The government has recently been in the news for promoting the policy of male circumcision to combat the spread of HIV/Aids. While this move is commendable in that it seeks to reduce the spread of a disease which has taken the lives of many Kenyans and left even more infected and affected, it raises some serious legal, constitutional and ethical issues that need to be resolved. It is not clear how the government intends to ensure the success of this policy. However, if not implemented in a socially-cum-human rights based manner, it is sure to touch a raw nerve with many people.
The first thing that needs to be considered is the constitutional effect of the policy. Article 2 of the Constitution of Kenya declares it as the supreme law of the Republic and binding on all state organs at both levels of government. Article 19(1) further states that the Bill of Rights is an integral part of Kenya's democratic state and is the framework for social, economic and cultural policies. This means that the state is bound by the Bill of Rights in the policies that it makes. One might be tempted to ask, are there any constitutional rights that might be affected, taken away or violated by the government policy of promotion of male circumcision?
Article 28 of the Constitution states that every person has the right to inherent dignity and to have that dignity respected and protected. Does the state intend to compel all men to be circumcised and if so, doesn't this violate the right to inherent dignity as set out in the above article? Should circumcision be a personal decision? How will we balance between the reproductive health rights, the right to life as read along the right to health so as to get the best of this policy?
Article 29 (f) states that every person has the right not to be treated in a cruel, inhuman or degrading manner. By compelling men to be circumcised, if in fact that is what it intends to do, wont the government be violating the Bill of Rights?
Finally, Article 43 (1) (a) provides for the right to the highest attainable standard of health. Male circumcision has been scientifically proven to greatly reduce the chances of a man getting infected with HIV/Aids. By developing a policy to encourage male circumcision, is the government performing its duty of ensuring the highest standard of health by reducing the chances of HIV/ AIDS infection?
The second thing that needs to be considered is the custom and practices of the various Kenyan communities that do not practise male circumcision. If at all the policy is to yield fruit, then the implementers of the policy need to fully understand why some communities did not practise male circumcision. This can then be used in trying to build up a case for why the members of that community should adopt the practice of male circumcision. If there is no research to find out why there is no male circumcision in the community, then this initiative is likely to come up against a stone wall.
Article 44 (3) states that a person shall not be compelled by another person to perform, observe or undergo any cultural practice or rite. Is circumcision being presented as a cultural rite or as a health issue? If it is being presented as a cultural rite, then the government is not only violating the Bill of Rights but also bound to fail in its mission. The State might have a good case if the issue is attended to from a health perspective.
Another issue that needs to be considered is the opinion of the sexual partners of the uncircumcised men. We need to consider what the spouses want and what is in their best interests. We need to consider whether they prefer to have their men circumcised or uncircumcised. If it is the latter, then do they have attendant rights especially if they are a married couple? In a marriage, the parties are recognised as having conjugal rights. Does this mean that they have a related right to obtain pleasure from their conjugal union?
We need to consider the two competing rights of a sexual partner's wants versus her interests. Should she be allowed to have a say in the matter? Should she be allowed to put her health at risk for the 'right' to pleasure?
While this might seem to be a straightforward matter of the government protecting the life and health of its citizens, clearly there are more factors at play here. The government therefore needs to think soberly about this policy especially during this nascent stage of constitutional implementation when we are laying the foundation for a new order of business.
That having been said, we cannot bury our heads in the sand. A healthy nation is a wealthy nation. We have to fight HIV/Aids from all angles.
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Of course it is humiliating and cruel to cut off half of the man's skin of his penis and MORE when talking about up to 85% of the erogenous pleasure receptors are cut off too. Thus leaving him more pain receptors than pleasure receptors ratio 5% to 95%. Even more humiliating when supposedly for health reasons, like the man is so stupid not to know how to use a condom or take away his own choice of destiny. For the state to promote circumcision, one then has to ask, is every man's penis then owned by the state? Circumcision has always been about control over men (and women). And Israel's Operation Abraham wants part of the action. Foreskins are sold to SkinMedica and cosmitics for facial cream.
