2010, Nebus, 47, of Boca Raton, filed suit to establish his parental rights. In 2012, Hironimus signed a parenting agreement, allowing Nebus to have the boy circumcised as long as he paid for it. Soon after, she said she had second thoughts about allowing her son to undergo the procedure.

She launched a court battle and one on social media seeking to persuade Gillen not to enforce the agreement. After various court hearings, Gillen in May ruled that the agreement trumped her reservations. The 4th District Court of Appeal upheld his decision without comment.

Protests by those who identify themselves as “intactivists" have been held throughout the county to support Hironimus’ efforts to spare her son from circumcision.

Earlier story

MALTA: Ban on infant intersex surgery

The Star Observer (Australia)
April 2, 2015

Malta the first country to outlaw forced surgical intervention on intersex minors

MALTA has become the first country in the world to outlaw medical practitioners or other professionals from conducting any involuntary or coerced surgical intervention on minors with intersex variations.

The Gender Identity Gender Expression and Sex Characteristics Act was passed through Maltese Parliament with cross party support, without a vote, in the early of the morning in Australian time.

A first of its kind around the world, the passage of the bill has been met with praise by Organisation Intersex International (OII) Australia, along with various European intersex and trans* organisations.

The new law officially recognises the right to bodily integrity and physical autonomy and protects intersex infants and children from non-necessary medical interventions. These sorts of medical procedures still take place in Australia and around the world, with parental distress or improving marriage prospects as common reasons for it.

Malta’s Gender Identity Gender Expression and Sex Characteristics Act also meets several other key demands of the intersex movement, including the 2013 recommendations of an Australian Senate committee report.

The relevant part of the act reads:
“It shall be unlawful for medical practitioners or other professionals to conduct any sex assignment treatment and/or surgical intervention on the sex characteristics of a minor which treatment and/or intervention can be deferred until the person to be treated can provide informed consent: Provided that such sex assignment treatment and/or surgical intervention on the sex characteristics of the minor shall be conducted if the minor gives informed consent through the person exercising parental authority or the tutor of the minor.

“In exceptional circumstances treatment may be effected once agreement is reached between the Interdisciplinary Team and the persons exercising parental authority or tutor of the minor who is still unable to provide consent: Provided that medical intervention which is driven by social factors without the consent of the minor, will be in violation of this act.”

The Interdisciplinary Team will be appointed by the government, alongside a larger working group that includes human rights experts, to establish improved treatment protocols “in line with current medical best practices and human rights standards”.

The new Maltese law also provides for an administrative mechanism for the recognition of gender identity, and protection from discrimination for intersex and trans* people.

While OII Australia president Morgan Carpenter said he “warmly” congratulated the Maltese government and parliament, he urged Australian parliamentarians to pass similar legislation, as well.
“This is legislation that Australian governments should be enacting, to implement the recommendations of the 2013 Senate committee report on the involuntary and coerced sterilisation of intersex people,” he said.

“Non-necessary medical interventions still take place on infants and children with intersex variations, across Australia, for rationales that include managing parental distress, social stigma and even ‘improving marriage prospects’.

“These violate international human rights standards and Australian governments must act.”

Intersex people are born with bodies that don’t meet stereotypical expectations for male and female, including a range of genetic, hormonal and anatomical differences in sex characteristics. People with intersex variations have as diverse a range of gender identities as non-intersex people. 

THAILAND: Minimal female cutting persists in Muslim south

The Guardian
April 1, 2015

In Thailand’s Muslim south, authorities turn a blind eye to FGM

Female genital mutilation, banned by the WHO, seems to be common in the
three Muslim-majority southern provinces, but officials are taking no action

by Gabrielle Paluch
Eight-week-old baby Amiyah grimaces when sunlight falls on her face as though she isn’t used to the idea of having been born yet. On a Saturday afternoon, in Thailand’s southern Pattani province, her Muslim mother has brought her to a small clinic so midwife Dah can slice her clitoris for sunat. The practice, a form of female genital mutilation (FGM), has been banned by the World Health Organisation.

In majority Buddhist Thailand, the public health department says FGM does not happen. But in the three southernmost provinces of Yala, Narathiwat and Pattani, ethnic Malay Muslims are a majority. Some are locked in an intractable conflict with the Thai government, which labels them insurgents. Here, midwife Dah says she has cut almost all female births she has attended.

“Her clitoris is so small,” says Dah, 64, who seems a little flustered as she swabs the crying baby’s vulva with alcohol with her gloved hands. Despite her experience, she is having difficulty finding the clitoris as the baby squirms on the operating table. She holds a sterile surgical blade, for which she has fashioned a handle out of tin foil.

After five long minutes, during which the baby cries relentlessly and the mother tries to comfort her, the incision is finally made. The midwife mops up a drop of blood with a cotton swab, recites the name of God, and declares the baby “circumcised”.

“I feel relieved that I have done my duty,” the mother says.

