KENYA, UGANDA: Men regret being cut, denounce campaign

BlackNews.com
November 30, 2016

Africans Speak Out Against the Mass Circumcision Campaign

by Max Fish
“We respect science honestly, but we do not support what science brings to finish us, to defile our cultures, defile our rights.” — Prince Hillary Maloba

— Since 2008, western public health giants* have been circumcising Africans by the millions to slow the spread of HIV/AIDS. American taxpayers are funding the effort through the President’s Emergency Plan for AIDS Relief (PEPFAR). An estimated 12 million men and boys have been circumcised to date. The world has not heard a word from them until now. —
 
Nationwide — The VMMC Experience Project recently sent cameras into Uganda and Kenya to document the realities of the mass circumcision program. Local investigators conducted interviews with 90 affected men and women and found:
1. Africans are told circumcision conveys immunity from HIV. 2. Condom use is at an all-time low, and AIDS is on the rise.
3. The program is killing the very people it is supposed to help.
4. No follow-up post circumcision (cut-and-release approach).
5. Resentment and outrage among Africans.
The “Voluntary Medical Male Circumcision” (VMMC) public health program is the first mass surgical campaign in human history. It targets Africans exclusively, leading some to question whether there are underlying racial motives. For centuries, western stereotypes have held that African men are lascivious or hypersexed, unable to control their sexual urges. Compulsory African-American male circumcision campaigns were proposed as early as the nineteenth century.

Prince Hillary Maloba is a native Kenyan, director of the VMMC Experience Project, and the driving force behind the investigation. “Male circumcision,” he explains, “as a project that has been applied for we [sic] Africans, has failed to reduce HIV the way we were told. Two, we view it as a violation of human rights. How target only one race in the entire world?”

Bishop Cleophas Matete, another native Kenyan, agrees: “I believe the entire process of trying to test it in Africa was wrong from the beginning.”

The mass circumcision campaign was introduced to reduce the incidence of HIV in fourteen sub-Saharan African countries that did not initially practice genital cutting. However, UNAIDS data indicate that the African HIV epidemic has only worsened since 2010—shortly after VMMC was implemented. For the first time since the war on AIDS began, HIV is back on the rise.

The World Health Organization claims that male circumcision curbs female-to-male HIV transmission by up to 60 percent and provides lifelong partial protection against HIV and other sexually transmitted infections. Their conclusions derive from a process of contentious surgical experimentation on Africans.

Opponents allege that the targeting of impoverished Africans constitutes a racial and human rights issue. Comparisons are made to the Tuskegee syphilis study. Others argue that the program results in a dangerous false security. The present investigation confirms that men, women, and teens are abandoning condoms out of a belief that they are already protected by circumcision. This in turn increases the spread of HIV.

Prior to the VMMC Experience Project investigation, none have consulted or followed up with the men and women who have been directly affected. Many are living in rural poverty, invisible to the developed world. They have had no platform or voice in the circumcision agenda. Maloba’s investigation is the first to shed light on the African side of the story.

African men and women say the campaign is violating their rights, confusing their cultural identity, and profoundly worsening the AIDS epidemic. They implicate the program in the spike in HIV cases we have seen in recent years. Seven respondents in Maloba’s investigation said that they had acquired HIV because of misinformation around circumcision.
 
“I blame those who told me that if I get circumcised I won’t get HIV,” said one respondent, “and I got HIV already!”

Others mourned the loss of friends, brothers, relatives, and neighbors to AIDS following the procedure they believed would protect them.

“These people are dying of HIV due to ignorance,” a respondent explained.

“If we don’t stop this thing,” Maloba warns, “this community will not have a generation that will take care of the old people.”

Instead of mass circumcision, Africans want funding for sustainable medical facilities, anti-retroviral medications (ARVs), more durable condoms, HIV education, and poverty reduction initiatives.

Many cite AIDS-related tragedies from the VMMC program. They seek an end to the circumcision campaign as a public health disaster and a form of cultural imperialism from the West. “It is something that has been imposed on us,” a reverend explained in his interview. “If I could get a forum to fight it, I could fight it very hard.”

*VMMC-promoting institutions include the Bill & Melinda Gates Foundation, the World Health Organization, UNAIDS, USAID, PEPFAR, Jhpiego (Johns Hopkins University), and numerous NGOs.

About the VMMC Experience Project The VMMC Experience Project is a 501(c)(3) nonprofit effort to document the effects and aftermath of the world’s first mass surgical campaign. Its aim is to empower the most frequently overlooked contingent in the African circumcision regime: Africans.

UGANDA: Boy, 4, botches DIY cutting of younger boy

The Monitor (Uganda)
December 18, 2014

Boy's genitals chopped in mock circumcision

by Mudangha Kolyangha
A four-year-old child has almost left his three-year- old brother without genitals after he tried to circumcise him.

The incident happened in Kamonkoli, Budaka District.

Imitating the Bagisu cultural circumcision practice commonly known as Imbalu, the two boys were seen dancing, dressed in banana leaves, but few minutes later the younger one was found lying in a pool of blood.

The four year old self-made surgeon who can not be named because he’s a minor is said to have used a sharp razor blade to cut off the fore skin of his colleague’s genitals.

The child’s parents had to rush the child to Mbale hospital for proper circumcision and medical attention.

Officials at Mbale hospital confirmed the incident saying the boy is in a stable condition.
This is an even year and the male circumcision season is on.

The legendary ceremony among the Bagisu ethnic group marks the initiation of boys into manhood.

Following the launch of the imbalu season in Bugisu region in August, President Yoweri Museveni, one of the witnesses as courageous young men face the knife in the rite of passage to adulthood, pledged to promote the cultural ceremony for tourism purposes.

UGANDA: Men resist being cut

Aids Ark
October 9, 2014

Uganda's flagging male circumcision drive

SHAREKAMPALA, 8 October 2014 (IRIN) – Limited funding and personnel, as well as misconceptions and cultural beliefs, are some of the challenges hindering Uganda’s goal of circumcising at least 4.2 million men by 2015 in a bid to lower the country’s HIV/AIDS incidence.