In Africa, 20%, 1 in 5 HIV infections are caused b medical personnel. By not addressing this FACT! infections are sure to follow penis cuttings. http://tinyurl.com/yks9apv 1/5 HIV Infections Caused by Medical Staff (5million/yr,Africa,09) papers backed by Royal Society of Medicine http://mysite.verizon.net/dortfay/science.html Science and Circumcision - Basic tenets of science http://tinyurl.com/ygmmrk7 Science News "Odds are, it's wrong" (Science fails to face the shortcomings of statistics) http://tinyurl.com/yayafgo " #Circumcision and HIV/Aids; time to cut losses" by Gawaya Tegulle Africans are starting to smell a rat
http://ow.ly/1rKVgZ "Factors Affecting Male Fertility" | Health Vene
http://www.circumcisionandhiv.com/2010/05/royal-dutch-medical-association-i ssues-statement-on-male-circumcision-of-infants-and-children-aap-no.html Royal Dutch Medical Association on Circumcision :
"There is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene. Partly in the light of the complications which can arise during or after circumcision, circumcision is not justifiable except on medical/therapeutic grounds. Insofar as there are medical benefits, such as a possibly reduced risk of HIV infection, it is reasonable to put off circumcision until the age at which such a risk is relevant and the boy himself can decide about the intervention, or can opt for any available alternatives.
"Contrary to what is often thought, circumcision entails the risk of medical and psychological complications. The most common complications are bleeding, infections, meatus stenosis (narrowing of the urethra) and panic attacks. Partial or complete penis amputations as a result of complications following circumcisions have also been reported, as have psychological problems as a result of the circumcision.
"Non-therapeutic circumcision of male minors is contrary to the rule that minors may only be exposed to medical treatments if illness or abnormalities are present, or if it can be convincingly demonstrated that the medical intervention is in the interest of the child, as in the case of vaccinations.
"Non-therapeutic circumcision of male minors conflicts with the child's right to autonomy and physical integrity."
That is the official position of the Royal Dutch Medical Association (KNMG). But then, Holland never suffered from anti-masturbation hysteria, so circumcision never became customary there.
http://tinyurl.com/mk39bk 2 out of 3 Swedish doctors won't do circumcision saying it is assault, barbaric and akin to unnecessary FGM.
http://www.sciencenews.org/view/generic/id/70435/title/Half_of_adult_males_ carry_HPV "Half of adult males carry HPV" Male circumcision and the use of condoms have shown little protection against HPV infection, Monsonego says.
http://cpj.sagepub.com/content/25/8/412.abstract Neonatal Cortisol Response to Circumcision with Anesthesia (circumcision with local dorsal penile nerve block doesn't work.)
http://www.norm.org/lost.html "The Lost List" What is lost to circumcision and what can be restored. http://www.norm.org/frenular.pdf foremost penis expert Dr. John Taylor's Frenular Delta http://research.cirp.org/ World's foremost penis expert Dr. John Taylor's site http://www.circumstitions.com/Sexuality.html Sorrells et al. Fine-touch pressure thresholds in the adult penis
There are other things that must be considered, and that is, DOES circumcision actually prevent HIV as it is now commonly assumed to be true?
I know that this is silly to question what already appears to have become common knowledge, but I think that there are questions that are not being asked. Who exactly came up with these "studies," and why? Isn't it peculiar that this procedure which is supposed to "save lives" happens to be a cultural practice that is a point of contention for quite a few people, including, but not limited to, Africans, Muslims, Jewish and Americans?
I ask this question because I feel that the media is not doing its job in scratching beneath the surface. It would all seem noble that there are some individuals who seem interested in "the health of the nation." But are they really interested in the health of the nation, or are they interested in something else? I challenge reporters and journalists to question these "studies," who wrote them, who is promoting them, and who is putting the money behind them. You might discover that there are people with more interests in circumcision than just "health."
Why does it seem that the majority of circumcision "researchers" just happen to come form cultures and ethnic backgrounds where circumcision is a norm? Research the conductors of the said "studies." Research Daniel Halperin, Ronald Gray, Robert Bailey, Marie Wawer, Stephen Moses, etc. etc... What do these people have in common? They all come from ethnic groups and cultural backgrounds where circumcision is a perceived norm. 80% of Americans are circumcised, and circumcision is a religious requirement in Judaism and Islam. Dig deeper and you will find that all of these people are either Jewish or from America. Dig even deeper and you will find that they didn't "just" discover that circumcision "prevents this or that"; they've been trying to associate circumcision with the reduction of some disease cum hoc ergo propter hoc for quite some time now. Circumcision isn't exactly "new innovation" either; people have been "studying" to legitimize it as "medicine" for at least a century now. Could it be that the Westerners with money are using Africans as guineapigs? It would be very easy too; a majority of Africans already circumcise as a matter of culture and/or religious tradition. Is Africa falling victim to cultural hegemony here?