The conflict in the southern Thailand can make it hard for women to access healthcare, according to Dr Sudarat Teeraworn, a public health supervisor for maternal health in neighbouring Yala province. Sudarat says FGM isn’t on the health ministry’s agenda – though according to her, almost every Muslim baby girl in the south is cut.

“There are no laws about it because there are not many health consequences, and it’s a cultural practice,” she says.

Thai health authorities have taken a pragmatic approach, apparently turning a blind eye.

FGM as practised in Thailand falls under type IV in the WHO’s classification, which involves pricking, piercing, incising, scraping and cauterisation. Types I and II involve excision of either clitoris or labia or both, and type III includes a procedure where the vulva is sutured together after removal of the clitoris and labia. The WHO says the procedure has no known health benefits, arises from a deep-seated gender-bias, and amounts to a violation of both children’s and women’s rights.

Just across the border in Malaysia, a study conducted in 2011 showed 93% of Muslim women have been cut, including in Kelantan state on Thailand’s border, which is culturally and religiously similar to Pattani. Though the practice dates back centuries for Muslims living across the Malay peninsula, Malaysia’s highest religious authority did not issue a fatwa until 2009 requiring the cutting of all Muslim women.

Malaysia’s fatwa has put health workers in an awkward position. As women increasingly give birth in hospitals, mothers looking for a safe way to cut their female babies are essentially asking doctors to break WHO guidelines.

To reduce the prevalence of FGM in Malaysia , Saira Shameem, who works for the UN Population Fund (UNFPA) in Kuala Lumpur, is working with health authorities to make the practice symbolic, with a routine alcohol swab performed by obstetricians at birth. “What the fatwa does not do, is it does not specify what the procedure should be,” she says, “that allows us an avenue to define the procedure in a non-invasive, non-harmful manner and shift the practice accordingly.”

In southern Thailand women are also increasingly giving birth in hospitals. Traditional midwives who pass their trade on from generation to generation are disappearing, and mothers are increasingly having their babies cut by doctors.

Many women in southern Thailand don’t even know they’ve been cut until adulthood, when they read about it. The practice is not talked about.

Dr Patimoh Umasa is one of the only female doctors in Yala, where she runs a small clinic on the edge of the city’s Muslim quarter. She knows the WHO guidelines, and doesn’t believe what she does directly contravenes them. “If it is done by a doctor and they are using the right technique, then never mind,” she says. “It’s just a little. Just an incision, no excision.”

But doctors such as Nawal Nour, director of the Global Women’s Health Centre at Harvard Medical School, believes a “right technique” does not exist. “There are girls who suffer short and long-term consequences, even from type IV,” she says. “The clitoris on a baby girl is tiny, and in error, cutters can remove it completely. Also botched jobs can lead to haemorrhage, infection, sepsis and death.”
Back in Pattani, Peung, 33, has gathered her family together to watch her eight-month-old daughter, Mia, being cut by her mother-in-law, who is sterilising a pair of nail scissors with alcohol. Some of Mia’s cousins are playing on the floor in the living room.

Peung’s two older daughters are curious. “What are they doing? Will it hurt?” they ask. “Sunat, we all must do it,” Peung responds. “The children are so eager, but it is not good for them to watch this. It will become a phobia for ever.” She caresses her youngest infant, about to be cut. “At least she doesn’t know what’s going on here.”

The baby’s grandmother draws blood from the clitoris with the curved tip of the nail scissors, a technique she says she developed herself to be safer. Mia cries loudly.

Peung is pleased her daughter is now “complete”, but she isn’t sure why. “I don’t know what the benefit is behind it, but I believe there must be one. I know the prophet said it is desirable for the husband when women are cut. Actually in Islam we believe that women have more desire than men, so there must be something to control the women, give them humility and modesty – and this could be one way to do it. Maybe in the future the scientists will find out and then we will know the benefit. All the girls here in the south do it.”

Some names have been changed

SWAZILAND: "Circumcise and Conquer" slogan increases risk

Is anyone surprised?

Swazi Observer
March 29, 2015

Soka Uncobe: Circumcision slogan gone wrong?

by Welcome Dlamini
A social and behaviour change communication campaign aimed at encouraging at least 80 percent Swazi adult males to circumcise within a one year period seems to have been misinterpreted by some of those it targeted.

A study by two university lecturers; one from the Department of Anthropology at the University of the Witwatersrand and the other from the Department of Theology and Religious Studies at the University of Swaziland, reveals concerns of how the slogan used in the campaign led people to behave in a way that could have put them at risk of contracting HIV/AIDS.

The campaign’s main aim was HIV prevention, seeing that Swaziland has one of the virus’ highest prevalence rates globally.

The slogan for the campaign was ‘Soka Uncobe’ – which should translate to ‘circumcise and conquer’.

It turns out that this slogan led people into believing that once they had been circumcised, they had conquered HIV/AIDS as well as their sexual partners and, therefore, could sleep around without using protection.

