SWAZILAND: More cut men have HIV than whole men

Why are we not surprised?

Star Africa
November 29, 2015

Swaziland: HIV infection higher among circumcised men – Survey

by APA
A study has shown that circumcised men have a higher HIV infection rate than uncircumcised men since 2007 when the Government of Swaziland introduced a policy on male circumcision, APA reports.

The study availed to APA Sunday morning [and available on this site since 2009]  states that out of the 305 circumcised men who were interviewed 21.8 percent were HIV positive compared to the 19.5 percent of uncircumcised men who were also interviewed and tested.

AIDS activist Vusi Matsebula told local media that most circumcised men are infected with HIV because of their behavior as they fail to use protection after undergoing the procedure because they believe circumcision is a preventive measure.

An official of Population Services International (PSI), Mandla Matsebula said; “The survey was conducted before the circumcision campaign was intensified. If they could conduct another survey now the results would be totally different.”  [Why should a more "intense" campaign have any different outcome? This is grasping at straws.]
 
Male circumcision, which is offered for free in Swaziland’s public hospitals, was introduced as a measure to minimize chances of infection by about 60 percent. [And still they chant their theoretical "60%" mantra, in  the face of real-world data that shows an increase in infection - using their own arithmetic - of  11.8%]
 
During school holidays the campaign gains momentum as male pupils are often the main targets for the free procedure funded by the government.

ZIMBABWE: Child circumcision ignites debate

Common sense breaks out....

Bulawayo24 (Zimbabwe)
May 25, 2014

Child circumcision ignites debate

Zimbabweans have expressed mixed feelings over an on-going male circumcision campaign, especially that which targets children.

Zimbabwe introduced ["voluntary"] medical male circumcision in 2009 following studies indicating that the procedure reduces chances of contracting HIV by 60 percent.

More than 40 local members of parliament volunteered to be circumcised in a campaign targeting 1,2 million males by 2015.

Population Services International, a US-based global health agency, is offering the testing and circumcision procedures.

There are others who believe the 2009 medical male circumcision campaigns being churned out through the media were misleading as they try to portray circumcised men as "confident, outgoing, sexually appealing, and set to succeed in life."

Raymond Majongwe, a National Aids Council, Nac board member said the media campaigns on male circumcision were mischievous in that they give a false sense of security to those who would have gone under the knife.

"They then think they are macho and can go on bedding girls. It is like a licence to be promiscuous.
"I also do not believe in those said ‘celebrities' that are being used to promote the idea. Stunner for example, is another male circumcision ambassador who after being circumcised went on to shoot a sex video that went viral, exposing his circumcised manhood," hit Majongwe at a recent gathering in Chinhoyi.

Stunner underwent circumcision in 2011 before he and Pokello recorded themselves having sex and the images later found their way on Internet and multimedia, first via Facebook and later circulated via WhatsApp.

Majongwe said it was puzzling that while God created man with the fore skin, there are others who now believe it has to be removed.

"God created us that way," said Majongwe adding that he has always been skeptical of the on-going male circumcision campaigns.

Dr. Karin Hatzold, deputy head of Population Services International (PSI) Zimbabwe, said her organisation is using entertainers to persuade young men to get circumcised.

"We have campaigns that are specifically targeting adolescents, people in schools — so during school holidays we are doing massive mobilisations on mass media... "So get smart, get circumcised. Male circumcision is not only HIV prevention intervention, but it is improving hygiene, you are cleaner, you are smarter.'"

Matobo senator Sithembile Mlotshwa once touched off a storm when she called on the ministry of Health and Child Care to stop circumcising children under the 2009 medical male circumcision programme.

In media reports, Mlotshwa was quoted as saying: "In our constitution, everyone is born with a right to life and I think it is wrong for a father and mother to sit down and decide to circumcise this young child who is a month old whereas the father was circumcised at the age of 40.

"This circumcised man's parents gave him all these years to mature and know the uses of all the organs of his body so as to decide how best to remake what is God-given.

