Tuesday, November 17, 2009

Africans Show America How to Implement Universal Circumcision

While the Centers for Disease Control (CDC) and the American Academy of Pediatrics, to say nothing of the U.S. government, dithers over whether to do the obvious -- embrace universal circumcision of all males -- African nations are showing western nations exactly the way to do it.

The latest news comes out of Kenya, which hopes to achieve 100% foreskin-free country by 2013. Under a news article just issued by IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs, the Kenyan government is doing exactly what the United States government ought to do.

The article is headlined: "The Million Man Cut." And that, of course, expresses the goal -- to circumcise one million uncircumcised males by 2013. According to this article, the circumcision rate in Kenya is good -- around 85%. But it's not high enough to provide the societal protection that circumcision gives. At least 1.2 million foreskins are still amongst them, foreskins that serve as portals for HIV, STDs, HPV, herpes, and other preventable diseases.

Here are excerpts from the news article. Don't you think it's time for the USA to learn the lesson from Africa?


"KISUMU, 17 November 2009 (PlusNews) - The Kenyan government is expanding services to meet the growing demand for voluntary medical male circumcision after the launch of a national campaign a year ago.

"We believe the launch of a rapid results initiative to scale up what we are already offering will help meet the demand; our target is an ambitious one to see to it that at least 1.1 million of the uncircumcised men in this country get the cut by the end of five years," said Jackson Kioko, director of medical services in western Nyanza Province.

Results of three random trials in South Africa, Kenya and Uganda in 2005 and 2006 demonstrated that medical male circumcision reduced the risk of HIV infection among men by up to 60 percent. According to the Kenya AIDS Indicator Survey 2007, 85 percent of Kenyan men are circumcised; HIV prevalence is higher by three-to-five times in uncircumcised men.

There are about 1.2 million uncircumcised men between the ages of 15 and 49 in Kenya, most of whom live in Nyanza Province, where fewer than 50 percent of men are circumcised. Since the launch of the national campaign in November 2008, an estimated 40,000 men have been circumcised and 124 sites opened and equipped with facilities and personnel to offer the service. The government has trained 700 health workers in the province to offer the services in various health facilities. "The trained health workers will ensure people who demand these services get them in a safe and timely manner and the training of others is ongoing across the various provinces within the country," Kioko added.

The government also plans to roll out mobile medical circumcision. "We do not want people to opt out simply because the services are not near them and we are making arrangements that we go to them rather than them coming to us," Kioko said. "We will, in the near future, offer infant medical circumcision; this has the potential to help people in time before their sexual debut."

19 comments:

  1. I need to get the snip done... wish they'd have the mobile circ trucks in California too!

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  2. Thanks, Anon. I was going to comment on the "mobile circumcision vans" that Kenya proposes to roll through the countryside. At first you laugh at the idea, but I can see how much sense it makes, depending how uncircumcised a particular region of the country is. In the USA, your state of California has more uncircumcised dudes than most, so it just might work there! In any case, Kenya is an example of a government that recognizes the value of a clean-cut male population. I wish we did here in the USA.

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  3. Just do it yourself dude: tie your stinking foreskin with a string and pull it taut over a chopping board. Then have a friend place a razor sharp meat cleaver over your diseased thing, and when you're sure your glans are safely behind the blade, have your friend hit the head of the cleaver with a sharp blow from a hammer. Thwang! Perfect, nice, neat cut. That's the way real men have it done Africa. You'll save thousands of dollars too.

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  4. Sorry last anonymous... circumcision is not something an untrained individual should try, not with children, not with adults!!! Mass circ ok, but please have it done by trained personnel.

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  5. Oh baloney. The Bible says that a father should circumcise his children. Circumcision is always described as a quick simple operation, a snip of a flap of skin, that's very safe with low complication rates. How hard could it be? Just do it like a bris: pull your foreskin taut, slide the barzel over it, pull as tight as you can, and slice in a single quick stroke with a razor. Over in a fraction of a second. Adult Jews who weren't circumcised because of the communists get this done all the time in Israel, just like that. NO big deal!

