To more recent news
(More recent items first)
Intactivism in Pride parades
Messages include: "His Body, His Penis, His Choice" "Circumcision: a Dead End" "Circumcision: Where Sex and Violence Meet" "An Intact Genital Organ is Every Child's Right" "Condoms Prevent HIV, Circumcision Does Not" "Circumcision is Unnecessary" "Genital Integrity For All"
And if they didn't do it, they wouldn't die...
Another initiate dies
A 16-year-old boy died on Saturday after being circumcised in Mthatha, bringing the initiation death toll to ten in the past week, Eastern Cape department of health said.
"The boy died after he was initiated at a school in the village of Gxulu, on the outskirts of Mthatha," said spokesperson Sizwe Kupela.
He said the boy died while on the way to hospital, during the early hours of Saturday morning.
"When police went to the school to investigate, they found that it had been deserted...the community told police that all initiates at the school were sent home, and that the person who was responsible for the circumcisions had disappeared."
The nine others had died in various parts of the Eastern Cape since Monday.
Police were searching for the man and investigating the increasing number of deaths, Kupela said.
Initiation death toll at nine
AUTHORITIES ramped up their raids on initiation schools in Mthatha and Libode yesterday following the death of nine boys in the province since the start of the season two weeks ago.
Yesterday, six schools were raided in Mthatha by health officials and police, who rescued six initiates in the process, including an HIV-positive boy.
Three others suffering from septic wounds escaped from Qokolweni as they were about to be taken by officials to Mthatha General Hospital. Two others who tried to run away were caught by police about 5km from their initiation school.
“The initiate from Ncise asked to be taken to hospital after he had disclosed his HIV status, while we had to forcefully take others to hospital because they did not want to go,” provincial Health Department spokesperson Sizwe Kupelo said.
Kupelo said the traditional surgeons who ran the schools that were raided were registered with the department, and no underage initiates were found.
In Qokolweni, much to the dismay of police and health officials, 30 initiates were crammed into a small shack, 20 others were jammed into a small mud room, while 16 others were packed into a small bedroom.
Each of these groups had only one nurse. The l aw requires that a nurse look after no more than six initiates.
In Libode, authorities raided four initiation schools, where they found some initiates unattended.
Two of the initiates had to be taken to hospital because they were dehydrated and their circumcision wounds had turned septic.
On Tuesday , a 25-year-old traditional surgeon from Highbury in Mthatha was arrested for allegedly circumcising 16 underage boys at Moyeni in Libode, bringing to five the number of traditional surgeons arrested in the province.
Of those arrested, three were from Ngqeleni and one was from Libode.
Police spokesperson Captain Zamukulungisa Jozana said some of the surgeons were charged with unlawful circumcision.
Jozana said they were still searching for two other surgeons who circumcised 11 underage boys, including two youths who were already circumcised last year at Mkhankatho in Libode.
Between March and April , four initiates died at initiation schools in Flagstaff and Libode and dozens of others were rescued in Flagstaff, Mb izana, Lusikisiki, Libode and Tsolo . Twenty-four died last summer. [When one girl died in Egypt, there were demonstrations in the streets.]
To raise awareness of problems around initiation, authorities took to the airwaves on Wednesday.
“The Pondoland area is the most problematic area in the province. One of the contributing factors to the problem is that boys undergo the rite without parental consent, or even their knowledge,” said Kupelo.
Provincial chairperson of the Congress for Traditional Leaders of South Africa, Nkosi Mwelo Nonkonyana, agreed that circumcision in the Pondoland area was a big problem.
“This ritual was not practised in Pondoland for many years. Now bogus surgeons are taking advantage of the situation,” he said.
Nonkonyana said one of the things that would help curb the problem would be for government to let traditional leaders take control.
- By MALUNGELO BOOI
But when it's an adult ...
Forced circumcision is unconstitutional
ON Wednesday a group of youth in Kampala grabbed an old man, unzipped his trousers to confirm he was not circumcised, shoved him into a car and drove him to a suburb for forced circumcision. Their argument was that the man, being an ethnic Mugisu, was under obligation to undergo circumcision. This is absurd.
Whereas the Constitution provides for citizens' rights to practise their culture, this must not be forced on anyone. It is the same constitution which guarantees individual citizens' rights to liberty and privacy. The youth not only invaded the old man's privacy, but also subjected him to unnecessary physical pain and psychological torture, let alone exposing him to undue risks of wound contamination. Sadly, this happens to many men every circumcision year. In some cases such militant youth 'arrest' an uncircumcised man and circumcise him on site. Such acts only reinforce and justify other harmful cultural practices such as female genital mutilation.
There are many other traditional practices such as kneeling [as a mark of respect], and widow inheritance that are generally accepted among certain communities. However, human beings should not be turned into prisoners of culture. Cultures should not infringe on people's dignity or welfare. Inhuman and degrading treatment should not be allowed.
More importantly, people should be allowed to decide whether they take up a cultural practice.
[Hear, hear! and people of any age or sex.]
U G Pulse (Kampala)
MPs condemn circumcision incident
Members of Parliament on the Forum for Food Security, Population and Development have criticized the manner in which an elderly man in Kampala was forced into circumcision.
Addressing journalists at Parliament today, Bundibugyo MP, Alisemera Babiiha says that it is against the law to force any one into circumcision.
Babiiha says that such acts are dehumanizing and detrimental to one’s dignity and self confidence.
She says that forceful circumcision is outdated practice since hospitals provide better and healthier methods. [That is hardly the point...]
Earlier, the Minister of Gender, Labor and Social Development, had criticized the action, calling it an infringement of the human rights of someone.
Kongasis MP, Toskin Bartille called upon government to come up with stringent laws to punish those who force others to get circumcised.
New Vision (Kampala)
Uganda: Forced Circumcision Illegal, Says Social Affairs Minister
She advised people who are forced into the practice to seek legal redress.
"The Government will not tolerate this practice. We support progressive and not retrogressive culture. We have no problem with circumcision but people should not be forced to do so," she said yesterday.
Bbumba was responding to a Wednesday incident in which Stephen Mujoroto, an elderly UPC veteran from Mbale, was "arrested" by five youth for allegedly dodging imbalu, a Gishu cultural circumcision rite.
Mujoroto, the former Nsangi sub-county chief in the Obote Two regime, was seized at the Canaan Restaurant on Uganda House in Kampala.
Bbumba warned that such practices would culminate into chaos.
"I do not think that what they (the Bagisu youth) did was proper.
"If they cannot do it in a peaceful manner, they should not force anybody into a cultural practice that makes a person uncomfortable. If he (Mujoroto) is aware of his rights, he can sue them."
The social affairs minister noted that with health issues at stake, there was need for consent before circumcising someone.
The minister said the Government would meet cultural leaders over the custom.
Aliro Omara of the Uganda Human Rights Commission explained that it was illegal for individuals to be forced into circumcision, saying it was a violation of human rights.
"There is no cultural practice that should break the law or violate human rights.
"Although circumcision is good, it should be voluntary. I know the Bagisu will argue that it is their culture but customs must respect human rights and the law," Commissioner Omara explained yesterday.
Why did it take 12 years?
Parents convicted of genital mutilation
Two Somali-born parents who had their daughter circumcised in Zurich in 1996 have been handed suspended prison sentences of two years.
The sentences to the parents of the girl, now aged 14, were read out in a Zurich court on Thursday. The judge's ruling was in line with what prosecutors had requested and was the first time anyone has been convicted for carrying out genital mutilation in Switzerland.
The parents had claimed they were unaware that female genital mutilation – sometimes referred to as female circumcision – was illegal in Switzerland.
They had been charged with grievous bodily harm, a crime punishable by up to ten years in prison.
The court heard that imprisoning the parents would have broken up the family, which the parents say is now better integrated.
The family's two younger daughters have not been subjected to the practice, something the parents say was part of their Muslim religion.
Earlier in June, a court handed down a six-month suspended prison sentence to a 50-year-old woman who had sent her 13-year-old half-sister to Somalia to be circumcised.
There are around 7,000 girls or women, mainly from Somalia, Ethiopia and Eritrea, living in Switzerland who have been or are at risk of being submitted to genital mutilation.
A breath of fresh air from the UK
The Guardian (Manchester)
There are few convincing arguments in favour of circumcision. Why is it still so common?
While respecting the right of Jeremy Kuper and Inayat Bunglawala to write of their support for infant circumcision, I'd like to introduce a few of the basic facts on which a cost benefit analysis of the practice ought to be founded.
Specifically, let's talk about the foreskin itself. Its function is – bizarrely – one thing you'll find absent in most of the discussion articles written about circumcision.
The foreskin is present in all mammals, but in the human male is uniquely sensual, containing the part of the penis most sensitive to fine touch. Often presented as a "tiny" vestigial flap of skin, most particularly by women and by men who haven't got one, a male foreskin measures around 10-15 square inches when unfolded, some 50% of his overall penile skin system. With a beautiful rolling mechanism it facilitates erection, often leaving spare, ruched skin to create pleasurable friction for a partner. Can it be a coincidence that the ridges of her G-spot interact directly with the most sensitive dorsal region of his foreskin?
There's much more to this part than pleasure though. Evolution has endowed it with multiple advantages including immunological agents, pheromones and oestrogen receptors. In its embrace the glans is maintained as an internal body part, shiny and delicate. In the infant it's especially important: fused with the glans and acting as a one-way valve, it protects him from the effects of ammoniac waste in the nappy. The cut baby by contrast commonly experiences ulceration of the tip of his glans. Although we hardly ever hear of this, it is clearly painful and it can lead to the narrowing of the urinary opening (which requires surgical correction).
Excluding adverse effects in the post-hospital period, such as infection, ulceration, stenosis, skin bridges, urinary infection and pain, Christakis (as quoted by Kuper) claimed only 0.2% of infant circumcisions caused complications. Williams and Kapila, taking a more comprehensive approach, reported 2% to 10%. It's revealing that many of the circumcision-related infant deaths of the past 20 years would not have appeared in Christakis' results, had they occurred within his data sample.
In 2007 a study from Saudi Arabia found complications resulting from neonatal circumcision so common that the authors concluded it should not be recommended. Thus when the Scottish NHS introduced a "pathway" for forced religious circumcision this year, they recommended he be six to nine months; old enough to reduce his operative complications (a bit), but not for him to be able to say no, or to call a lawyer to say no for him.
Many claim that it is difficult to find circumcised men who admit sexual harm. Not so. Fink found 38%, Coursey 27%, Masood 18%, Kim and Pang 20% and Solinis 35%. Considering that most of these surgeries addressed a chronic medical condition, it seems reasonable to think that the results are on the low side, compared with the effects of cutting a healthy penis.
Senkul's study of satisfaction after adult circumcision showed positive results, but was delivered in the context of an almost universally circumcised society – with almost all the subjects citing religious reasons for their choice. We know religious and cultural loyalty can be a powerful panacea – it's demonstrated by the women who defendfemale genital mutilation. Likewise money, which should affect the way we view the African mass circumcision experiments, in which subjects were paid. Reviewing the trials in 2007, UNAids suggested the possibility that an observation-driven change in behaviour influenced the results.
Most now accept that excising the foreskin leaving a more keratinised penis can reduce the absolute risk of female to male HIV infection by around 1.3% over 21-24 months. The population effect remains uncertain however, with HIV rates among the circumcised and uncircumcised comparable on the ground in sub-Saharan Africa.
There is no convincing proof that circumcision reduces sexually transmitted infections in developed nations, and its effect on penile cancer rates is similar to that of soap. The question remains: have we the right to amputate the most sensitive part of a child's genitals based on a presumption about future behaviour?
What is wrong with these people?
