Eugene Kwibuka
10 December 2008
Kigali — Local doctors and their Canadian counterparts have started a five-day brainstorming session aimed at exchanging skills and experiences on how to carry out safe male circumcision.
This comes after a recent government decision to embark on a countrywide campaign of encouraging circumcision for both male adults and children as a way of curbing the prevalence of HIV/AIDS.
In the workshop that started yesterday at King Faisal Hospital in Kigali, surgeons from the two countries will exchange techniques and practices on how they can go about circumcising their patients.
"How do we deal with cultural differences while doing circumcision? Some patients come back complaining about the result of the operation," asked Dr Emmanuel Kayibanda of King Faisal Hospital.
He made the intervention following a power-point presentation by his Canadian counterpart, Dr. Neil Pollock.
The two doctors agreed that some patients ask doctors not to remove a large portion of their fore skin from their organs during circumcision while others need it depending on their social background.
"We need to learn about the realities in a given environment in order to introduce a model to do circumcision operations," said Dr. David Patrick, an epidemiologist from Canada's University of British Columbia.
Research conducted in Uganda and Kenya suggests that male circumcision could reduce a man's risk of contracting HIV through heterosexual sex by 65%.
In response to the findings, the World Health Organisation (WHO) and the UNAIDS recommended the procedure in 2007 as a way to help reduce transmission of the epidemic through heterosexual sex.
Rwanda has since embarked on a plan to address myths about male circumcision which encourages men to be circumcised.
"We are looking at how circumcision can be added on other means we use to prevent HIV/AIDS," said Dr. Anita Asiimwe, the Executive Secretary of the National AIDS Control Commission (CNLS), shortly after attending the surgeons' workshop.
She said that Rwanda's Treatment and Research AIDS Center (TRAC-PLUS) is still devising ways on how to implement a national plan to scale up male circumcision after considering all the perceptions that Rwandans have on the procedure.
Fourteen Rwandan doctors from five hospitals in Kigali City, and 3 Canadian doctors are attending.
Dr. Kayibanda, said that they have been able to learn how to use new equipment to carry out circumcision much quicker than they were doing it.
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2.1% of intact Rwandan men aged 15-59 have HIV. 3.5% of circumcised Rwandan men aged 15-59 have HIV.
(source: Demographic and Health Survey 2005)
Why would anyone want to encourage circumcision in Rwanda? It certainly isn't because they're worried about AIDS.
Rwanda has more than nine million people, but only one doctor for every 50,000 people and one nurse for every 3,900 people, so why would they want to waste their medical resources operating on intact Rwandan men who are less likely to be HIV+ than circumcised Rwandan men? Other countries where circumcised men are *more* likely to be HIV+ than intact men are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives not save them.