Monday, May 14, 2012

NORWAY: Ban considered after circumcision death

btno (edited Google translate)
May 12, 2012

Boy died after circumcision in Oslo

A two-week-old boy died of complications two days after he was circumcised by a doctor in Oslo.
The circumcision was at a doctor's office on the East side, and both the police and county physician in Oslo are now investigating the matter, writes Aftenposten.

The boy was circumcised last Sunday and died two days later. County medical officer Peter Schou confirms that the child died of complications following circumcision.

- We have put two unnamed doctors under formal supervision, said Schou.

According to him there have been several cases supervised by medical offices in Oslo, which have been about circumcision.

Complaints rare
- These are very difficult cases to investigate because patients rarely complain about circumcision, but we have had serious concern from hospitals that put these children into therapy later, he told Aftenposten.

Each year an estimated 2000 boys are circumcised in Norway, many of them privately and without professional control.

Health and Care Services is now considering tighter laws to make circumcision safer, but both within government and within the coalition parties, there is disagreement about of circumcision of boys. Some want to ban it, while others would offer the procedure in the public health system. A bill has recently been circulated, and many would ban or limit it.

Prohibition or limit
Weightier bodies consulted believe the circumcision of male children should be banned. The Medical Association, Nurses, the Children's Ombudsman, the NHA, Resource people and the Medical Faculty of the University of Oslo want the practice [outlawed].

Child Ombudsman Reidar Hjermann want a debate about the minimum age, but believes that ritual circumcision should be banned for children under 15-16 years.

Justice Policy Center spokeswoman, Jenny Klinge, said ritual circumcision of young boys should be banned in line with the [law against] circumcision of girls.

Original Article:

btno
12.mai. 2012

Gutt døde etter omskjæring i Oslo

En to uker gammel gutt døde av komplikasjoner to dager etter at han var blitt omskåret av en lege i Oslo.

Omskjæringen skjedde på et legekontor på Oslos østkant, og både politiet og fylkeslegen i Oslo undersøker nå saken, skriver Aftenposten.

Gutten ble omskåret forrige søndag og døde to dager senere. Fylkeslege Petter Schou bekrefter at barnet døde av komplikasjoner etter omskjæring.

- Vi har opprettet en formell tilsynssak mot to navngitte leger, sier Schou.
Ifølge ham har det vært flere tilsynssaker ved legekontorer i Oslo som har dreid seg om omskjæring.

Klager sjelden
- Dette er veldig vanskelige saker å undersøke fordi pasienter sjelden klager på omskjæring, men vi får alvorlige bekymringsmeldinger fra sykehusene som får disse barna inn til behandling senere, sier han til Aftenposten.

Hvert år blir anslagsvis 2.000 gutter omskåret i Norge, mange av dem privat og uten faglig kontroll.

Helse- og omsorgsdepartementet vurderer nå innstramminger i lovverket for å gjøre omskjæring sikrere, men både innad i regjeringen og innad i de rødgrønne partiene er man uenig i synet på omskjæring av gutter. Noen vil ha forbud, mens andre vil tilby inngrepet i det offentlige helsevesenet. Et lovforslag har nylig vært på høring og mange ønsker forbud eller aldersgrense.

Forbud eller aldersgrense
Flere tunge høringsinstanser mener omskjæring av guttebarn bør forbys. Både Legeforeningen, Sykepleierforbundet, Barneombudet, Human-Etisk Forbund, Ressurssenteret for menn og Medisinsk fakultet ved Universitetet i Oslo ønsker slutt på praksisen.

Barneombud Reidar Hjermann ønsker en debatt om nedre aldersgrense, men mener at rituell omskjæring bør forbys på barn under 15-16 år.

Justispolitisk talskvinne i Senterpartiet, Jenny Klinge, mener rituell omskjæring av små gutter må forbys på lik linje med omskjæring av jenter.

AFRICA: No money for HIV programmes that work, only circumcision

May 10, 2012

Africa: Less Global Funds, More Problems

By Laura Lopez Gonzalez,
Fund medicines or fund the programmes that support uptake and adherence? That's the choice countries are now facing amid Global Fund shortfalls. With money tight, countries are slashing civil society-led HIV and TB programmes - treatment supporters, community-based volunteers, support for people living with HIV - to safeguard essential services, according to preliminary research being conducted by the Open Society Foundations.

