Intactivism News

July-September 2010

To more recent news

(More recent items first)

Earlier items


ABC (Melbourne)
September 29, 2010

Clinic opens in Melbourne to treat victims of female genital mutilation

A landmark de-infibulation clinic opens at the Royal Women's Hospital this Friday.

The clinic provides a discreet half-day procedure to reverse female circumcision - commonly known as Female Genital Mutilation - or just simply FGM.


For more information about this service, call the Women's Health Information Centre on 8345 3037 and ask to be referred to the FARREP Program.


Global Press Institute
September 28, 2010

Traditional Male Circumcision Rite Linked to High Rate of HIV Transmission

The cultural circumcision rite is a sacred rite of passage for young boys among the Luhya tribe in western Kenya. But some suggest that as many as 40 percent of initiates seek medical attention for botched circumcisions and new data from one on the ground survey indicated that one in eight boys is infected with HIV during the rite. While statistics remain difficult to verify, many parents say they are ready to opt for medical circumcision.

by Joanne Wanjala

BUNGOMA DISTRICT, KENYA -- Oscar Wafula, 13, is recuperating after undergoing the cultural circumcision rite many boys in his village have begun to avoid.

Born in the Bungoma district of western Kenya, Wafula is the first-born in a family of five. He is one of the lucky initiates who successfully underwent the cultural male circumcision rite this August, a marker of the transition from childhood to adulthood. A member of the Bukusu community, a sub-tribe of the larger Luhya who believe in traditional male circumcision as a marker of manhood, Oscar's father, Martin Wekesa, says it would have been considered cowardice if his son would have opted for medical circumcision.

The "traditional circumcisers," who practice the rite with homemade knives and no anesthetic, are considered to have special powers handed down from generation to generation, but have no medical training. In Kenya's western districts, some suggest that as many as 40 percent of the young men who opt for cultural circumcision end up in the hospital with a host of complications, including the loss of the entire penis. But with little corroborating data, the acutal impact it impossible to determine.

But despite the risks and the frequency with which young men here seek hospital treatment after the rite, the practice, which dates back to late 17th century, remains an important community ritual that celebrates a boy coming of age. Research, however, suggests that cultural circumcision is a major factor in the transmission of HIV/AIDS here. New data suggests that one out of every eight initiates becomes HIV infected during the rite. ...

Early on the morning of the big day, the likhoni is removed and the initiates, usually 10 per clan group, are led to a special place in the wilderness where their naked bodies are smeared in cold mud to numb the nerves. Then, they are led back to the village. Using a crude knife, the circumciser jumps on the approaching initiates one by one at a lightning speed and once done, whistles and runs off. Women and girls then ululate and come out to witness their man, singing songs of praise for his bravery during the cut. Each circumcision, performed at great speeds, is done with the same knife.

Advocates say the speed at which the circumciser is expected to perform the cut is what leads to most complications and as many as 40 percent of the initiates are transported to hospital after the rite. The high number of injuries and concerns over the use of the same knife in regions that have high HIV/AIDS rates is slowly forcing a cultural shift, as many parents do not want their sons to engage in the now controversial circumcision rite.

... Joseph Masafu is a 90-year-old traditional herbalist.

... He adds that he does not have to worry about HIV or other infections to the family because he has crafted many knives for the job. "Besides, I use special herbs to sterilize these knives and therefore make them safe," he says.

... (to the rest - if this link fails, contact us)


The Australian
September 28, 2010

Pilot 'obsessed with circumcision' to continue flying after avoiding conviction for photographing naked boys

A PILOT with a circumcision obsession will be able to continue his career after avoiding a conviction for photographing naked boys.

Glenn Anthony Armstrong, 48, was arrested at Brisbane's South Bank Parklands on Australia Day after he was spotted taking a photo of a naked three-year-old boy being changed by his parents, the Brisbane District Court was told today.

Prosecutor Chris Minnery said police discovered 10 photos of the genitals of three boys on Armstrong's camera.

Armstrong's barrister, Peter Kelly, said his client had a "passionate interest in photography'', but was also "obsessed with circumcision'' due to his body dysmorphic disorder. [And his body dysmorphic disorder was due to ... ? ]


The court was told a psychologist had also confirmed Armstrong's obsession with circumcision was anatomical, and not sexual. [And he used a camera, not a scalpel.]


Armstrong pleaded guilty to three counts of making recordings in breach of privacy, and was sentenced to a $5,000, three-year good behaviour bond.

Earlier story


September 25, 2010

6 year old dies before circumcision

Feni, Sept 25 (bdnews24.com) — A six-year old has died allegedly from an injection over dose for circumcision at Sonagazi Upazila.

The child was identified as Sajjad Hossain Mimu, son of Mofiz Uddin of village Safarpur of Amirabad Union.

The village doctor who had treated Sajjad, one Kamal Uddin, reportedly fled on Saturday shortly after the boy's death.

Mofiz said he had taken his son to Kamal for circumcision. The quack applied three injections into the child's body. The child became sick and fainted.

Mofiz said he then shifted his son to Feni Sadar Hospital and doctors declared him dead.

Sonagazi Upazila Health Complex medical officer Saiful Islam told bdnews24.com that lidoquine injections are used in circumcision, but in the case of the child, it appears to have been a case of overdose. "There is a death risk for over dose of that kind of injection."

Mofiz said that he was preparing to file a case with the police.

Sonagazi police chief Nizam Uddin said he had heard about the incident and would take appropriate measures upon receving a complaint.

Two experts have commented:

  1. Lidocaine is a nonspecific sodium channel blocker. All muscle cells have sodium channels in them. When Lidocaine is injected into a vein it reaches the heart undiluted in a few seconds and can stop it. The area involved by circumcision is of course highly vascular [rich in blood vessels]. Lidocaine was once used to help slow heart arrythmias [irregular beating]. There are better, safer drugs now.
  2. Local anaesthetic agents are recognised to be toxic in overdose. They poison the central nervous system causing fits and loss of consciousness, and they poison the heart, causing rhythm disorders, potentially lethal. That's presumably what happened in this case. Obviously, the smaller the patient, the less medication it takes to cause toxicity. It highlights the fact that it is not acceptable to take the view that circumcising children is acceptable so long as pain is controlled.


SUNY Cortland News
September 22, 2010

Challenges to abolishing FGC

Ellen Gruenbaum, who has conducted research in Sudan and Sierra Leone on the practice of female genital cutting and the social movements against “harmful traditional practices,” will discuss her work on Wednesday, Sept. 29.