Just 26 percent, about 1.4 million, of the men targeted under the Safe Male Circumcision (SMC) programme – launched in September 2010 – had been circumcised by the end of 2013, according to Uganda’s AIDS Commission (UAC) mid-term review report of the National HIV/AIDS Strategic Plan (2011-2015).

The US President’s Emergency Plan for AIDS Relief (PEPFAR) and the joint UN Programme on HIV/AIDS (UNAIDS) indicate that circumcising 4.2 million Ugandan men in 2011-2015 could help to halve the country’s HIV incidence. Uganda’s HIV prevalence rate has risen from 6.4 to 7.3 percent over the past five years.

The 4.2 million target represents 80 percent of the estimated number of uncircumcised men in Uganda. “I don’t think we will achieve the 80 percent target by 2015. The service is limited to a few areas mainly because of the limited funding from donors and government. PEPFAR contributes the biggest portion of this fund out of the many donors supporting health related projects,” Sylvia Nakasi, policy and advocacy officer, Uganda Network of AIDS Service Organizations (UNASO), told IRIN.

“Other factors affecting demand are the mixed messages on SMC, limited coordination of the private and public SMC service providers which affects timely reporting and quality assurance of the service provided, limited training of health workers to do SMC surgery, inadequate SMC supplies, lack of SMC champions and limited health workers.”

According to the UAC report, about 14 districts (out of 112) had reported no SMC activities by March 2013.

“We have had challenges in building capacity and putting systems in our health facilities for the service,” Joshua Musinguzi, the programme manager of the AIDS Control Programme at Uganda’s Ministry of Health, told IRIN. “We are now focused to consolidate and scale up SMC to try to achieve our target. We have harmonized communication materials to create demand, uptake, fight behavioural disinhibition and dispel myths.”

Myths and misconceptions
The UAC report noted that limited mass awareness on SMC may lead to risky sexual behaviour. “Disinhibition” implies the loss of inhibition on behaviour that had been restrained.

“The circumcision disinhibition might cause men to abandon previous risk reduction behaviours such as partner reduction or condom use. There are reports of local misperceptions that SMC is a magic bullet to prevent HIV, a belief that is likely to inhibit safe sex practices,” it stated.

The report added that the preference for traditional circumcision among some ethnic groups, such as the Bamasaba and the Bakakonjo, is affecting government efforts to scale up SMC. SMC is medically carried out under hygienic conditions to prevent the spread of infectious diseases, which are risk factors in traditional circumcision.
...

Myths abound. “There are many misconceptions and myths which surround this intervention. It’s also [a] frightening procedure. Men think of the risks involved, the pain and how long it will take them to heal,” added Sarah Kayagi, the chairperson of Uganda’s HIV/AIDS parliamentary committee. “Some women don’t want their husbands circumcised on grounds that they will become sexually weaker… Some think it’s meant to convert people to Islam."

[Not to mention - never to mention - that men may refuse to be circumcised because they know the value of their foreskins and that the claimed benefits are insufficient to justify it.]
...

UGANDA: Prostitutes take more risks with cut men

The Observer (Kampala)
September 2, 2014

Uganda: Circumcision Promoting Risky Behaviour - Report

by Racheal Ninsiima
A new study of 314 female sex workers (FSWs) in Makindye division found that more than half of respondents falsely believe that once a man is circumcised, protection is not necessary during sex.

The International Health Sciences University (IHSU) study was titled: "Understanding the dynamics and practices of female sex workers with both circumcised and uncircumcised men in Makindye division."

It was done in the Kampala suburbs of Kabalagala, Kansanga, Makindye II, Kibuye, Katwe, and Ggaba, between July and August 2013. Although there is no significant difference in sexual practices between circumcised and uncircumcised men, there is a misconception about the advantages of male circumcision among FSWs.

Of the interviewees, 17.7 per cent preferred having sex with circumcised men because they believe the risk of HIV infection is nil. Some 20 per cent of the 60 FSWs that reported to be HIV-positive had not used a condom in their last sexual encounter before the interview. One interviewee summed up the misconception of using circumcision as a 'natural condom' this way:

"A man who is not circumcised takes long to ejaculate and at times such men want to have sex with you without a condom such that they can infect you. But a man who is circumcised can even rape you without a condom and you do not get infected."

With regard to condom use, 187 (72.5 per cent) said they used condoms with steady clients every time while 67 (26 per cent) said they used condoms occasionally.

"Meanwhile, four FSWs (1.5 per cent) said they never used condoms with their steady clients and three of these did not think that circumcised men could infect someone with HIV yet they had had STIs in the past three months," the report partly reads.

The report notes that the 60 per cent protective effect from HIV/Aids that is associated with safe male circumcision (SMC) is likely to trigger a high propensity for risky sexual behaviour and worsen the incidence of HIV.

...

UGANDA: Museveni wants "old style" circumcision shunned

ComesaRIA
August 20, 2014

Museveni Wants 'Old Style' Circumcision Shunned

by John Nalianya
Ugandan president Yoweri Museveni has told the Bukusu and Bagisu tribes living in Kenya and Uganda to shun the old style of undergoing circumcision.

Museveni said while his government respected diverse culture, the two communities should break loose from the old retrogressive cultures.

"While we support you in keeping your culture find ways of trying to modernize this culture in tandem with the changing times ,"said Museveni.

Museveni said the traditional circumcision ceremony among the two communities had only promoted prostitution. He warned the tribes over myths that circumcised men could not contract the Aids virus.

"Stop lying to people on this traditional myths that people who are circumcised have low chances of being infected with Aids. You will die," he said.

Museveni was speaking at Namboboto shrines in Mbale, Eastern Uganda where he presided over the launch of the Bagisu circumcision ceremony popularly known as "Imbalu".