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  6. Wow. Um... I think we can all agree that doing everything we can to stop AIDS in Africa is good (its an issue I have been following for a number of years) But I think your making the same mistake that many do with this issue, over simplifying. Finding that "magic bullet" (you know, the one that does not exist)

    I could care less whats going on in another man's pants (heh, to be honest I get a creepy vibe from this blog in general) but I think focusing on some million foreskins cut project just takes away resources that could be used to deal with AIDS prevention in the more complex way it needs to be dealt with.

    It certainly is easy to say all you need to do is perform some surgery's while everyone else just sits back and waits for AIDS to go away. (if only it were that simple). The easy way out always comes back to bite us in the butt.

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  7. Come on, last anon: this blog isn't really about AIDS and saving those poor Africans, wink wink.

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  8. I am tempted to delete some of the Anonymous comments to this recent post for violating my personal rule that the content not be sexually prurient. Take your porn elsewhere, dudes.

    As regular readers know, this blog is about a spirited debate over a call for universal circumcision, a minor procedure that will protect the male, his partners, and society as a whole. This post and previous ones examine why that is true AND how we can achieve that healthy goal of a foreskin-free society.

    I welcome intelligent comments on all sides of this issue, including sarcasm and ridicule, if you wish. But let's keep it clean. This is NOT a restricted site because the foreskin problem afflicts everyone.

    Finally, as simple a process as it may be, circumcision should always be performed by trained individuals and only under the appropriate medically safe situations. Those who do otherwise risk damage, and that's just plain stupid. Secondly, I certainly would never suggest that circumcision is a cure-all to AIDS. The studies suggest it reduces risk by 60% but it does not eliminate all risk.

    Let's try to keep the facts in front of us!

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  9. PD, it's interesting that your take-away message from the posts above was tinged with pornography. The focus of circumcision is always sexual, and circumcision got started in the U.S. to prevent masturbation, or at least make it less enjoyable. This has flipped, and now there are doctors who say it either has no effect, or is a sexual plus. Funny turnaround worthy of psychiatric study. There has always been a strong connection between circumcision and pornography, whether it's winking doctors trying to convince parents to cut or mohels sucking the wounded penis.

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  10. I think universal circumcision would be a good thing here. Who wants a foreskin? I certainly don't!

    As for the sex comment, is it surprising that a procedure involving the penis would have sexuality as part of the discussion? I think not.

    In fact, the opponents are usually the first to bring up sex, and they seem to be fond of pictures and videos. What's up with that?

    As for DIY circumcision, it's a bad idea unless you really know what you're doing, and just because someone thinks he knows how to successfully perform a circumcision doesn't mean he actually does.

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  11. Exactly Carlos! And the best answer to your question "who wants a foreskin?" is: Let the owner of the penis decide.

    That answer would end this controversy *entirely*. But it's an answer that promoters/defenders of circumcision simply cannot understand.

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  12. Thanks for the good comments, Carlos. Glad to see another advocate for universal circumcision. And you are exactly right that it is the anti-circ fanatics who always want us to look a pics and videos of newborn circumcisions and so-called "botched" circs. They have even been known to dub in cries of babies to make it seem painful. WTF. And, just like the last Anon proves, they want to deny parents the right to circumcise their sons when all the medical evidence proves it's beneficial. There are no limits the foreskin lovers will go, do, or say to end circumcision. That, by the way, is how they want to "end this controversy *entirely" -- deny parents the right to circumcise.