A professor and chair of the Anthropology Department at Purdue University, she will begin her lecture on “Secrets, Fear, Honor and Outrage: Challenges to Abolishing Female Genital Cutting” at 4:30 p.m. in Moffett Center, Room 2125.

Presented as part of the 2010-11 Rozanne M. Brooks Lecture Series themed, “Women’s Worlds Redux,” the event is free and open to the public. A reception to welcome Gruenbaum starts at 4 p.m. at the Rozanne M. Brooks Museum in Moffett Center, Room 2126.

A medical anthropologist drawing on more than five years of fieldwork in Sudan, where the most severe forms of genital surgery are common, Gruenbaum shows that the practices of female circumcision are deeply embedded in Sudanese cultural traditions — in religious, moral, and aesthetic values, and in ideas about class, ethnicity, and gender.

“I will examine the validity of Western arguments against female circumcision,” said Gruenbaum, the author of The Female Circumcision Controversy: An Anthropological Perspective. “In doing so, I will explore both outsider and insider perspectives on the custom, concentrating on the complex attitudes of the individuals and groups who practice it and on indigenous efforts to end it.”

In her book, The Female Circumcision Controversy, Gruenbaum points out that Western outrage and Western efforts to stop genital mutilation often provoke a strong backlash from people in the countries where the practice is common.

“The criticisms of outsiders are frequently simplistic and fail to appreciate the diversity of cultural contexts, the complex meanings and the conflicting responses to change,” she observed.


“That does not mean that there is no role for outsiders,” Gruenbaum asserts. She will offer suggestions for those who wish to help facilitate change.



Times of Swaziland
September 22, 2010

bully cuts boy's private parts in toilet


SITEKI – A Grade I pupil sustained serious injuries on his private parts after his foreskin was cut off by his classmate in a school toilet.

The classmate is alleged to have told the young boy that he was circumcising him. The incident happened just over a week ago at Lonhlupheko Primary School.

As a result Mangaliso* has not been attending classes for over a week due to the injuries as he has been in and out of hospital.

Mangaliso, 7, was in the toilet when Zama*, 9, approached him and informed him that he wanted to circumcise him.

Mangaliso is said to have refused but Zama insisted.

Upon realising that he was adamant on his refusal, Zama is said to have kicked him and pushed him to the ground. He then undressed him and cut him with a surgical blade.

Zama is said to be a bully among his classmates. Unlike normal doctors, Zama’s idea of circumcision was to cut the front part of the private parts and this resulted in Mangaliso sustaining a deep cut.

Ironically, health officials had been to the school recently on their circumcision campaign.

[It's not ironical at all - rather, predictible.]

However, they did not conduct any circumcision because the pupils are still young. Mangaliso’s grandmother who is also his guardian ... went to the school to complain about the incident so that she could get financial assistance but was told that it was not the responsibility of the school.

The school is later said to have met with Zama’s parents who visited Mangaliso and promised to assist him with medical expenses.

Only the area’s community police were informed about the matter but nothing has been done so far. The school’s principal, who only identified herself as M. Gama confirmed the incident but was quick to say the children are safe.

She admitted that she had heard reports that Zama was aggressive towards other children but said he had changed. [Clearly not.]


The Law Offices of Jeffery M. Leving, Ltd.
September 22, 2010

Purported Dad Wins Court Order Restraining Mom From Circumcising Infant

CHICAGO, Sept. 20 /PRNewswire/ -- DuPage County Judge McJoynt today granted an emergency restraining order to Richard Tranchida through his family law attorneys, Jeffery M. Leving and William Dowling, against Alana Lynn Muschong from obtaining a circumcision for the infant child born late Friday evening, September 17, 2010.

Infant circumcision is a very controversial and emotionally charged topic over-ladened with social, cultural and religious factors. While many doctors try to avoid controversy by appearing neutral, more health professionals are challenging the perceived necessity of routine infant circumcision. The American Academy of Pediatrics reports that the benefits of circumcision are not significant enough to recommend circumcision as a routine procedure and that circumcision is not medically necessary.

"Our client believes that there is no medical emergency or necessity which would warrant the mother to direct a circumcision procedure to be performed on the child at the present time. Valid consent from both parents is needed before any decisions on any procedures are performed. In addition, we need to consider the infant's best interest and our current understanding of bioethics and infant rights should be taken into consideration," said Jeffery Leving (http://dadsrights.com).

This case is set for further hearing in front of Judge McJoynt on September 29, 2010 at 9:30AM at 505 County Farm Road in Wheaton, Illinois.


Less penis - more man??

September 20, 2010

Zimbabwe: Fungisai Angers Fans

by Tichaona Zindoga

Harare — Gospel songstress Fungisai Zvakavapano-Mashavave has courted the anger, and even contempt, of her followers after reportedly telling a local paper that uncircumcised men were "useless" recently.

Fungisai, who was speaking at a graduation ceremony of some Shangaan men who had undergone circumcision, said an uncircumcised male could never be considered a man.

Fungisai is a board member of the National Aids Council, which is promoting male circumcision as a way of combating the spread of HIV and Aids. She reportedly said: "I would like to say to men, you are not a man unless you are circumcised."

But many people interviewed by The Herald expressed outrage over the statement, saying as a celebrity she risked alienating some of her fans who do not subscribe to her religious or cultural views.

Tawanda Magunje from Chitungwiza said as a proponent of the practice, Fungisai should find ways of preaching her circumcision gospel without looking down upon other people.

"That was uncalled for," Magunje said. "I would want to ask in what respects she would say an uncut man is not a man considering that it is the same organ that determines someone's sex."

Others pointed out that it could only be those that had met both uncut and cut men who could be better informed as to who was really "a man" between them.

Newspaper reader comments and feedback have been unsparing over the past week following the "Makomborero" hitmaker's comments.

However, in a telephone interview Fungisai said people should "forget about my ethnocentric views" but focus on the benefits of male circumcision.

"I'm only human and I'm entitled to my own opinion," she averred, saying her statements should be read in the context that she is a Remba. "But circumcision is good for the body just like food to the body. "As a Christian I'm not saying it will make you go to heaven but it is what God prescribed for his people of Israel," she said.


Real story - RACP rejects circumcision

ABC (includes audio)
September 20, 2010

Sydney doctors resume circumcision debate

Barbara Miller reported this story

ELEANOR HALL: It's the exception rather than the rule these days to have baby boys circumcised for health reasons, but several [two] prominent physicians say that should change.

