Wednesday, August 29, 2012

Your Male Circumcision Q and A

                                                                       By Meluse Kapatamoyo

A discussion on Male Circumcision (MC) posted on this blog a few weeks ago ignited a fierce debate. Centred on whether or not it would be a move in the right direction for MC to be considered a prerequisite to civic centre, church or any other lawfully sanctioned marriages in Zambia, readers, especially the male folk, had a lot to say on the topic.

MC also known as ‘The cut’  is the removal of the foreskin from the head of the penis. The ministry of Health is currently on a drive to circumcise 198,000 men in the country this year. Scientific evidence shows that MC reduces HIV transmission by at about 60 percent.

However, doubts surrounding the surgical procedure and the benefits of MC have seen more men shunning the operation. Circumcision is mainly traditionally practiced by the Luvales, Lundas and Kaondes in North-Western Zambia.

In a bid to find answers to questions sent to Pokeyourmind by readers, I came across three small easy to read booklets being distributed by the Health ministry and its partners- Marie Stopes International, USAID and Partnership For Integrated Social Marketing (PRISM). 

The booklets give a low down on circumcision, from its benefits, the surgical procedure and healing process.

Benefits of MC

MC improves hygiene and can reduce a man’s chance of getting some sexually transmitted infections (STIs) including HIV, syphilis, chancroid and human papilloma virus (HPV). HPV is a virus that can cause penile cancer in men and cervical cancer in women. And because MC keeps the penis clean and dry, baby boys who are circumcised are less likely to get urinary tract infections.

Appropriate age for MC

MC can be done very safely for baby boys below the age of 90 days old. Healing takes less than one week. Note that MC is not offered to children between the age of two months and seven years because children in this age group are very active and do not follow instructions. After seven years old, the procedure can be done on boys and men at any age.

Safety

MC is a very safe procedure if done by a trained health provider. But as with all surgical procedures there are some risks, including pain, bleeding, swelling, infection or reaction to the medicine. It is therefore important to speak with the MC provider about the possible risks and follow instructions to the latter.

Surgical Procedure

A clinical assessment is done before each procedure. This includes an examination of the genital area to rule out the presence of any genital diseases. If any are found, they must be treated before the procedure can take place.

You will be given a few small injections to numb the pain at the base of the penis. This will ensure that the person feels no pain when the foreskin is being removed. After the foreskin is removed you will be stitched and bandaged.

Healing period

You should be able to return to work or school within 2-7 days but the patient will need to return to the MC centre after two days to have the bandage removed and again after one week so that the provider can access if the wound is healing properly.

Sexual performance after MC

MC does not change sexual pleasure and it does not affect a man’s ability to have children. However, there is a six week healing period, and during this time the man is expected to completely abstain from sex or masturbation.  A man is actually more at risk of contracting HIV and some other STIs if he has any sexual contact during the six week healing period.

How to tell a circumcised man from one who is not

A man is circumcised if the head of his penis is fully exposed all the time. A man is not circumcised if there is a bit of skin that folds over and covers the head of the penis while the penis is not erect.

Protection

MC only provides about 60 percent protection and not 100 percent. Thus, after the procedure, always use a condom or abstain from sex and be faithful to one partner who is faithful and know your status. PYM

10 comments:

Field Shachizanda said...

i say yes to male circumcision and its very safe,Pain and risks are invitable thats why its good to follow the instruction given by the MC Providers to the latter.

Boyd said...

Hi Meluse,

Mind touching subject yet again. Thanks for this informative article. The debate on MC has raised a lot of controversial issues. Others feel the campaign is a propaganda ploy aimed at collecting statistics of HIV infection among males. This argument sterms from the fact that there is no systematic and complusory testing of HIV infection in males as is the case in pregant women. Others feel it is the best itervention so far in HIV infection prevention. Personally, I appreciate the stakeholders' involvment in the distribution of the booklets about MC but are the same booklets in local languages as well? It would also be very beneficial to intensify communication through radio spots, dramas, use of influential figures such as Chief Mumena who was in the media recently over the same subject and other puclic communication strategies. If MC is indeed a factor in the prevention of HIV infections by 60%, then it's a cause worth supporting!

