In African cultures, such as the Bugisu of Uganda, a male is not considered a man until he is circumcised. In other cultures, such as the Luo of Kenya, circumcision was forbidden. But scientific studies showing that circumcision reduces a man’s chance of

Swaziland

In the Kingdom of Swaziland, 19% of the population of 1.1 million are HIV positive and 40% of pregnant women are HIV positive. Little wonder that Swaziland is a trailblazer in promoting circumcision to reduce the spread of HIV. Once illegal, the practice of circumcision is now endorsed by the government.

This year surgeons and public health officials from the Jerusalem AIDS Project responded to Swaziland’s interest in stepping up its male circumcision services. Delegations made several trips to the country to train medical officials and consult with the government.

Dr Inon Schenker noted a positive response to the initiative by both the medical community and the general population.

Swaziland has one of the lowest circumcision rates in the world. But since news spread that circumcision is an HIV-preventative measure, the Jerusalem AIDS Project and the Family Life Association of Swaziland report that locations that once performed one circumcision per month are performing 10 to 12 per day.

Kenya

Prime Minister Raila Odinga made the bold move of publicly endorsing male circumcision despite the fact that he is a member of the Luo tribe.

At a health conference held in Kisumu, Kenya’s Assistant Finance Minister, Mr Oburu Oginga, said the prohibition of circumcision is wrong. “We cannot cling to repugnant traditions for years while our people die at an alarming rate of HIV/Aids-related diseases,” he said. “We must change.”

Mr Oginga and his Education Counterpart Ayiecho Olweny consequently announced their intentions to be circumcised to bolster support for Odinga’s male circumcision campaign.

Since hearing the compelling evidence presented by government officials and medical experts Luo elders, highly regarded traditional community leaders, have reportedly softened their position on circumcision.

Many men in Kenya are eager to have the procedure. According to IRIN, health facilities in Nyanza Province are struggling to meet the demand.

The Cons

The enthusiasm that has international agencies such as UNAIDS and WHO and African governments endorsing circumcision are based on three trials. The first study, done in South Africa, showed circumcision reduced HIV risk for males by 60%. A study in Uganda showed a 48% risk reduction and a study in Kenya showed a 53% risk reduction.

Despite these results, the medical community is still divided on whether the results will actually hold up. Doctors Opposing Circumcision (DOC) says that researchers did not allow the tests to run their course. “All three studies were terminated early,” they wrote in an article slamming the results and the motives of the trials.

The DOC article and other opponents of circumcision promotion point to the United States, which has an extremely high circumcision rate as well as an extremely high HIV infection rate.

Other organisations, including the Family Life Association of Swaziland which supports circumcision, note that promotion without proper education can encourage an increase in risky sexual behavior. If men are not thoroughly informed, some tend to believe that circumcision makes them immune to HIV.

Even if all opposing arguments are put to rest, the National Institute for Allergies and Infectious Diseases, which supported the Kenya and Uganda trials, says there are definite recognised risks including serious infection, severe blood loss, mutilation, penile amputation and even death.

Furthermore, if men do not adhere to the six-week-no-sex-while-healing advice, they face increased risks of contracting HIV.

DOC refers to writing by James Ntozi of Makarere University in Uganda highlighting another potentially huge and historical risk. Since many Africans are still sensitive to colonial exploitation and are suspicious of biological warfare, if the researchers are wrong, Africans are likely to feel abused and exploited and the failure is likely to be a big issue.

Michelle Smith for RT