New Vision Online (Uganda)
Bagisu youth grab UPC man for circumcision
Bagisu youth check Mujoroto’s private parts to confirm whether he is circumcised before lifting him into a car
By Ronnie Kijjambu
Traffic on Nasser and Nkrumah roads came to a stand-still when an elderly UPC veteran from Mbale, Stephen Mujoroto, was “arrested” by five youth for allegedly dodging imbalu (the Bagisu cultural circumcision rite).
Mujoroto, who is a staunch UPC supporter and former Nsangi sub-county chief in the Obote Two regime, was seized at the Canaan Restaurant on Uganda House at about 11:00am.
Well-built youth, one of them believed to be Mujoroto’s son, held him by the trousers when they identified him chatting away with colleagues.
Sensing danger, the group fled, thinking the Kampala City law enforcers were arresting criminals.
But after the youth explained their mission, Mujoroto’s colleagues allowed them to take him to sort out the “tribal affair”.
Mujoroto’s pretence to be weak and unable to walk did not save him. The youth lifted him into a special hire taxi and took him to Nsambya to face the circumcision knife.
His friends at the scene later said the group had been hunting for Mujoroto the previous day, but on a tip-off, he hid for the whole day.
A youth said to be his son argued that problems had afflicted their family, which he blamed on their father’s refusal to be circumcised.
He said they had sent several emissaries, including his elder sisters, to persuade him to circumcise to no avail.
The helpless Mujoroto opted to dodge photographers. Most of his friends had known him to be a Muganda. After his arrest, a crowd that gathered blamed Mujoroto for having sex for such a long time without being circumcised.
What is wrong with these people?
The Sowetan (South Africa)
Abducted for circumcision
A Limpopo man has been abducted for the second time to undergo circumcision with his son after a school principal suspected he was not initiated.
The 26-year old man from Metz in Sekororo near Tzaneen had gone to the Koma school to register his son but the school principal allegedly told him that he too must be registered.
According to the man’s sister, who asked to speak on condition of anonymity, he was forced to undress and show the principal his private parts. [Could that have been the point of the exercise?] But the principal insisted he needed a letter and a photo of his graduation to prove that he was indeed circumcised.
“We had no picture of his graduation to prove to the principal. We only had a letter from his previous school, but still it was not enough for him,” she said.
“He said he needed the graduation photo or my brother would be forced to stay in the school until graduation. The principal said he suspected my brother had undergone circumcision in hospital.”
And quite unnecessary....
Hamburg Morning Post
Doctor in court because of circumcision
by THOMAS HIRSCHBIEGEL
Little Murat (name changed) was screaming in pain and thrashing about, but the 35-year-old surgeon went ahead with his circumcision. Now the doctor has to answer to the St. Georg District Court, because he's believed to have used insufficient anaesthesia for the procedure on the 8-year old boy.
"Medical precautions and aftercare go without saying in our center, just as smooth and medically perfect care for our young patients. Your son will be prepared professionally for surgery." That's how the Circumcision Centre at Steindamm, St Georg, advertises for its work on its website [not in English].
But trouble began even before the operation was performed on the Turkish schoolboy. The doctor wanted to use a new, bloodless method for circumcision with the name "Smartklamp", but the parents wanted a conventional procedure. Even though the parents demanded the operation be called off, the surgeon is reported to have carried on.
The public prosecutor charges the man for having continued even when the 8-year-old screamed because the anaesthesia apparently hadn't taken effect. The doctor now has to answer to the court for bodily harm.
Arzt wg. Beschneidung vor Gericht
THOMAS HIRSCHBIEGEL, WS
Der kleine Murat (Name geändert) schrie wie am Spieß, schlug um sich, doch der 35-jährige Arzt führte die Beschneidung durch. Nun muss sich der Mediziner vor dem Amtsgericht St. Georg verantworten, weil er bei dem Eingriff an dem Achtjährigen eine zu geringe Dosis Betäubungsmittel verwendet haben soll.
"Ärztliche Vor- und Nachsorge sind für uns ebenso selbstverständlich wie eine ruhige und medizinisch einwandfreie Versorgung unserer jungen Patienten. Ihr Sohn wird professionell auf den Eingriff vorbereitet." So wirbt das Beschneidungszentrum am Steindamm auf seiner Website für seine Leistungen.
Doch schon vor dem Eingriff an dem türkischen Schüler gab es Ärger. Der Arzt wollte eine neue, unblutige Methode der Beschneidung mit dem Namen "Smartklamp" durchführen, doch die Eltern wollten offenbar einen konventionellen Eingriff. Obwohl die Eltern den Abbruch der Operation verlangten, soll der Arzt weitergemacht haben.
Auch als der Achtjährige schrie, weil offenbar die Betäubung nicht richtig wirkte, machte der Mann, so die Anklage der Staatsanwaltschaft, einfach weiter. Nun muss sich der Mediziner am Mittwoch wegen Körperverletzung vor Gericht verantworten.
Ressort: HH Hamburg
The juggernaut rolls ...
'Cut' to boost war on Aids
Story by JOHN NGIRACHU
The campaign is spearheaded by the National Aids Control Council. Mr Peter Mutie, the council’s head of communications, said on Wednesday that a policy and an implementation plan have been finalised.
Studies have shown that the foreskin’s inner surface is a suitable breeding ground for the deadly virus and its removal can significantly reduce one’s chances of being infected. Mr Mutie said the council would embark on a countrywide campaign to sensitise Kenyans on the importance of circumcision in the fight against Aids. “Experts recommend complete removal of the foreskin and since most communities circumcise differently, all will need to be educated on the recommended method,” he said.
Traditional circumcisers will have to abandon the outdated practice of using one knife to operate on many initiates. [That, at any rate, may have an impact on transmission.] Doctors will also use the programme to educate initiates on HIV and Aids, with emphasis on the fact that circumcision does not provide immunity against infection, Mr Mutie said at the start of a three-day national conference on Aids.
Girl 'circumcises' boy, 5, at school
A five-year-old Limpopo pupil has been subjected to a botched circumcision by a five-year-old girl pupil in an incident that has set tongues wagging in Giyani.
The shocking incident happened during a school lesson at the Jim Nghalalume Primary School.
It is alleged that Martin Hlungwani, 5, a grade R pupil from Nghalalume village was circumcised by the 5-year-old girl on Thursday.
His guardian, Maria Makhubele, said the boy was well when he left for school. But things when he came back from school he was crying.
“Late in the evening, when I took him for a bath, I discovered that his penis was swollen and bleeding,” Makhubele said.
“I called my neighbours to show them what had happened to the boy, before calling an ambulance.
“I spent the whole night in the Nkhesani Hospital, where the doctor removed the hanging foreskin.”
She said she did not know exactly what type of an instrument had been used but was unhappy that the incident had happened during school hours.
“Other children who heard about the incident told us that Martin had screamed when the girl performed the circumcision on him.
One of the teachers allegedly ignored the information when other children alerted her tot the incident.
The teacher responded by saying, “Martin is a naughty boy”, Makhubele said.
The boy was admitted to hospital and discharged later the same day. He is in a stable condition.
Department of Education spokesman Dou Magala said they would investigate the matter.
Sowetan learnt on Friday that the school had arranged a meeting at one another and decided not take the matter any further. The matter was not reported to the police.
Vos iz Neias
Côte St. Luc, Canada - Rabbi Speeding to [unfortunate consequences of ] Bris Milah Beats Ticket
Côte St. Luc, Canada - Quebec’s Jewish chaplain for prisons got a speeding ticket quashed after convincing a judge he’d been rushing to a medical emergency: a baby boy who was bleeding from a ritual circumcision.
“It wasn’t like I was going 120 kilometres an hour - I was going a reasonable speed,” Jacob Lévy told Judge Alain St-Pierre in Outremont municipal court, where he contested the ticket.
After listening to the rabbi’s story, the judge said Lévy had proven the “necessity” of why he’d been speeding, and threw out the charge.
Lévy, who used to be grand rabbi of Geneva and also lived in France, leads the Sephardic congregation at Beth Rambam synagogue in Côte St. Luc. Trained in Jerusalem as a mohel, the Hebrew word for circumciser, Lévy has been practicing the ritual procedure for 30 years.
His first Bris was his own son, he told St-Pierre at the Van Horne Ave. courtroom, where he’d brought along his surgical kit as proof of his trade.
Lévy testified he’d received an emergency call from a distraught mother in Côte St. Luc whose 8-day-old boy had been recently circumcised. The bandage had come off and the boy was bleeding into his diaper.
The judge asked Levy why the mother hadn't called 911.
"Doctors don't like to treat circumcision cases because the practice is so rare nowadays here -- they prefer to leave it to specialists like me," Levy said.
The judge said he understood the "necessity" of Levy's haste and dismissed the ticket, the newspaper said.
There was no indication of who ultimately treated the infant.
[This could have been a serious medical emergency. A baby's body only holds about 350 ml of blood (less than 12 US fluid ounces), and he can lose only about a couple of tablespoons before he needs a transfusion. Modern disposable diapers can easily conceal this much. If the baby had gone into shock by the time the rabbi got there, what could he have done that the parents could not have done much earlier?
The question arises, why wasn't he charged with practising medicine without a licence?]
The question arises, why wasn't he charged with practising medicine without a licence?]
Court rules in case of genital cutting
In a landmark ruling, a court in Switzerland has handed down a six-month suspended prison sentence for genital mutilation.
The defendant was accused of allowing the circumcision of her 13-year-old half-sister in Somalia.
The judge found that the 50-year-old woman, who came to Switzerland in 1993 as a refugee, failed in her duty to look after the girl by sending her back to Somalia despite knowing that she was likely to be circumcised there.
Another case, involving a case of genital cutting carried out in Switzerland, is pending.
There are around 7,000 girls or women – mainly from Somalia, Ethiopia and Eritrea living in Switzerland who are circumcised or at risk of being submitted to the practice.
Moves are underway in parliament to impose an outright ban on female circumcision.
New device to make circumcision smooth and bleeding less
New Delhi (PTI): In what can aid the fight against HIV/AIDS, an Indian andrologist has developed a design for a device to carry out circumcision in men, known to prevent the spread of the virus, at a mass scale.
The device, which will make the process smooth with no bleeding involved, has been developed by Dr Sudhakar Krishnamurti, Andrologist, Andromeda Centre, Hyderabad, as part of a project of the International Society of Sexual Medicine (ISSM).
The ISSM launched the project after it was approached by the World Health Organisation (WHO) and other international agencies to help develop a technique for carrying out circumcision, especially in sub-Saharan African countries.
"Even paramedics can do mass circumcision with the new device. And once done, there will be no bleeding," said Krishnamurti.
The new device is designed to consist of light-weight metal or high-grade polymer in the form of two concentric cylinders which carry at their respective ends two consecutive rings for placement on the inner and outer layers of the foreskin respectively, Krishnamurti explained.
"Thermal, laser or electrical energy will then be applied to these two layers through the respective concentric rings [Sounds as though development is in a very early stage: deliverly of those three very different kinds of energy would have to be done in very different ways] in order to seal blood vessels and to cut neatly the two layers of the skin," he said. [But the necessary incision is not a circle - the frenulum gets in the way.]
The device is then removed along with the circumcised skin. [Is the device intended to be disposable? And if so, does it self-destruct on use? If not, it will be reused, with uncertain degrees of sterilization.]
The technique has been accepted by the world bodies and could be implemented in sub-Saharan countries, where HIV/AIDS has taken epidemic proportions.
Circumcision helps protect against HIV infection substantially, as it removes cells under the foreskin, that are vulnerable to the virus.
When the foreskin is removed, the skin on the head of the penis becomes less sensitive and therefore less likely to bleed, thereby reducing the risk of infection. [This is confusion - nobody has suggested that bleeding from the glans is a factor in HIV transmission.]
Circumcision is practised in certain communities wherein it is performed amongst children as a religious belief.
"In adults, it is performed by qualified surgeons, which involves a long hospital stay and bloody procedure," said Krishnamurti.
Bogus? Bogus? Circumcision is bogus!
