Male circumcision: Another stride to curb HIV/AIDS
Times Zambia
MALE circumcision defined as the removal of the foreskin, or the extra skin that folds over and covers the head of the male private part is one of the oldest and most common medical procedures practiced globally.
The process has been practiced in Zambia and in many African countries such as DR Congo, Nigeria, among other nations.
Male circumcision is being promoted by the Ministry of Health in Zambia as part of the nation’s comprehensive HIV prevention strategy.
Baby boys below sixty days old as well as toddlers aged from seven, and men are queuing to be circumcised at both public and private health centres dotted across the country.
Male circumcision or MC is performed by first injecting the base of the male organ to numb the area that is in front of the private part.
Although the battle over who was the true discoverer of AIDS, a pandemic that continues to ravage mankind from the time it was discovered on June 3,1981 is not known, the media and medical experts are now looking to other ways of reducing the risks of contracting HIV/AIDS.
Circumcision has been clinically proven to reduce the risk of HIV and some other Sexually Transmitted Diseases (STDs) in men, including Syphilis, Chancroid and Human Papiloma Virus (HPV).
HPV is a virus that can cause penile cancer in men and cervical cancer in women. It should be emphasised that male circumcision does not provide 100 per cent protection, hence it is important for all circumcised men who are sexually active (after the six week healing period is complete) to use condoms correctly and consistently every time they have sex.
To support the importance that the Government of Zambia attaches to tribes that revere the cultural practice of male circumcision, on December 2, 2002, former Minister of Health Brian Chituwo noted that North Western Province had a peculiar lowest HIV/AIDS and Syphilis cases and partly attributed this to circumcision.
Dr Chituwo said this as former chairperson of the Cabinet committee on HIV/AIDS .
This was during the HIV/AIDS parliamentary seminar which was held at Lusaka’s Mulungushi International Conference Centre.
Dr Chituwo in recommending circumcision said the practice had proved to hold back the spread of STDs including HIV/AIDS.‘’North-Western Province has the lowest HIV/AIDS in the country because of some male practices like circumcision despite its causes of grievous bodily harm,” Dr Chituwo remarked.
“I am ready to set up a camp and conduct the exercise.
There is no age limit for circumcision and parliamentarians should consider it as we fight HIV/AIDS in the country,” he said.
Dr Chituwo said HIV/AIDS was fuelled by poor health system, poverty, gender inequality as women could not negotiate for safer sex due to stigma and discrimination.
History seem to repeat itself to some extent.
In the 15th century syphilis, a venereal disease spread throughout Europe and claimed lives in many countries.
Later the disease became more of a chronic infection which remained incurable until the arrival of active Antibiotics just before the Second World War and it retained scars of stigma to people who became victims.
Then in 1981 came HIV/AIDS, a nemesis to mankind and deaths that have claimed millions of productive lives are still the irrevocable consequence that humanity is grappling with.
Sexually active people are either contracting AIDS through unprotected sex, while innocent children get the virus at delivery through their mothers.
Moreover some are infected through contact with contaminated razor blades and syringes among other ways.
For example in 2002 official statistics from the Central Statistical Office (CSO) indicated that Zambia’s population that stood at 9.3 million had an HIV/AIDS prevalence rate of 16 per cent of the adult population ranging between 15 to 49 years.
But latest CSO statistics indicate that the population is slightly more than 13 million and the levels of new infections have drastically fallen, an indication that sexually active adults are cautious with their sexual lives.
According to Geoffrey Sikapizye, a clinician, though circumcision is not a remedy to the fight against HIV/AIDS, the removal of the foreskin in male circumcision makes it more difficult for HIV to enter the body.
“The skin on the neck of the manhood under the foreskin is very soft and moist.
During sex, this inner foreskin can get bruised or irritated.
When this happens, tiny openings appear in the foreskin that can allow the HIV virus to enter the body. Just below the foreskin there are a lot of special cells called “HIV target cells.”
There are more of these HIV target cells in the foreskin than any other part of the male body.
The HIV target cells in the foreskin act like a sponge, taking in any HIV virus that comes into contact with the private part.
Therefore after the healing process is complete in a circumcised male, the skin on the neck of the manhood becomes dry and many of these HIV target cells are removed making it more difficult for the HIV virus to enter the male body during sexual intercourse,” explained Mr Sikapizye.
Richard Zulu is one of the many people who has undergone the surgery and was full of smiles when he narrated his experience in an interview.
“I am now a real man because my organ has already been cut.
Even in the Bible it is written that Jesus Christ was circumcised immediately his parents saw it fit to take him for the practice so as to keep their tradition.
Against such biblical teachings and after observing that a Luvale friend of mine is circumcised, I became motivated as well,” Mr Zulu said.
Mr Sakapizye outlined how the process of circumcision is done.
“Before the circumcision procedure, one will be asked to participate in an education session led by a trained counselor or MC (male circumcision) provider where more detailed information about what to expect during the procedure is taught.
After the session, a client will have another one-to-one counseling session where an encouragement to take a confidential HIV test is discussed.
Knowledge of one’s HIV status before going for an MC assists in maximising the benefits of the process. Would be male clients should be informed that male circumcision is not recommended for people living with HIV.
In occasions where a client tests positive but still wants to undergo MC ,they will need to be evaluated to see if their immune system is strong enough’’ Mr Sikapzye explained.
A clinical assessment is done before the operation to rule out any active or recent genital diseases.
If there is an active disease, it is treated before an MC is done.
Some injections of pain killing medicine is administered at the base of the private part prior to the process to numb the entire manhood so as to enable one not to feel any pain while the foreskin is being removed.
The providers use clean needles and a special thread called suture to close up the private part wound so it will heal quickly.
Clients are encouraged to wait for six weeks before having sex to enable the wound to heal properly.
If a client engages himself in sex, they risk damaging or delaying the healing of the sexual organ.
Besides that, one is actually at a high risk of contracting HIV and other STIs.
After all the information is gathered from experts on male circumcision and churned out for the public to know, it has to be alluded in plain language that circumcision is not a 100 per cent protection.
Circumcision is just but one of the many other interventions like abstaining and correct usage of condoms that should be employed to prevent spread of HIV.
