BOTSWANA: "Safe" infant circumcision - with Accu-circ and Mogen clamps

Daily News (Botswana)
February 4, 2014

Ministry introduces SMC device for infants

The Ministry of Health has introduced two new devices for infants’ Safe Male Circumcision (SMC).
The SMC national coordinator, Mr Conrad Ntsuape said the two devices were the best that Botswana opted for. He noted that the entire procedure was bloodless, requiring no anesthesia, suturing or a sterile setting.

Mr Ntsuape said the median time for complete healing was seven days after device removal. The devices Mogan Clamp and AccuCirc would be administered on children from zero to two months, eight hours after birth. Circumcision would be done on physically fit babies with no signs on abnormality weighing more than 2.5 kg and a penis of at least one centimetre.

He said the two devices were safe and effective for nonsurgical male circumcision without anesthesia or sterile settings. The distinction between the two devices is that the Accucirc is disposable while the Mogan Clamp is useful in mass circumcision programmes particularly in resource-limited setting. The disposable component of it is the razor blades.
[The Mogen has caused several serious botches, resulting in the Mogen company losing lawsuits and going bankrupt and out of business. The Accu-circ has had no impartial field trials. It chops the foreskin off out of sight, with no knowledge of how the cut will turn out - or whether it will be complete. The word "Safe" is deeply ironical here.]

He said the decision to adopt the two devices followed a lengthy consultation process that focused on acceptability of infant male circumcision as part of HIV prevention and male reproductive health efforts that was conducted by the governments of Botswana and United States through Harvard Institute in 2008. The survey was also done on the acceptability of infant male circumcision among mothers of newborn male infants in Botswana.

Mr Ntsuape said the results of the survey indicated that 96 per cent of mothers in Botswana accepted early infant circumcision while the remaining four per cent were undecided or not interested. He also said infant circumcision was long overdue because Botswana was among 14 periotic [sic] countries in Africa that should scale up safe male circumcision for both children and adults.

The uptake of SMC follows a study by the World Health Organisation that had shown that such countries have high HIV prevalence and low SMC uptake. [There is every reason to suppose that in Botswana, as in Lesotho and Swaziland, circumcised men are as likely as intact men - or more likely - to have HIV.] Twenty five infants have so far been circumcised in the past two weeks at Princess Marina, Nyangabwe and Bamalete Lutheran hospitals.

He said training was conducted on midwife nurses and doctors. ... ENDS

ZIMBABWE: ...so they're doing it to babies

...so they do it to people who can't resist.

Newsday (Zimbabwe)
April 15, 2014

500 infants circumcised in government programme

THE Health and Child Care ministry has circumcised at least 500 infants in a pilot programme which started last year designed for young children before they become sexually active.
by Feluan Nleya
The ministry was working together with the Population Services International (PSI) on the programme.

PSI director for voluntary medical male circumcision Ngonidzashe Madidi said for the purposes of sustainability, they were studying the early infant male circumcision (EIMC) to ensure protective effect of male circumcision is sustained.

Madidi said they wanted EIMC to run parallel with the adult Voluntary Medical Male Circumcision (VMMC) programme.

"Currently, EIMC is in a study phase and we are happy to say we managed to circumcise at least 560 babies successfully," Madidi said.

"The first training to do implementation was done in December 2012 and that saw at least 50 babies being successfully circumcised by doctors."

Madidi said there was also a programme to train midwives to be able to circumcise infants as they were the first to make contact with babies.

The programme has so far been introduced at Edith Operman and Mabvuku clinics in Harare.
"The programme by the midwives saw them successfully circumcising 331 infants using the AccuCirc device," Madidi said.

Madidi said they planned to scale up the programme after the pilot phrase and would be guided by the ministry in implementing it.

He said EIMC protected the infant from future infections such as HIV and bladder infections by 98% and 82% respectively.
[There is no evidence that infant circumcision has any effect on HIV transmission. These figures have been pulled out of the air.]

The World Health Organisation recommends neo-natal circumcision should be a component of prevention campaigns since it is less complicated than circumcision performed in young boys, adolescents or adults. [But it isn't. Any tiny mistake on a baby is magnified on the man he becomes. Genitally cutting a baby is ethically a very different matter from doing it to an adult volunteer.]

ZIMBABWE: Babies to be circumcised as mothers die

ZimEye
November 10, 2013

Zimbabwe Buys Into Controversial Israeli Style Circumcision

At at time when government is struggling to provide bath and drink water for women in maternity wards across the country, the Ministry of Health and Child Care (MoHCC) has embarked on an expensive and controversial Israeli style pilot programme to circumcise young boys a few days after being born under the hope of stopping the spread of HIV AIDS.

This comes as women were being told to bring their own water to bath soon after giving birth as they were informed the hospitals have no money to drill boreholes; a time when the latest statistics reveal that at least 1000 pregnant women die in every 100 000 pregnant women in Zim hospitals because of inadequate money.

The ministry’s program will see over 500 babies between the ages of 10 and 60 days in Harare being circumcised voluntarily at the government’s own expense.
[There is no evidence that infant circumcision has any effect on HIV. And of course, no baby ever volunteers for anything.]
 
The state media reports that the programme is meant to assist Government in determining the best age at which to start conducting male circumcision, which is said to reduce the likelihood of contracting HIV by approximately 60percent albeit amid protest from other independent practitioners that this is untrue.

MoHCC male circumcision co-ordinator Dr Sinokuthemba Xaba said ... “Parents are the ones who are giving us the consent to circumcise their boys using the accucirc method,” he said.

“When phase one of the pilot program was initiated last year in December we set a target of circumcising 150 babies using two methods which were the accucirc and morgan clap [Mogen clamp] methods. [Never mind that the Mogen clamp is no longer made in the USA after the Mogen Company went bankrupt, having lost millions in lawsuits to the families of boys who lost parts of the heads of their penises in Mogen clamps.]

“After reaching the target in May this year, the assessment clearly showed that most parents preferred the accucirc method which is why we have embarked on the second phase of our pilot programme.

“We now want to see the strength and weakness of the most preferred method, parents’ responses to the method, their suggestions and also how nurses can handle the procedure.”

Dr Xaba noted that the results of the programme will determine whether the ministry will continue circumcising newborn babies.
...

“A complete waste of money”
The move by the ministry comes amid criticism from senior practitioners such as Dr Timothy Stamps who says that the very same studies undertaken on circumcision on which the United Nations body relies upon had on the contrary proven that countries such as the US with a higher number of circumcised men had a high HIV prevalence rate.

“Instead of channelling funds towards circumcision, the money must be used to save pregnant mothers who die in huge numbers in this country,” he said.

“When we are losing 960 mothers for every 100 000 pregnancies, should circumcision be a priority?” Stamps added.

Other investigations have have found that circumcised men actually contracted HIV after going through the surgical procedure.
...