Daily Despatch Online (South Africa)
Dead initiate's surgeon sought
By MALUNGELO BOOI
Police spokesperson, Inspector Phumzile Njombela, said Lwandiso Msitho of Caguba village died at the initiation school on Tuesday.
He said Msitho had been circumcised by a traditional surgeon at Lusikisiki without his parents’ consent and that they were hunting down the bogus surgeon who circumcised the underage boy without following proper procedures. ["Bogus"? In what sense are any of them not bogus?]
Njombela said boys over the age of 16, but younger than 18 must have their parents’ permission before they can take part in such a ritual.
“We are also searching for his nurses to see whether they too cannot be charged as they did not report this (the boy being underage) to authorities,” said Njombela.
He said postmortem results had not yet been released, but Msitho’s body was covered with fresh beating marks at the time of his death.
Attempts to speak to the Msitho’s parents were unsuccessful, but Njombela said the parents claimed they had never consented . On Thursday morning, a 16-year- old initiate from Slovo Park died, while another 17-year-old died at Highbury in Mthatha. In both cases inquest dockets have been opened. No arrests have been made.
Doctor bungled circumcision then lied about it
By Hannah Crown An independent medical watchdog ruled last Friday that Dr Anthonipillai
Nicholas-Pillai, a GP at the Bush Hill Park Medical Centre, Amberley
Road, not only left the baby boy with "two tone" genitals but then tried to
cover up his blunder.
He will be suspended for six months by the investigating Fitness to
Practise Panel, but will not lose his license and the panel judged it was not
necessary to suspend him immediately because he does not pose a threat
to the public.
The 22-week-old Somali boy had too little inner skin removed from his
penis. After the operation, the suture lines contracted over the tip of the
penis leaving only a pinhole, and three months after the operation in April
2001, another operation was performed by a different surgeon. Experts were
divided on whether too much external skin was removed, as well as whether the
operation made him look "cosmetically abnormal".
These actions were condemned by the panel as falling "below the standard
to be expected of a reasonably competent medical practitioner" and being
"clearly not in (the boy's) best interests."
After the event, Dr Nicholas-Pillai acted in a "dishonest" way and was
intentionally misleading to the child's parents.
He refused to hand over the notes when they complained about the
operation, only sending them on six months later to their lawyer. Then it was found
that he had wrongly recorded the date of the operation, as well as the
medication given to the little boy prior to the operation.
Panel chairman Dr Roger Ferguson said that the panel gave "little weight
to the credibility of your evidence. Overall, the panel was satisfied that
besides the date of the consultation, there were a number of inaccuracies
in the notes and that they were not prepared contemporaneously or as soon
as possible after the matters to which they related."
Mr Nicholas-Pillai now has 28 days to decide whether he will appeal the
An independent medical watchdog ruled last Friday that Dr Anthonipillai Nicholas-Pillai, a GP at the Bush Hill Park Medical Centre, Amberley Road, not only left the baby boy with "two tone" genitals but then tried to cover up his blunder.
He will be suspended for six months by the investigating Fitness to Practise Panel, but will not lose his license and the panel judged it was not necessary to suspend him immediately because he does not pose a threat to the public.
The 22-week-old Somali boy had too little inner skin removed from his penis. After the operation, the suture lines contracted over the tip of the penis leaving only a pinhole, and three months after the operation in April 2001, another operation was performed by a different surgeon. Experts were divided on whether too much external skin was removed, as well as whether the operation made him look "cosmetically abnormal".
These actions were condemned by the panel as falling "below the standard to be expected of a reasonably competent medical practitioner" and being "clearly not in (the boy's) best interests."
After the event, Dr Nicholas-Pillai acted in a "dishonest" way and was intentionally misleading to the child's parents.
He refused to hand over the notes when they complained about the operation, only sending them on six months later to their lawyer. Then it was found that he had wrongly recorded the date of the operation, as well as the medication given to the little boy prior to the operation.
Panel chairman Dr Roger Ferguson said that the panel gave "little weight to the credibility of your evidence. Overall, the panel was satisfied that besides the date of the consultation, there were a number of inaccuracies in the notes and that they were not prepared contemporaneously or as soon as possible after the matters to which they related."
Mr Nicholas-Pillai now has 28 days to decide whether he will appeal the ruling.
The dog that didn't bark in the night - intact men are not at greater risk
Medical News Today
Genital Herpes More Common Among New Yorkers
A new study found that more than one in four adults in the city of New York (compared with fewer than one in five nationally) is infected with the Herpes Simplex Virus-2 that causes genital herpes, a lifelong sexually transmitted disease that helps to spread HIV and can result in painful genital sores, although most people don't notice any symptoms.
The study was carried out by lead author Dr Julia Schillinger, Director of Surveillance for the City's Health Department's Bureau of STD Prevention and Control, and is published this month in the journal Sexually Transmitted Diseases.
To carry out the study Schilling and colleagues used data from the City's 2004 Health and Nutrition Examination Survey (NYC HANES, modelled on the national version). This surveyed a representative sample of New York City adults aged 20 and over by conducting door to door interviews and personal medical exams to bring together a range of measures covering diabetes to depression, to assess the health of people living in New York. Of the 1,999 participants, 1,784 were tested for HSV-2.
The researchers found that genital herpes is more common among adults in New York City than it is among American adults overall: the infection rates were 26 per cent and 19 per cent respectively. More women appear to be infected than men (36 versus 19 per cent), more blacks than whites (49 versus 14 per cent), and more men who have sex with men are infected compared with those who do not (32 versus 18 per cent).
Also they found that over 80 per cent of infected adults were undiagnosed. And among HSV-2 infected individuals, non-Hispanic blacks (as opposed to non-Hispanic whites), uncircumcised men, and those with no routine place of care were less likely to be diagnosed.
[But by their omission from the list above, we can conclude that intact men are no more likely to be infected.]
"Seroprevalence of Herpes Simplex Virus Type 2 and Characteristics Associated With Undiagnosed Infection: New York City, 2004." Schillinger, Julia A; McKinney, Christy M; Garg, Renu; Gwynn, R Charon; White, Kellee; Lee, Francis; Blank, Susan; Thorpe, Lorna; and Frieden, Thomas. Sexually Transmitted Diseases, 35(6):599-606, June 2008.
Doctor 'botched baby's circumcision'
An Enfield doctor botched a circumcision on a Muslim baby, leaving him with "abnormal" looking genitals, a hearing has been told. The procedure left the five-and-a-half month old infant with a "two-tone" coloured penis, the General Medical Council heard.
Dr Anthonipillai Nicholas-Pillai denied unprofessional conduct when he appeared before the GMC in central London.
The child's Muslim parents, who are of Somalian origin, took the baby and his brother, then six, to Bush Hill Park Medical Centre in April 2001 to have the operation conducted for religious reasons.
The panel heard how the baby's mother discovered abnormalities when bathing her child the morning after the circumcision.
The child's father told the Fitness to Practise hearing: "The bandage really fell off when she put him in the water and she saw that it was a very abnormal penis. It was kind of reddish. [It's wounded, and a wound is red, raw and bleeding...] There was still a bit of green [... but green, that sounds disturbing.] but no glans." [Was the glans amputated? It isn't mentioned again, so probably not.]
The couple returned to the surgery to see Dr Nicholas-Pillai the next day.
After examining the baby, the doctor reassured the child's parents that everything was satisfactory and prescribed a cream for them to use on the child. However, the parents were dissatisfied and made several trips to their local GP and the Accident and Emergency Department of Chase Farm Hospital, Enfield between the months of April and July. A revision procedure took place on July 25, 2001. [If the boy had lost his glans, a revision wouldn't help.]
Baby A's father said his son's penis is still two-tone in colour. "Physically it won't affect him but the colour is not there. We are not sure how it will affect him psychologically." [What single colour did he expect? Of course there are two colors if normal skin and newly exposed mucosa are next to each other. Did they expect the baby's circumcision to look like his father's - after years of exposal and keratinisation - right away?]
The Bangalore-trained doctor denies charges of acting unprofessionally and below the standard of a reasonably competent medical practitioner.
[What happened and how it looks now may be simply what they signed their son up for when they gave their consent for circumcision. Perhaps parents who want circumcision should be required to look at pictures of circumcisions - fresh, after a week, after a few months etc. - as part of the "informed consent" process, as well as seeing the operation itself.]
Egypt's child law is greeted with stiff opposition
By Ramadan Al Sherbini, Correspondent
Cairo: Mustafa, a father of three girls, is proud of having his children circumcised, and vows to do the same if he gets a new baby girl.
Under a new law passed by the Egyptian Parliament this week, female circumcision, also known as female genital mutilation (FGM) is criminalised.
"This is nonsense," said Mustafa, a native of the south Egyptian city of Sohag who has been living in Cairo for around 20 years. "Circumcision for girls is a must as it protects their chastity," added the 48-year-old Muslim father. "Islam also encourages circumcision for girls as well."
Egypt's Mufti Ali Juma, the country's top Muslim cleric, has, however, branded the centuries-old tradition as sinful and un-Islamic. Egypt has intensified its fight against female circumcision after the death of two local girls last year due to complications from FGM procedure.
The practice is believed to be widely spread in Egypt's countryside in particular. "The amendments to the old child laws reflect strange values and foreign cultures," said Mohammad Mokhtar Al Mahdi, a member of the Islamic Research Centre, an influential arm of Al Azhar, considered the Sunni Muslim world's leading institution.
"The new law is alien to our traditions, the aim being to destroy the Islamic society's values on the pretext of promoting the concepts of freedom and human rights," he told Gulf News. "It must have been adopted under foreign pressure."
"There has been no US pressure in Egypt in this regard," said Naela Jabr, the Egyptian Assistant Foreign Minister. "There are international conventions by which all countries are guided."
The official asserted that the new law does not contradict the Sharia [Islamic Law], "which has taken the lead in safeguarding rights of children and women."
Under the new law, mothers of children born out of wedlock are given the right to get them a birth certificate, which is necessary in Egypt to have access to healthcare and schooling services.
This stipulation in particular has drawn fierce opposition from Islamists. "This will lead to the spread of vice in Egypt," said Islamist MP Mohammad Al Beltagui.
Child welfare groups, however, consider the new right a breakthrough. "The child cannot be blamed for what the parents did," said Somaya Sa'ad Al Din, an expert on child rights.
Local courts hear an estimated 12,000 suits annually filed by mothers of children born illegitimately or under non-official marriage contracts seeking legal recognition for them.
"Without a birth certificate, the child cannot attend the school, thus putting his future at stake," Sa'ad Eddin told Gulf News.
Did you know?
Those involved in the practice shall be punished by a jail term ranging from three months to two years or a fine of Egyptian pounds 1,000 [Dh687] to 5,000 [Dh3,436].
The new law, meanwhile, sets 18 as the minimum age for marriage in Egypt. "Previously, Egyptians were allowed to legally marry at the age of 16."
Step by step ...
Medical News Today
Newborn Circumcision: The Controversy Revisited
ORLANDO, FL (UroToday.com) - Dr. Byron Joyner moderated a point counter-point discussion on neonatal circumcision. Dr. Paul Austin discussed pros and Robert Van Howe the cons. The jury is still out, but the take home message was that circumcision is not without its complications and one of these complications is death. It appears to be a risky procedure with truly little medical indication in the newborn period.
Moderated by Byron Joyner, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.
Reported by UroToday.com Medical Editor Pasquale Casale, MD
Webcast of the debate (To support his argument, Dr Austin uses images of the US Flag, the Bill of Rights and the raising of the flag at Iwo Jima!)
Egypt MPs vote to outlaw female circumcision
CAIRO (AFP) — Egypt's parliament on Saturday outlawed female circumcision except in cases of "medical necessity," a condition which could undermine the ban, parliamentary sources said.
Female genital mutilation, which dates back to pharaonic times in Egypt, will now be punishable by a jail term of between three months and two years or a fine of 1,000-5,000 Egyptian pounds (190-940 dollars), they said.
