Gender Focus with EMELDA MWITWA
THE knowledge that male circumcision reduces men’s risk of HIV infection by HIV 60 percent has given rise to the demand for circumcision services.
Women are actually happy to see men and boys volunteering for male circumcision because research shows that circumcised men reduce the risk of cervical cancer (human papilloma virus) infection and other sexually transmitted infections (STIs) in their sexual partners.
So, the rush for circumcision services and its affirmation by previously non-receptive regions and religions in Zambia is understandable.
There has been no era in Zambian history than now when males of all age groups – infants, boys and adults – have been receiving circumcision services in health centres and traditional camps.
Male circumcision has been practised in Zambia for many years, although it was mainly done for religious and traditional purposes in certain regions such as North-Western Province.
In the traditional point of view, circumcision was one way of initiating boys into adulthood. And this was done (it is still being done actually) in traditional initiations camps where boys where secluded from the general public for months for the surgical operation and other puberty rites.
Zambia’s own research found that the prevalence of HIV and other STIs in the regions where men were circumcised was low.
Similarly, on the global scale, the World Health Organisation (WHO) indicates that ‘there is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 percent.’
WHO further assures that male circumcision provided by well-trained health professionals in properly equipped settings is safe.
And this brings me to the danger that the circumcision fever is posing in Zambia because some clients are rushing to untrained people in unsafe environments to conduct operations.
We have quack surgeons who have continued to provide circumcision services using non-medical personnel, to make it worse, in unsafe environments.
Perhaps decades back this was normal, not in this era when we have trained medical personnel providing medical male circumcision in health centres, using the recommended tools.
But alas, traditional doctors are still conducting operations in religious and initiations camps such as the Luvale Mukanda campsite in Livingstone, in this age of mobile clinics.
If conveners of initiation camps for boys can’t make use of established clinics to have their candidates circumcised, I bet they should opt for mobile clinics in their camps to minimise the risks of the operations going wrong.
Like every surgical operation, male circumcision has its own risks, but WHO indicates that the risks are often rare if the operation is conducted by well-trained medical personnel who are adequately equipped with the necessary tools.
Some of you may recall that last August, this newspaper reported about police stepping into a traditional circumcision camp for Muslims in Lusaka and rushing two boys who were bleeding profusely to the University Teaching Hospital (UTH).
Bleeding, pain, injury to the private part and infection of the wound (at the site of the circumcision) are among some of the risks a client may experience soon after the operation.
However, we are told that if the operation is conducted by experienced medical personnel, these complications can be well managed.
In the botched operation of the two boys who were among 13 other boys aged between 14 and 16 that were operated on in a grass fence near the railway line between Chawama and Kamwala South townships.
I bet the structure where the operations were being done was not suitable and of course the traditional doctors did not have necessary and sterilised tools.
Thanks to alert police officers who moved in quickly to stop the initiation ceremony and rushed the 15 boys to UTH for treatment.
And just this week, this newspaper reported about a traditional circumcision ceremony in Livingstone’s Natebe area where suspected typhoid has broken out and two boys have since died.
Thirty-nine out of 149 boys who went under the traditional scalpel at the Luvale Mukanda camp developed symptoms of typhoid and were admitted to Namatama Health Post in Livingstone.
Following this sad development, some parents of the boys, some as young as 11, are demanding the release of their children from the Mukanda camp.
The boys, some in examinations classes, are due to stay in the Mukanda camp for six months.
Convener of the initiation camp, Betrand Chilekwa, referred to as Elder of the Mukanda, confirmed that 25 of the children in the camp were writing Grade 7 examinations, and 15 were sitting for Grade 9 exams.
Honestly, I couldn’t understand why parents of children in examination classes could allow the young ones to be secluded in an initiation camp for months at such a critical time.
One wonders whether the children were allowed to attend school from the Mukanda camp. In any case, the environment (without electricity) is not suitable for studying.
Can you imagine 207 people (149 initiation candidates and 58 trainers) have been using one pit latrine? The boarding facilities at the camp aren’t good either because it’s a village set up.
I thought the era of parents distracting children’s education with puberty rites was long gone, but the Mukanda incident confirms it isn’t.
The death of two boys and hospitalisation of 39 children for suspected typhoid should be reason enough to close the initiation camp with immediate effect.
I don’t agree with the suggestion by the Elder of the Mukanda that they will quicken the initiation ceremony and let the boys graduate ‘soon’.
The boys who have been confined for five months are due to graduate next month, should go home now because some of them are writing exams, whereas the environment where they are poses a threat to public health.
If gender activists could come out strongly on initiation ceremonies for girls, particularly its negative impact on girl’s education and the premature bedroom tips, what is so special about Mukanda?
Why should school boys stay in an initiating camp for six months? For all I care, whatever they are being initiated into can wait until they finish school or when they are ready to marry.
And in this day and age, why should we continue to carry out traditional circumcision in the bush using non-medical personnel?
If the initiation ceremonies for the youth are that important, conveners should invite qualified medical personnel to carry out medical circumcision in sterile environments. And no school-going boy should be confined in those camps.
Apart from that, the Ministry of Health needs to give out clear guidelines on who can carry out male circumcision and the environment under which this should be done.
I know that male circumcision is an age-old tradition, but we can’t afford to put the lives of our boys in danger in they are safer means of doing it.
Well I am glad that WHO is working on new and updated guidelines for male circumcision.
I hope they will address issues to do with safe circumcision methods, taking into consideration the public health threat that traditional operations and unsterile environments pose to clients.
For your information, in 2007 WHO and UNAIDS recommended male circumcision as an additional HIV prevention intervention in settings of high HIV prevalence.
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Gender Focus with EMELDA MWITWA