Saturday, September 7, 2013

BOTSWANA: Men unwilling to be circumcised, funding stopped

Mmegi (Botswana)
August 29, 2013

Japan withdraw circumcision funds

by Onalenna Kelebeile

SELEBI-PHIKWE: A Japanese company JHPEGO, has withdrawn funding for Safe Male Circumcision (SMC) because the country failed to meet the target of 40 males per day. The programme known as SMC/MOVE was a national strategy that started in October 2012 and was supposed to go on for five years. The withdrawal of funding means that the programme stops less than a year after it started. Delivering the Urban Development Committee report recently Selebi-Phikwe District Officer Orishiwa Sitekia said the SMC/MOVE programme stopped due to lack of funds and the team halted work on August 15.

"Funds for this national strategy were withdrawn due to the programme failing to meet the set target of circumcising 40 males a day. "Only 10 males on average were circumcised in a day," she said.

Sitekia said SMC would continue to be done in local health facilities by the district health management teams.She said the SMC/MOVE under the Japanese company had a higher rollout than in the local health facilities Meanwhile, the urban development report shows that there was an insufficient supply of food in the local primary schools during the first quarter of 2013/14 financial year.


Ilajewe FM
August 7, 2013


The United States government through the President’s Emergency Plan For AIDS Relief (PEPFAR) has stopped funding Botswana’s Safe Male Circumcision (SMC) programme. Addressing residents of Khuduyamajako in Letlhakeng East recently, the Assistant Minister of Health, the Honourable Gaotlhaetse Matlhabaphiri, said this was due to the unwillingness of men to be circumcised. He pointed out that government planned to have circumcised thousands of men by the end of this year and was concerned about the low turnout they had experienced since the inception of the programme.

“At least during the school vacation, almost 4 000 school going boys were circumcised,” he noted. On other issues, the honourable Matlhabaphiri expressed concern about the growing number of defaulters enrolled on the ARV programme. He was also worried that such patients did not follow doctor’s instructions on how to take their medication.

IRAN: Some Jews circumcised "incorrectly"

The Jewish Press
August 29, 2013

Concern: Some Iranian Jews Improperly Circumcised

by Yori Yanover

According to the website Ladaat, there is a concern that Iranian Jews who were circumcised in the city of Shiraz may not be properly circumcised according to Halacha, and may need to undergo a corrective procedure.

This alarming revelation is based on testimony by one Shiraz-born Jewish man, who is 56 today and goes by the name of Motti. In a get-together marking the month of Elul—a time of contemplation and repentance—which included Rabbi Yaron Amit of the Brit Yosef Yitzchak organization, the rabbi shared that there is a growing phenomenon of adult, observant Jews whose circumcision was not done in keeping with Jewish Law.

It turns out that there exists a less invasive method of circumcision, which does not fully remove the foreskin, and so, according to the law, despite the pain the subject of circumcision endures in the process, in the end he is not considered to be circumcised.

Motti, for reasons he does not share in the video, decided to go and be checked by Brit Yosef Yitzchak, and, just as he had suspected, his brit milah required some corrective surgery, which was performed on the spot.

Motti was circumcised at the age of 8 days, like every newborn Jewish baby, but the mohel-ritual circumciser did not finish the job.

According to the website, there has been a similar phenomenon in northern Israel a while back, and some children also required corrective surgery to complete their circumcision.

In Motti’s case the suspects are a father and son team of mohels who worked for years in Shiraz. If this is true, and Motti’s botched circumcision was not the exception, but merely one sample of the Shiraz “style” of circumcision, it could mean that a large number of men in their fifties and sixties from that city may require an examination.

["botched"? On the contrary.]

This is why Motti has gone to the trouble of shooting a video—in Hebrew—to alert his former neighbors to the possibility of the need for a recall.

This reporter inquired with immigrants from Iran, and it appears that the general impression of the Shiraz community is that it is more machmir-stringentin than many in their religious practice, and so the problem with the brit could not have stemmed from rejection of the custom.

Normal foreskin to be coded as an abnormal - and billable - condition

How to make a disesease - and a "cure"

by Hugh Young

A forthcoming diagnostic code proposes to make a normal baby's foreskin a "disorder" and its treatment - circumcision - billable.

When a boy is born, his foreskin has usually not separated from his glans (head), and it commonly takes several years to separate, sometimes not until puberty.

Home > 2013 ICD-10-CM Diagnosis Codes > Diseases of the genitourinary system N00-N99 > Diseases of male genital organs N40-N53 > Disorders of prepuce N47-
> 2013 ICD-10-CM Diagnosis Code N47.0
Adherent prepuce, newborn
  • N47.0 is a billable ICD-10-CM diagnosis code that can be used to specify a diagnosis.    
  • ICD-9-CM will be replaced by ICD-10-CM beginning October 1, 2014, therefore, N47.0 and all other ICD-10-CM diagnosis codes should only be used for training or planning purposes until then.
ICD-10-CM N47.0 is part of Diagnostic Related Group(s) (MS-DRG v28.0):
  • 727 Inflammation of the male reproductive system with mcc    
  • 728 Inflammation of the male reproductive system without mcc    
  • 795 Normal newborn
Convert ICD-10-CM N47.0 to ICD-9-CM
The following ICD-10-CM Index entries contain back-references to ICD-10-CM N47.0:
  • Adherent - see also Adhesions    
  • prepuce, newborn N47.0

This seems to be an attempt to implement (by stealth?) the AAP Task Force on Circumcision's recommendation that non-therapeutic infant circumcision should regain Medicaid coverage, to stem the decline in unnecessary circumcisions.