The ceremony that was attended by over ten Ugandan ministers, a host members of parliament and the Kenyan delegation led by Bungoma governor Kenneth Lusaka saw over ten [sic] boys circumcised.

Museveni who hails from Banyakonle tribe of Western Uganda, that don't undergo the cut, called on the elite from Bagisu and Bukusu communities to be in the forefront in encouraging the communities to shun the old culture.

...

Museveni said some of the bad old culture practiced by the two communities have made the two communities lives poor.

"Let's focus on the cultures that will create jobs for our children and improve our standards of living," said Museveni.

UGANDA: Circumcision funds misused

The Daily Monitor (Uganda)
July 3, 2014

NGO probes misuse of Shs400m meant for male circumcision

by David Mafabi
Budaka- The Management Sciences for Health [formerly Star E project], an NGO, has opened investigations into alleged mismanagement of Shs420 million [$US 159,880] meant for Kaderuna Health Centre III by its staff.

The money was meant for male circumcision to prevent the spread of HIV/Aids.

The Daily Monitor learnt that the focal person for ART programme, Mr Abdulla Wambedde, and a doctor had allegedly been drawing Shs18 million every month for the last two years but never did the work.

Members of the Kaderuna Health Centre III led by Mr Hassan Kibwika, accused Mr Wambedde of mismanaging the male circumcision programme and diverting funds.

The Budaka District speaker, Mr Abdu Kagoda, said he heard of MSH [Star E] and that they promised to come to the area to perform male circumcision, but they never appeared.

“They promised to come on several occasions, we lined up people from Kaderuna and we have never seen them. And yet as a district we know money was released for the activity for two years,” said Mr Kagoda.

The MSH chief of party, Dr Edward Ssemafumu, said they had been releasing money for the programme at the facility but received reports from the ground that the money never reached.

Investigations
“We have already started investigations as MSH,” Dr Ssemafumu said. “What we know is that about Shs400 million was disbursed to Kaderuna Health Centre III but there has been no activity, we have already suspended a doctor and we have started an audit. I am sure we shall get to the bottom of the matter.”

When contacted, Mr Wambedde denied any wrong doing, saying he had reported the matter to police against people spreading malicious information about him.

UGANDA: Women shun circumcised men

The Obsever (Uganda)
June 27, 2014

Gulu wives reject circumcised men

by Zurah Nakabugo
Vincent Okello, 27, was one of the many men who turned up for circumcision in northern Uganda in recent months.

Yet despite his interest in the exercise, Okello is concerned about the reaction of his wife once he returns home.

This is because of reports that some women in the north have rejected their circumcised men, accusing them of having become sexually weaker after undergoing the operation that experts say helps reduce the chances of contracting the deadly HIV/Aids virus.

“I came here for circumcision after hearing messages from the media about the benefits of circumcision; that it protects us from acquiring HIV/Aids and other infections like Sexually Transmitted Diseases (STDs,” Okello said. “However, my concern is about my wife who is likely to abandon me after circumcision following misconceptions from the public that I will become sexually less powerful.”

Okello told The Observer at Gulu hospital, that some of his colleagues who were circumcised before had already been abandoned by their wives. However, according to Roselyn Oyella, the safe male circumcision counsellor at Gulu hospital, such perceptions are false.

“If you have been impotent you remain impotent. If you have been sexually active, there won’t be any change after circumcision,” Oyella said.

Virility is not the only reason why circumcision is causing conflict in families, according to Stuart Ochora, 25, a resident of Layibi village in Gulu Municipality. It is said that the practice contradicts local cultural norms and many locals think it is meant to convert people to Islam.

Medical personnel such as Dr Leonard Were, the voluntarily medical male circumcision (VMMC) officer, attribute the lopsided perceptions to lack of or limited sensitisation of people, especially women, about the importance of circumcision in the fight against HIV/Aids.

“Because of removing the foreskin of the penis, the virus has lesser area [through which] to enter the man during sexual intercourse,” Dr Were said. [If that's the reason, cutting the whole thing off will be 100% effective.]

Dr Were, who is also the programme officer of the Northern Uganda Health Integration to Enhance Services (NU-HITES) project, says for the last one-and-a-half years, 74,000 men have been circumcised in northern Uganda by NU-HITES project alone. However, he fears that due to cultural beliefs and lack of sensitisation about its importance, they might fail to meet their target of circumcising 100,000 males every year.

The RDC of Gulu, Catherine Lamwaka, said the low number of males circumcised would eventually become a social and economic burden to government.

“We are fighting hard to sensitise people in the region about the importance of circumcision,” Lamwaka said.

At 8.3 per cent, northern Uganda has the second highest HIV/Aids prevalence rate, after the central region.

UGANDA: Myths about circumcision help spread HIV

Is anyone surprised?

USAIDAssist
April 15, 2014

Is female participation in voluntary medical male circumcision of any value? Experiences from Uganda.

by John Byabagambi, MPH
Improvement Advisor, USAID ASSIST Project/URC
Uganda adopted voluntary medical male circumcision (VMMC) as part of its comprehensive HIV prevention strategy in 2009. From its inception, the service was designed to target males and most of the efforts were focused on ensuring that as many males as possible were circumcised. In December 2012, a PEPFAR interagency team conducted an external quality assessment for the Uganda program and found several quality gaps. ... there were various myths surrounding circumcision which led to negative outcomes, and we believed that, by engaging female partners, we could educate them about the process and improve outcomes for males undergoing the procedure. Some of these harmful myths include: having unprotected sex after circumcision promotes wound healing; a painless post-circumcision penile erection is an indication of complete wound healing; as a cleansing procedure, the first post circumcision sexual encounter should be with a partner that will never come into your sexual life again; and there are possibilities that lignocaine may affect penile function and the sooner these effects are tested after surgery through sexual intercourse, the better.