The doctors argue that boosting the male circumcision rate in Australia could significantly reduce HIV transmission among heterosexuals, but the Royal Australasian College of Physicians is against the move, as Barbara Miller reports.

BARBARA MILLER: These days it's the exception when an infant boy in Australia is circumcised for non-religious reasons.

Sydney woman Sally said she thought long and hard about the pros and cons of having the procedure done when she had a baby boy earlier this year. She decided to go ahead, but wasn't prepared for the backlash.

SALLY: It was a terrible decision because I didn't feel like I could talk to other mums about it and when I did ask mums who did have sons and I mean, it had never been a question on my mind because I had two girls, most of them hadn't and a number of women were quite aggressive about it and quite, you know, confronting about it.

BARBARA MILLER: Sally says one factor in her decision was evidence from studies in sub-Saharan Africa that circumcision can reduce the rate of HIV-AIDS transmission in heterosexuals.

In the current edition of the Medical Journal of Australia a group of physicians [two doctors and Brian Morris] argue that that evidence is compelling. They say boosting circumcision rates as a long-term strategy to reduce HIV transmission would be sound public health policy in Australia.

One of the authors is Dr Alex Wodak, the director of the Alcohol and Drug Service at St Vincent's Hospital in Sydney.

ALEX WODAK: It is a significant reduction. Now, of course, we shouldn't be abandoning all the excellent prevention measures that we already have. In fact, we should be intensifying them. This should be a new prevention measure in addition to the other ones.

BARBARA MILLER: Is it not a bit extreme to recommend that the entire male population is circumcised in the hope of just achieving a reduction in possible rates of transmission?

ALEX WODAK: Well, no one is calling for this to be mandatory or obligatory or routine. [Being "routine" the way it used to be is exactly what they are calling for.] What we are calling for is a level playing field. That is to say parents should be given balanced information, not the extremist information they are given at present which exaggerates the risks and underestimates the benefits.

How about not exaggerating the benefits?

Fewer than 1000 people a year are infected with HIV in Australia. In 2008, 15.2% (144) transmissions were known to be female-to-male, and a further 7 unknown cases can be assigned to that cause on the assumption that the they were distributed in the same ratio. But if we consider only Australian-born cases, that number falls to 64. If 60% of those are circumcised and circumcision confers 60% protection, the number of cases that would be prevented by circumcising all males born in Australia can be shown to be 60 (There would be 100 cases if none were circumcised, 40 if all were).

Almost all those infected were aged between 20 and 65, and there are approximately 4.7 million Australian-born men aged 20-64. 4,700,000/45/60 =

an approximate Number Needed to Treat.

At a very conservative $300 per circumcision, the cost of averting one HIV infection by this method is more than $500,000 - with a very large number of circumcisions wasted for this purpose, and a significant number of complications and other adverse outcomes, and resentful men who would have chosen other methods of prevention.

ANDREW PESCE: I guess on a personal level I find it difficult to believe that a foreskin evolved over billions of years of human evolution needed to be chopped off as soon as the baby was born.

BARBARA MILLER: Dr Andrew Pesce is the president of the Australian Medical Association.

ANDREW PESCE: What we are talking about is that otherwise healthy boys have an operation because of a feeling that it's good for them in the future even though there is nothing wrong now and that requires a lot of rigorous data collection, a really good understanding of what the potential benefits over the lifetime of the operation are and balancing them up against the immediate surgical risks of a procedure which can have a low but a measurable complication rate of bleeding, infection, scarring things like that.

BARBARA MILLER: Just last week the Royal Australasian College of Physicians affirmed its opposition to routine circumcision after a review of the latest evidence.

Gervase Chaney is the college's president of the paediatrics and child health division. He says he can't support the arguments put forward by Alex Wodak and his colleagues:

GERVASE CHANEY: We don't agree with it. We believe that the evidence currently would not support that in Australia, that it might be supported in other countries particularly obviously in Africa where there are much higher rates of HIV transmitted heterosexually but that at this stage that that is not something that we would support but that we agree to disagree with that group.

BARBARA MILLER: The College of Physicians says parents need to make their own decision about circumcision, saying it recognises it's a difficult choice and Sydney woman Sally says it's not just medical issues that need to be considered.

SALLY: I was worried that he would get teased at school when he was older you know, in the dressing sheds if everybody else was not circumcised and he was and the doctor said to me that by the time he is an adolescent about 30 even 40 per cent of boys will probably be circumcised [the rate among his peers will be exactly what it is today - fewer than one in five in NSW - there won't be any newborn babies in the dressing sheds] and as a friend of mine said to me, look Sally, no adolescent boy is going to admit looking at someone else's penis let alone teasing them for it so maybe that is not such a big deal.

BARBARA MILLER: The Royal Australasian College of Physicians is expected to make its latest advice on circumcision publicly available later today.

ELEANOR HALL: Barbara Miller reporting.

Earlier story


The Martlet (Vancouver)
September 18, 2010

Foreskin activist calls for genital awareness

Kailey Willetts
CAN-FAP founcer Glen Callnder at Vancouver Pride

CAN FAP founder Glen Callender defends foreskin at Vancouver Pride.
Gemma Karstens-Smith

Have you ever seen a man put a grape inside his foreskin? How about nine of them? That’s exactly what Glen Callender of the Canadian Foreskin Awareness Project (CAN FAP) does to catch the audience’s attention at the beginning of his foreskin demonstration.

CAN FAP is an advocacy group dedicated to “foreskin education, appreciation and stimulation.”

“[We] advocate for the right of all children, male, female, and intersex to grow up with intact genitalia, and decide for themselves if they want to have medically unnecessary surgery performed on their genitals,” said Callender.

“The amputation of sex organs is a big deal and it’s something that as a culture we don’t want to face, and it’s really time for it to be faced.”

The project launched on June 20, Father’s Day, a deliberate move on Callender’s part. He hopes that one day CAN FAP will be “considered the greatest Father’s Day present that Canada ever received.”

There are several reasons Callender is advocating for foreskin awareness. According to Callender, males with foreskin experience more sexual pleasure than their circumcised counterparts.

“[My foreskin] is very sensitive, it brings me a lot of pleasure. It brings me orgasms, specific orgasms that you don’t get from other places,” he said. “I even have multiple orgasms from stimulating my foreskin, which is very rare in men.”

Callender believes that there is no medical reason for circumcision, and it is practiced purely for cultural or religious reasons.