"So then why does this person want to agree with his wife to circumcise an infant who is a third person who has a right to be fully developed as he is so that he makes his own decisions about his body organs?"

Mlotshwa believes children should be allowed to make their own choices when they grow up instead of being circumcised under this programme funded by international donors.

"I want to take our minister of Health to task because I believe that you don't have to circumcise infants."

Celebrated writer Virginia Phiri said the fact is that circumcision of males has always been there. "That is either for religious or traditional beliefs and at times for medical conditions."

...

"As this procedure is not easily reversible or it can be expensive to do, so these sons will have to live with the situation that they will find themselves in," she said.

...

Legislator Jessie Fungayi Majome said it is a sad or happy (depending on the circumstances) fact of life that children are bundled with the fate and decisions of their parents.

"To cut or not to cut must be decided according to which of the two is in the best interests of the child as required in our new Constitution.

"I think more research must be done to give objective knowledge of the pros and cons of male circumcision.

"Any circumcision campaign must still and concurrently emphasise the necessity to either abstain, or be faithful or use a condom," said Majome. [Any of which makes circumcision irrelevant.]

...

Social commentator Precious Shumba ... added that from experiences of some residents, a circumcised person cannot abstain from sex, meaning there is reported increase in the demand for sex, risking infection.

Political activist Tabani Moyo said ... "... those agitating circumcision should engage in ethical advertising by outlining the dangers that come with the process so that when people decide to do it, they do so with all the critical information at hand.

"At the moment, there is too much high voltage advertising which borders on deceit that might end up leading to unintended consequences as the adverts seem to give an impression that your chances of getting HIV/Aids for example are reduced, this is irresponsible advertising," said Moyo.
 
...

Pan Africanist, Thomas Deve said what we know about circumcision makes us welcome it for health and religious purposes or as a rite of passage to manhood in some traditions.

"I am sceptical of the Americans pouring in money via the PSI-led initiative when they are withdrawing state-funded programmes in their own country," said Deve.

PSI's health director Louisa Norman has been quoted in the media as saying: "If we can circumcise 1,2 million men by 2015 we can prevent 750 000 new cases of HIV, which means we can really start to envision a country in which there are no new HIV infections." [These figures are based on "modelling", assuming the "60%" reduction claimed in the three trials translates exactly on to the real world - in other words, Just Made Up.]

Zimbabwe has 1,1 million people living with HIV, including 150 000 children, according to Nac.
[And more of the circumcised men have HIV than the non-circumcised:]

ZIMBABWE: Doctor cuts off boy's penis during circumcision

CrazyNews 24 (Zimbabwe)
April 29, 2014

Clinic cuts off boy's little manhood during circumcision

ZIM: What started as a simple surgical procedure went horribly wrong for a 12-year-old Bulawayo boy after his penis was also cut off during circumcision.

The nightmare unfolded at the new Lobengula Circumcision Clinic on Thursday last week.

Sources at the clinic yesterday told Bulawayo24 News that the doctor was supposed to hold only the foreskin and cut it off; "But somehow nipped off the head of the penis as well. Although the boy was under local anaesthetic, he screamed as blood gushed out of his organ."

"On realising his gory mistake, the doctor arranged for an ambulance to rush the child to hospital as he battled to stem the copious bleeding," said a source.

The boy is admitted at the United Bulawayo Hospitals (UBH) where the cut off organ has been sewn back on.

A source at UBH said while he was in stable condition, it was too early to know if his penis would be normal again.

His father, who identified himself as A Sibanda said he was devastated by the gruesome incident.
"This could be a one in a million case and I am crushed in spirit. We are waiting for a specialist doctor from Harare to look at him. We will then sit down as a family and decide on the next step," said Sibanda.

Population Services International (PSI) spokesperson Paidamoyo Magaya was unreachable for comment. PSI sponsors the circumcision drive in Zimbabwe. Removal of the foreskin is believed to reduce chances of one contracting HIV by as much as 60 percent.

MALAWI: Boys being circumcised again

Polysurgery addiction by proxy...