... Here is a service whose main goal is to reduce the chance of HIV transmission, but what is happening is that it’s leading to behaviors that greatly promote HIV transmission because it is promoting unprotected sexual intercourse for clients with fresh wounds, which act as a direct entry portal for the virus! The myths encouraging even males who have been faithful to their partners to have multiple sexual partners - a known risk factor for HIV transmission because of the belief that they need to “cleanse themselves.” Through discussions with staff and clients we learned that it was actually the female partners that were encouraging their male partners to have intercourse with other women so that they wouldn’t transmit the bad omen to them, the most common omen being that their foreskins would peel off.

Additionally, we heard complaints in which female partners were reluctant to allow their spouses to complete the mandatory six weeks of post-circumcision abstinence to allow complete wound healing. Some circumcised clients reported that when they would inform their partners about the period of abstinence, their female partners would think that their partners were cheating on them, and that it was untrue that they must abstain for that long.
...

UGANDA: Prisoners forcibly circumcised

the Monitor (Uganda)
December 13, 2013

Former inmates decry forced circumcision

by Ronnie Layoo
Gulu- Former inmates at Gulu Main Prison have accused the authorities of circumcising them against their will.

The inmates say the prison wardens force them to get circumcised, saying the move is to enhance good sanitation and health living.

Speaking to the Daily Monitor recently, Mr Richard Okello, 22, who was remanded in the prison for alleged assault for three months, said the prison warders forced him to get circumcised.

“The wardens came in the hall and announced that those who have not circumcised should get on the line, no one could resist it,” Mr Okello said.

He said he was exposed to infection since they did not provide him treatment.

Another former inmate, Mr David Ojok, who claimed he was also forced to circumcise, said proper sanitation, which should guarantee proper healing, was not provided.

However, the regional prison commander, Mr Kenneth Mugabiirwe, dismissed the allegations.

“Nobody can be forced to get circumcised; it’s voluntary,” he said. Mr Mugabiirwe acknowledged overcrowding and poor sanitation as the challenges facing the prison due to poor facilitation.

The officer in-charge of Gulu Main Prison, Ms Orik Obonyo, said a committee was recently set up to carry out investigations.

UGANDA: Man loses penis in circumcision botch

New Vision (Uganda)
July 16, 2013

Man loses penis in medical circumcision

by Paul Kiwuuwa and Simon Masaba

At 44 years, Patrick Izimba, is a lost man after he lost his penis to a botched male medical circumcision procedure in a private clinic. Izimba is at Mulago Hospital... , where he has endured pain for the past three weeks.

Speaking with teary eyes, Izimba curses the day he read a sign post at the private clinic that offers free male medical circumcision.

“I underwent an operation at Medik Medical Centre Limited in Kawempe,” he says. “Free things are expensive they have cost me a life. I depend on pain relievers. My penis is falling off and requires me to wear a skirt.”

“Pain killers have become my daily bread because if I do not take them, I cannot sleep,” Izimba narrates. Izimba has a catheter connected to his bladder to allow urine to flow out.

He says Dr. Francis Kakooza, an employee with Medik Medical Centre, carried out the operation under the supervision of Dr. Edward Kunoya, the clinic’s director and proprietor. ...

Start of his woes
On the fateful day, Izimba met Dr. Kunonya who told him the circumcision was free, but he had to pay sh20,000 [$US 7.73] for the drugs. Izimba paid the money and was asked to bring Jik [bleach] and a polythene bag to place on the surgical table.

He recalls that before the surgery, Dr. Kakooza administered an injection which was painful. “I objected to the operation, but Kunonya shouted at me: ‘Be a man, don’t fear.’ Meanwhile, Kunonya sprayed something on my nose that threw me into sudden deep sleep,” Izimba recalls.

He woke up three hours later. “My penis was very stiff and I had lost a lot of blood. They bandaged the penis to prevent further bleeding. ...

“Kunonya transferred me to another room and I was put on a drip. I was weak. They gave me tablets to swallow. I had a sleepless night due to the pain and the penis remained stiff. The following day I reported for dressing in terrible pain, the penis skin became dry and pale,” he says.

On the third day, Izimba’s penis was still stiff; the skin had tuned so dark and began to peel off.

... Dr. Kunonya said: ... “Izimba developed a complication during the recovery period during the dressing when the skin started peeling off. ... Probably Izimba did not use the drugs as instructed. [Blame the victim.] Many patients have undergone operation in the clinic, but they heal within one week,” Kunonya said.

Expert opinion
A medical worker on routine ward duty at Mulago Hospital who preferred to speak on condition of anonymity described Izimba’s condition as “gangrene.” This means that blood supply to the penis has been cut off, evidenced by the pale skin.

“I suspect they injected certain drugs in the penile vein which blocked the supply of the blood to the penis, rendering the skin dry, causing the rotting,” the medical doctor says. He, however, says there is hope with plastic surgery to reconstruct the penis, to enable him pass urine, but not fulfill his conjugal rights. ... Izimba is married with two wives and seven children. ...

UGANDA: Museveni still opposes circumcision

Africa Review
January 2, 2013

Museveni sticks to position on circumcision

by Agatha Ayebazibwe
Uganda's President Museveni has reaffirmed his earlier stand against safe male circumcision in eliminating HIV, saying the campaigns in favour of the method are misleading Ugandans into unchecked sexual behaviour. [He's right.]

In his end of year message to the nation on Sunday, the President said there was need to revisit the earlier strategy of Abstinence, Being faithful and Condom use (ABC) strategy if the current trend of HIV is to be reversed.

The 2011 Uganda Aids Indicator Survey figures show that the prevalence of HIV among adults has increased from 6.4 per cent in 2005 to 7.3 per cent in 2011. Ministry of Health figures also indicate that new infections increased by 11.5 per cent between 2007/8 and 2010/11.

The President said Ugandans should return to morality and sexual discipline if HIV\Aids is to be fought effectively, adding that HIV/Aids is not a medical but a moral problem that should be treated as such.