Boyd

Stephen Kangwa Chilobwa said...

Meluse,

Thanks for the article, I must say we really need to be very careful what information is going on at the grassroots. A lot of people have a very big misconception of the benefit s of circumcision in relation to HIV, when one is circumcised the risk reduction or to borrow words from the extract (Protection -60%) it does not relate to HIV but to sexually transmitted infections. HIV is transmitted through exchange of bodily fluids and the fact that one feels when they are circumcised they are 'protected' the indulge in unprotected sex that does not keep one safe from infections. So even as we know it is good for hygiene purposes and also offers some kind of so called protection lets also remind people that they need to use protection despite them being circumcised.

All concerned stakeholders need to intensify on sensitizing the communities both rural and urban.

All in all a great staff.

Stephen

Adams Muftawu said...

Male circumcision is not entirely a bad exercise but the question of how it is done is the problem.Relating this issue to the HIV infection;HIV for that matter is not contracted solely by sexual intercourse,exchange of bodily fluids but as it is,exchange of infected instruments.In my country Ghana,non-sterilized instruments were way back used for this act and has caused serious problems not only HIV but acute pain and some unknown forms of diseases.Till date this act is still practiced in some part of Northern Ghana.So in my opinion,the exercise in entirely wrong but how it is done and must not be a prerequisite to the enjoyment of any social amenity or any public place.

Meluse Kapatamoyo said...

Good question Boyd, i amnot sure if the booklets have been translated into local languages but i will find out and give you feedback. I hope they have so people can make informed decisions.

Meluse Kapatamoyo said...

Adams thank you for your contribution. Unfortunately that is the case lmost everywhere, its the reason why there is so much emphasis on having the procedure done by a professional at an MC centre. So, is The Ghanian government also pushing for more males to be circumcised as is the case in Zambia or is emphasis on other interventions?

Meluse Kapatamoyo said...

Good to know Field and thank you for your contribution.

Meluse Kapatamoyo said...

Stephen, well said. Infact just the other day i stumbled upon some recent research questioning whether or not MC was indeed good for Zambian men in as far as fighting HIV and STIs is concerned because most circumcised men were failing to abstain from sex as per the stipulated healing period of six weeks.We know that having sex or masturbating during the 6 week healing period, puts a man more at risk of contracting HIV and other infections. I think we may have a new problem on our hands which needs to be addressed.

Adams Muftawu said...

The Ghana government is laying emphasis on doing the exercise more professionally and safer than what I enumerated in my earlier comment and that to some extent is yielding some results.Yet still some people will still not give up on the old ways of doing things and that as well still prevails.

Mabvuto Zulu said...

I think circumcision is good practice that every man of legal age should go through. With this era of various STI's that include cervical cancer and HIV, circumcision can held reduce the infection incidences. I have actively continued to research on this topic and although I find many voices that still speak against the practice, it is apparent that most of these people speak from a point of ill or mis-information.

Being a professional journalist working for a nurses union as Research and Information Officer, my job is to research on issues that are common to the nursing fraternity and those affecting the communities in which nurses live, and subsequently communicate my findings, I have found that circumcision is one issue that everybody wants to learn about today.

However, I have also found that the "marketing" of this practice should include an aspect of history to show exactly where this practice started. It should also be localised to specific regions and the evidence or effects in every region should then be compared to other regions and see if there is some consistency of the results.

In Zambia, for instance, HIV prevalence in Northwestern province, where circumcision is historically and culturally practiced as a rite of passage from boy-hood to man-hood, should be compared to the other provinces where the practice is not customary. And results should be should be shown as to why they are as they are.

Further, extensive research should be done in countries that practice circumcision as a religious rite and its relation to HIV and compared to countries that do not have such practices.