Malawi News Agency
April 23, 2014

Double knifed to fulfill the needful

by Josephine Chinele
Blantyre, April 23: Even though his son had gone through the traditional male circumcision, Geoffrey Linje, a Manase resident was not satisfied.

“During our time, the traditional circumcision was okay but nowadays, it’s fashionable to have both,” he said, whilst waiting for his 11 year old son who was having the second time circumcision procedure inside the make shift theatre at Namasimba primary school in Blantyre.

Linje recalls that during his youthful days, anyone who was not circumcised was regarded as a toddler even if they grew up and raised a family.

World Health Orgsanisation describes Voluntary Medical Male Circumcision (VMMC) as the surgical removal of the foreskin- the retractable fold of tissue that covers the head of the manhood.

It is believed that traditional male circumcision rite is not fully done hence other people like Linje are taking their children to have VMMC.

The father of six children, two of whom are boys proudly says the first boy also had two circumcisions and this makes him feel better.

“The first circumcision is like a mere transition from a ‘toddler’ to a fully grown adult. Now with the advent of many diseases, it’s very necessary that such children should also have medical male circumcision,” he elaborates.

Linje is however quick to say he did not know of any VMMC campaign until his 11 year old boy told him that he heard from ‘chimkuza mawu’ (Mobile Public Address system) which was going around their area announcing the same.

He points out that VMMC reduces a man’s chance of contracting HIV and helps in hygiene of the individual.

Linje’s child is one of the many youths that expressed interest in VMMC at Namasimba mobile clinic.

Site supervisor, Jofirisi Jofirisi says the centre circumcised an average of 25 youths per day from April 9 to April 15, 2014.

“I believe adults are not forthcoming because of perception. May be they think they are already married and no longer need VMMC. The youth may be coming because they want to fit among their peers,” he says.

Nevertheless, Jofirisi reveals that all youths who present themselves for VMMC are tested for HIV, counseled and clearly told that VMMC is not an HIV vaccine.

“We also advise them to take a lot of fluids so that they should have frequent urination to avoid erection since this could disrupt the healing process and increase bleeding on the stitched area,” he says.

World Health Organisation says there is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 percent.

[Except in the real world:]

Malawi
HIV Rates:	Circumcised men	13.2%
	Intact men	9.5%
Source: www.measuredhs.com

“Male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package which includes: the provision of HIV testing and counseling services; treatment for sexually transmitted infections; the promotion of safer sex practices; the provision of male and female condoms and promotion of their correct and consistent use,” reads the information in part.

[ A traveller came to a farmhouse and offered to make the occupants Nail Soup in return for a night's shelter. He threw a large iron nail in a pot of boiling water, but said: -
"A Magic Nail provides only partial soup-making power, and therefore should be only one element of a comprehensive soup-making package which includes: vegetables; meat; herbs; stock; the provision of pepper and salt and spices and promotion of their correct and consisten use," he said in part.
The farmer's wife accepted this, and in the morning the traveller went on his way, refreshed after a night in a comfortable bed, minus the Nail, with some gold coins in his pocket and the thanks of the family ringing in his ears for the wonderful Magic Nail that made such delicious Nail Soup.
Thus if a circumcised man doesn't get HIV, circumcision will get the credit, but if he does, he can be blamed for failing to take the other precautions. And if a non-circumcised man gets HIV, his foreskin will be blamed, but if he doesn't, nobody will take any notice.
Circumcision is as good at preventing HIV as a Magic Nail is at making soup.]

PSI Community Counselor responsible for Blantyre Manyowe, Chikondi Magalasi, says many people still do not know the difference between VMMC and traditional circumcision.

“I have at least encountered situations where people decided to take their children for VMMC even after they had the traditional one like the case of Mr. Linje,” he says.

Magalasi says to some extent, ‘Angaliba’ (Traditional circumcision surgeons) are feeling threatened by the coming in of VMMC since they think it may take away their source of income and public respect.

