Feature

Cham scales up medical circumcision

 

It is a chilly Wednesday morning and Grant Shuga is interacting with his peers under a tree by the roadside.

The boys, almost 30 of them, have been sitting here for about 30 minutes, having walked from Amidu Village in Balaka. In the shade, they are waiting for a vehicle from the Christian Health Association of Malawi (Cham) to come and pick them up to Comfort Clinic, some 30 kilometres away, to access voluntary male medical circumcision (VMMC).

The boys have come with their parents who want their sons to get circumcised by skilled health workers at the clinic run by the Catholic Church.

When the vehicle arrives, the boys scramble for the ride. Grant says he just cannot wait to be circumcised.

“The campaign for us to go and get circumcised at the clinic is good, but we are many in our village. We have to take turns to access the procedure,” he says.

Medical circumcision is known to reduce exposure to HIV infection
Medical circumcision is known to reduce exposure to HIV infection

Four years ago, government adopted VMMC as a way of reducing HIV infections following findings that it reduces the risk of contracting the virus by 60 percent. The procedure is also credited with enhancing personal hygiene and protecting women from cervical cancer.

Some of the boys, who were eagerly waiting for a turn, had a chance to undergo traditional circumcision when initiation ceremonies were in session in their village.

Although circumcision is a cultural obligation in the Eastern region, the young men and their parents say they prefer doing it with the assistance of health workers because it is safer and more beneficial.

Asked why they want their sons to get circumcision at the hospital instead of the village-based initiation camps, the parents said they are convinced it has several advantages.

“At the hospital, trained staff do the circumcision. Besides, they use safe tools and this is important for the boys’ health,” says a father of two of the boys in the vehicle.

But there is a more interesting twist.

For some, the VMMC campaign is also a cost-cutting measure.

“In Balaka, this is the season of initiation camps when young boys are taken to be circumcised as a rite of passage to adulthood. However, this year is tough. Most of us did not send our children because we cannot afford to pay for them due to the ongoing food crisis in the district,” said a Mr. Lazario of Thom Village.

The parents pay up to K5 000 to have the boys initiated. Besides, the parents pay extra costs because the initiates need daily food supplies for the entire period at the camp.

Balaka is one of the districts hit hard by the drought that has drastically reduced the country’s maize yield.

Christina Kachingwe, wife to group village head Magombo in Traditional Authority (T/A) Amidu, aides the boys from the area to get circumcised at Comfort  Clinic and make sure they all return home safely afterwards.

She explains: “After hearing of the campaign, my husband and I agreed to take the lead. Being the village head, he organised village meetings to encourage parents to register their children. I decided to be the chaperon for the boys to make sure they meet in designated points from where Cham picks them up. Together with their parents, I go with them to the clinic. Afterwards, I make sure everybody gets home safe.”

Overcoming cultural and religious myths, the village head’s wife admittedly feels duty-bound to ensure all children in her area grow up to be healthy citizens.

“Medical circumcision is safer for these kids than getting what they go through in initiation camps, locally known as ndagala, where they face the risk of HIV infection as the elders use unsterilised equipment. That aside, the boys are subjected to harsh conditions and some boys die due to inadequate care given after circumcision,” she laments.

Recently, police arrested two initiation counsellors after a 13-year-old boy bled to death in their initiation camp following traditional circumcision.

In contrast, after they are operated on at the clinic, the boys come again to the clinic for two post operation check-ups.

Since the campaign started last month, nearly 3 000 boys have been citcumcised by trained health workers in Cham facilities—Comfort Clinic; Kankao Mission Hospital and Kapire Health Centre—in Balaka.

Gift Werekhwe, Cham coordinator for the VMMC campaign in Balaka, the response is so overwhelming that the health workers sometimes tell the clients to come again the next day to avoid compromising on quality.

“It is pleasing that parents are realising the need to get their kids circumcised at a health facility and not initiation camps,” he said.

Cham executive director Dr Mwai Makoka says this campaign is another example of the unwavering commitment the association has in ensuring Malawians get the best in health care.

“Cham is committed to providing quality health care for Malawians. Even through VMMC campaign, we want to reach out to as many underserved populations as possible,” he explained.

The six-week initiative is part of an ongoing VMMC programme funded by Pepfar through the Centre for Disease Control and Prevention (CDC).

The campaign is taking place at Pirimiti Hospital and two satellite camps in Zomba as well as St Gabriel and Likuni mission hospitals in Lilongwe.

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One Comment

  1. Is this about HIV prevention or culture facilitation/preservation?

    This innitiative is being paid for by PEPFAR for the supposed purpose of HIV prevention.

    But is this message lost on those who see this as nothing more than an opportunity to get a free alternative to the mutilations that go on at initiation schools?

    What will be the take away message?

    “Get circumcised AND were protected from HIV! (So who cares about condoms?)”

    Fact: 80% of US males are also circumcised at birth.

    Fact: In the 1980s, when the epidemic hit, that number was 90%.

    Fact: According to the CIA World Factbook, the US has a higher HIV prevalence than 53 countries where circumcision is rare or not practiced.

    Fact: According to USAID, HIV prevalence was found to be higher among *circumcised* men in 10 out of 18 Africab countries.

    Fact: Even if the latest research is correct (and it has many questionable flaws, namely the lack of a scientifically demonstrable causal link, failure to correlate with world data, unconfirmable results, etc…), circumcision would still be ineffective at preventing HIV, so ineffective that circumcised males and their partners must still be urged to wear condoms.

    Fact: Circumcision is forbidden to Gentiles under the New Testament.

    It must be asked why so much money is being pumped into such a questionable procedure for which more effective, less invasive alternatives are already available.

    How is something that never worked for the US going to suddenly start working miracles in Africa?

    If circumcised men and their partners must still be urged to wear comdoms, what is the point of promoting circumcision?

    What’s the point of spending millions of dollars promoting a surgery, when that money can be better spent?

    Is no one going to question the ethics of promoting what is essentially genital mutilation in a hospital setting?

    Is no one concerned that this is a green light for tribal circumcisions which result in injury and death?

    Is no one going to talk about all the mishaps that happen in the medical setting?

    The fact that male circumcision promotion is a stumbling block to activists trying to stop female circumcision?

    The fact that this promotion is resulting in the forced circumcision of non-consenting minors?

    The coercion of boys and men to get circumcised?

    What is this about?

    Is this truly about HIV prevention?

    Or is this about legitimizing, preserving a controversial procedure that is dwindling back home?

    (Back home meaning the home country of those pumping money and effort in spreading circumcision in Africa and elsewhere under the guise of public health? PEPFAR? JHPIEGO? Bill and Melinda Gates? The Clinton Foundation? CDC? What do these organizations that are so eager to circumcise millions of males in Africa have in common? They all come from America, where male infant circumcision used to be a common procedure for the majority of newborn makes, and where these numbers are falling and doctors are struggling to convince parents to circumcise their children. So is this about medicine? Or culture preservation? Subplantation? Look at the fine print; these companies’ organizations’ ultimate goal is to implement infant circumcision in Africa as it exists back home. Never mind this hasn’t helped to prevent STDs. What is this really about? Why does the world watch in silence as the US imposes male genital mutilation on Africa under the guise of disease prevention?)

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