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

Chlorhexidine - A Saviour for Newborns through Umbilical Cord Care

By Meluse Kapatamoyo

The risk of an infant to infection and death can be reduced by as much as 20 percent by cleansing the newborn’s umbilical cord with the antiseptic chlorhexidine, a new study has revealed.

According to the study funded by the United States Agency for International Development (USAID) and Save the Children’s Saving Newborn Lives program, which was led by researchers at the Johns Hopkins Bloomberg School of Public Health and conducted in rural Bangladesh, is the latest in a series of studies showing that umbilical cord cleansing with chlorhexidine can save lives.

 A randomized controlled trial of over 29,000 infants in Bangladesh found that cleansing a newborn’s umbilical cord with chlorhexidine reduced an infant’s risk of infection and death by 20 percent.

Dr. Rajiv Shah, administrator of USAID said “giving birth and a child’s first week is a risky time for a mother and her newborn”.

Approximately one-third of the 3.1 million neonatal deaths that occur each year can be attributed to infections that develop into life-threatening conditions. The umbilical cord is a common entry point for infection to the surrounding tissue as well as internally into the baby’s bloodstream.

“These studies provide evidence of a simple, low-cost technology that can prevent illness and death for the most vulnerable children. USAID is committed to transforming research into better results and access to life-saving interventions,” Dr Shah added.

A similar study was conducted in Pakistan by researchers from Aga Khan University where data showed that cord cleansing reduced the risk of infection in babies by 42 percent and mortality by 38 percent. The studies supported earlier research in Nepal, which showed that cleansing the umbilical cord with chlorhexidine resulted in a 24 percent decrease in mortality compared to children who received dry-cord umbilical care.

Neonatal deaths are responsible for more than 40 percent of an estimated 8.8 million deaths of children under the age 5 each year worldwide. Over half of such deaths are as a result of serious infection

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