Mr Museveni had made the same call in Rakai during the World Aids Day celebrations on December 1, 2012.

The President’s call is in disagreement with that of [some] scientists who advocate for safe male circumcision as another preventive measure which offers [only men] up to 60 per cent protection from the HIV virus that is yet to have a cure.

Mother-to-child
Officials of the Aids Control Programme (ACP) at the Ministry of Health received the news with criticism, saying HIV is a big problem in Uganda that cannot be tackled with a single strategy but rather a combination of all scientifically-proven preventive measures, including circumcision.

“Currently, the scourge is on the rise despite the fact that the ABC campaign has existed for several years now,” said Dr Alex Ario, the ACP programme manager. Dr Ario added: “Other methods cannot be excluded at a time when we have to ensure that the rate of infection is brought down.”

He, however, said the government should acknowledge that there is a problem so it can adopt all the available preventive measures. “We are not telling people to go on rampage because they are circumcised. [They can do that without being told.] We will continue to use a combination of preventive measures until that time when we will get one method that offers 100 per cent protection against HIV.”

The UNAIDS Country Representative, Mr Musa Bungundu, said the ABC strategy is not enough to reduce the increasing HIV infection rate and therefore should be used alongside other measures.

He said if the President thinks that circumcision is not effective, the government should ensure that policies against mother-to-child transmission of HIV are implemented beyond paper to check the more than 15,000 children who are born infected every year.

UGANDA: Women discourage men from getting circumcised

AllAfrica.com
September 28, 2012

Uganda: Tororo Women Discourage Men From Circumcision

By Faustin Odeke
Tororo women are discouraging their husbands from undergoing circumcision, health authorities have disclosed.

Willy Mungoma, the district health educator, said ... "In our routine sensitisation programmes and radio tallkshows, women challenge us to explain how long their husbands would take to heal. This is because they think taking a long time to heal would make them miss sex,"...

...

Under the National Priority Action Plan, the health ministry targets having 1,250,000 men circumcised by 2013. They also want 3.5 million men counseled and tested for HIV/AIDS.

...

The district chairman, Emmanuel Osuna, said some of the circumcised men were being promiscuous, a trend that increases the number of new infections since circumcision provides only about 60% protection.

He appealed to leaders in the district to sensitise and mobilise men for HIV testing and circumcision.

...

KENYA: Girls seek refuge from cutting

The Monitor (Uganda)
September 15, 2012

Pokot girls desert their homes, fear undergoing circumcision

Girls in Amudat District in north-eastern Uganda seek refuge from schools and authorities over forced circumcision.
By Steven Ariong
 
Sarah Cherot is playing a hide and seek game with a dozen other girls at Kalas Girls Primary School in Amudat District. The thrills and laughter that come from them echo through the empty classrooms as it is holiday time and the other students are at home.

Ms Cherot is one of 140 girls from the Pokot community in the district that have remained at school, refusing to go back to their homes for holidays fearing to be circumcised.

“Here, we are safe and do not have to worry about forced circumcision and marriage,” says 14-year-old Cherot, who is in primary five.

Cherot, together with a group of friends, escaped from their homes in Nabokotom Village in Amudat Sub-county in March this year when their parents were preparing them to face the surgeon’s knife.
“If you get a chance and watch the way a girl or a woman cries while going through the process, you will feel like to killing the surgeon that time,” she said.

The girls say they have lost many of their friends and relatives to the knife due to excess bleeding while others have remained disabled. ... It is carried out as a ritual to initiate young girls into womanhood. ...

In 2010, government passed the law against female circumcision after health experts found it was claiming many lives of expectant mothers and girls due to prolonged pregnancy. ...

UGANDA/ZIMBABWE: More resistence to circumcision for HIV

Zim Eye
August 4, 2012

Uganda's president dismisses circumcision, HIV research

By Tidi Kwidini

Uganda’s president, Yoweri Museveni, has taken a swipe at the current UN backed male circumcision for HIV prevention program massively promoted across Africa, and has cautioned people against considering male circumcision as the remedy and automatic control of HIV/AIDS infection.

President Museveni said that the messages promoting the practice were misguiding and may put the lives of many people in danger since it had not been proven to be scientifically true.

“I have witnessed Muslims and other people from tribes that cherish circumcision like the Bagisu, die of Aids. Therefore, who told [health workers and leaders] that circumcision [prevents] HIV [infection]? ” he said.

Museveni advised leaders and health workers to sensitize the youth about the dangers of peer pressure, saying many young people have been influenced by their friends into engaging in early sex and pre-marital sex and early marriages, not in getting circumcised to avoid being infected with HIV.

“[Leaders and health workers] are busy spreading confusion of circumcision, instead of concentrating on behaviour change,” he said.

His comments come as Zimbabwe’s government health advisor to the president Timothy Stamps also rubbished the method hinting that there was no comparative scientific basis for it.

COMMENTARY
Male circumcision has not only this week been subject of debate but has been for a couple of years. Barely two weeks ago the former Minister for Health Timothy Stamps rubbished a UN backed circumcision program that concluded that male circumcision reduces HIV transmission. Stamps argued that ‘it did not make any difference to the adult prevalence rate stating further that studies undertaken on circumcision had shown that countries such as the US with a higher number of circumcised men had a high HIV prevalence rate.’ Additionally that money should be ‘channelled into saving pregnant mothers who die in huge numbers in the country.’

To a greater extent many would have to agree with Stamps, that rather than channelling money into a project that does not have any guarantees or that would only promote reckless sexual behaviour, the money to jump start this program could be best used in many other areas-one of them being the promotion of sexual awareness and sexual health programs that are much needed, especially in countries where there are high percentages of people contracting HIV/Aids. Male circumcision, the oldest surgical invention that is being pushed as the ‘intervention bullet’ for HIV is not the answer to the ever growing problem of HIV/Aids.