In November 2011, the Global Fund to Fight AIDS, TB and Malaria faced US$2.2 billion in unpaid donor pledges and cancelled its Round 11 of funding. This was the most dramatic manifestation of years of broken donor promises.

Two years earlier, Global Fund donors reneged on almost 15 percent of pledges - a figure that rose to almost a quarter of donor pledges in 2010, according to former Global Fund Executive Director, Michel Kazatchkine's November 2011 report to the board.

To ascertain the impact on civil society of these Global Fund shortfalls, OSF undertook research in three countries that had planned to apply for Round 11 funding - Swaziland, Malawi and Zimbabwe.

Through interviews with nearly 45 representatives from civil society, Global Fund Country Coordinating Mechanisms (CCMs), HIV and TB programmes, and UN agencies, OSF found that these countries are facing funding gaps for essential services such as HIV and TB testing and treatment, prevention of mother-to-child transmission services (PMTCT), and support for orphaned and vulnerable children (OVC).
The research found that to free up funding for these initiatives, all three countries are cutting the kinds of complementary, civil society-led activities identified as 'critical enablers' in the UNAIDS Strategic Framework.

Swaziland has now halted HIV prevention programmes with the exception of PMTCT and medical male circumcision and may re-programme phase II of its current Global Fund money to shift more money towards buffer ARV stocks, according to Vusi Nxumalo, CCM member and Vice Chairperson of the Swaziland National Network of People Living with HIV and AIDS.

Swaziland's Round 11 application - like that of Namibia - would also have been the first to include HIV prevention programming aimed at criminalised, most-at-risk populations, such as sex workers and men-who-have-sex-with-men. In addition, the country would have addressed the needs of its small population of injecting drug users.
...

KENYA: Men not volunteering to be cut, so boys targetted

AllAfrica.com
May 10, 2012

Kenya: The Cut for Boys to to Tame HIV

By Habil Onyango
THE Ministry of Public Health and Sanitation will soon introduce circumcision programme for children under the age of 15 to help curb HIV/Aids in the country. Homa Bay branch DASCOP coordinator Alice Nyambai said they hope to introduce the program to children under 15 years, as a way of supplementing the Voluntary Medical Male Circumcision (VMMC) exercise.

Nyambai said that the programme will help in the reduction of HIV/AIDS infections as more males get circumcised in the region despite being more affordable as compared to the VMMC. [She has NO evidence whatsoever for this claim.]
 
She added that the children circumcision programme will cost the government Sh1, 000 [$US 11.95] for each circumcised child, while the VMMC costs Sh5, 000. [$US 59.74] "We are hopeful that the children's circumcision program is likely to be more successful as more grownups are reluctant to enroll for the VMMC that targets males of age bracket 25 to 49 years," said Nyambai.

She said that the since September 2008 when the program was initiated, only 11, 000 men have been circumcised out of the estimated 42, 000 in Homabay district.
[In short, men aren't buying it, so they're imposing it on boys who can't resist.]
...

Friday, May 11, 2012

SHANGHAI: Botched circcumcision takes man's whole penis

Shanghaiist
May 10, 2012

Man's penis amputated after botched circumcision

By Horace Lu
A 21-year-old man in Tianjin has had his penis cut off after what appears to be a botched circumcision procedure just two weeks before his wedding ceremony.

Xiaohe (not his real name) said he decided to go for circumcision before his big day but his wound would not recover following the operation, despite days of transfusion.

Immediately following operation on November 11, 2011, Xiaohe said he felt a sharp pain in his penis the day after, and his penis began to swell, eventually turning red, and then black as the cells and tissues in his penis began to die.

Doctors at various hospitals were unable to save Xiaohe's penis and the decision to amputate his penis was made on December 21, 2011.

He has now sued the hospital where he had the circumcision for a compensation of 150,000 yuan (23,833 USD).

Xiaohe's wife and former schoolmate, Xiaoli, also sued the hospital for compensation. Xiaohe was upfront with his fiance about the botched procedure, but she decided to go ahead with the wedding believing everything would turn out fine.

Xiaoli's claims have, however, been thrown out by the court, because Xiaohe was below the legal marriage age of 22 and hence their marriage was not officially recognised by the law.

Xiaohe's lawyer has also asserted that the doctor who performed the circumcision had no legal papers to be practising in Tianjin and urged authorities to punish the hospital.

