The Herald (Harare)

Zimbabwe: Circumcision - Doctors Up in Arms

Government has failed to achieve set targets for male circumcision because a few selected individuals are carrying out the procedure which any doctor should have been allowed to do, provincial medical directors have said. The country's provincial medical directors revealed this at an HIV and Aids meeting held by the National Aids Council in Kwekwe last week.

The provincial medical directors from across the country urged Government to incorporate male circumcision in the general health system to allow for easy access.

According to the Ministry of Health and Child Welfare, 80 000 men had been circumcised as of September against a target of 1,2 million for the next five years.

This is the third year into the five-year target. The senior doctors also urged Government to expedite initiation of neo-natal circumcisions.

"The problem is that male circumcision came as a programme where a few selected people were trained and put in charge. And yet this is a simple procedure which any medical doctor can perform," said the acting PMD for Matabeleland North, Dr Nyasha Masuka.

"Teams are coming from Harare or Bulawayo into our provinces, pitch their tents under a tree, circumcise a few men, and get paid hefty allowances and then leave."

Dr Masuka said the approach frustrated other doctors and patients.

"Some people hear of the programme when teams are long gone and the local doctor has to explain to them that the teams have left," he said.

Mashonaland East PMD Dr Simukai Zizhou said male circumcision was a proven method in reducing HIV transmission from an infected partner to a circumcised man and there was no need for Government to have it implemented separately from other health services.

Dr Zizhou said the majority of doctors could perform the procedure and that there was no reason for Government to select a "chosen few" to carry out the circumcisions. "If an old man from the village can perform this procedure, then any doctor should be able to do that," he said. Dr Robert Mudyirandima, PMD for Masvingo, said the programme should be available all the times just like any other health service within an institution.

Acting PMD for Mashonaland West Dr Solomon Mukungunurwa said circumcision services should be universally accessible.

"If we are to realise full benefits of this programme, circumcision should start as soon as a child is born."

He said implementation of neo-natal circumcision should be expedited to avert possible new infections. Responding to the PMDs' concerns, preventive services principal director in the Ministry of Health and Child Welfare Dr Gibson Mhlanga said Government would consider integrating circumcision into general health services.

"We have heard their concerns and we are going to consider them as soon as we can," Dr Mhlanga said. Male circumcision has been touted as an effective method of preventing HIV infections by 60 percent. According to national male circumcision co-ordinator Mr Sinokuthemba Xaba, the country should have circumcised one million men after three years.

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  • Human Rights Abuse
    Nov 20 2012, 09:15

    If anyone thinks that male circumcision will reduce the sexual transmission of HIV then they are seriously misinformed. http://www.salem-news.com/articles/december112011/circumcision-hiv-rg.php

    As for the AAP policy statement (2012) see what OXFORD UNIVERSITY says about this unethical report, that was drafted by self-appointed AAP members, ALL of whom had religious, cultural, financial, or professional career vested interests: http://blog.practicalethics.ox.ac.uk/2012/08/the-aap-report-on-circumcision -bad-science-bad-ethics-bad-medicine/

  • Human Rights Abuse
    Nov 20 2012, 09:16

    If anyone thinks that male circumcision will reduce the sexual transmission of HIV then they are seriously misinformed. http://www.salem-news.com/articles/december112011/circumcision-hiv-rg.php

  • Ronald Goldman, Ph.D.
    Oct 24 2012, 14:31

    Many professionals have criticized the studies claiming that circumcision reduces HIV transmission. They have various flaws. The absolute rate of HIV transmission reduction is only 1.3%, not the claimed 60%. Authorities that cite the studies have other agendas including political and financial. Research shows that circumcision causes physical, sexual, and psychological harm. This harm is ignored by circumcision advocates. Other methods to prevent HIV transmission (e.g., condoms and sterilizing medical instruments) are much more effective, much cheaper, and much less invasive. Please see http://www.circumcision.org/hiv.htm for more information and links to literature.

  • TLC Tugger
    Oct 25 2012, 11:19

    To blame doctors for targets not met is to ignore the obvious. Foreskin feels REALLY good. Most men would not choose to lose theirs.

    Most of the US men who have died of AIDS were circumcised at birth. The US has 3 times the HIV incidence seen in Europe where circumcision is rare.

  • JackieNo
    Oct 25 2012, 14:38

    The problem is that male circumcision UIS A WOUNDING of the male. It is a reduction of the penis and it harms sensation and sexual and protective function. It shuts down a part of the man's sensory system.

    The parts of the penis that are cut off are some of the most highly innervated parts of the human. The lips, nipples and fingertips have similar touch sense. Pushing this is heinous. Particularly as real population data shows no HIV advantage to men missing parts of penis.

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InFocus

Zimbabwe to Start Neonatal Circumcision

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The government is hoping to start the circumcision of babies at birth between the year 2013 and 2014 at a national scale in an attempt to fight HIV/Aids. Read more »