To cut or not to cut

With the recent discovery that there was a correlation between HIV prevalence among uncircumcised males, there has been much debate on the issue. Some countries like Rwanda and Kenya have gone a step further to even propagate its adoption among its adult male population. Male circumcision is one of the oldest and most common surgical procedures known, traditionally undertaken as a mark of cultural identity or religious importance. Historically, male circumcision was practiced among ancient Semitic people including Egyptians and those of Jewish faith, with the earliest records depicting circumcision on Egyptian temple and wall paintings dating from around 2300 BC. With advances in surgery in the 19th century, and increased mobility in the 20th century, the procedure was introduced into some previously non-circumcising cultures for both health-related and social reasons. According to some estimates, approximately 30 per cent of all males across the world— representing a total of approximately 670 million men — are circumcised. Of this number, about 68 per cent are of Islamic faith, less than 1 per cent of Jewish faith and 13 per cent are non-Muslim, non-Jewish Americans. With the recent findings that male circumcision significantly reduces a man’s risk of acquiring HIV the practice is receiving renewed interest as the world looks to understand what this will mean for HIV prevention,” said UNAIDS Chief Scientific Adviser, Dr Catherine Hankins. “Looking at the determinants of male circumcision and the acceptability of male circumcision in non-circumcising societies give a better picture of how to take the latest research findings forward.” Many accuse the medicalprofession of being inconsistent by treating circumcision as natural since, when on rare occasion a male is born without a foreskin, it is noted in his records as a birth defect, suggesting that the foreskin should have been there all along. Two recent reports of clinical trials in East Africa successfully demonstrated that circumcision of adult men significantly reduces the risk of contracting HIV. The trials have renewed a debate in the U.S. as to the procedure’s efficacy. While female circumcision is nearly universally denounced in the West as a form of barbarity, male circumcision persists for medical, cultural and religious reasons. In search of answers, one Jean Bosco Murekezi said that he would not have wanted a genital surgery of any kind under any circumstances unless his condition rather his foreskin made him sterile or caused any health risks. That brings us to the question of how healthy or unhealthy is it for the man to have a foreskin. Recently in Kenya, there was a wave in the Nyanza province of male circumcision where politicians were urging an ethnic group to take the initiative in the fight against HIV/Aids. This did not go down very well even after the Kenya’s Prime Minister Raila Odinga launching a campaign of creating awareness to his fellow tribes men. Of course some of the young men in the region went ahead and did it but the council of elders had to meet to decide whether to shun their long lived culture or to believe in the medical side of view. It is said that the earlier in life the practice is done, the easier to heal and the cheaper it is. Some argue that all abuse on babies is easier since they are powerless and have no say whatsoever. One Kenyan from the Kikuyu tribe whose name is withheld told The New Times that if only he would have been allowed to make the decision himself, he would not have gotten circumcised. His reason was that he feels empty or like bald headed and said that the matter of cleanliness is ones choice since he is smart he can always find the best way of cleaning the troublesome cheese behind the foreskin. Ladies have different opinion on this issue. One Charlotte said that it only depends on how clean one is. In her own words “it does not matter how cold it is, one decides on whether to put on a jacket or not to, it all depends on how one handles the weather.” Circumcision halved a man’s risk of contracting HIV. “Science News” notes that the fragile foreskin around the penis harbours immune cells that are easily infected with HIV. After the foreskin is removed in circumcision, the remaining outer layer becomes tough and more difficult for HIV to penetrate. Today the debate over male circumcision is at a higher level than it did since its adoption in the 19th Century. The worldwide condemnation of female genital mutilation intensified the debate. The recent medical report as to the procedure’s value in the prevention of its transmission to HIV has refocused. Male circumcision is a valid medical procedure especially in regions like East Africa, with wanting public hygiene infrastructure and faced with a catastrophic health crises. But this does not mean that circumcision, like slavery and the hanging of witches, should not disappear as a social practice. Contact: karuthum@gmail.com