“VMMC is not only cultural but a must-have for today’s man. Women should also take a role by encouraging their spouses to go for it since one benefit of VMMC is that when a man is circumcised, they don’t carry the Human Papaloma Virus (HPV) which causes cervical cancer to their spouses,” he elaborates. [That is completely false]

Another Community Counselor responsible for Nancholi, Jonathan Dinesi says it is pleasing to note that some parents have been taking their children to have VMMC even if they already had the traditional one.

“I have personally met three of such children aged between 10 and 15. It takes an understanding parent to do that,” he says. [Misunderstanding, rather.]

Ministry of Health’s deputy spokesperson, Adrian Chikumbe says the fact that other parents are taking their children for VMMC even after the traditional rite is an indication that people understand the VMMC concept. [Except "Voluntary"]

“The message, however, still stands that VMMC is a supplement to all other HIV prevention measures not a vaccine therefore people should still observe abstinence and condom use,” he emphasizes.

Chikumbe says the ministry is trying to work together with ‘Angaliba’ so that they should be arranging for the initiated boys to have VMMC at a medical facility then take them back to their initiation camps so that their job is not compromised. [Oh dear, heaven forbid that their jobs should be compromised?]

ZIMBABWE: Men are not buying circumcision...

Men aren't buying it...

Newsday (Zimbabwe)
April 14, 2014

Low uptake of male circumcision

by Feluna Nleya
ZIMBABWE has recorded a very low uptake of the voluntary medical male circumcision (VMMC) within and the country is failing to meet targets set every year, the Ministry of Health and Child Care has said.

Speaking at a workshop hosted by the Population Services International (PSI) in Bulawayo last week, Ministry of Health and Child Care Matabeleland South provincial medical director Rudo Chikodzore said the male circumcision programme was lagging behind set targets.

“We are trying to scale up on the circumcision programme as we are working against our targets,” Chikodzore said. “We have been able to achieve only 4,8% of the target and this means we still have a long way to go.”

Last year, Zimbabwe had targeted to circumcise at least 115 000 men, but only managed to have 112 869 men go under the knife.

In 2010, the target was 20 000, but 11 123 were circumcised. In 2011, 36 742 were circumcised against a target of 60 000, while in 2012 only 20 775 against a target of 80 000.
...

She said that high male circumcision should be able to turn around the high HIV prevalence.
“We should be able to avert 42% of new HIV infections through scaling up of MC between 2011-2015. If MC is scaled up, we will be able to avert 150 000 new infections,” Chikodzore said.
  [That's very debatable:]
PSI director for VMMC Ngonidzashe Madidi attributed the low targets to men’s fears of the surgical procedure.

“Men have certain fears of the surgical procedure,” Madidi said. “Many men were shunning the programme because of it being surgical and men have the fear of injections. That is why there is a new method, the Prepex, where we use a device around the foreskin, thereby cutting blood supply to the end. The device is worn for seven days and is only used by adults of 18 years and above.”

Madidi said 161 men have undergone circumcision through the prepex method since March 31 this year.

PSI is using celebrities as brand ambassadors in order to lure more men to be circumcised. The ambassadors include Albert Nyathi who was circumcised last week, Jah Prayzah, Sulumani Chimbetu, Winky D and Fungisai Mashavave-Zvakavapano.

Earlier story

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: Children indoctrinated about circumcision

Brainwashing? Indoctrination?

December 8, 2013

Zimbabwe government takes circumcision into the classroom

by Phyllis Mbanje
OFFICIALS from the Ministry of Health and Child Care have been going around schools in the country disseminating information on procedures and benefits of male circumcision to pupils, some as young as 12 years old, courting the ire of some parents.

The officials however said they were targeting pupils in higher grades in both primary and secondary schools. For anyone below the age of 18, consent for circumcision has to be sought from the parent or guardian.

But some parents felt that the issue of circumcision was being introduced too early and might be harmful to the pupils.

Ministry of Health and Child Care national male circumcision (MC) coordinator, Sinokuthemba Xaba said the exercise was meant to furnish the pupils with information which they would share with their families and help them make a decision.

