Friday, 28 August 2009

Cross your legs, gentlemen.......

An extract from today's "New Times". And when Rwandan authorities say things like this, they have a habit of meaning it.....

Massive circumcision drive on the books


A massive sensitization programme on circumcision is expected to kick off early next year as one key measure to combat HIV/AIDS. The exercise has for long been delayed because of the lack of capable personnel to carry out the circumcisions.

Mass male-circumcision, a policy that was adopted by government last year, as a way of reducing the HIV/AIDS infection rate is at a snail-pace due to lack of capacity to carry it out countrywide, according to Dr. Richard Sezibera, the Minister of Health. Sezibera said that training programmes have been introduced in a number of hospitals like King Faisal Hospital to ensure safe circumcision.

“We do not want to use local methods of circumcision so we are training enough personnel to carry out these operations.

It is however very vital for the public to know that although this is a preventative measure, it is not 100 percent effective,” the Minister said.

“Despite the fact that it reduces the circumcised person’s risk of getting HIV, it does not protect his partner. So other preventative measures like abstinence, faithfulness and use of condoms must apply,” he advised.

Rwanda launched a campaign to encourage all men to be circumcised, to reduce the risk of catching HIV/AIDS.

Health experts say that men who are circumcised are 60 percent more likely to be protected against HIV during sexual intercourse than those who are not.

The ministry said that soldiers, policemen and students would be asked to come forward first for circumcision. (But not teachers or VSO volunteers - hooray!)

The National Coordinator of HIV clinical prevention in TRAC plus, Elévaniè Nyankesha Umunyana said that, once training of health specialist is done, a mass sensitization campaign of this policy will begin.

“By the end of this year, there will be enough personnel to carry out these surgeries at all hospitals in the country.

Apparently we are ensuring that all health insurance companies include circumcision as a priority and so far RAMA has adopted it,” Umunyana explained.

The 2007-2008 Demographic Health Survey revealed that only 15 per cent of the men in the country are circumcised.

However, citing army personnel who have successfully undergone the operation, Umunyana expressed optimism that once the public is informed about the policy, attitudes will change and more men will come forward.

So just what do they mean by "local methods of circumcision", eh?

1 comment:

Trevor said...

After reading this, I thought "Wow, could that be worth it?" Well, some quick googling reveals the following:

Circumcised men have a 40-73% lower risk of contracting HIV during sex.


Wow! Sounds good, right? Well, no.

Giving relative risk percentages like that doesn't say much and is a slightly dishonest and unscientific way of presenting results. Given that the risk of a man contracting HIV from vaginal sex from an infected partner is about 5 in 10,000, basically, 2-4 people in 10,000 will be spared an HIV infection by circumsizing all 10,0000.

I know this is approximate, but I just want to do a 'back of the envelope' calculation here.

Ok, so circumcising 10,000 might be worth it because 2-4 of them might be spared an HIV infection. Sounds good, right? Well, no.

Because the risk of complication from HIV is 2-10%, even at the low end -- let's say 1% -- 100 people are going to be suffering complications including permanent damage, sterility, infections, death. Also:

Of course, it sounds like these people doing the circumcisions aren't a crack team of experts, so the complication rate is probably going to be much higher.

Sounds like this whole campaign is a bad idea. What do you think?