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Kenya: Luo Elders to Consult Over 'Cut'
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The East African Standard (Nairobi)
22 April 2008
Posted to the web 21 April 2008
Jack Nduri And Obote Akoko
Nairobi
Luo elders say male circumcision cannot be introduced in the community without consultation.
Luo Council of Elders chairman, Mr Riaga Ogallo, said the Government's proposal could not be implemented without an agreement on the way forward.
"Anyone interested in circumcision should do so as an individual. NGOs are not allowed to undertake the initiative on behalf of the community until consultations are done," said Riaga.
Early this month, the Ministry of Health recommended male circumcision following last year's findings of World Health Organisation-sponsored studies in Kenya, Uganda and South Africa. The studies showed that circumcision offered up to 60 per cent protection against HIV.
The ministry launched a five-year pilot programme covering Nyando, Kisumu-East and Kisumu-West districts at Ahero Sub-district Hospital on April 1.
During a two-day workshop in Oyugis at the weekend, the elders said any change to Luo culture needed consultation.
The workshop co-sponsored by Nyanza Reproductive Health, Health Policy Initiative and Aphia Nyanza sought to introduce circumcision into Luo culture as a medical intervention to reduce the spread of HIV/Aids.
"We are neither contradicting the scientific findings nor rejecting male circumcision," Riaga said.
He emphasised that if it was to be adopted by Kenyans for the sake of saving lives, a convention would decide for the Luo.
More than 30 elders attended the meeting in which Ministry of Health officials backed the male cut.
"We told the health experts to wait for the stakeholders' meeting instead of asking us to give them the green light," Riaga said. "This thing has not been in our culture. We must go easy on it," he added.
At the meeting, the elders lamented that male circumcision per se was not the solution to the HIV/Aids pandemic, especially in Nyanza Province, which has had the highest prevalence rate.
Although HIV infections in the province have reduced (prevalence of 15 per cent in 2004), it is not yet out of the woods.
Dr Agot Kawango, the director of Nyanza Reproductive Health, said studies done in Kenya, Uganda and South Africa revealed that circumcision reduces chances of contracting HIV/Aids.
But elders said the Luo community would not embrace the method as a means to contain the scourge.
About 30 million people in Africa are believed to be HIV positive and more than 90 per cent of HIV infections in adults result from heterosexual intercourse.
One of the practices blamed for HIV/Aids prevalence among the Luo is wife inheritance.
This prompted WHO to select Kisumu as a centre for the research that was carried out by the Universities of Nairobi, Illinois and Mannitoba (Unim) Project under Prof Kawango Agot.
In the study, 3,000 HIV-negative men were circumcised and followed up for five years.
Among them, 54 per cent did not get infected with HIV.
In South Africa, male circumcision produced 60 per cent protection to men who were enrolled for the study while a similar trend was observed in the study at Rakai in Uganda.
Last year, the fourth international conference of the Social Aspects of HIV/Aids and Health Research Alliance took place in Kisumu. The conference was attended by 420 delegates from 40 countries. Prof Ndeye Niang, from Senegal, cautioned Africans against embracing wholesale prescriptions from the west without considering their anthropological and spiritual ramifications.
Niang said male circumcision could only be adopted as an intervention in controlling the spread of HIV/Aids after consultation with specific communities.
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He said drastic cultural changes, even on the advice of experts, would fail if stakeholders in communities are not engaged.
A study by Dr A Kamau, in Central Province, revealed that adolescents were psychologically coerced into having unsafe sex after circumcision, a practice known as kwihura mbiro (wiping soot) in Kikuyu.
It was observed that older peers told new initiates to have sex with girls or die, fall sick or have the wound forever.
The first scientific study to find that post-sex washing reduces risk of HIV infections was conducted in Kibera, which is heavily populated by Luo.
This study found that regardless of whether a man was circumcised, "bathing" for 10 minutes within an hour of sexual intercourse reduced his risk of HIV infection.
The most prestigious member of the team that did this study is Professor King K. Holmes, American dean of research on sexually transmitted diseases. He suggests that male circumcision might be effective because it makes it easier for men to wash their penises.
But the key variable... [Read Full Text]
Your article has some serious errors. You say, "In the study, 3,000 HIV-negative men were circumcised and followed up for five years."
No, 1,391 were circumcised and 1,393 were left intact ("controls"). 87 circumcised men and 92 controls were "lost to study", their HIV status unknown, creating an uncertainty much greater than the supposed benefit.
They were followed up for two years, not five, but the study was cut short (it was not thought ethical to carry on - though it was thought ethical to test men for HIV and not tell them they had the disease) and now we... [Read Full Text]
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