Although there are studies that have suggested that circumcised men are half as likely to contract the virus from unprotected sex as their uncircumcised counterparts, the reality is that circumcision only offers partial protection and there is still a significant risk of contracting HIV and other STI’s if men engage in unprotected sex with an infected partner(s). Further circumcision does not offer the man’s partner any protection from contracting HIV whether he is or is not circumcised.

In addition, this UN backed program will only promote reckless sexual behaviour by irresponsible people who think that circumcision is the new form of protection. However, the actual reality is that condoms are about the most effective way of ensuring that both sexually active males and females are less likely to contract the virus.

Past and present surveys as suggested by (Bourne 2008) have revealed that most men would be willing to undergo the knife. However, the argument is that it would be fairly short-sighted not to consider that while circumcision may offer a 60% chance of not contracting HIV that not coupling circumcision services with education on HIV prevention and safe-sex-provider initiated counselling and testing, as well as referrals would be unwise.

The effect of circumcision on male-to-female HIV transmission has not been extensively researched. Boyle and Hill (2011) highlighted some concerns about the methodology of the three randomised controlled trials (RCT) carried out in Kenya, Uganda and South Africa. They stressed issues to do with researcher expectation bias, participant bias, inadequate double blinding, selection and sampling bias. Wawer et al(2009) in their study on the trials argued that male circumcision was a possible cause of HIV transmission as it was associated with over 60% increased transmission of HIV to female sex partners of circumcised HIV-infected men (Wawer et al., 2009).

The trial involving 922 HIV infected men in Uganda found circumcision did not reduce HIV transmission to uninfected female partners. The findings suggested that the risk of HIV transmission could even have been increased in the six weeks after circumcision due to unhealed wounds from the procedure. However, another study found that male circumcision was not significantly associated with women’s HIV risk.

[The proposition that circumcision itself increases the risk to women has been insufficiently considered.]

Furthermore, HIV and the epidemic reality is that women account for the majority of people who live with HIV in Sub-Saharan Africa. Bourne (2008) suggests that a woman is 8 times more likely than a man to contract HIV during intercourse with an HIV positive partner regardless of circumcision.Therefore it is clear that circumcision is an imperfect way to HIV prevention.

[Therefore the much-touted "60% reduction" amounts to less than 7% reduction in the bigger picture - if it amounts to anything.]

Although the main beneficiaries of male circumcision are men let those who are pro-circumcision not lose sight of the fact that women are stakeholders in these programs. Before such a program can be even considered the main focus should be on areas where funding is really necessary, specifically equipping men and women with sexual advice, including men and women’s health groups and those living with HIV, should be involved in the analysis of how circumcision will affect them.

If there is a possible future for this program, it should be closely monitored and evaluated in collaboration with these health groups. Funding should especially be allocated as well to initiating new research into what biomedical, structural, and behavioural interventions can best help women protect themselves from HIV infection such as microbicides (Bourne, 2008).

Perhaps the most important thing that also needs to be done before this program is considered is to communicate clearly about what male circumcision will, and won’t, do for a man and his female partner(s). Furthermore undertake education campaigns to ensure that women and men have a clear understanding that this program is not an excuse to promote promiscuity.

Circumcision does not completely protect men from HIV and circumcised men should continue using condoms to protect themselves and their partner(s) from infection. It should also be made clear that it is no excuse for females to have unprotected sex with circumcised men as there are no guarantees. Male circumcision is not a vaccine, and it is not a cure-all. It is simply one of the best ways to prevent HIV infections in men. [Simply?]

Charity organization HIV/AIDS Zimbabwe (HAZ) have argued in their review that there are multiple factors that need to be examined when evaluating between male circumcision and HIV prevalence especially in relation to risky sexual behavior, time of male circumcision, education, among other factors. HAZ in their counter argument in relation to Stamps, suggest that policy makers need to implement male circumcision as a public health measure to stop growing heterosexual transmission of HIV in Sub-Saharan Africa and globally, as various findings have otherwise suggested that it is in fact effective in conjunction with contraceptive methods (hivaidszimbabwe.org, 2012). However, the question still remains, is this program crucial enough to divert funds from the real pertinent issues in order to test a theory that might not really be effective?

...

UGANDA: HIV campaign confused with circum-rape: no effect on HIV rate

VOA News
July 19, 2012

Ugandan Circumcision Campaign Goes Awry

July 19, 2012 MBALE, Uganda – Uganda’s national campaign to help reduce HIV/AIDS transmission through male circumcision has taken an unexpected turn in eastern Uganda, where Bamasaba tribesmen forcibly circumcised more than 20 men in recent weeks.

Traditional male circumcision is an important cultural tradition for the eastern Ugandan ethnic group, for which the procedure represents entry into manhood. Every other year, the tribe holds a ritual circumcision ceremony called Imbalu. Although the decision to be circumcised is supposed to be voluntary, men have consistently been pressured to participate. Now that pressure has spread beyond the tribe.

Seeking work, Charles Mukwana arrived in Mbale, a town in the heart of Bamasaba lands, from a neighboring region. It was after he started driving a motorcycle taxi that he overheard other drivers at the staging area talking about forcibly circumcising the transplant.

“I feared, because they were bothering me," he says. "I heard them talking about me when they wanted to force me. They were asking me why I’m staying here and I’m not circumcised in their land."

Mukwana avoided forced circumcision by voluntarily undergoing an operation at a local health facility, but others weren't so lucky. [Lucky? That's lucky?] For several days at the end of May and beginning of June, local officials say more than 20 men were forcibly circumcised, a half-dozen of whom were hospitalized. Many of those targeted were outsiders like Mukwana, who had come to Mbale in search of work.

Officials say dozens of people have since fled Mbale, and several businesses owned by non-Bamasaba remain shuttered more than a month later.

John Martin Okware, another motorcycle taxi driver, was part of a group that encouraged four men to undergo circumcisions. There was no specific intention to drive outsiders away, he says, but only to reduce their risk of getting infected or transmitting HIV.

