PAPUA: Male cutting imposed

Jakarta Post
June 30, 2015

Painless circumcision method introduced to curb HIV spread

by Nethy Dharma Somba
The Papua AIDS Eradication Commission (KPAD) began to distribute 1,800 PrePex circumcision devices to residents on Monday in four regions in a bid to reduce the risk of HIV infections in the province.

The device, made of elastic rings and placed on male genitals for seven days before it is released, has been considered practical and easy to use and can provide a non-surgical, medical means to achieve adult male circumcision.

Papua KPAD secretary Constant Karma said that the 1,800 PrePex units, which were donated by the US-based Clinton Foundation through the Clinton Health Access Initiative (CHAI), would be distributed to Jayapura, Jayawijaya, Paniai and Manokwari, starting Monday.
[No mention of informed consent.  Papua is under military occupation by Indonesia and the rights of local people are severely curtailed. Is this just another example?]

“This is only the first stage. For the second phase, we will receive another 10 million PrePex units [from the foundation],” Karma said on Monday on the sidelines of a free circumcision service held to introduce PrePex use at the regional administration-run hospital RSUD Dok II Jayapura.
[The population of Papua is 3.5 million. Who are the other 8.25 million Prepexes for?]

The hospital, according to Karma, would open such a service until Friday.

In 2007, the World Health Organization and UNAIDS argued that circumcised men could reduce the risk of HIV infection by approximately 60 percent in high-risk areas.

The spread of HIV infections in Papua is alarming, according to the Papua KPAD. HIV in Papua is mainly transmitted through unsafe sexual intercourse. [And mainly from men to women, to whom male genital cutting offers no protection and may increase the risk.]
 
Unlike regular circumcision surgery, PrePex-assisted circumcision is much easier to perform. After the male genitalia is cleaned and measured, anesthesia cream is applied on the tip of it to get rid of a tingling sensation.

Then the PrePex, which is a set of two rings, one black and one white, is inserted onto the genitals according to the respective size.

The white ring is put inside the genital skin while the black one is put around the outer skin. The rings will clamp the skin, stopping the flow of blood, nerves and nutrition to the skin that will be cut off.

“As the flow of the blood, nerves and nutrition stops, the skin will automatically feel nothing so that no pain will be felt and no blood will come out,” said Suwardi, one of the hospital doctors who assisted in Monday’s circumcision service. [This is optimistic to say the least. The sensation caused by a tourniquet of any kind can be intensely painful. Pain and blood are far from the only downsides of genital cutting.]
 
After the rings are attached, patients could engage in normal activities and then return to the hospital a week later to have the dead skin cut off and the rings released, said Karma, who was also among the patients.
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