Tuesday, July 17, 2007

Lose that foreskin

African health departments should scale up male circumcision, according to this report by Esther Nakkazi, the Uganda-based science correspondent of the East African newspaper.
Andrew Grulich, the head of HIV epidemiology and prevention program at Australia's National Centre in HIV Epidemiology and Clinical Research (NCHECR) yesterday told the National Press Foundation training programme in Sydney that there was no reason to delay a circumcision roll-out in the developing world.
Studies in Kenya, Uganda and South Africa have proved that condoms can halve men's chances of contracting HIV infection. The World Health Organization (WHO) has already said that circumcision should be done under hygienic conditions and warned against adult males who undergo circumcision and then resume sex before complete healing of the wound six weeks later, as they may face an increased risk of HIV infection.
But whether governments have the resources to implement the WHO guidelines is another issue. It is not known how much cash-strapped African governments would spend on mass male circumcision if the WHO pro-circumcision policy is passed, although it would certainly be cheaper to do it on newborns.
However, Ugandan ministry of health officials have already recommended mass male circumcision. The letter C has already been added to the famous ABC - abstinence, be faithful and condomise. Now it's ABCC, in spite of Ugandan president Yoweri Museveni’s public skepticism about the strategy. Without giving it political support no one knows what will happen but the health workers are bent on convincing him.
As a result of study results, it would appear that more Ugandan men are heading to hospitals for the ‘cut’. Many hospitals are not prepared for the demand, with the exception of hospitals affiliated to religions, in particularly the ones for Muslims like Kibuli hospital in the national capital, Kampala.
Hillary Bainemigisha, the health editor of the leading daily English-language newspaper in Uganda said the practice was not widespread but that there were four groups of people currently practicing circumcision.”
“People from the east of Uganda, the Bagisu, practice circumcision but it is not safe, with the same knife being used,” he pointed out. ''In the Muslim population, Imams are licenced by the Supreme Muslim Council, a religious body, to carry out circumcision and there is no medical training.”
The New Vision editor said two smaller groups were those who volunteered for circumcision, generally as adults, and those who required it for medical reasons.
The point to remember is that circumcision is NOT instead of condoms. The mantra is circumcision AND condoms.
“It would be a complete disaster if men stopped using condoms after being circumcised. It would be a public health disaster everywhere,” said Grulich.

* Esther Nakkazi is the East Africa newspaper, a weekly business newspaper for Kenya, Rwanda, Uganda and Tanzania. She is also a member of the World Federation of Science Journalists' mentoring programme and later this year takes up a Knight fellowship at the Massachusetts Institute of Technology in the USA.

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