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  13. I find it shocking that you are using studies done in Sub Sahara Africa to justify circumcising infants in the United States. The two countries are 100 percent different. If you look at this chart of prevalence of HIV/AIDS from highest to lowest, you see that your argument falls apart. http://en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_adult_prevalence_rate

    Why is it that the bottom 20 countries are almost all in Asia and Europe? that also incidentally have some of the lowest circumcision rates? Why is the UK, in which under 10 percent of men are circumcised, has lower HIV/AIDS rates than the United States where 70-80 percent of men are circumcised? Why are the top 20 countries almost all countries in Africa? I'll tell you why. Because circumcision has nothing to do with HIV/AIDS prevention.It has everything to do with knowledge,condom use, and lifestyle choices. In many parts of Africa there were surveys done which found that over 60 percent of women didn't even know what a condom was. Even the proponents of the HIV/AIDS study has admitted that it showed no reduction in male to female transmission or male to male transmission.
    Something else, INFANTS ARE NOT HAVING SEX. There is no reason you should be circumcising day old infants for "benefits" they may see 15-18 years later. The slight increase of UTIs in infants who are intact were only relevant in the first year of life, after that there was no difference. Girls are over 4 times as likely to get a UTI than circumcised or intact males, and we don't chop off our parts. We take an antibiotic for a week. This is not a third world country, we have competent medical doctors and antibiotics to treat things like UTIs. We don't chop off toes when we get an infection from a hangnail, or take our eye out when we get an eye infection. Let a person decide for himself whether or not he wants to get circumcised. An adult has the luxury of being under anesthesia and pain medication prescription afterwards, both of which are too dangerous to give infants.

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  14. Why is it that the bottom 20 countries are almost all in Asia and Europe? that also incidentally have some of the lowest circumcision rates? Why is the UK, in which under 10 percent of men are circumcised, has lower HIV/AIDS rates than the United States where 70-80 percent of men are circumcised? Why are the top 20 countries almost all countries in Africa? I'll tell you why. Because circumcision has nothing to do with HIV/AIDS prevention.It has everything to do with knowledge,condom use, and lifestyle choices

    This is such an absurd argument. Why on earth do people keep making it? Look, there are multiple risk factors for HIV, both at the individual and at the population level. Consequently if you want to compare two or more countries by examining their HIV and circumcision rates, you must ensure that their exposure levels to all other risk factors are equal. Otherwise you're comparing apples and orangutans.

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  16. "This is such an absurd argument. Why on earth do people keep making it? Look, there are multiple risk factors for HIV, both at the individual and at the population level. Consequently if you want to compare two or more countries by examining their HIV and circumcision rates, you must ensure that their exposure levels to all other risk factors are equal. Otherwise you're comparing apples and orangutans."

    Well then why are circumcision advocates comparing studies done to sexually active men in Africa to infants in the United States? My whole point was that education, condom use, and lifestyle choices are what reduce HIV/AIDS cases, NOT CIRCUMCISION. So if you are going to say " if you want to compare two or more countries by examining their HIV and circumcision rates, you MUST ensure that their exposure levels to all other risk factors are equal." You need to explain how adult men in Sub Sahara Africa have in any way shape or form equal risk factors to infants in the United States do.So, in essence, I am agreeing with you. My point was to show that there is no correlation showing circumcision reduces HIV/AIDS infections. So why do pro circumcision lobbyists keep using these African studies as justification to circumcise baby boys in the United States?

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  17. Also note that studies done show that circumcised males put females at a GREATER risk of contracting HIV/AIDS than their intact counterparts. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
    another study showed the same thing http://www.ncbi.nlm.nih.gov/pubmed/8082965?dopt=Abstract

    Circumcised men cause abrasions because of the increased friction during intercourse which in turn leads to higher AIDS/HIV cases.

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  18. It isn't an absurd argument Jake.

    For infant circumcision in the USA to be worth it you should be able to see a noticable effect from circumcised developed country to non-circumcised developed country surely?

    Otherwise it isn't worth it. Ergo it isn't worth it.

    Evangeline makes some excellent points . As someone who fights the pro-circ corner your silence speaks volumes.

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