Harry Vanderwal from The Luke Commission with Sipho (a translator) at one of their clinics.
This last week I (Amy) had the privledge of attending a training for counselors on Male Circumcision. My first training Swazi style, including tea at 10:30, lunch at 1:00, tea again at four, and instead of mints to suck on during the training they give you cough drops. I went with the staff of The Luke Commission. The Luke Commission is a ministry/organization started by Harry and Echo Vanderwal (he is a Doctor and she is a PA). Together with their Swazi staff and four boys they have day long clinics in rural areas. What they do is truly amazing. They see every person that comes to the clinic, no matter how late they come and all for free. Soon The Luke Commission will be having male circumcision procedures done at their clinics.
Recent studies have shown that when a man is circumcised he reduces his risk of transmission of HIV/AIDS by 60%. This was found when researchers tried to figure why the percentage of AIDS is so high in eastern and southern Africa. As many of you know Swaziland is home to 70% of people infected with HIV/AIDS throughout the world.
At one point Swaziland was performing circumcision, but the king banished the practice due to the recovery length taking to long. Which in return affected his army. This is the first year that newborns are now being circumcised. Circumcision is starting to be offered to men for free by certain clinics.
This is where the training of counselors comes into play. Coaching a man into circumcision is not always an easy thing. Each patient goes through a group session and individual session with a counselor. In the training I attended we spend two days discussing fears, myths, and benefits patients might have. Training also included a full break down on the anatomy and we watched a circumcision being done (on video). Needless to say, I learned a lot! The cultural differences amazed me. As a counselor trained in America they felt the need to call on me to answer many of the questions. It was a time I will never forget.
In Swaziland, the HIV rate among circumcised men is 21.8%, and among non-circumcised men "only" 19.5%, according to the National Health and Demographic Surveys, p227 (248 of 507). Similar figures apply in at least six other African countries. The three trials that gave the much-touted "60% reduction" were held in other countries. The figure is based on a total of 73 circumcised men who didn't get HIV, after circumcising 5,400 men and leaving a similar number alone. Meanwhile 64 of the circumcised men did get HIV, and 327 left the trials, their HIV status unknown. Maybe you too are the victim of "myths".
ReplyDeleteDid the "full breakdown of the anatomy" include a discussion of the structure and functions of the foreskin, its unique rolling action, and its ~20,000 specialised nerves, similar to those of the fingertips or the lips?
Did the discussion of the risks of HIV include the study by Wawer et al. that found 18% of the partners of circumcised men contracted HIV but "only" 12% of the partners of non-circumcised men (but was stopped "for futility" before it could reach statistical significnce)? (Lancet 374:9685 229-37)
"Coaching a man into circumcision is not always an easy thing." That is not my understanding of a counsellor's job. How about helping men to decide for themselves what they want?