"We were taking them to circumcise, because they get HIV very fast," he says. "A person who is not circumcised, he gets HIV very fast. The person who [is] already circumcised, he cannot get that disease immediately at that time."

Attacks Coincide With Campaign
In Uganda, where more than 75 percent of the population is uncircumcised, the Ministry of Health has been encouraging men to undergo the procedure. Research has shown circumcision can reduce the risk of HIV transmission by up to 60 percent, and the attacks come amid an ongoing national campaign for safe male circumcision.

Since the campaign launched, the Bamasaba have been praised for already practicing circumcision, although the region’s HIV infection rate is only slightly less than the national average of 7.3 percent. By forcing men to get circumcised, Okware says, he is doing his part to reduce HIV transmission and uphold tribal tradition.

But Charles Siango would disagree. As Bamasaba minister of culture, heritage and sports, he says forced circumcisions do not represent the tribal culture. Circumcision, he says, has always been a decision men make voluntarily in consultation with their family and that uncircumcised outsiders are welcome.

“We quickly went to radio and told people concerned -- circumcisers, those surgeons, the rest of them -- to stop, because that’s not the way our cultural things should be taken," he says.

But recent attacks still raise questions about the ritual practice of Imbalu, during which, Siango says, trained professionals perform the circumcisions, albeit in an area outside of town and away from medical facilities.

Local officials says they are working with the Bamasaba to make next month’s Imbalu as medically sound as possible, and district health educator Deborah Alupo recommends seeking circumcision at a health facility, even if the advice contradicts cultural norms.

“You have to undergo that process," she says. "But if you go to hospital and it is done there, they say you’re a coward ... [that] the way the hospital cuts is not [in keeping with the] cultural way.”

She hopes expansion of safe male-circumcision facilities, a part of the government’s health campaign, might help to change attitudes.

Earlier story

UGANDA: Forced circumcision campaign stopped

UG Pulse (Uganda)
June 30, 2012

Forced circumcision drive stopped in Mbale

Authorities in Mbale have banned an operation that has been going on in the area by a group of Bagisu men, particularly mechanics, to catch and circumcise all their tribesmen deemed to have dodged the circumcision ritual.

The ban comes after some of the targets who are not Bagisu sought intervention of security against the operation that had seen nearly 50 men circumcised.

Circumcision is practiced among the Bagisu as a ritual to usher one into manhood and is conducted every even year.

Operations such as that in Mbale are common as some men who fear the knife, flee the region to seek safe haven somewhere else.

Earlier story

UGANDA: 220 men forcibly circumcised

The Africa Report
June 21, 2012

Storm brews over forced circumcision in Uganda

By Godfrey Olukya
The Ugandan town of Mbale was brought to a standstill on Tuesday afternoon, as a naked man ran through the streets, with more than 50 men in pursuit. He was fleeing a forced circumcision.

Only identified as Deo, the man sought sanctuary from the Resident District Administrator, as the men and a local scalpel-wielding surgeon gave chase.

Deo survived the forced circumcision after guards at the administrator's office were able to disperse his assailants, but that was not before other men had fallen victim to the enforced surgical operation.

More than 40 men of various ages have been subjected to the cut in the last two days, as the town goes through a general circumcision programme, but this has faced widespread protests.

Mbale is mainly inhabited by the Bamasaba tribe, which prescribes circumcision to all males from the age of 15, and those who do not undergo the cut are forcefully circumcised.

However, it has emerged that the 40 men who were forcefully circumcised are not of the Bamasaba tribe, but rather were forced to undergo the operation, as they either had Bamasaba wives or girlfriends.

"Since they sleep with our sisters and daughters, we felt they had to be circumcised like the rest of us," Gerald Wambedde, an advocate of forced circumcisions, said.

The leader of the exercise, Badru Wasike said the circumcision exercise was both a cultural and health exercise.

"We are helping those who feared getting circumcised through cultural processes. We are aware that circumcised men do not easily get infected with HIV/Aids. Since they love our relatives we want them to be safe," he explained.

But this has raised a wave of protests in the town, 400 kilometres east of the capital, Kampala with some saying the forced circumcisions were inhuman.

"Men were told to unzip on the streets to ascertain whether they had been circumcised. That is not only unfair but also inhuman," a human rights activist, Mbale,Keneth Mabonga, said.

The RDC has responded by banning forced circumcision and has instructed local police to arrest anyone suspected of enforcing the said cultural rite.

Culturally, the Bamasaba hold circumcision ceremonies every two years.

Those to be circumcised, as a rite of passage, undergo rituals including dancing half naked, while their bodies are smeared with ash.

---

New Vision (Uganda)
June 20, 2012

Forceful circumcision in Mbale: Police fire teargas

By Paul Watala
Police in Mbale have fired teargas and deployed heavily to disperse hooligans forcefully circumcising people on the streets including non-Bamasaba.

The District Police Commander, Michael Angucia Wednesday vowed to crack down the hooligans who are causing insecurity in the town.

“I am not trying to fight the culture of the Bamasaba but the way the practice is handled may cause tribal conflicts. Several people have fled the town, property robbed and business is being paralyzed,” Angucia said.

“We have deployed on the streets to arrest the hooligans,” Angucia added.

He said that several groups of such people have taken advantage of the cultural festival of the Bamasaba to force whoever they suspect to have not been circumcised.

Angucia said that due to public outcry from the people and local leaders, police had no alternative but to provide security on the streets to restore serenity in town, adding that some people have fled town and abandoned business in Mbale main garage.

It is estimated that a total number of about 220 people have been circumcised from the time the exercise began date.

Dr. Jaffer Balyejjusa a senior Consultant surgeon Mbale regional Referral Hospital condemned the act of forceful circumcision.

He said that so far they have received two cases where the victims had been circumcised badly putting lives in danger.

Bamasaba cultural board chairperson, Augustine Wandende condemned the act of forcing people who are not Bamasaba into circumcision without their consent and appealed to the authorities to take action against the culprits.