“The exercise is merely for giving out information. We do not expect the pupils to then make decisions but the parents, if they so wish, will then consent in writing,” he said.

Xaba said in some instances the schools had invited them to either give the lectures to the teachers who would in turn filter the information down to the pupils, or address the children directly.

“It differs with schools; some allow us to interact directly with the pupils while some prefer the officials to address teachers. Bottom line is that it is all about disseminating the right information,” he said.

An official from Population International Services (PSI) said there was nothing wrong with disseminating information about circumcision to pupils. He however admitted that some parents had reservations about the exercise.

“Even if the children do not immediately put the information to use, it might help them as young adults to know and appreciate the benefits of circumcision,” he said.

[No mention of risks or harms, of course, nor any doubts about the HIV claims.]

Last month, Xara said the programme faced a myriad of challenges which included limited demand for the services among older men, inadequate human resource and limited government funding.

This is despite the belief that if the exercise is successfully rolled out, 212 449 infections would be averted by 2025 while HIV prevalence would decrease to 4,4% by 2025 compared to an anticipated 7,3% if MC is not scaled up.

[These figures are Just Made Up, based on mathematical models that assume the protection supposedly given to 73 men after 5,400 were circumcised in clinical trials can scale up to mass-circumcision in the real world. ]

Parents who were attending a graduation ceremony at a preschool in Meyrick Park in Harare recently expressed mixed feelings over distribution of information about circumcision to pupils.

“I do not see anything wrong with the ministry giving information to the children as long as they are mindful of the language they use and do not try to manipulate the children,” said Sheila Hove from Harare’s Westgate suburb.

However, Robert Gwata from Richwell Gardens in Mabelreign had this to say: “Surely, that is a preserve of parents and guardians. Why should these guys go to schools and try to sweet talk our children to have the procedure done. We will have problems when they come home with their heads full of things that they have no control over.”

ZIMBABWE: Man wants his foreskin back

Bulawayo24 (Zimbabwe)
November 4, 2012

Man demands his foreskin back after circumcision

A Chiredzi man who claims to have lost erection after being circumcised in the Pinda Musimati HIV and Aids Campaign has become a bother at the Family Aids Caring Trust (FACT) in Chiredzi where he is demanding his foreskin back.

FACT executive director for Chiredzi, Ropafadzo Magwaza confirmed the story and said she was happy that the man had not become violent. ...

Magwaza said she quickly organised a stakeholders meeting to clear the man's issues. The man confronted FACT Chiredzi volunteers working in the area and demanded that they give him back his foreskin as he had experienced weak erection since he went through the knife. He said he had become weak and could not get the erection that he used to and even accused the organization of taking people's foreskins for ritual purposes because other newspapers had refuted the claim that circumcision reduces HIV and AIDS by 60%.

"Yes, we received the report but we are happy that the man never became violent but is always nagging our staff over his foreskin. This prompted us to call for an urgent stakeholders meeting where we called the National Aids Council (NAC), Zimbabwe Aids Network (PSI), NANGO, traditional leaders including Chief Chilonga, Chief Chitanga Chief Tshovani, a medical doctor from Hippo Valley and councilors.

"FACT Chiredzi does not carry out circumcision but we only mobilize people and do all the Voluntary Counselling and Testing (VTC), while the hospital carry out the circumcision. We are happy that Chief Chilonga managed to explain to participants fully about male circumcision. It was a relief to hear words of wisdom from a traditional leader," said Magwaza. [And did the words of wisdom give the man back his erections - or his foreskin?]

Confusion over circumcision hit the head lines as newspapers ran conflicting stories on the advantages of circumcision, with President Robert Mugabe's health advisor Timothy Stamps rubbishing the survey and calling it baseless and misleading.

[Memo to circumcision advocates and providers: Include
"I understand that circumcision is irreversible and I can NEVER get my foreskin back" in informed consent forms.

And he could be shown with this model what is removed:

[Before]

[After]