“It’s so bizarre that in our culture we’re trying to prop up this absurd purely cultural double standard where we say, ‘Oh, genital cutting is bad for girls but it’s good for boys.’ That’s frankly nonsense,” he said. “It’s merely something that’s propped up by over a century of ignorance and an old fad from Victorian England that hasn’t washed itself out of the system.”

However, not everyone is on board with CAN FAP’s message. Rabbi Barak Cohen from UVic’s Multifaith Services, addressed some of the claims made on CAN FAP’s website.

“With regards to the necessity of [circumcision]? I don’t know. I mean I understand someone who’s not coming from a Jewish perspective, or also Muslims practice this as well, I would understand why they would not want to go through this procedure,” he said.

Cohen said there are some medical benefits to circumcision, such as studies that have shown it reduces HIV transmission rates in Africa.

“There are those who believe that medically it does have benefits. There are those who say those benefits are so small they wouldn’t go through such a procedure,” he said. “It’s an issue of what do we, as parents, have a right to do to children, for what we think is the best for them. Again, there’s two things – there’s religiously, if you’re a Jew or a Muslim, and physically, if you’re a human being.”

Immunizations are given to children for health benefits despite the fact that they’re uncomfortable, said Cohen. He added that while there may be minor benefits to circumcision that some parents feel are worth the procedure, for a Jew the benefits go beyond the physical.

One of those is a commandment called brit milah, which translates as “covenant of… circumcision,” said Cohen. “It’s this relationship that God entered into with Abraham through this ritual.”

Cohen acknowledges that some believe religious circumcision should be saved until the age of majority. “In theory that is a valid point — the only thing is that the ritual ... becomes that much more complicated and is that much more painful when you’re older,” said Cohen. “To an eight-month-old baby, it’s not much of a procedure.”

However, Cohen [Callender?] disagrees.

Callender says that with his personality and foreskin demonstrations, he and CAN FAP are in a position to bring a lot of awareness to circumcision.

“As a front man for CAN FAP, I will be doing a puppetry of the penis-type thing. It’s evolving very quickly,” Callender said. It certainly is an evocative performance, moving from the initial “guess-how-many-grapes” attention-grabber to a more informative presentation on foreskin hygiene, pleasure and other topics.

Callender plans to take CAN FAP on a campus tour and hopes that both those who agree and those who disagree with his cause will attend. He’s going to visit Lower Mainland campuses in the fall, and hopes to later come to UVic.

Callender has already taken the project to several Pride events. The queer community, according to Callender, knows “what it feels like to be repressed sexually, especially by an old book of fairy tales.”


You saw it here first

the Times of Swaziland
September 19, 2010

More circumcised men are HIV positive


MBABANE – Even though male circumcision is considered to have a protective effect for HIV infection, circumcised men have a slightly higher HIV infection than those who are not.

The Times SUNDAY can today reveal that government has known this for close to three years.

It is contained in the Swaziland Demographic and Health Survey (SDHS) of 2007 which still prevails.

This report summarises findings of the 2006 survey carried out by the Swaziland Central Statistical Office (SCO).

The report places the infection rate for circumcised males at 22 per cent while for those uncircumcised stands at 20 per cent.

HIV stands for Human Immuno Deficiency Virus. It is the virus that can cause the acquired immuno deficiency syndrome (AIDS).

The report states that the protective aspect of male circumcision is based in part because of the physiological differences that increase the susceptibility to HIV infection among uncircumcised men. However, the relationship between HIV prevalence and circumcision is not in the expected direction.

"It is worth noting that the relationship between male circumcision and HIV infection may be confounded by the fact that the circumcision may not involve the full removal of the foreskin, which provides partial protection," stated the report.

But additional analysis is needed to determine if this lack of a relationship between male circumcision and HIV infection is a result of confounding factors or represents the true situation.

In 2007 government introduced a policy on male circumcision, which has a goal of halting the spread of HIV infection to achieve an HIV-free generation.

Cited in the report is that to meet this objective, male circumcision services, as part of the national comprehensive HIV prevention package, would have to be availed to men of all ages.

To maximise the health benefit for HIV prevention, the primary targets of the services are men who are HIV-negative, in the age bracket of 15-24 and also newborn babies.

Additional information collected by the SDHS in the 2006 to 2007 period revealed that eight per cent of men age 15-49 were circumcised.

"Older men are markedly more likely than younger men to have been circumcised, which the rate peaking at 20 per cent among men aged 35 -39 years. Urban men (13 per cent) are more than twice as likely to be circumcised compared with rural men (six per cent)," said the report.

Also discovered is that the rate of circumcision among men is slightly higher in the Hhohho and Manzini regions compared with the rate in Shiselweni and Lubombo.

Meanwhile, the belief that circumcision can provide a considerable measure of protection against HIV infection has been questioned by academicians and medical professionals of repute.

Last week Occupational Health Specialist Dr Cleopas Sibanda questioned the rationale of circumcision to justify it being adopted as part of the national HIV and AIDS prevention strategy.

"What exactly happened in Uganda as far as HIV and AIDS and population demographics are concerned to correctly attribute the observed previous decline in their national HIV and AIDS statistics to wholesale male circumcision?" Sibanda was quoted as having asked.

But he noted that circumcision for the wrong reasons can be very dangerous, in fact it has increased episodes of diminished consistent use of condoms and increased incidences of HIV and AIDS affected populations.


An antidote to Operation Abraham?

September 8, 2010

New Israeli treatment kills HIV cells

A new treatment that destroys HIV-infected human cells without damaging healthy ones has been developed by a team of Israeli researchers.

The therapy, developed by scientists from the university's Alexander Silberman Institute of Life Sciences and the Institute of Chemistry, destroys cells infected with HIV without damaging adjacent healthy cells. It is described in an article published last month in the scientific journal AIDS Research and Therapy.


The new treatment fights HIV by causing infected cells to self-destruct. When the AIDS virus infects a cell, its DNA penetrates the cell, which then manufactures new HIV viruses that infect neighboring cells.

Dr. Abraham Loyter of HUJ explains that with the treatment peptides, or segments of short proteins that the scientists developed, interfere with the HIV virus's replication of its genetic material, by transmitting a massive number of replications of the genetic material into the infected cell, triggering its self-destruction.

"The usual medications kill the virus that has entered the body during infection, and the [peptide] treatment allows cells infected with the genetic load of the virus to be killed," Loyter said in an article in Israel's Ha'aretz newspaper.

The study by Loyter, Prof. Assaf Friedler, Dr. Aviad Levin, and Dr. Zvi Hayouka, examined the effectiveness of the new treatment on the HIV-1 virus, which is the predominant cause of AIDS in developing nations.

