The Herald (Harare)

24 October 2012

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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