The new legislation is part of a bill on children's rights which has been the subject of fierce parliamentary debate for several weeks.
Those who supported the practice argued it was appropriate when female genitals protruded too much, adding that it was needed to preserve the woman's virtue.
"Nothing in Islam forbids circumcision," said Saad al-Katatni, president of Egypt's main opposition group, the Muslim Brotherhood.
The health ministry tried in 1997 to ban the tradition, which affects both Muslim and Christian women in Egypt, and introduced curbs which allowed only doctors to carry out the operation and solely in "exceptional circumstances."
The restrictions were further strengthened in June 2007 when Health Minister Hatem al-Gabali issued a decree -- rather than law -- banning all doctors and members of the medical profession from performing the procedure.
The new law, which takes immediate effect, toughens penalties for anyone who is convicted of flouting the ban.
Circumcision involves the partial or complete removal of the woman's external genitals and has remained widespread in Egypt despite the efforts by political and religious authorities to stop the practice.
Female circumcision can cause death through haemorrhaging and later complications during childbirth. It also carries risks of infection, urinary tract problems and mental trauma.
Norway accuses Gambian couple of circumcising daughters
OSLO (AFP) - Norwegian police accused a Gambian couple on Friday of subjecting five daughters to genital mutilation in the country's first-ever case against the illegal act of female circumcision.
"The father and mother are accused under laws against genital mutilation because they are suspected of contributing to the circumcision of five of their six daughters," Hanne Kristin Rohde, a police official told NRK radio.
Only two of the six children who are aged between three and 14 live in Norway, although the others -- who live in West Africa's Gambia, with the man's two other wives -- have Norwegian passports. These include a three-year old who has not yet been circumcised.
Rohde made it clear that Norway's public child protection agency would be entrusted with caring for all the children.
Their father, a 41 year-old whose identity has not been disclosed, is expected to appear before a judge with authorities seeking his detention. Their mother, due to give birth to a seventh child, is said to be too weak to spend time behind bars.
Rohde said Norwegian laws against female genital mutilation carry a prison term of several years depending on the severity of the case.
It's like deja vu all over again.
In 2003, Prof. Roger Short claimed a breakthrough against HIV/AIDS - lemon juice in the vagina (below, right). Now it's oestrogen on the foreskin (left). In 2000 he published the experiment on which is based the claim that the Langerhans cells of the foreskin extert a peculiar attraction for HIV.
In the fairy tale, the boy cried "Wolf! Wolf!" too often. Prof. Short seems to cry "Huntsman! Huntsman!"
Female hormones key to HIV prevention
PM - Wednesday, 4 June , 2008 18:22:00
MARK COLVIN: Researchers in Melbourne believe they've found another weapon to fight HIV AIDS.
For more than 20 years, public health experts have battled against the disease armed with little more than a safe-sex message and some condoms.
But now they've discovered that applying the female hormone, oestrogen, to the penis can prevent a man from becoming infected with the virus.
And they say the essential ingredient is cheap and easy to produce.
Ashley Hall reports.
ASHLEY HALL: It's a discovery that could provide public health professionals with the magic bullet they need to curtail the break-neck speed of HIV transmission in developing countries.
The researchers say by simply rubbing an oestrogen cream into their foreskin, men could generate a barrier to stop the virus passing into their bodies from an infected sexual partner.
It stems from some earlier work which found that apart from unprotected anal sex, men are most likely to contract the disease when the virus passes through the very tender skin on the inside of the foreskin.
So they borrowed an idea from the treatment of post-menopausal women.
ROGER SHORT: After your ovaries have stopped making oestrogen, your vagina gets very thin and somewhat painful. And women get great benefit from thickening the vaginal (inaudible) with topically, locally applied oestrogen cream. We've known that for donkey's years.
ASHLEY HALL: Professor Roger Short of the University of Melbourne's Faculty of Medicine says that thickening of the tissue is a process known as keratinisation.
It happens when oestrogen comes into contact with receptor molecules on the vagina wall.
And since keratinisation is a complete barrier to the virus, Professor Short wanted to check if those oestrogen sensitive receptors were also on the penis.
ROGER SHORT: So my colleague, Doctor Andrew Pask and I applied some post-menopausal vaginal oestrogen cream to foreskins and did contact smears, which we examined under the microscope.
ASHLEY HALL: Dr Andrew Pask from the University's Department of Zoology says there's no noticeable change in skin texture.
ANDREW PASK: The foreskin itself may become more sort of flexible than it would have been beforehand. But you certainly wouldn't actually feel a physical change yourself, in the skin itself.
And yet you can actually test it by either taking a small section of the skin or by actually just looking at the amount of cells that are sloshed off the top of the skin. So in very highly keratinised skin, you get a lot of keratin actually being sloshed off the top of the skin.
ASHLEY HALL: But Professor Short says the AIDS virus won't pass through.
ROGER SHORT: You create what you could call really a natural condom. You create a biological membrane which the virus can't get through.
ASHLEY HALL: So this is 100 per cent effective?
ROGER SHORT: We don't know yet. Looking at it under the microscope, the layer of keratin is so thick it's very difficult to imagine that any virus could get through it.
ASHLEY HALL: Two years ago, Professor Short caused an upset when he called for the promotion of male circumcision as a way to reduce HIV infections in developing countries.
His research showed that the main point of HIV infection was not the head of a man's penis, but the inside of his foreskin.
But the World Health Organisation still recommends that circumcised men use a condom during sex because foreskin removal is only 55 to 60 per cent effective at preventing HIV infection.
ROGER SHORT: We have a suspicion that the reason may be that most circumcision techniques don't actually remove all the foreskin, all the inner foreskin. So there's still some there for the virus to enter.
And we could use this oestrogen cream, even in uncircumcised men, and we would hope that that might increase the protection from 60 per cent to up to nearer 100 per cent.
But that, of course, we've got to prove in a clinical trial and that still lies ahead of us.
ASHLEY HALL: The researchers say the treatment would be cheap and easy to make and distribute because the oestrogen is excreted in human urine, and any decent pharmacist could mix-up the cream.
They're even considering adding the hormone to the lubricant used on condoms. That way, the condom would protect the woman from infection and pregnancy, while the oestrogen would stop the virus passing to the man.
MARK COLVIN: Ashley Hall.
Professor Roger Short
We call ourselves the clever country, but so often we fail to acknowledge the truly clever people. The man you're about to meet may well hold in his hands the key to stopping the spread of AIDS. Please welcome from Melbourne University, Roger Short.
Andrew Denton: Is it Doctor or Professor?
Roger Short: Professor.
Andrew Denton: Professor. My apologies — not just Roger, but Professor Roger Short. The secret weapon — you have it with you. Could you show it to us, please?
Roger Short: I've got two. Which do you want first?
Andrew Denton: Uh, whichever you choose.
Roger Short: Left or right?
Andrew Denton: Left or…left.
Roger Short: Left. Right.
Andrew Denton: Or right.
Roger Short: Well, that…that's one of the secret weapons.
Andrew Denton: Yes.
Roger Short: And the other one, which is very similar…
Andrew Denton: These are the secret weapons for stopping the spread of HIV. How does this work?
Roger Short: Well, uh, we've rediscovered a bit of history. If we read the history books, we find that lemon juice, um, or a slice of lemon, squeezed out a bit and put in the vagina, will provide women with perfect contraception. And what we've found is that not only will lemon juice or lime juice, um, inactivate sperm like that, almost immediately — it just freezes the sperm tail and stops it wriggling so that it can't fertilise the egg — but also that same juice will kill the AIDS virus. So we're trying to reinvent history and see if we find any communities around the world today that are still using either lemon juice or lime juice to see if it will protect them against sexually transmitted diseases in general, AIDS in particular, and also contraception.
Andrew Denton: I don't wish to digress but I find that, uh, the sight of Bette Midler also freezes sperm.
Roger Short: Quite a few things freeze sperm.
Andrew Denton: How did you find out about it, though? Did you deliberately go back to the history books looking for something like this?
Roger Short: Yes, I've always been interested in history and there's a wonderful book called 'History of Contraception' which I was reading. And there's no doubt that it was actually a very effective contraceptive. And I had to give a lecture in London in the National Portrait Gallery in Trafalgar Square. And I said, you know, "Isn't it amazing that in the 1920s, apparently women were using a slice of lemon as a contraceptive?" And after the end of the lecture, about 15 women came up to me and said, "You know, in those days I used lemon juice. It was all there was." And I thought, "Wow!" And then last year I was in Thailand, in Bangkok, talking to my friend Meechai Viravaidya, who's a Thai Senator and runs Thailand's family planning clinics. And as I was telling him the story, I suddenly thought, "Gosh, you silly idiot. Lemon juice, it's so acid that not only would it immobilise sperm, it should kill HIV." And I said to Meechai, "Hey, I've just had an idea." Actually in the conversation. And I've got two PhD students and I said to them, "Drop everything, and let's see, first of all, whether lemon juice does indeed immobilise sperm." And we were able to show that emphatically it does.
Andrew Denton: You've trialled it just recently on primates.
Roger Short: Yes.
Andrew Denton: And how did that go?
Roger Short: Well, we got the results on Friday, believe it or not. We persuaded the Indonesian, um, Department of Agriculture, which has a primate colony on the island of Bogor, to do some tests on these crab-eating macaque monkeys, putting a little bit of cotton wool, um, like this, um, soaked in — if you'll excuse me using your water…soaked in lemon juice and just pop that in the vagina once a day for a month. And as far as we can see, that daily treatment with that juice has caused no pathology at all, no abnormalities in the reproductive tract of any of those six moneys.
Andrew Denton: What would you say to women who are at high risk now? Would you advise them, even though you don't have the full clinical trials, to use this?
Roger Short: I feel I would say as of Friday, er, yes, it's safe. It's not going to harm you, I think I feel absolutely sure of that, and we know that it kills the virus. You need to have about half a millilitre of juice and there's actually…you'll find there's about two millilitres of juice in there. So that's more than enough.
Andrew Denton: If this turns out to be correct, if this is indeed the key to stopping the spread of AIDS, we're talking about one of the great medical breakthroughs, are we not?
Roger Short: Well, er, I think…
Andrew Denton: Don't be modest.
Roger Short: Yes, half of me hopes that that's true. I guess half of me is still sort of terrified that it might not be true, because I think all scientists, although we may appear as sort of self-confident extroverts, inside us we have this miserable little maggot of self-doubt. And if you don't have the maggot, if you don't doubt yourself, if you're not your own worst critic, then I think you're useless. But if the maggot gets too big, it kills you 'cause you never do anything.
Andrew Denton: I think you're being perhaps a little modest here. My understanding is that the World Health Organization, amongst others, are basically hanging on your next piece of research, are they not?
Roger Short: Well, I've just sent them a fax today, um, just before coming here, saying, "Hey, it looks good. Can I come to Geneva in a couple of weeks time when I'm going to be in London and just tell you the results and think how we disseminate it?" And one of the nice things about sort of going public and talking about this is that there could be somebody in this audience who has some invaluable information for me. A couple of weeks ago I gave a talk in Melbourne and one of the doctors in the audience there said to a colleague of mine after the lecture, he said, "Oh, that's interesting, Roger talking about that lemon juice. I've been working in Laos and, um, Laotian women report using lime juice quite regularly to protect themselves against sexually transmitted diseases." And if you look up the World Health Organization figures for the incidence of AIDS in Laos, it's not sort of zero, but it's incredibly low. So could it be that by going back to Laos and going to Vientiane we might actually find that all our ideas have been scooped years ago by Laotian women who've been using this for obviously quite some long time with no adverse effects? And maybe, maybe, it's actually protected them from HIV, because all the countries around them — Vietnam, Cambodia, Thailand — have very high incidences of HIV, but little Laos with 5 million people — very little HIV.