When the treatment, which was patented earlier this year, was applied to human cell cultures, the infected human cells disappeared in two weeks, and did not reappear up to two weeks later.



Not all are lemmings...

Afrique en ligne
September 16, 2010

Malawi rules out policy on circumcision as anti-AIDS strategy

Blantyre, Malawi - Malawi will not make it an official policy to promote and encourage circumcision among men as a way of preventing the spread of HIV, the virus that causes AIDS, two government officials announced here Wednesday.

'We have no scientific evidence that circumcision is a sure way of slowing down the spread of AIDS,' said Dr. Mary Shaba, Principal Secretary for HIV and AIDS in the Office of the President and Cabinet.

Shaba said she was aware that studies in countries where circumcision was mandatory showed that HIV/AIDS figures were comparatively low, noting however, that circumcision may not be the only reason why that was so.

Recent studies in Uganda, Kenya and Morocco [? - it would be hard to find a man who is not circumcised in Islamic Morocco; the third study was in Orange Farm, South Africa] have found that prevalence rates are reduced by up to 60 percent among men that are circumcised. [No, they found that after circumcising 5,400 men, 64 contracted HIV in less than two years, 73 fewer than comparable groups of intact men.]

Anglican Bishop emeritus Bernard Malango also said in districts where circumcision was practiced in Malawi, studies had shown HIV prevalence rates were also high.


HIV Rates:

Circumcised men


Intact men


Source: www.measuredhs.com

Circumcision is culturally and religiously mandatory among Muslims and some tribes in Malawi.

However, most Christians and most tribes do not practice what is socially dubbed 'the cut'.

Since reports started spreading that circumcision may have an impact on the spread of HIV, more men have been flocking to hospitals to have the cut.

While some men get circumcised in private hospitals at a fee, many are flocking to public hospitals who are offering the service for free.

About 12 per cent of Malawi population are HIV positive.

[Now watch the intense pressure, political and financial, come on to Malawi to reverse its policy. It would be intolerable to the circumcision lobby for there to be even one real-world control group in its all-Africa experiment, that might demonstrate that circumcision does not in fact reduce the spread of HIV/AIDS.]


Flesh and Stone
September 15, 2010

Mother to sue Miami hospital that wrongfully circumcised baby


"She [Vera Delgado] wants a law passed that would prohibit any hospital from routinely circumcising newborns without a compelling medical or religious reason," added Aronfeld on an entry on his blog.

South Miami Hospital has a poor patient safety track record, according to HealthGrades, an organization that rates all U.S. hospitals on factors like treatment outcomes, mortality rates, and patient safety. Of 12 patient safety categories, South Miami scored "worse" than expected standards in six categories. It scored "average" in five patient safety areas, and "better" than expected for a hospital its size on just one measure, the incidence of hospital-acquired infections.


VSVN (with video)
September 11, 2010

Family to sue hospital over procedure

SOUTH MIAMI, Fla. (WSVN) -- A family is taking legal action against a local hospital

... Mario spent 10 days in intensive care for complications related to his birth. During this time, hospital staff asked Delgado and her husband if they wanted Mario to be circumcised. "Every time that the doctor asked if we're going to have the circumcision on him, we always say no. Always. All the time, we always say no, because we always think that it was unnecessary surgery for him," said Delgado. [How many times did they ask? How many times is harrassment?]

However, on the eighth day of Mario's hospital stay, Delgado discovered a painkiller in his bassinet. A nurse informed Delgado that doctors performed the circumcision on her son. "I asked her what the Tylenol was for, and she told me that it was for the pain caused by the circumcision. She opened the diaper, and when she opened the diaper, we saw all the blood, and we saw everything, and I started crying. She told me, 'Unfortunately, they did the circumcision on him,'" Delgado said.

Delgado and her husband hired Attorney Spencer Aronfeld, who has worked on circumcision lawsuits in the past. "The hospital didn't just commit medical malpractice. What they did is a battery, because it was an unauthorized touching of this baby boy," said Aronfeld. "This is more than a procedure and policy error at the hospital. This is a doctor signing a document stating he had had conversations with parents that never occurred, and this is the kind of answers to the questions that we have for South Miami Hospital and for this physician."

For any surgery, there is a standard procedure, with a checklist:


Items to Be Verified on the Preprocedure Patient Safety Checklist*

Preoperative items **

  1. Identification band is on the patient and is confirmed with two other methods of identification (ie, name, medical record number, date of birth).
  2. The anesthesia/sedation consent has been completed and reviewed.
  3. The surgical consent has been completed and reviewed.
  4. Pregnancy test results are available for all postmenarchal female patients or female patients older than 12 years.
  5. All jewelry, contact lenses, and appliances are removed.
  6. Provider order sheet/requisition is complete and signed.
  7. Patient history and physical examination, which was completed within 30 days of the procedure, has been reassessed on the day of the procedure and the procedure is still indicated; any changes to the history and physical examination have been documented.
  8. The medication history form has been completed by the health care provider, verified, and signed by the physician or physician's designee.
  9. The invasive procedure is verified with the patient, a parent or guardian, or the transferring caregiver.
  10. When indicated, the surgical site or side is initialed per policy.

Time out#

1. A time out was completed immediately before the incision was made or the invasive procedure began and the following were verified: patient identification; procedure/site/side; patient position; imaging studies, when applicable; special equipment, when applicable; and implants, when applicable.

* The back page of the checklist includes an area to document additional time outs. An additional time out is necessary if there is more than one procedure on the same patient, particularly if there are different sites or sides and the patient is repositioned.

** Preoperative items either must be checked as not applicable (items 1 and 7 may not be checked as not applicable) or must be marked with a verifier's initials (items 1 to 6) or with the surgeon's and a verifier's initials (items 7 to 10).

# Time out documentation must be marked with a verifier's initials.


Time Out and Site Verification Audit Statements *


1. When site initialing is required, the site is marked by the physician or physician's designee with his or her initials. ...

2. Time out was initiated by a member of the team and performed before the incision was made.


3. Time out is documented in the patient care record (eg, time out checklist, sticker in chart, progress notes).

4. When site initialing is required, there is documentation that the site was marked according to policy.

* All statements should be marked as either yes or no; if site verification is not required for the procedure, statements 1 and 4 should be marked as not applicable.

Adapted ... from Children's Hospital Boston, Mass.

The problem is that circumcision has been so normalised that it is not considered surgery.