Penis reconstruction surgery is available, but is a highly complex procedure which is unlikely to give Xiaohe a fully functional penis even if successful. Moreover, the operation, which can cost tens of thousands of dollars, is too much for Xiaohe's farmer family to bear.

Tuesday, May 8, 2012

MAPUTO, MOZAMBIQUE: Civilians unwilling? US urges Africa to circumcise military

AFP
May 7, 2012

US urges circumcision for soldiers to fight HIV in Africa

Male circumcision is the best way to prevent new HIV infections in the military, the head of US anti-AIDS efforts told a gathering of top army brass from Africa, Eastern Europe and central Asia.
"We believe male circumcision is a highly significant, lifetime intervention. It is a gift that keeps on giving. [No, it is a theft that keeps on taking.] It makes a lot of sense to put extraordinary resources into it," US global AIDS coordinator Eric Goosby told the 400 delegates.

The meeting on AIDS and the military gathered officials from 80 countries, including most of Africa but also countries from Surinam to Georgia and Estonia.

Studies show that circumcision can dramatically reduce HIV infections. One study in South Africa last year found new infections fell by 76 percent after a circumcision programme was launched in a township. [Last year? How could they possibly get significant results in so short a time?]
 
In 2006, trials in Kenya, Uganda and South Africa found foreskin removal more than halved men's risk of HIV infection. Longer-term analysis has found the benefit to be even greater than thought, with a risk reduction of around 60 percent.

The United States is sponsoring programmes in several African countries with a goal of circumcising four million men by 2013.

Results so far are patchy. Although Kenya is close to reaching its target of 80 percent of sexually active men, Uganda has achieved less than five percent of its target.

"We need the military to take up some of these circumcisions," said Caroline Ryan of the US Global AIDS Coordinator's Office. [So if some men refuse to have part of their genitals cut off, find others who can't refuse.]
 
...

Little data exists on HIV rates among soldiers. Few countries are willing to divulge statistics, fearing they will be perceived as weak. [Perhaps they should find out at the same time whether circumcised soldiers are any less likely to have HIV than intact ones?]

Saturday, May 5, 2012

DENVER: Colorado Medicaid will not resume funding circumcision

Health Policy Solutions
May 5, 2012

Circumcision bill dies in Colorado House

By Katie Kerwin McCrimmon
A bill that would have restored Medicaid funding for circumcisions in Colorado died Friday.
The measure squeaked through a hearing in the House Health and Environment Committee on Thursday, then died in Appropriations Friday morning.

Opponents, who included health professionals, budget hawks and anti-circumcision activists told health committee members on Thursday that circumcision is cosmetic and potentially harmful, and taxpayers should not fund it.

Proponents for the bill argued that funding for circumcision for babies on Medicaid is a social justice issue. In general, insurance companies pay for the procedure for insured Colorado babies even though the American Academy of Pediatrics does not deem circumcisions to be “medically necessary.” Meanwhile, low-income parents who want their babies circumcised are being put on waiting lists for the procedure until parents can prove they’ve paid in advance.

Sen. Irene Aguilar, D-Denver, an internal medicine doctor for Denver Health, testified on behalf of restoring public funding for circumcision. Last year, Colorado lawmakers decided to save money and cut funding for Medicaid circumcisions. They were following the lead of 17 other states. Proponents wanted taxpayers to once again pay for the procedures for parents who choose to have their infants circumcised.

Fiscal analysts estimated that covering the procedures again would cost the state about $195,000 next year and $230,000 the year after that.

“As a physician, I don’t try to influence parents one way or the other,” Aguilar said. “People make this decision based on religious and cultural reasons.” [What business does a doctor have performing surgery based on religious or cultural reasons? (Answer: good business....)]
 
She said that there is some evidence that infant boys who don’t get circumcised have higher rates of urinary tract infections and that adult men who are uncircumcised and live in poverty tend to have increased rates of HPV, which can lead to higher rates of cervical cancer in female partners.

Only one other doctor testified on behalf of circumcision. The rest of the witnesses opposed public funding for the procedure for a variety of reasons.

They included Dr. Jennifer Johnson, a family physician who works with Medicaid and uninsured patients at Clinica Family Health Services.

“I’ve done at least 100 circumcisions and just recently decided to stop,” Johnson testified.