Andrew Denton: Extraordinary. I'm going to ask a question without notice here — how much government funding do you get?
Roger Short: None.
Andrew Denton: Roger Short, thanks for coming in tonight.
Roger Short: Thanks, Andrew.
And WHY should they want to circumcise HIV+ men? The emperor is still naked, but now he's dancing in cap and bells.
Medical News Today
Circumcision Safe In HIV Positive And Negative Men
It is safe to perform circumcision on HIV-infected men if the disease is not in its advanced stage, according to an article released on June 2, 2008 in the open access journal PLoS Medicine.
One of the major forms of transmission of HIV in Africa is through sex without a condom. Previously, three separate trials in South Africa, Kenya, and Uganda have shown that circumcised men were only half as likely as uncircumcised men to contract HIV from infected females during intercourse. As a result, male circumcision is encouraged as a means of stifling HIV transmission, even though it cannot provide complete protection. However, the safety of the circumcision procedure has not yet been tested in HIV-infected individuals.
To measure the safety of this procedure in HIV positive men, two clinical trials of circumcision were performed in the rural Rakai district of Uganda by Ron Gray of the Bloomberg School of Public Health, Johns Hopkins University and colleagues. In each trial, men who showed no symptoms of HIV infection, and with normal CD4 T-cell counts, were circumcised and tracked for complications. They found that under optimal surgical conditions, both HIV-positive and HIV-negative patients had approximately a 3% rate of moderate or severe surgical complications, usually in the form of infections. However, HIV-infected men showed a longer healing time, and a higher risk of complications if they resumed sexual intercourse before this wound healing process was complete.
This study not only shows a promising future for the circumcision of HIV-positive men to help curb the HIV/AIDS epidemic in Africa, but also indicates that less screening may be necessary before this procedure. If men are not showing symptoms of HIV-infection, screening for the disease should not be required for the procedure to be performed, assuming the patient waits until he is completely healed (sometimes six weeks or longer) to resume intercourse. This should reduce the complexity of the procedure, and reduce the stigma of community exclusion, thus making the process more accessible to men in this situation.
[And just how can the circumcision of HIV-positive men help curb the HIV/AIDS epidemic? This seems to assume that it is not possible to tell a man he is HIV-positive without his community finding out. It ignores the enormous benefit to a man of knowing he is HIV-positive by allowing treatment to begin. It seems to be quite unconcerned that HIV-positive men are going to have unprotected sex, apparently in the belief that they are "protected" because they are circumcised. And it assumes circumcising men is more important than protecting their partners. The people who perpetrate this fraud are more interested in promoting circumcision than in preventing HIV.]
Another analysis from one of these trials, which was reported separately, found that the female partners of men who resumed intercourse before healing were more likely to contract HIV. This underscores the importance that men undergoing the procedure wait the full recovery period before resuming regular sexual activity.
[No, this underscores the criminal folly of circumcising men to protect them from contracting HIV when they have contracted it already.]
The safety of adult male circumcision in HIV-infected and uninfected men in Rakai, Uganda. Kigozi G, Gray RH, Wawer MJ, Serwadda D, Makumbi F, et al. PLoS Med 5(6): e116.
Children's Rights Group calls for Genital Integrity Policy
Doctors Opposing Circumcision announces publication of its new Genital Integrity Policy for America's Children.
Seattle, WA (PRWEB) May 31, 2008 -- Doctors Opposing Circumcision, a member of the Child Rights Information Network, has published a new Genital Integrity Policy. George C. Denniston, the group's president said "Our new statement provides conclusive evidence that genital integrity provides the highest level of health and well-being for America's children."
"Our organization is the world's leading authority on genital integrity." Denniston said. "We have been developing this evidence-based policy for two years. We discuss the lack of any real preventive benefits of male circumcision, the risks, complications, and disadvantages that occur both immediately after circumcision and throughout life. Since we lack the conflict of interest that troubles other medical organizations, we can tell the whole truth."
"Moreover, this statement includes chapters on human rights, law, and medical ethics," John Geisheker, J.D., general counsel for DOC, added. "There are many reasons to believe that non-therapeutic circumcision of children may be unlawful, and no reason to believe that it is lawful. Non-therapeutic circumcision fails every medical ethics test."
Denniston commented, "We call for all segments of society to protect the health, well-being, and human rights of America's children by supporting and defending their genital integrity."
"Non-therapeutic male circumcision was introduced as a medical practice in the nineteenth century," Denniston said. "It has no rationale in twenty-first century medical practice. The amputative operation is harmful both to normal sexual function and emotional well-being. Our twelve-chapter policy statement makes absolutely clear that genital integrity advances the health, well-being, and best interests of the child."
"International human rights law has profoundly changed medical ethics. Injurious non-therapeutic circumcision cannot comply with contemporary ethical standards and must yield in favor of protecting the genital and bodily integrity of children," George Hill, DOC's vice-president for bioethics and medical science, commented."
Hill said, "We are making our policy available both online in HTML and as a downloadable PDF file to facilitate maximum distribution. The policy is at http://www.doctorsopposingcircumcision.org/DOC/statement0.html.
Doctors Opposing Circumcision, founded in 1995 by Professor George C. Denniston, M.D., M.P.H., is an international non-profit educational organization with offices in Seattle, Washington.
Channel News Asia
Philippine doctors question medical benefits of circumcision
By Channel NewsAsia's Philippines Correspondent Christine Ong
OLONGAPO, Philippines: Circumcision is an age-old rite of passage for young boys in the Philippines, but a group of surgeons question the medical benefits of going through such a tradition.
Nelia Tabiolo, mother of a 10-year-old boy, had to drag his son to a makeshift operating room where a free circumcision clinic is being held. This is the second time her son has tried to run away from the procedure.
"I want (my son) Jonathan to be circumcised because I want him to become a man and have good health," said Tabiolo.
Situations like this have led a group of doctors to question the basis of routine circumcision in the country.
"You are subjecting or mutilating boys when they undergo circumcision. This is a traumatic and painful experience for everyone who eventually undergoes circumcision. If you weigh the benefits, risks and costs of doing routine circumcision, it is not very rational," said Dr Jeffy Guerra, Chief Resident, Surgery Department, Manila Hospital.
Since 2002, surgeons at the government hospital have stopped offering routine circumcision and have campaigned against it.
Anti-circumcision advocates believe that young boys should not be forced into circumcision because of cultural tradition and peer pressure. They believe it is important for parents to understand both the benefits and risks of routine circumcision before allowing their children to be circumcised.
According to surgeons, recent studies show that the medical benefits of routine circumcision is not compelling enough.
"The incidence of penile cancer worldwide is less than 2% and to do the procedure for such a low incidence would be an overkill," said Dr Guerra.
Doctors admit that changing Filipinos' long-held beliefs towards circumcision is difficult, but for anthropologist Dr Michael Tan, it is high time that Filipino families re-think these rituals.
"With time, we will have to redefine the contours of being a man, that a man is not just your foreskin but much more. (It's about) a sense of character, of being of strong character," said Dr Tan.
- CNA /ls
"Even a little prick gives a completely wrong message"
Islam in Europe (blog)
A drop of blood
Netherlands: Doctor calls to allow light form of female circumcision
Jannes Mulder, former internist and oncologist, writing in the Dutch medical journal Medisch Contact, says that girls are still being circumcises, even though the procedure is banned.
The Dutch Council for Public Health estimates that at least 50 girls are circumcised every year, mostly in the Somali community.
In his article, 'A drop of blood', Mulder suggests that since banning the procedure doesn't work, a symbolic form of the practice - pricking the clitorial hood - should be allowed. This would prevent more serious forms of female genital mutilation, and allow medical oversight of the procedure.
His idea was immediately dismissed by Monica Van Berkum, head of Pharos, an information center about preventing and dealing with female circumcision. Van Berkum says that no compromise should be made regarding the integrity of a girl's body. Even a little prick give a completely wrong message, as if that's needed to make a girl fit.
Een druppeltje bloed
Auteur: J.H. Mulder
Buig vrouwenbesnijdenis om in onschuldige, symbolische traditie
Sinds 1993 kent Nederland een wettelijk verbod op de genitale verminking van vrouwen en meisjes. Toch gaat de praktijk van circa vijftig mutilerende besnijdenissen per jaar gewoon door.1 Intensievere opsporing en strengere handhaving lijken zelfs contraproductief te werken. Een zero tolerance-beleid tegen vrouwelijke genitale verminking is riskant en het herziene bulletin van de Inspectie voor de Gezondheidszorg (IGZ) is legalistisch, weinig genuanceerd en daarmee politiek correct.2 Door een symbolische besnijdenis te gedogen, zouden veel ernstiger vormen worden voorkomen.
De circa 16.000 meiden, merendeels Somalische Nederlanders, en hun ouders zouden de gelegenheid moeten krijgen te ontdekken dat je genitale mutilatie kunt ombuigen en dat het in feite gaat om een druppel bloed op een steriel lakentje. Zo zou de zogenoemde sunna - de mildste vorm van vrouwenbesnijdenis - op creatieve wijze verder kunnen worden verdund tot een sunna light. Zolang de orthodoxe besnijdenis in Nederland nog verminkend is, stel ik voor om op de polikliniek van enkele GGD’s een symbolische besnijdenis (een prikje in de voorhuid van de clitoris) mogelijk te maken. Maak er een ceremoniële plechtigheid van, waarbij de GGD-arts een oogje in het zeil houdt.
Gewoonten en rituelen veranderen omdat het verhaal eromheen verandert. Het ouderwetse duel met dodelijke afloop is ook omgebogen tot het debat en uiteindelijk verdund tot eventueel publiekelijk afgaan. Een oud gebruik als katknuppelen, ganstrekken of levende paling vellen ging de gegoede burgerij steeds meer tegenstaan en getuigde op den duur van een gebrek aan goede smaak.3 Gênante gewoonten, pijnlijke rituelen en beschamende praktijken die diep zijn ingesleten, moet je niet primair wettelijk willen breken. Een selectief beleid van gedogen en ombuigen blijkt ook civiliserend te kunnen werken.
dr. Jannes H. Mulder, internist-oncoloog n.p. en voorheen werkzaam op het ministerie van VWS en het ministerie van Volksgezondheid in Paramaribo, Suriname
Museveni refuses to ride the juggernaut
Uganda grooms its future
In the 1980s, Museveni won respect within his own country and internationally as the first African leader to recognize the threat of AIDS and to mobilize his country against it. His nationwide campaign exhorting young people to delay sex, married people to remain faithful (the catchword was "zero-grazing"), and others to use condoms reduced the percentage of HIV-infected Ugandans from 18 percent in 1990 to 7 percent in 2005.
The infection rate has increased recently, however [... because the zero grazing campaign has been neglected, condoms denounced and abstinence promoted ...], and AIDS remains a devastating problem, not least because of the thousands of orphans - many themselves infected - that it leaves in its wake. Uganda, a nation of 31 million, has 70,000 to 130,000 new infections annually. With a population of 300 million, the United States has 40,000.
Despite such data, Museveni has resisted lending his support to ... the circumcision of adult men.
Circumcision has support in the Ugandan health ministry, but Museveni remains skeptical. The president said "reckless behavior" is the root of the AIDS problem. When I pressed him on the need to take new measures against the disease, Museveni referred to Ugandan tribesmen who have long practiced ritual circumcision but still become infected. He said only that he would "study the science" of circumcision as a preventive measure and "see."
[This opinion-piece is considerably shorter with the pro-circumcision opinion removed.]
More voices of sanity...
The Herald online (South Africa)
Call for enforced circumcision slated
Nomahlubi Sonjica HERALD REPORTER
YCL acting secretary Patrick Makape said: “Scientific research demonstrates that circumcised men have reduced chances of being infected with HIV/Aids.”
He said the World Health Organisation also recommended that HIV/Aids comprehensive strategy should include circumcision.