[Would this have happened if Drs Gray, Quinn, Wawer etc. ha not assured Ugandans that circumcision is wonderful?]

UGANDA: Free male circumcision gets priority over life-saving obstetrics and gynaecology

National Post (Toronto)
May 14, 2012

Jean Chamberlain Froese on Ugandan health care: Women and children last

By Jean Chamberlain Froese
As a Canadian obstetrician working in the developing world, I’m reminded daily of the superior health care available to men here compared to the health care available to women. Sadly, this discrepancy is often supported and perpetuated by well-meaning international donors.

The profound injustice hit me when I was visiting a local health-care facility in Uganda — I hesitate to call it a hospital, but it does offer obstetrical care for pregnant mothers and can, when strained to do so, perform cesarean sections for mothers who need them.

I met Helen in the delivery room at this facility. She was a Ugandan mother-to-be who had been in labour for nearly two days with no progress or chance to deliver naturally. After careful assessment by the local midwife and doctor, the obvious decision to do a C-section was made. Now the only thing that stood between Helen and a safe delivery was the $60 that this government health facility required from her — after all, she needed to pay for the gloves, medicine and anesthesia required to surgically deliver her baby. Her alternative was to hop on public transit — in this case an overcrowded minivan — and risk a two-hour drive followed by numerous hours of waiting at the national referral hospital, where she would queue up behind the many other mothers trying to access free services.

As director of the Save the Mothers program and a qualified doctor, I couldn’t just stand by and watch. The delay in moving to another facility would mean certain death for the unborn baby and probably significant injury, if not death, for the mother. I reached into my pocket and pulled out the Ugandan cash; Helen could now receive the medical care she urgently needed.

I was relieved to see that within an hour, Helen was operated upon and a healthy baby boy was born. But as I approached the operating room, I was shocked at the commotion outside. There were 10 men waiting — all lined up in a row, clutching their medical files with sheepish looks on their faces. They were scheduled for male circumcision — an approach to reducing HIV/AIDS transmission that [perhaps] shows some benefit in decreasing men’s susceptibility to infection. It was a procedure the men could access for free and one that was advertised nationally with billboards and radio campaigns. These operations took up nearly all the space in the operating theatre and the attention of the medical staff — at least three times more of whom were assigned to one man’s care than were assigned to Helen’s. This injustice stung me.

There really is a distinct difference in the care available for men versus women in the developing world. Male procedures that potentially reduce HIV/AIDS receive unlimited and sustained international support, while health interventions to categorically save mothers’ (and their babies’) lives still take a back seat — or a small corner of an operating room in Helen’s case.

Shouldn’t the women who are risking their lives to deliver the next generation at least receive the same free health care as the men who want to reduce their personal chances of HIV/AIDS acquisition? Don’t their lives count as much as those of men? If that operating room in Uganda was any indicator, the current answer is no.

UGANDA: Pretty women entrap intact men for enforced circumcision

Uganda Picks
May 1, 2012

Cultural Circumcision-Pretty Women Used to Find Bugishu Uncircumcised Men

By Sandra Birungi
Pretty women are being used to find out which men have not been circumcised. Among such victims was Shaban Kidudu who was sexually lured by a woman who later revealed that he was not circumcised despite his claims that he had been circumcised.

Kidudu from Lugazi used to tell the Bagishu community that he had been circumcised before and he did not need the cultural performance to be carried out on him. However, it was later found out that he had not been circumcised which forced [forced?] the bugishu community to use force for him to be circumcised. [So they threatened him with violence?]
 
“My husband went through the knife so when he told me we should go and find the man who was scared of it, I was more than willing to go ahead and help. I called him and told him I needed to meet him and he told me he would meet me in five minutes. Five minutes later, I called again and he said he was sloping down the hill and he would be next to me soon. [So this man put out his wife to offer sex to Kidudu, and they claim the moral high ground?] Later on, when I inspected him, I found out he was not circumcised so when we were leaving, I called the people and told them he had not been circumcised,” narrated the planted woman.

Kidudu at first rejected the woman’s claims saying he had been circumcised but later on admitted to not being circumcised. He was smeared with maize flour as culture demands it and walked around the village announcing he was going to get circumcised.

Kidudu works at a washing bay and he had previously assured the people that he had been circumcised. After realising it actually works to find the culprits ["culprits"?] , the residents promised to start using the pretty women to find those men who were not circumcised. Kidudu later confessed that he was going to go for circumcision in the hospital and the operation had been scheduled to take place sometime this week.

“If he was a muslim, we would have had no trouble letting him go because that would mean he had been circumcised but he was not,” said the woman who laid the trap for Kidudu.

In Bugishu culture, circumcision is a must for every boy. By the age of 18 years, it is believed that a boy is able to stand the knife and feel the pain like a man. In previous years, an MP was forcibly circumcised after it was found out he had not been circumcised. Being uncircumcised is looked at as a sin, you are not a man until you have withstood a knife.

UGANDA: Target of 4.2 million men circumcised

UG Pulse
April 30, 2012

Uganda Health News: Ministry of health targets 4.2 million people for circumcision

The Ministry of health has a target of 4.2 million people to be circumcised by 2015, as part of the means to check new HIV infections.
[The male population of Uganda is aprroximately 18 million. ]
 
The country registers 130,000 new infections annually, in a trend that experts say is worrying.
The ministry’s Program manager Aids Control, Dr. Joshua Musinguzi says the campaign is expected to have positive results, since circumcision has been proven to reduce chances of contracting HIV/AIDS by 60%

[Only for men, and hardly "proven".]
 
Musinguzi however cautions those circumcised against living reckless lives, since it does not offer full protection;
[While the leaders speak in euphemisms about "living reckless lives" they are never going to grasp issue.]
 
Meanwhile, the Government has today rolled out a campaign where mayors and municipal leaders are being engaged to promote safe male circumcision and eliminate mother to child transmission of HIV.
[Eliminate? How?]