This article brings up very good points; what about the rights of those who do not want to become circumcised? What if a man and a woman are faithful to each other? Why would the man have to undergo circumcision to prevent a disease that neither he nor his wife are at risk for because they remain faithful? What if a youth wants to remain uncircumcised because he has determined that he is not promiscuous, and that if he ever has sex he will use condoms? Why should the uncircumcised have to face a stigma of being "against national health policy?"
Reporters and journalists need to dig deeper. Here is another big question; why are studies and situations where HIV was more prevalent among the circumcised being overlooked? Let's take a look at a few places where circumcision HAS NOT prevented HIV:
Countries in Africa According to demographic health studies performed in other countries in Africa, HIV transmission was prevalent in circumcised men in at least 6 different countries:
Cameroon - DHS 2004 - 4.1 vs 1.1 (91% circumcised) Ghana - DHS 2003 - 1.6 vs 1.4 (95.3% circumcised) Lesotho - DHS 2004 - 22.8 vs 15.2 (23% circumcised) Malawi - DHS 2004 - 13.2 vs 9.5 (20% circumcised) Rwanda - DHS 2005 - 3.8 vs 2.1 Swaziland - DHS 2006-2007 - 22 vs 20
How many governments are rolling out "mass circumcision" campaigns in these countries despite their own realities?
According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia, most, if not all Muslim men are circumcised, whereas circumcision is uncommon in the non-Muslim community. 60% of the Malaysian population is Muslim, which means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.
Interestingly enough, Malaysia is home to the TaraKlamp, a controversial circumcision device being marketed in KwaZulu Natal, Africa in the name of HIV prevention.
The Philippines In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or decreasing.
The United States Finally, in America, the majority of the male population is circumcised, approximately 80%, while in most countries in Europe, circumcision is uncommon. One would expect for there to be a lower transmission rates in the United States, and for HIV to be rampant in Europe; HIV transmission rates are in fact higher in the United States, where most men are circumcised, than in various countries in Europe, where most men are intact.
A common explanation given for this difference is the fact that sex education and instruction in the proper use of condoms is better executed in Europe than in the United States, where sex education is poor. However, it is precisely these reasons given, that sex education and condoms aren't catching on in Africa, why circumcision advocates say "mass circumcision campaigns" should be promoted in Africa. What failed in the United States is somehow supposed to work miracles in Africa.
The deeper you dig, the more you find inconsistencies in the circumcision story. Circumcision may be an important part of culture, but that is not being contested. If circumcision does not prevent HIV, then African men are being lied to, the men who do not circumcise as part of their culture are being raped in the name of "medicine," and entire governments are wasting money where it could be better spent. Funds and doctors being wasted on circumcision means that medicine is not reaching other places where it should be.
Africans, please wake up. Whatever reservations you may have about circumcision, it does not, cannot prevent AIDS. Only education and condoms prevents AIDS. Please investigate the issue further. Africa is being raped by the West, yet again.
We have already read of many instances of Kenyan (and other) men being forcibly circumcised in a brutal and humiliating fashion. The reporting of these abuses trivialises and adds to the outrage. There is something peculiar about circumcision that makes people overlook ordinary human rights and common sense considerations. They are readier to accept myths about it they would never believe about any other practice. That is why we should be more than usually sceptical about the the claim that it helps to prevent HIV.
THE POINT IN THIS CASE OF CIRCUMCISION IS THAT: DON'T AFRICA AND AFRICANS HAVE THEIR OWN VALUES, BELIEVES AND TRADITIONS? IF SO, WHY DO "AFRICA AND AFRICANS" CONTINUE TO FOLLO THE VALUES AND TRADITIONS OF OTHERS; OTHERS WHOSE MAIN IDEAS AND INTERESTS ARE TO CONTINUE TO DISRESPECT AND DEGRADE AFRICANS AND AFRICA THROUGHOUT THE WORLD. AFRICA, WHEN ARE YOU GOING TO WAKE-UP AND TEACH YOUR PEOPLE "THE COMMON AFRICANS AND AFRICANS" ABOUT THE DESTRUCTIVE ABILITIES, EVILNESS AND IDEAS OF YOUR ENEMIES TOWARDS AFRICANS AND AFRICA?? WHEN?????