Makape said people should not confuse circumcision and initiation as the two were totally different.
Port Elizabeth urologist Dr Jan Enslin, however, said circumcision should purely be a personal preference.
“I have not seen any scientific data that says it has been proven that circumcision reduces the spread of HIV/Aids.”
“I have not seen any scientific data that says it has been proven that circumcision reduces the spread of HIV/Aids.”
General practitioner Dr Bonakele Qabaka agreed, adding culture also played a major role in people‘s decisions to be circumcised or not.
“If circumcision plays a role in reducing the spread of HIV/Aids, why do we have an increasing number of men infected?”
Qabaka said men should be told to use a condom.
Both Enslin and Qabaka said circumcision in the past was done for hygienic purposes.
Nelson Mandela Metropolitan University cultural anthropology lecturer David Makape said: “I find it strange that all men must be forced to be circumcised to curb the spread of HIV/Aids ... I doubt very much that circumcised men are not at risk of being infected.”
He said circumcision was cultural and “those who don‘t practice it will find it very difficult to be forced to do it”.
Icamagu Institute director Nokuzola Mndende said the YCL was sending a wrong message to the youth.
She said the YCL should instead teach young men to be responsible and practise good behaviour.
Another nail in the coffin
Long-term population effect of male circumcision in generalised HIV epidemics in sub-Saharan Africa
Abstract: This paper examines the complex relationship between male circumcision and HIV prevalence and incidence in sub-Saharan African countries that have generalised epidemics. In South Africa, the mean yearly HIV incidence and an estimate of the net reproduction rate of the epidemic (R0) (in this case, the ratio of the number of HIV-infected persons between 1994 and 2004 to the number of persons infected in 1994 from which they were presumed to have become infected) were computed from antenatal clinic data for the period 1994-2004, and then compared, by province, to prevailing levels of male circumcision (high, medium and low). In South Africa, mean yearly HIV incidence and net reproduction rate of the epidemic were not lower in provinces with higher levels of male circumcision. For thirteen other countries where Demographic and Health Survey data were available, male HIV prevalence in circumcised and non-circumcised groups was compared. A meta-analysis of that data, contrasting male HIV seroprevalence according to circumcision status, showed no difference between the two groups (combined risk ratio [RR] = 0.99, 95% CI = 0.94-1.05). Individual case study analysis of eight of those countries showed no significant difference in seroprevalence in circumcised and uncircumcised groups, while two countries (Kenya and Uganda) showed lower HIV prevalence among circumcised groups, and three countries (Cameroon, Lesotho and Malawi) showed higher HIV prevalence among circumcised groups. In most countries with a complex ethnic fabric, the relationship between men's circumcision status and HIV seroprevalence was not straightforward, with the exception of the Luo in Kenya and a few groups in Uganda. These observations put into question the potential long-term effect of voluntary circumcision programmes in countries with generalised HIV epidemics.
Father 'not guilty' in circumcision case
A father who had his sons aged three and six circumcised against the wishes of his ex-wife has been found not guilty of causing them serious physical harm, the Parool reports on Wednesday.
But the man was given a six week suspended jail term for taking the boys away from their mother, who has custody, against her will.
[How can it be a more serious crime to take them from their mother against her will than to cut part of their genitals off against her will (and theirs)?]
The lust to circumcise overwhelms other needs...
Renal and Urology News
Urologist Sued by Patient Mum about His Diabetes
The surgeon should have ordered a urinalysis prior to performing a circumcision on a 53-year-old man
BY ANN W. LATNER, JD
Dr. U, 41, was a sole urologist in a small community in the Midwest. He'd been in private practice for only two years, but he felt quite positive about his professional prospects and his future—until he was sued.
It all started routinely when a new patient, Mr. K, a 53-year-old man, came in. He was asked to fill out a medical information form as well as provide his in-surance information before entering the examination room. After skimming the medical information form, Dr. U spoke to Mr. K, and examined him. He discovered a urological lesion that the patient claimed he'd “had for several months and that it just wouldn't heal.” Dr. U recommended circumcision, and subsequently scheduled Mr. K for the procedure the following week.
The surgery was performed in Dr. U's office under local anesthesia. The procedure was routine, and both Dr. U and the patient expected a positive outcome. However, serious problems soon developed. Over the next three months, Mr. K kept returning to Dr. U's office with a host of issues, including pain, an unusual protrusion, urination problems, and lack of sensation. Then Mr. K abruptly stopped coming to Dr. U's office, or calling, and sought the help of another physician.
The new physician ordered a urinalysis that indicated Mr. K had diabetes. When the new physician asked whether Mr. K was aware that he had diabetes, the patient answered that he was aware. “Do you take medication?” queried the physician. “No, I just try to eat healthy and exercise sometimes,” replied Mr. K. “Did you tell your previous doctor?” asked the new physician. “He didn't ask,” replied the patient. “Did Dr. U do a urinalysis before your circumcision?” asked the physician. “No,” replied Mr. K, “Should he have?”
Diabetes hinders recovery
Thedefense attorney pounced on Mr. K during cross examination. After making Mr. K state that he knew that he had diabetes, he launched into a line of questions about the medical form that had been filled out in Dr. U's office.
“The form asked if you had any medical conditions, didn't it?”
After six hours of deliberation, the jury found Dr. U 54% at fault for Mr. K's injuries, and Mr. K 46% at fault. The jury awarded $200,000 for past and present pain and suffering and $1,750,000 for future pain and suffering.
... [Mr K's] total award, therefore, is reduced by 46%. Dr. U was 56% at fault due to his failure to inquire about diabetes or perform a urinalysis prior to surgery. He is responsible for paying 56% of the $200,000 and $1,750,000 in damages.
A comprehensive medical form, a thorough conversation about medical history, and basic screening tests (urinalysis and/or blood) are clearly good insurance before performing any surgical procedure, no matter how routine it may seem.
From the April 2008 Issue of Renal And Urology News
Comment by Sarah
Future Medicine - Future HIV Therapy
Male circumcision is not the HIV ‘vaccine’ we have been waiting for!
Lawrence W Green, Ryan G McAllister, Kent W Peterson & John W Travis
Regardless of whether circumcision might offer some heterosexual males a partial degree of protection from HIV, numerous other issues need to be thoroughly considered before instituting mass circumcision campaigns.
In short, given the large number of unknowns, confounding factors and lack of long-term follow-up in the three R[andomised ]C[controlled ]T[est]s, it is premature to recommend circumcision as an HIV-prevention strategy. Much more evidence must be gathered on real-world efficacy of male circumcision as a prevention tool before mass surgeries are implemented.
An objective scientific assessment must be conducted to determine if the three RCTs are applicable in real-world settings. And, to determine the true cost of a circumcision campaign, there must be a comprehensive resource analysis of the plan. These mass circumcision costs also must be compared with the opportunity costs of funding ABC campaigns.
As part of these assessments, the very real risks of circumcision surgery, including directly increasing HIV transmission to men as well as indirectly increasing transmission to women, surgical risks such as hemorrhage, other infections, meatal stenosis, need for repeat surgery and even death, must be considered.
Finally, the value and function of the foreskin as an integral part of the male sexual organ  and the ethical issues surrounding such surgery, including informed consent, the possibility of coercion and the dangerous implications of conveying erroneous messages of HIV immunity, must also be carefully considered in any analysis.
ABC programs offer nearly full protection from HIV infection, yet even if circumcision’s effectiveness matches the 50–60% effectiveness the RCTs reported, it only partially protects men, does not protect women at all, and leaves women more vulnerable to unsafe sex practices being forced upon them.
Those promoting circumcision argue that circumcision is an additional tool that will ultimately reduce infections more than just relying on condoms, monogamy and abstinence. However, African males are already lining up to be circumcised, thinking they will no longer need to use condoms. Rather than complementing ABC programs, promoting circumcision will undermine the ABC approach by diverting funds and encouraging risk compensation behavior, ultimately leading to an increase in HIV infections.
The world community must cautiously review and carefully consider the long-term consequences of mass circumcision campaigns, from the risk of increasing deaths and infections to human rights violations. In the rush to save lives, many may instead be lost and human rights trampled in the stampede. Circumcision is not the panacea the world has been waiting for in the battle to stem the HIV crisis.
Sports, blood, jocks, religion AND penises! What more could a sports writer ask?
Florida Gators star Tim Tebow's legend grows when 'Dr. Tebow' assists with surgeries on a missionary trip
Dave Curtis | Sentinel Staff Writer
Fans by now know the legend of Tim Tebow by rote: he plays quarterback as well as anyone in America, sings on stage with the stars of country music, makes girls swoon every time he smiles.
During spring break, Tebow added a new facet to his fame. In an impoverished village outside General Santos City in the Philippines, Tebow helped circumcise impoverished children.
On the Friday of a weeklong trip to the orphanage his father's ministry runs in Southeast Asia, Tebow assisted with the care of locals who had walked miles to the temporary clinic that the ministry helped organize. More than 250 people underwent medical and dental procedures, some of them from "Dr. Tebow," who has no formal surgical training.
"The first time, it was nerve-racking," he said. "Hands were shaking a little bit. I mean, I'm cutting somebody. You can't do those kinds of things in the United States. [- unless you call it "religion"] But those people really needed the surgeries. We needed to help them."
Tebow started as a helper and gofer, holding tools and running errands for the medics. By afternoon, he was asking questions and looking for more active ways to help. And by the end of an exhausting day, he was wearing gloves and a mask, wielding surgical scissors, finishing off stitches with a snip.
The locals started by hearing a brief Christian sermon from one of the Tebows and then moved to a brief medical exam from a Filipino doctor.
Others saw Moleno, who after a crash course from the Filipino professionals, circumcised 10 boys and removed six cysts, some the size of tennis balls. Tebow helped with the last few circumcisions, growing more comfortable with each one.
"I got a kick watching him," Bob Tebow said. "He did a great job, and he didn't look really nervous. I wouldn't let him cut on me, but he did well and helped where there was a need."
The men worked until dark, Bob Tebow said, and still had to turn away at least 50 people. The Americans performed in tight quarters by their standards and helped introduce basic tenets of medical care to their Filipino friends; Young said he got some strange looks from his professional colleagues when he wanted to sterilize tools between each procedure. [And they're circumcising "to prevent the spread of HIV/AIDS"] ...
All three remembered the reactions of the children they helped heal.
"It's really vivid for me," Tim Tebow said. "I don't remember anybody crying while we treated them. Those kids were so tough."
Dave Curtis can be reached at firstname.lastname@example.org.
[This story was repeated many time with every "humorous" string pulled. One photo shows him and friends with box cutters / Stanley knives]
The one to reap the benefits will be the Grim Reaper.
Billboard in Swaziland
This billboard, from Swaziland, was reproduced in a humour website.
So do the varied 'stitions intersect and cross-connect
New Vision (Uganda)
News in brief...
Circumcision campaign on
KAMPALA-The Uganda Muslim Suuni Association has launched a circumcision campaign. Chairman Yusuf Shubdin said the free service would also be offered to non-Muslims. Presenting the association’s annual report at the Uganda Muslim Supreme Council on Monday, Shubdin said the campaign was in response to the Government’s call on people to get circumcised. He said the exercise would be carried out every Thursday at Aldina Mosque in Old Kampala. Shubdin also said the mosque would take care of the circumcised people until they heal.
More kid-glove treatment of [male] genital cutting
Mail & Guradian Online (Cape Town)
Mpofu snips circumcision doccie
The SABC pulled a documentary on circumcision hours before it was due to be aired in response to a complaint from a member of the Congress of Traditional Leaders of South Africa who had not seen the programme.
The decision to stop the showing of the documentary was made unilaterally by SABC head Dali Mpofu, because the documentary had not been approved by an advisory body set up to guide the public broadcaster on cultural and traditional issues.