The campaign conducted awareness and advocacy with royalty, traditional leaders, unions, businesses, religious groups, schools, and government to create awareness of and understanding of MC, using interpersonal communications, mass media, especially radio, and educational print materials.

The project was a collaboration between the ministry of health (MOH), Swaziland National AIDS Programme (SNAP), National Emergency Response Council for HIV/AIDS (NERCHA), Population Services international (PSI) and Pulse.

The study by the two lecturers is titled ‘Christians’ Cut: Ecumenical Perspective on Male Circumcision amid Swaziland’s HIV Epidemic’ and it focused on Christian members of the kingdom’s three main church organisations, namely the League of African Churches in Swaziland (LACS), the Council of Swaziland Churches (CSC) and the Swaziland Conference of Churches (SCC).

Part of the study’s focus was on how the Christian religion (given that a majority, about 90% of Swazis are Christian) influences acceptance, rejection or understanding of male medical circumcision (MMC).

A number of those interviewed for the study pointed out to that people participated in circumcision because of the material incentives that were being handed out and the branding of the MMC campaign such as the free literature and gifts distributed at circumcision clinics and NGOs.

They said such gifts and literature “seductively clouded peoples’ own critical examination of the procedure and its effects on gender identities and sexual relations”.

States the study: “One Zionist LACS member noted, ‘some young men are drawn by pull factors such as T-shirts, juice bottles, tracksuits which are distributed as incentives to every male that visits the clinics to circumcise. These material pull factors are branded with the circumcising NGO or clinic, and more widely under the banner Soka Uncobe, which several people across churches saw as unappealing or dangerously inciting male sexual proclivities and broad licences to no longer use contraception.”

Quoting another study on socio-cultural aspects of MMC by Khumalo (2014, page 135), the study notes that there are those who argue that some men misinterpreted the Soka Uncobe slogan to mean once circumcised they had conquered HIV and AIDS or perceived themselves to be sexual conquerors of their partners.

This view, according to the study, was echoed across several church members and was strikingly highlighted by one woman from an SCC church who narrated the following: “I have a younger brother who is 18 and he is circumcised.

Ever since he performed this surgical procedure he has been sleeping around with many girls of his age. His friend partly attributes this behaviour to the manner in which circumcision is promoted in the schools.”

The woman informed the study that her brother’s friend told her that MMC promoters who visited their school would use a metaphor of a bush knife in their illustrations to explain that circumcision also strengthens your manhood.

There is the misconception that the ‘bush knife’ (penis) is sharpened by circumcision, and young men develop insatiable sexual appetite. Such language can be destructive because it dupes young men to think that they are justifiable to sleep around because their ‘bush knives’ are now sharpened,” further states the study.

It further found that the language used by the promoters and the advertisements as well as slogans for circumcision were also persuasive and indirectly manipulative.

“For example, ‘lisoka lisoka ngekusoka’, which implies that you are not a real man unless you are circumcised; and ‘soka uncobe’ which depicts a circumcised man as a conqueror. Some adverts would even state that once you circumcise you become ‘lichawe’- a hero,” study points out. It goes on to add: “For both women and men we spoke to, the branding of the MMC campaign was problematic. It potentially shored up male sexual supremacy and forms of violent masculinity, pointing to the otherwise ambiguous facets of general patriarchy, which in Swaziland endures as part of everyday life and “Swazi Culture.”

IVORY COAST: Woman jailed for female genital cutting

Times Live (South Africa)
March 26, 2015

Mother jailed for circumcision of 4 year-old daughter in Ivory Coast

A mother who took her four-year-old daughter to be circumcised was sentenced to one year in prison Wednesday in the north of the Ivory Coast, where such convictions are rare.

A relative who accompanied her for the procedure on March 11 received the same jail term, as well as a fine of 360,000 CFA frances ($600), in what prosecutors said was a "warning" to those still carrying out female genital mutilation on young girls.

Another mother, whose five-year-old daughter was also mutilated in the same village, was acquitted, while the person who carried out the circumcisions has gone on the run and is wanted by police.

The sentence is the lowest possible under Ivorian law.

"This is a warning," said prosecutor Hamed Diomande.

Despite efforts by aid workers to raise awareness, he said, "you continue to circumcise your children". "The next time, the punishment will be heavier," he continued.

Female genital mutilation is a "tradition", one of the defendants said in court, saying they had not known it was against the law and promising to never do it again.

Nine women were sentenced to jail terms in 2012 for the female circumcision of around 30 young girls in Katiola, in what the United Nations said was the first criminal prosecution of its kind in Ivory Coast.

Female circumcision affects around 38 percent of the female population in Ivory Coast, according to the UN Children's Fund (UNICEF). The practice is particularly prevalent among northern Muslims and animists in the west of the country where up to 80 percent of females are circumcised despite a 1998 ban and numerous initiatives aimed at eradicating it.

Wednesday's conviction is "a positive sign," said Louis Vigneault-Dubois, spokesman for UNICEF in Ivory Coast.