Delgado said, the mistake cannot be undone. "I'm not sure if someday he's going to ask why he's so different from his brother or his father. [More to the point, he's going to ask why he doesn't have all he's entitled to.] I don't know, but we're going to have to start thinking about that. Any mother, they want to protect their child, and I couldn't protect my child at that time," she said.


September 10, 2010

Baby Gets Circumcised Against Family's Wishes

SOUTH MIAMI - Mario Viera is just four weeks old. When he was born, his mom says she told doctors at South Miami Hospital several times that she did not want Mario circumcised.

"It's a big hospital," said Vera Delgado, Mario's mother. "It's a good hospital, and I thought he's safe, he's good there."

But eight days after his birth, without his mother even present, doctors performed the surgery.

"I was crying. I spent that day and the next day crying," Delgado told CBS4's Gio Benitez exclusively.

It turns out every man in Mario's family is uncircumcised. It's a family tradition. [So is not notching his ear.]

Delgado knows a lot of people will think, "Oh that's not a big deal. But what would happen if you don't want that for your son, and they do it anyway?"

"This is not malpractice. This is a battery," said Attorney Spencer Aronfeld, who is working the case.

[Which raises an interesting question about the legal status of all other non-therapeutic circumcision....]

On Monday, he says he'll file a lawsuit against the doctor and hospital for battery.

"They went and they did an unnecessary, unwanted procedure on this child without the parents permission," he said.

The hospital released this statement: "The baby's circumcision was an unfortunate mistake caused by a misread consent form. As soon as the error was discovered, the doctor and nurses let the family know what had occurred."

"I see hospitals make mistakes all the time. What I don't see is hospitals make mistakes, and admit them," said Aronfeld.

But he and Delgado say the hospital has to do more than admit the mistake because Delgado says it's a risk Mario didn't need to face.

"And with him being in intensive care, with more reason," she said.

Mario was in intensive care for ten days. He was circumcised on the eighth.

Hospital spokespeople say they're sorry.

"I know they apologized and everything, but it's done, the damage is done," said Delgado.

This is South Miami Hospital's full statement regarding Mario Viera's circumcision:

"The baby's circumcision was an unfortunate mistake caused by a misread consent form. [Someone misread "No" as "Yes"?] As soon as the error was discovered, the doctor and nurses let the family know what had occurred. We also immediately implemented new processes to ensure this mistake will not occur again. The procedure itself was performed following appropriate surgical guidelines and the baby didn't have any complications. ["It was the best butter" - The March Hare] Nevertheless, we're all deeply sorry that this happened."


Capital News
September 10, 2010

Infants targeted in Kenya circumcision project

KISUMU, Kenya, Sep 10 - A pilot project to have male children circumcised at birth has commenced in Nyanza under a partnership by the universities of Nairobi, Illinois and Manatoba (UNIM).

UNIM project coordinator Dr June Odoyo said the new initiative is being piloted at New Nyanza General hospital, Kisumu, Siaya and Kombewa district hospitals.

Dr Odoyo said already they have trained health workers, mostly nurses, in the selected hospitals on how to circumcise the infants.

He explained that the nurses will use special gadgets known as a Mogen clamp to perform the circumcision at birth.

[A Mogen clamp!? When the Mogen company has just gone out of business after losing a $US 10.7M law suit to a family whose son lost the head of his penis to a Mogen clamp?]

He says the new initiative is cheaper and heals faster and should be embraced by parents.

Speaking during a media training on male circumcision in Kisumu, Dr Odoyo said acceptance is low among the mothers besides resistance from the Luo Council of Elders.

He said the elders have declined to support the pilot project claiming it is against the culture of the Luo community.

Dr Odoyo said the report on the new initiative would be released by the end of the year to assist the government to plan on the health of its citizens.

He says ideally, male circumcision in Nyanza province ought to have targeted the infants but narrowed down on the adults who were at risk of contracting HIV/AIDS.



Times of Swaziland
September 8, 2010

Inyanga's warning about circumcision


MBELEBELENI – A traditional healer has related how he treats many men who have STIs due to their belief that after circumcision they will not contract HIV.

The healer, who wished to be identified only as Nkambule, said he had been receiving an influx of male clients who wanted to be treated for sexually transmitted infections.

He said when he questioned them on why they do not use condoms, the response was that they were of the view that since they were circumcised, they did not need to use one.


"Most of them then require me to treat them with my traditional medicine," he said.

Nkambule explained that in one instance his client asked him to prepare a concoction that would enhance his manhood as he would not be required to use a condom since he had undergone circumcision.

"I always advise them to follow the laid-down procedures a person is expected to undergo after circumcision, but most of them insist that they be given traditional medicine. As a traditional healer, I support circumcision but it is now clear that people have different understandings of it," he said.

Nkambule disclosed that he always advised his clients to test for HIV before opting for traditional treatment.

"After observing the condition of my clients, I always advise them to check their status so that the necessary treatment can be administered," he explained.

He said circumcision was introduced to reduce the chances of people contracting HIV.

He urged government to consider making circumcision compulsory, especially among the youth, but educate them that they still had to use condoms.

He said there was a need for the ministry of Health to educate people about circumcision because it was clear that it has not been well understood, especially in the rural areas.


Nkambule said, judging from the number of people who came to him after circumcision, it was clear that people have this strong belief that circumcision prevented one from getting a sexually transmitted disease.

"I treat people for different ailments, but the number of those who come with problems of sexually related diseases is increasing," he said.

Government, through the prime minister’s office, recently affirmed the nation’s commitment in getting more males circumcised.

Studies have also shown that circumcision reduces the chances of getting HIV by 60 per cent, and people are still urged to use condoms even after getting circumcised.


Mail & Guardian (Johannesburg)
Septermbr 3, 2010

Tender details get the KLamp


The decision by the KwaZulu-Natal health department to award a tender for the supply of a controversial circumcision device, the Tara KLamp, has been obscured by a cloud of mystery.

The department, the supplier, a rival supplier and the device's inventor remain tight-lipped about how and why the health department procured the device.

The Mail & Guardian reported in June that the Malaysian-made KLamp had been flagged as unsafe by independent experts in 2004, that no further randomised control trials (RCTs) on the device had since been conducted and that the device was not approved by the World Health Organisation.

In addition, other circumcision devices are available on the market, such as the Shang Ring, which, unlike the KLamp, have received the all-clear in RCTs.