The advisory panel was set up a year ago after the broadcaster bowed to pressure from the National Heritage Council and Contralesa to halt a coming-of-age mini series titled Umthunzi Wentaba that traditionalists believed "dishonoured" circumcision.
This week award-winning reporter Hazel Friedman's full-length Eastern Cape investigation titled Rights of Passage was pulled hours before it was to be broadcast on Tuesday's Special Assignment. Friedman's report had looked into the death of 25-year-old University of Cape Town student Buntu Majalaza. He died of septicaemia as a result of a botched circumcision last year.
Special Assignment staff members tell of a frantic last-minute rush to make Mpofu a copy of the programme so that he could suspend the broadcast.
Friedman, who won the Vodacom Journalist of the Year Award last year, said this week that she was "outraged" by Mpofu's decision. In making the programme she had consulted provincial ministers for culture and health in both the Eastern Cape and the Western Cape and had received permission to film in hospitals.
"The programme was approved by our Special Assignment executive producer Johann Abrahams and head of current affairs Themba Mthembu.
"I know that we are not allowed to talk to the media but I am certainly allowed to speak in defence of a story that was absolutely respectful of tradition. It did not violate any secrets or undermine the role of any legal representative or any legal cultural custodians," Friedman said.
A staff member who spoke off the record said Mthembu and head of television news Amrit Manga had viewed the final edit of the programme and were also alarmed when Mpofu had single-handedly pulled the completed work off air. As the editor in chief and SABC Group chief executive officer Mpofu is allowed to take unilateral decisions.
Kaizer Kganyago, SABC spokesperson, said on Wednesday that the programme had been suspended because "we had not consulted everybody. Umthunzi Wentaba caused a lot of hoo-ha and we committed to consult widely before we flight any programme of this nature. By [Tuesday] we had not finalised all the steps that we wanted to go through and a decision was made to put the programme on hold."
Contralesa president, Chief Phathekile Holomisa, told the Mail & Guardian that Mpofu's move had been "a good decision. We feel in the first place that some of our cultural rituals, especially this one, don't need to be flighted on television. This is a private ritual requiring the presence and participation of those directly involved."
He said the media did have a duty to expose unscrupulous operators of back-yard initiations, "as [long as] they do it in a manner that brings this ritual into disrepute. There are structures that are meant to deal with problems emanating from malpractices."
Holomisa said he had not viewed the programme before the objection had been sent to Mpofu; in fact the objection from Contralesa chairperson of the Eastern Cape Ngangomhlaba Matanzima, had been sent to Mpofu on the strength of a promotion that had been airing on television since last Friday.
When asked if this was an act of censorship Holomisa said: "It is complex, not a straightforward matter. You are talking about the media's freedom of expression. But there are other freedoms: freedom to privacy and the freedom to exercise your cultural rights." [Whose "cultural rights?" Is there a "cultural right" to die of septicaemia?]
Doctor makes a circus of circumcision (if true)
This story was published for less than 24 hours before it was removed. It is now only available as cached or archived versions. That could indicate that it is a hoax.
La Union doc aims for circumcision record
By Jun Elias
SAN FERNANDO, La Union – A doctor here aims to be the world’s fastest circumciser of the most number of patients in an hour.
Dr. Jessie Miranda, a law graduate who was once president of the La Union Gay Society, is confident of setting the record after taking only five seconds to circumcise an eight-year-old boy from Barangay San Agustin here and 66 patients in one hour.
“I think this is the first time that a doctor like me is aiming for the record and I know I was the first because I conducted research if there is such a record, but there’s none,” Miranda told The STAR during a break from foreskin cutting duties.
Miranda said he thought of the activity to establish a record for himself and for San Fernando because he will be submitting his documents to the Guinness Book of Records.
“We are thinking then of an event that will establish a record for San Fernando, so this is what we thought of,” he said.
Miranda’s longest circumcision did not exceed a minute.
Starting at 8:15 a.m. Miranda circumcised boys from different barangays of San Fernando City, who lined up at the City Health Office yesterday.
Miranda took a break at 9:15 a.m. to check how many of his more than 700 patients have already been circumcised.
Using a laser machine, Miranda occupied a 4x10-meter air-conditioned room at the health office.
He was positioned between two beds, a patient in each of them, and was assisted by six health workers – three for each bed – to apply betadine and place surgical plaster on the penis of each patient.
The circumcision starts with each patient being injected with anesthesia in a separate room after which they line up for Miranda’s room.
Inside the room, a patient lies down on the bed and the health workers prepare him before Miranda places the tip of his laser to the skin of the penis.
The laser will cut and burn the skin, bloodless and painless, and the operation needs no stitches.
San Fernando City Mayor Pablo Ortega helped Miranda organize the medical event, which coincided with Ortega’s “Operation Tuli” project spearheaded by the CHO under Dr. Eduardo Posadas and several non-government organizations.
Aside from the record, Miranda said he also wants to share his knowledge with his townmates, particularly those who cannot afford the medical expenses of circumcision in hospitals.
“I know that some cannot afford the P3,000 to P5,000 expenses so I offered this activity,” he said.
“I’ve been doing this for more than 10 years now and this is only the first time that it was properly documented,” he said.
Ortega thanked Miranda, a former city councilor who is now the supervisor of the Auxiliary Wet Market here, for conducting the activity free.
“I hope for his success and I’m glad that this activity was conceived because this is for hygiene purposes especially for the young boys,” Ortega said.
Ortega said Miranda initially scheduled the activity as a gift for his birthday celebration on April 3, but it was moved yesterday due to his load of activities.
The final number of circumcised patients was not yet available as of press time.
[If this story is true, it is appalling malpractice. A doctor who raced to break a record for any other operation would be struck off. The Guinness Book of Records does not award records to risky activities, and it is to be hoped that it withholds any from this one.]
L A Times "Babylon & Beyond
YEMEN: Parliament upholds female circumcision
After a heated debate in parliament this month, Yemeni women's rights advocates lost their battle to ban female circumcision, according to a report in the Yemen Times.
The parliament in recent days voted against a bill that would have outlawed female genital mutilation, a practice that is believed to affect almost 25% of Yemeni women.
Opponents claimed that the issue remains too sensitive among Yemeni and that no legal measure could be taken as long as there was no consensus among religious scholars against the practice.
Female circumcision is a widespread practice in the Middle East and Africa. Many Muslims believe that removing a girl's clitoris to tame her libido is a religious obligation.
Top Muslim clerics, including the Grand Sheik of al-Azhar Mosque, the world's oldest Sunni Muslim religious institution, have repeatedly decried the practice as purely traditional and without basis in Islamic scriptures.
Yet the scholars’ declarations have not been able to end to the centuries-old practice.
Egyptian lawmakers have been embroiled in a similar debate. A draft bill calling for the criminalization of the practice has been dismissed by Islamic lawmakers in Cairo as a Western ploy to demonize Islamic traditions.
— Noha El-Hennawy in Beirut
[Yemen is also noteworthy for the most severe form of male genital cutting.]
HIV prevention studies in Africa: it's important to ask about anal sex
Studies into sexual behaviour in Africa have often neglected to enquire about anal sex, and sex between men. There has either been an assumption that such behaviour was not prevalent, or a sensitivity to cultural taboos and prejudices means that investigators are reluctant to enquire about such behaviour. But studies are now suggesting that anal intercourse is common in Africa in both heterosexual and homosexual contexts and is an important mode of HIV transmission.
The study also showed that relying on patient report of symptoms will lead to many sexually transmitted infections remaining undiagnosed, and that simple microscope examinations of genital and anal swabs can lead to more infections being diagnosed.
Numerous HIV prevention studies are underway around the world. Investigators involved in one such study in Mombasa, Kenya, wanted to demonstrate the value of introducing routine sexual health screens involving basic laboratory tests, and the value of asking individuals about anal sex so that they could be offered appropriate tests and treatment.
The study ran between 2005 and 2007 and recruitment was focused on individuals with a high risk of HIV, including 334 commercial sex workers, 316 men who have sex with men, 169 individuals with multiple sexual partners, 59 patients with recent symptomatic sexually transmitted infections, and 28 HIV-negative individuals with an HIV-positive partner.
Initially the investigators did not ask about receptive anal intercourse. It was only in 2006, after the study had been running for over a year, that questions about anal intercourse were included because participants were frequently reporting this behaviour or symptoms suggestive of a sexually transmitted infection in the anus.
Another important finding of the study was a high prevalence of receptive anal intercourse, which was reported by 36% of the men who have sex with men and by 18% of the women. Most (89%), but not all of these women were sex workers. Symptoms suggestive of an anal infection were reported by a third of patients reporting receptive anal sex. A total of 69 patients agreed to have an anal examination using a proctoscope, and 20% of these patients had visible discharge, 20% inflammation, and 7% ulcers. Proctitis was diagnosed in 7% of patients after microscope examination of rectal swabs.
Amongst men, recent receptive anal sex was strongly associated with HIV infection (adjusted odds ratio, 3.8; 95% CI, 2.0 – 6.9), however this was not the case in women. But the investigators did note that two-thirds of syphilis cases in women were in individuals reporting anal sex (adjusted odds ratio, 12.9; 95% CI: 3.4 – 48.7).
The investigators also found that men infected with HIV were also more likely to have anogenital ulcers and warts and have urethritis. HIV infection in women was associated with anogenital warts and pelvic inflammatory disease.
This study raises some significant issues about the design and robustness of HIV prevention studies in Africa. In particular, it is notable that although this study recruited men who have sex [with] men from the outset, the study protocol did not initially include questions on anal sex. It was only after the study had been running for over a year that reports of anal sex from participants lead to a change in the protocol and the inclusion of questions about anal intercourse.
Furthermore, there is a continuing reluctance in some African contexts to acknowledge the prevalence of anal intercourse in both heterosexuals and homosexuals. The investigators note, “questions on receptive anal intercourse in the recently conducted national AIDS survey in Kenya were rejected as being too offensive to ask…unfortunately, data on the general population practice of anal sex in Kenya remains elusive."
Reference: Grijsen MA et al. Screening for genital and anorectal sexually transmitted infections in HIV prevention trials in Africa. Sex Transm Infect: published online, March 28th, 2008.
Reported in non-cutting Sri Lanka ...
Uncircumcised Might Fare Better Against Genital Warts
Uncircumcised seemed to fare better against genital warts, according a US survey. Nearly 6% of sexually active people surveyed suffered from the problem, it being acute among women in 25-34 age group.
The National Health and Nutrition Examination Survey looked at 8,849 sexually active men and women aged 18 to 59 from 1999 to 2004.
... Circumcision appeared to have an effect on rates of genital warts:
4 1/2% of circumcised men reported having genital warts
2.4% of uncircumcised men reported having genital warts
Genital warts, a common sexually transmitted disease in the United States, are caused by the human papillomavirus (HPV). Researchers say more than 90% of genital warts are brought on by two strains of HPV, types 6 and 11, WebMD says.
The survey appears in the April issue of Sexually Transmitted Diseases.
As if Kenya didn't have trouble enough already ...
Nation Media (Kenya)
Government adopts male cut as strategy in fight against HIV
Story by ARTHUR OKWEMBA
It is now official. A new circumcision policy for men aimed at reducing HIV infection rates has been published by the Government.
The policy, stipulating how all willing Kenyan men, irrespective of their age, will undergo circumcision, sets into motion the use of the surgical procedure as a standard HIV prevention strategy for the country.
Health personnel from Government health facilities at various levels are to undergo in-service training to hone their skills on the new procedure.
A Male Circumcision Task Force that will guide male circumcision in Kenya will be set up soon.
Titled Policy on Male Circumcision in Kenya 2008, the document also wants circumcision to be promoted and delivered to males of all ages in a manner that is culturally sensitive to minimise the stigma that may be associated with an uncircumcised person.
In the past, fears been raised over the possible conflict between this policy and the traditions of some of Kenya’s communities, which, as a custom, do not practise circumcision.