She said she and her husband, who is Jewish, decided not to circumcise their own son, who is now 4. She said she was concerned when she researched the issue and found that removing the foreskin from a boy’s penis damages numerous nerve endings. While circumcision is traditional in the Jewish community, Johnson said her husband was open to new research about the potential harms from circumcision.

If boys or men decide to remove the foreskin as adults, then they can make that decision, Johnson said. But she decided that as a physician, she should no longer do a procedure that is “potentially harmful.”

“This is not a necessary procedure,” Johnson said. “It’s a healthy, normal body part.”“There are a lot of medical needs in our population. We have no business using limited health care dollars on a medically unnecessary cosmetic procedure.”

One lawmaker, Rep. Sue Schafer, D-Wheat Ridge, elicited laughter in the hearing room when she asked Dr. Johnson if circumcision might help reduce teen pregnancy rates and teen sexual activity by reducing nerve sensation in boys’ penises.

“I’m wondering if there’s a risk of more sexual activity, more male irresponsibility” for uncircumcised boys, Schafer asked.

 [Rep. Janak Joshi, R-Colorado Springs, looks incredulous at Rep. Schafer's question.] Joshi, a retired doctor, voted against restoring circumcision funding, saying circumcision is uncommon in India and he's never seen infections due to lack of circumcision.

Johnson answered that teen pregnancy is certainly a problem, but said circumcision won’t halt teen sexual activity.

“Circumcision is not a cure for behavior. That’s about education,” she said.

...

While circumcision is an ancient tradition in some religions, circumcision opponents said it became popular in the U.S. as a method to prevent masturbation among boys. Later, fathers wanted their sons to look like them.

“Frankly that’s cosmetic surgery…and I strongly urge you to vote against it,” said Dr. Matt Mason, a physician from Telluride. He was skeptical about cost estimates and said circumcision is now rare in Western Europe, Canada and New Zealand. [Circumcision has always been rare in Western Europe.]
 
...

Earlier story

Friday, May 4, 2012

EGYPT: Women's group sues pro-FGC MP


May 4, 2012

Egypt women's NGO takes pro-FGM Parliamentarian to court

By Manar Ammar
Egypt’s New Women Foundation said they are suing Islamist Parliament member Azza al-Garf over her pro-female genitals mutilation (FGM) statements. The women’s rights foundation sent a letter to the speaker of parliament Saad al-Katatny, informing him of legally going after Garf and asking for his permission to be allowed to take the MP to court.

The parliament needs to lift immunity for an MP in order for them to be held accountable in a court of law.

Garf was reported saying that FGM is an Islamic practice and that the anti-FGM laws should be amended. Garf is a Freedom and Justice [!] Party (FJP) member, the political arm of the Muslim Brotherhood in Egypt.

“We are on our way to sue Garf to preserve our rights and the gains of Egyptian women,” said the open letter to the speaker.

“We are suing her for going against Egyptian laws that criminalize sexual harassment and FGM, practices that goes against women rights and human rights.

“We completely refuse Garf’s statements and announce that she does not represent us.”

Garf gave similar statements on her Twitter account last month, calling for lifting the laws that criminalize FGM. The statements stirred criticism, which led to the FJP to announce that Garf has no account on Twitter and no comments were made by Garf herself.

Rights surveys in the country put the number of women who go through FGM to be around 86 percent. ...

In 2010, a 13-year-old girl died after a local doctor in the Nile Delta region’s Menoufiya governorate failed in the operation.
...
The doctor... is to stand trial ...

In June 2007, 12-year-old Badour Shakour died as a result of a circumcision operation. The death sparked a battle within the country over the use of the controversial medical procedure. Her death galvanized women and children’s rights groups to action, where they pushed for more stringent penalties against those who carry out female genital mutilation.
...
In summer 2008, Egypt’s Parliament passed a law that ostensibly bans the controversial procedure. Not that it should have needed to legislate against FGM – it was already officially banned in the country during the mid-nineties – but with doctors continuing to perform the procedure on girls as young as five, Parliament felt it was necessary to intercede.

The new law stipulates a fine of 1,000 Egyptian pounds ($185) to 5,000 Egyptian pounds ($900) and a prison term of anywhere between three months and two years if caught performing FGM.

A doctor also could lose their medical license. In the case of Shakour, the doctor who performed the procedure languishes in prison after being convicted of manslaughter.

Earlier story