Despite these concerns department spokesperson Chris Maxon swatted away the M&G's questions about the tender award, saying: "We wish to state we find it disingenuous for you to ask for these [tender] documents without providing reasons. These are contract documents that are kept to protect their authenticity." The M&G has established that the company which supplies Tara KLamps to the department is Intratrek Properties, which company registration documents list as an Mpumalanga-based real estate firm.

Provincial treasury public finance manager Ndoda Biyela said Intratrek Properties was the sole distributor of the device in South Africa and that the Malaysian manufacturer, Taramedic Corporation, was the sole manufacturer.

The product's unique status made a competitive bidding process "impractical", Biyela said.

According to treasury regulations, tenders can be awarded to lone suppliers, but motivation for doing so must be recorded and approved by the accounting officer.

"These are available if you request them," Biyela said, but Maxon rejected the M&G's request.

Earlier story

Video story about Tara KLAMP risks


the Times of Swaziland
September 2, 2010

PSI forgets 4 boys after circumcision


NHLANGANO - The male circumcision campaign has been tainted by controversy as a group of boys were neglected after undergoing the exercise.

The campaign is pioneered by the ministry of Health and other implementing partners such as Population Services International (PSI).

Four boys have come out to disclose how PSI failed to stick to its obligation of providing after care services to them for about a week.

The boys said they were circumcised last Tuesday by PSI officers at the Nhlangano Health Centre and since then, they had not been getting any medical assistance to deal with the pain nor to help change their bandages.

*Mkhulisi Maseko, 20, said after they were circumcised they were told by the officers to come back two days later to check if the wound was healing well and to change bandages.

He said they were promised a kombi would fetch them from their various places of abode and that they should be at the stations from 8am.

He narrated that they waited until sunset on Thursday for the kombi to no avail and when they enquired from the emergency and transport numbers, they were assured the kombi was on its way and they should continue waiting.

He said they continued to wait but the kombi never showed up.

Meanwhile, another circumcised member of the dumped group Banele said he was in great pain and could hardly walk.

"The painful part was seeing the blisters on our manhood and experiencing unbearable pain due to lack of pain killers. We ended up removing the bandages ourselves since they were covered in blood. It is now six days and no one from PSI has bothered to check to see whether the wounds are healing or not. We are confused on what to do because some of us did not report to our parents that we were going to be circumcised. To be on the safer side its better we seek medical services at the Hlathikhulu Government Hospital," he said on Monday.

Meanwhile *Jomo was found last Friday at his parental homestead limping and using a supporting stick.

His grandmother, condemned the act by PSI and said they were not consulted in the first place.

"As parents we were not even consulted. Our government should come to the rescue of the children because they are suffering. I wonder how they just dump the children without giving them the necessary assistance," said the grandmother.

It has since been revealed that the boys eventually got treatment from PSI this week.


September 1, 2010

Sugar for newborns does not relieve pain: study

PARIS (AFP) – Contrary to international guidelines, sugar given to newborn babies does not ease pain, according to a study published on Thursday by The Lancet.

In 2001, doctors published recommendations, based on a series of trials, that oral sucrose be administered to newborns to help relieve pain from invasive procedures.

But a new look suggests that sucrose does not reduce pain signals in the brain or spinal cord, but merely changes the babies' facial expression, which gives a false impression that pain is being relieved.

Rebeccah Slater of University College London and colleagues pricked the heels of 59 newborns with a small blade -- a procedure that was required anyway to draw a blood sample -- and monitored pain activity in the brain and spine using electrode caps.

The infants were assigned either sterile water or a sucrose solution, placed on the tongue by a tiny syringe.

Pain activity did not differ significantly between the two groups.

"The absence of evidence for an analgesic action of sucrose in this study, together with uncertainty over the long-term benefits of repeated sucrose administration, suggest that sucrose should not be used routinely for procedural pain in infants without further investigation," Slater's team said.


The Zimdiaspora (Zimbabwe, UK-based)
August 30, 2010

Man gets death threats for refusing circumcision

A Zimbabwean man has fled his homestead after receiving death threats for refusing to be circumcised, it has been reported

Mr Patrick Chauke (46), who comes from Masekesa village under Chief Tshovane in Chiredzi, said he fled his home last month after receiving death threats from the chief and his council for refusing to be circumcised.

“I am a victim of harassment and fear that they will kill me. On 27 July this year, the chief sent his man to take me to the bush for circumcision and threatened to kill me if I refused,” he said.

“I left Chiredzi on 6 August and came to Bulawayo with two of my older children, leaving my wife and our younger child behind.”

Mr Chauke said the circumcision practice was part of their culture.

“It’s not the first time that they are doing this to me. The practice is part of the Shangani culture and is done every year. The only problem is that each year when this is done some people have to be killed and this time it was my turn so I ran away.

“In 2007, I was taken by force and stripped naked in front of people before I got circumcised. I was told that it was my turn to die but managed to survive because during those days there was a birth certificate registration outreach and court officials and police camped in our area so they were afraid.

“A lot of people are dying and others have disappeared and no one knows that. I am the first person to survive the onslaught and they are after my life. The culture of that area demands blood and they eat the flesh of the first person to be circumcised and burn the remains to make concoctions for n’angas [traditional healers].

“At the moment I am under threat and fear for my life. Since I left my wife makes calls everyday saying they are hunting for me and they are even threatening to kill her if I don’t come back.”

Mr Chauke said the chief and his advisors were abusing a lot of people yet nothing has been done to stop that. He also revealed that the case has been reported to the police.

“Those who are circumcised are forced to eat their removed foreskins in order to be strong and I have been brutally assaulted for refusing to take that order.

“Since the 2007 encounter they seemed to have forgotten and I had relaxed only to get the shock of my left in July this year to learn that I was the prime target and so I ran away because I knew what was to follow.”

According to police documents given to Chronicle, Mr Chauke reported his case of assault and abuse to the Legal Advice Centre in Chiredzi on 27 November 2007, who forwarded the issue to the police seeking advice on what to do with the matter.

In response, Chiredzi charge office ordered the arrest of the accused in a document dated 21 September 2007 and wrote the second document on 21 November 2007, indicating that the accused (names stated) were found guilty and liable to payment of a deposit fine of Z$40 000.

However, Mr Chauke said he has lost faith in the police because the problem has continued after three years and the perpetrators are still free.

“Before I came here I ran to the police station at Chisumbanje in Chipinge District but the police took me back to Chiredzi police station and there I was referred to the district administrator who deals with community administration issues with the chiefs.

“The DA took the statement but I could not go back home for fear of being killed and I came here before getting the outcome of what the DA did.