While some Kenyan communities invoke religious, cultural or social reasons for circumcision, others like the Teso, Luo, Turkana, and a few groups in the Coast undertake other rites of passage, which do not include circumcision.
Circumcision involves the removal of the foreskin of the male member.
Studies have shown the skin’s inner mucosal surface to be the breeding ground for the virus. This is because compared to the external surface, more of its cells are vulnerable to HIV infection. [This is pure speculation based on studies of foreskins taken from dead bodies. Other studies show the foreskin cells have a protective effect.]
Circumcisers will, therefore be required to counsel males and use techniques that reduce or eliminate the pain associated with such a surgical procedure so as to encourage more men to opt for circumcision.
Says the policy: “Ensure that male circumcision is performed by well-trained practitioners in antiseptic settings under conditions of informed consent, confidentiality, risk reduction counselling and safety.” ["Informed consent" should mean no babies, but will it?]
Health facilities from the dispensary to the district hospital levels are to be strengthened to ensure that they cope with the expected demand from men seeking to be circumcised.
Those implementing the policy will be required to put in place appropriate laws, regulations and supervisory mechanisms that are going to ensure that circumcision services are accessible and provided safely without any discrimination.
The Government’s move to adopt the policy comes at time when results from HIV vaccine trials indicate that circumcised volunteers had a lower risk of HIV infection compared to their uncircumcised counterparts.
Scientists are trying to investigate this development further to see if there is any correlation between the HIV vaccine and circumcision. [Which sounds like the circumcisors are getting ready to keep circumcising when circumcising alone has failed and an effective vaccine has been found.]
Likewise, the policy is also being implemented at time when there are fears that the number of males being circumcised may be reducing.
According to the 2003 Kenya Demographic and Health Survey, close to 72 per cent of men aged between 15 and 19 years were circumcised compared to 84 per cent above this age. However, the survey does not analyse HIV prevalence in regions that predominantly circumcise compared to those which don’t. [In Kenya, HIV is high among the non-circumcising Luo primarily because they are fishermen on Lake Victoria with a "wife" in every port, who relies on them for fish supplies and rewards them with (unprotected) sex.]
The new policy has generated excitement and disquiet among members of the public who talked to Nation, with some praising it and others saying it will worsen the vulnerability of women to HIV infection as men are likely to refuse to have protected sex.
But Ruth Njeri, an anti HIV/Aids campaigner, fears that the idea behind the new policy may make circumcised men engage in unprotected sex thinking they are safe.
“Men who have been using condoms or those who have been faithful to their spouses will now opt for unprotected sex,” Ms Njeri says.
In Kisumu, for instance, there have been reports of circumcised males engaging in unprotected sex and then ending up with HIV infection.
Such tendencies are bothering the Ministry of Health as well.
In the proposed policy, the Government says those promoting circumcision should ensure it does not replace the known effective HIV prevention methods and that it should always be considered as part of a comprehensive prevention package.
The policy further states: “Community and individual education programmes provide sufficient and correct information on the partial protection provided by male circumcision and the continuing need for other HIV and sexually transmitted infection prevention measures.”
“What we are trying to pass across is that a circumcised man who either uses a condom or is faithful to his partner has a reduced risk of HIV infection,” says Prof Alloys Orago, the director of the National Aids Control Council.
The other issue the Government has to grapple with is the cost of circumcision. While it acknowledges that the intervention is expensive, it does not specify where resources for implementing it are to come from.
It just calls on the Ministry of Health to “strengthen health systems to ensure that male circumcision programmes do not interrupt or divert resources from other primary healthcare services”.
To achieve this, the Ministry is required to integrate the management of reproductive, sexual health and HIV prevention programmes to provide male circumcision services.
Strengthening the services through monitoring and evaluation to guarantee quality control and planning purposes are other issues that are to be addressed before the programme gets fully underway. [Will any monitoring be done to determine whether circumcision does actually reduce the rate of HIV transmission?]
The proposed Male Circumcision Task Force is expected to help the Government confront these challenges. Some of its functions include:
World Health Organisation and UNAIDS have already issued a strong recommendation calling for increased male circumcision rates in countries where HIV infections are high.
Kim Dickson, the coordinator of the joint WHO/UNAIDS team that came up with the recommendations, is quoted in the March 2007 edition of New Scientist magazine as saying: “We reviewed all the evidence, and it is compelling.” [This is simply not true.]
In the South African study, circumcision was found to reduce HIV infection rates by more than 60 per cent in a group of 3,000 HIV-negative men
Of the 1,546 circumcised men, 20 became infected with HIV, while 49 of the 1,582 uncircumcised men were infected. [An absolute risk reduction of 1.55%]
Funded by the French Agence Nationale de Recherches sur le Sida (ANRS), the study sent a strong message in 2005 on the effectiveness of circumcision in HIV prevention.
Buoyed by results
In December 2006, the Data Safety Monitoring Board that was overseeing the Kenyan and Ugandan male circumcision trials announced that the operation was a safe and effective way to reduce HIV infections among men.
The two-year trials in Kisumu and Rakai, Uganda, involved adult HIV-negative heterosexual male volunteers who were randomly divided into two groups — one group was circumcised and the other wasn’t.
In the Kisumu trial, circumcision reduced the chances of getting infected with HIV by 53 per cent. Similar results were registered in the Rakai trial in Uganda. [Except that twice as many men - 4996 - were involved in Uganda, but fewer non-circumcised men there contracted HIV thancircumcised men in Kenya - probably because of Uganda's "zero grazing" policy.]
When these trial results came out, National Institute of Allergy and Infectious Diseases (NIAID) director, Anthony S Fauci, whose organisation supported and conducted the studies, said: “We now have confirmation showing definitively that medically performed circumcision can significantly lower the risk of adult males contracting HIV through heterosexual intercourse.” [- but not of women - who are at more risk - contracting HIV through heterosexual intercourse, or men through homosexual intercourse. Condoms protect both.]
The beginning of the end?
Manila Standard Today
Are we there yet?
A very public circumcision
It’s either of two things: Dumb luck or brilliant marketing strategy.
It is possible that the people behind ABS-CBN’s “Pinoy Big Brother Teen Edition Plus” simply stumbled into the circumcision issue and made an on-the-spot decision to make a big thing out of it. But it is also possible that they knew about it beforehand and that, therefore, this whole frenzy about circumcision is simply a well-calculated marketing campaign designed to attract attention and audience share.
The latter of course puts ABS-CBN’s screening process for housemates in question. I don’t think it is ethical to ask applicants highly intimate questions such as whether they are circumcised or not. At the same time, deliberately putting the spotlight on a minor for being supot, regardless of the willingness of the adolescent in question to bare it all, hardly qualifies as ethical. Or even fair.
But I would like to give ABS-CBN people the benefit of the doubt. Although I know that PBB’s ongoing focus on circumcision is primarily motivated by business concerns, I am willing to grant that the quest for ratings can be pursued alongside nobler goals.
It’s actually about time that a public discussion on something that is an integral part of our culture be conducted. It is high time that we have an intelligent and open discussion about circumcision. After all, it is a practice that majority of Filipino males submit to; and mostly without any comprehension or appreciation for the practice, or even choice on the matter. It’s just a surgical procedure we submit to because it’s part of our culture. And for many, it is a traumatic experience.
Oh, in case you don’t watch PBB and you are happily unaware about what’s happening in that very public fishbowl, one of the male teen housemates admitted on public television that he is uncircumcised. The 18-year-old housemate, Alex Anselmuccio, has a Filipina mother and an Italian father but he grew up in Italy—where circumcision is not the norm. The uncircumcised housemate has since then declared his intention to undergo circumcision inside Big Brother’s House—to become Filipino! Of course, the whole thing will be broadcast on television although no one knows yet exactly how the coverage will be handled. In the meantime, ABS-CBN has launched a gimmick to drum up more interest in Alex Anselmuccio’s rite of passage. They will conduct free circumcision to the first 100 boys to register at ABS-CBN today.
As can be expected in a country where hypocrisy is still prevalent, the censors who go by the name Movie and Television Review and Classification Board, have already sent a warning to ABS-CBN that they are closely monitoring the situation. In response, ABS-CBN executive Lauren Dyogi went into defensive mode justifying PBB’s decision to tackle the circumcision issue by trumping up the “culture” argument. In so many words, ABS-CBN believes that because circumcision is part of Philippine culture, there is nothing inherently wrong with discussing it on television or even showing footages related to the practice.
Actually, ABS-CBN is not the first television show to discuss circumcision in public television or to show footages of the practice. It’s something that news reporters regularly cover during summertime when most boys submit themselves to the practice.
In the final analysis, however, it really boils down to the kind of coverage given to the issue and what kind of footage is shown on television. Offhand, I don’t think that showing the circumcision procedure is objectionable per se as long as they are careful about the way pain and trauma is presented. The last thing we need is to traumatize young viewers. [And being circumcised doesn't traumatise young boys?] Obviously they also have to safeguard the privacy of the housemate in question. This means they have to be careful about showing body parts. [But a sanitised item would fool people into thinking it is bloodless and painless.]
What I liked so far about the way ABS-CBN is handling the issue is the way they have been trying to do away with the stigma directed at uncircumcised males. The bullying and the teasing that uncircumcised males receive are facts of life in our culture. Kids can be cruel, particularly after they’ve been circumcised and it becomes their turn to bully younger playmates or classmates who still have to submit to the rite of passage. I know—been there, done that. I’ve had my share of being bullied in grade school. So when I finally got circumcised in Grade 5, it was payback time and I did more than my share of bullying others.
The show has gone out of its way to explain to viewers that contrary to myth, circumcision is not a global norm and that in many countries it is a choice given to males. But the reaction of the other male housemates is more telling and encouraging. They’ve expressed empathy and understanding rather than ridicule or tease the uncircumcised housemate. They’ve also shown great maturity in terms of discussing openly the various social and cultural issues around circumcision.
ABS-CBN has also shown footages of the surgeon-father of one of the teen housemates explaining the official stand of the College of Surgeons, which is that circumcision is not anymore encouraged or considered a “requirement.” There are in fact many doctors all over the world who are against the practice particularly neonatal circumcision (i.e., circumcising an infant upon delivery). According to them, circumcision violates the Golden Rule and the first tenet of the medical practice, which is “First, do no harm.” Others see circumcision as a form of mutilation, one that deprives people of a basic human right—the right to an intact body.
In some countries, circumcision is a religious practice. There are passages in the Bible that are interpreted by many as endorsing circumcision. The Philippines may be predominantly Catholic but in our country, circumcision is not associated with religion but with culture. In other words, Filipino men and boys don’t submit to the process to adhere to some religious beliefs but because in our culture, a man has not yet transitioned to adulthood if he has not gone through this process. In fact, one is never a complete man if he is uncircumcised. [Huh?]
And then of course, there are the many myths around circumcision. I was told, for example, that unless I submitted to the practice, I would stop growing. Experts of course say that the perceived relationship is purely coincidental since the growth spurt happens around the age bracket when a boy is ready for circumcision.
The only compelling argument that supports circumcision is hygiene. But then again, hygiene is a purely personal thing. One can be circumcised but continue to be a total slob anyway, or conversely, one can be uncircumcised but be very diligent about hygiene. Some experts cite medical benefits including lesser vulnerability to HIV infection. There is an ongoing debate on the issue, but in the end, it is really safer sexual practices that eliminate the risk of HIV transmission.
Many among us don’t want to talk about circumcision because it involves private parts and we’ve all been conditioned to think that that part of our body is taboo. It’s unfortunate of course that the current discussion is happening amidst a very artificial and seemingly contrived context, one that is fueled by commercial considerations, but if that’s what it takes to bring home the point then we should be thankful for small dividends.
According to blogs, another Pinoy Big Brother contestant, Kevin Flood, has also been exposed as intact, but he is refusing to be circumcised, despite considerable pressure.
To more about the movement to question pagtutuli and support supét.
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