More students get circumcised

Written by: 
Charlotte Ninsiima

As one passes by Wandegeya taxi stage (Kamwokya-Ntinda), a storied building with a poster, ‘Rita’s Health Clinic’ invites men aged 12-45 years for free circumcision. In addition to that a repetitive recorded message calls upon the men who haven’t read the poster.

The ongoing campaign for male circumcision has yielded positive results over the past four years. Although many criticisms attached with different perceptions have come along with the concept, more numbers are undergoing the surgery daily.

Male circumcision refers to the removal of the foreskin from the penis. The foreskin covers the penis, which is soft and susceptible to diseases because it can easily get cracks. The opening at the foreskin is the entry of any fluids contracted from sexual intercourse. Once the foreskin is removed, the penis becomes hardened with time with the help of Keratin hormone. This reduces the chances of contracting any infections.

However once left uncircumcised, the foreskin can accumulate bacteria and viruses, and one is at risk of getting urinary tract infections.

This is done to decrease Human Immune Virus (HIV) by 60%, improve hygiene, reduce chances of prostate cancer especially amongst men above 14 years, reduce the chances of spreading Sexual Transmitted Infections (STI) and also reduce chances of women contracting cervical cancer.

The triage – refers to a preliminary test operated on a person before surgical circumcision. It involves assessing blood pressure, measuring weight and temperature. This helps the doctor to know the state of the body.

The Safe Male Circumcision (SMC) Surgeon, Abraham Twinomujuni, at Makerere University Hospital’s SMC Clinic, confirms that a patient undergoes HIV counseling and testing, and STI screening to facilitate the surgical process.

“STIs delay the healing of the wound since they bring pus. Not everyone undergoes surgery immediately however medication is prescribed or the STIs are treated first,” said Mr. Twinomujuni. STIs cause wounds on the penis. The wounds provide a comfortable environment to the HIV to get in contact with body fluids.

Makerere Joint Aids Program (MJAP) under President’s Emergency Plan for Aids Relief (PEPFAR) funds safe male circumcision projects at Makerere University Hospital, and facilities in Mbarara and Mulago.

The Public Relations Officer, Moses Karugaba said, “The project started in 2010 with a funding of $60 million to cover male circumcision for a period of 5years. The funding covers logistics, equipments to be used, payment of staff, consumables and also supports the facility if it’s in Hospitals.”

Mr. Karugaba adds that an average of 5 surgeons is employed at each facility. They operate with mobile clinics “tents are put up in areas for people to access the services” and static clinics that locally operate or in hospitals. A number of 44,700 males have undergone circumcision in facilities under the MJAP project since 2010.

According to the USA Ambassador to Uganda, Scott DeLisi‘s speech at the Hospital last year, the U.S government through PEPFAR has supported male circumcision as an HIV prevention intervention for an estimated 2million in Sub Saharan Africa. In Uganda, PEPFAR has supported more than 450,000 circumcisions since April 2010 for all the USA projects in Uganda including MJAP. The investment in safe male circumcision in Uganda has increased exponentially over the last four years from $1.6million in 2009 to over $31million in 2012. The percentage of circumcised men in Uganda is 23.6% according to the HIV –Aids statistics in Uganda. With increased sensitization about SMC programs by government and civil society, free services have been offered in government health facilities.

Amidst Uganda’s high prevalence rate of HIV infections, the President Kaguta Museveni advised youth to make good choices hence reducing risks and chances of contracting HIV on the World’s Aids day. An estimated 1.4 million people in Uganda living with HIV.

A report from the United States Agency for International Development (USAID) in Uganda shows that circumcised men have higher odds of having 4 or more life time partners, having first sex before reaching the age 18,engaging in higher risk sex and non- condom use compared to uncircumcised men. Circumcision is often misunderstood among circumcised men as a vaccine of HIV, hence gives more leeway to unprotected sex and having many sexual partners.

The former U.S. Secretary of State Hillary Clinton said in her remarks at the International AIDs Conference last year, “If we are going to beat Aids, we cannot afford to avoid sensitive conversations and fail to reach the people who are at the highest risk.

Challenges

According to Mr. Twinomujuni, Uganda has lagged behind other countries in the effort to scale up the number of male circumcision due to cultural conservativeness, traditional methods that were painful, delayed wound healing (one’s usage of herbs), lack of trained health workers and limited funds or support, religion (associated with Muslim).

Effort to scale up the numbers

The Communications Coordinator at Reproductive Health Uganda, Mr. Simon Richard Mugenyi says routine outreaches in communities and camps like Comprehensive Sexual Reproductive health are held to educate publics about the benefits of male circumcision and other related health concerns like HIV testing and cervical cancer screening.

The camps offer services for 5 days and medical personnel are availed to provide surgical circumcision. Also static clinics are encouraged to embrace and offer safe male circumcision services.

According to Mr. Karugaba, male circumcision is combination prevention for HIV/AIDS. An age bracket targeted between 15-45 years is perceived as the most sexually active. This helps to mitigate contractions of HIV/AIDS. MJAP has also sensitized the public on male circumcision via the media; radio spot messages and talk shows and television features. Other initiatives like the community outreach programs, and usage of mobile and static clinics.