“At the moment, I stay with my brother in Sizinda but I am afraid again that they will kill my wife. I appeal to the law enforcement agents and Government to take action because I am in a desperate situation and a lot of people are being abused and killed,” he said.

Contacted for comment, the acting police spokesperson for Masvingo Province, Assistant Inspector Prosper Mugauri, confirmed that Mr Chauke made an assault report to Chiredzi police station.

“I can confirm that Patrick Chauke reported a case of assault in 2007 and the people who assaulted him were arrested,” said Asst Insp Mugauri.

“However, we have not received his latest report of assault and we advise him to report his case to any nearest police station where he feels free because it is a serious matter.

“No one has the right in our country’s laws to intimidate and threaten anyone,” he said.


LA Times
August 23, 2010

Boys hoping to gain their manhood lose it - forever

In Eastern Cape, South Africa, circumcisions performed to make youths into men are often botched. Some are too young to understand the extent of the damage.

By Robyn Dixon and Kylé Pienaar
Reporting from Libode, South Africa —

In the windblown hills of the Eastern Cape, boys from the Xhosa tribe are in a hurry to be men.

At 20, Siphelele Zweni was ridiculed in his village. They called him nofontyela, a non-man, who'd gone too long without his coming-of-age circumcision.

But when it did take place, Zweni's circumcision and initiation was like a sadistic scene from "Lord of the Flies." It cost him, literally, the very thing he yearned for: his manhood.

"They taught me about being a man, but it was hell," says Zweni, defying a taboo about speaking out against the ritual, which in the Xhosa tribe traditionally had occurred when men were about 20.

But early in the last century, the traditional ways were lost in some areas as local rulers stopped circumcisions. The practice was revived in the 1980s and 1990s, and now younger and younger boys are desperate to have it done so they won't be nofontyela.

Swayed by the peer pressure, Zweni would have had his operation earlier but for the lack of traditional surgeons, who had disappeared during those long years of no circumcisions.

Medical research has shown that circumcision sharply reduces the spread of HIV and other diseases. [They have to throw that in, don't they?] Hospital circumcisions are reviled in the Eastern Cape, however, leading young men to undergo dangerous bush procedures, often at the hands of con men, who pretend they know the traditional ways, or inexperienced teenagers.

The problem is that, in taking over a procedure traditionally done by elders, the young ones aren't doing it right. Alien new practices have crept in to the "initiation": severe beatings, harassment and a dangerous ritual of tightening the dressings on boys' wounds.

Boys as young as 13 are circumcised. Many live in single-parent households where the mothers have no say on the procedure.

A law banning bush circumcisions hasn't helped. Thirty-seven have died in Eastern Cape province this year; others, like Zweni, have lost all or part of their penises. More than 400 boys have died in the province since 1994, according to government health figures.

"More than a hundred years ago, this custom was stopped by the King of Pondos," says Nkosi Ngangomhlaba Matanzima, chairman of the Eastern Cape House of Traditional Leaders. "Now, because children are mixing with other tribes at school who practice this custom, young ones all of a sudden take this upon themselves."


Xhosa boys retreat to huts in the wild for a month to become men. They're told how to behave, respect their elders, treat women, and conquer fear and loneliness. They're ordered to make submissive gestures when any circumcised man enters the hut.

Naked but for a blanket in the freezing Southern Hemisphere winter, they get no water, just dry food, for the first eight days after circumcision. Groups of boys are cut with one kitchen knife, potentially spreading HIV infection.

One part of the ritual — the binding of the penis after circumcision — is described by survivors as like torture. Initiated "men," many of them young teens, repeatedly bound Zweni's penis tightly. When one group had finished, another arrived. It went on day and night. Crying or protest meant failure as a man.

Enduring the pain of the cut is an important sign of manhood, but easy to bear, Zweni said, compared to what came later. "It was very tight. They were just doing it tight without explaining why," he says. "All I can tell you is it was very painful and I was very weak. I lost a lot of blood."

None of this, according to elders, is central to the original ceremony, but is a corruption of the traditional practice of applying herbs and leaves to prevent infection.

Another initiate, Lucky Dikiso, 18, forced open the door of the locked initiation hut and fled after four agonizing days at the hands of 23 circumcised men.

"I was defenseless," he says. "They would leave and within a few minutes another group would come and do the same thing. They tightened it so tightly, I can't even describe it."

Zweni, a herder, was desperate to prove his manhood. "When you go around the village, almost every circumcised man will ask, 'When you are going to be circumcised?' and they will chase you away. I was isolated and told they wouldn't mix with me as an uncircumcised boy," he says. At important festivals, men would get meat and beer, but not boys.

"There was this anger inside me. I felt their disrespect."

There was no traditional surgeon, so he and 13 other boys approached an old man in the village who they'd been told was doing circumcisions. He agreed to perform the procedure, but the initiated boys did the rest.

"No one looked after us," Zweni says, speaking hesitantly in a ward at St. Barnabas Hospital in the town of Libode, nervously fiddling with his left sock. About 30 victims of botched circumcisions fill the men's wards.

The boys huddle together, nudging, whispering, teasing and laughing. In blue pajamas and aquamarine robes, they're more like children at bedtime than patients. Only the bloodstains at the crotches of their pajamas betray the tragic undercurrent of their friendships.

Dikiso, who didn't sustain permanent damage, gazes sympathetically at a new patient who is sweating and feverish, legs splayed uncomfortably. Another boy, soaking his sheet with perspiration, jumps up yelling, believing he's still in an initiation hut in the wild.

Just being in the hospital — tended by female nurses — means failure. (Women are supposed to have no part in the manhood ritual.)

Back home, once released from the hospital, the boys won't be accepted as men. They will always be nofontyela, because they failed the ritual.

To gain acceptance, some go back to the "mountain" to be circumcised again after leaving the hospital. But not Dikiso.

"What they've done to me is punishment enough," he says.

The ward is filled with denial more than grief. Lolling on one of the beds, three giggling shy boys, ages 13 and 14, don't understand that the organs won't grow back.

Zweni thinks he'll be released any day, without lasting damage. He does not understand that doctors are keeping him in to allow the rest of the gangrenous flesh to fall off.

He says he will never let his son be circumcised in the bush.

It hasn't yet sunken in: He probably won't ever have a son.


the Guardian (London)
August 23, 2010

LEYTONSTONE: Doctor "carrying out female circumcision"

A LEYTONSTONE doctor is suspected of carrying out female genital mutilation (FGM) proceedures, as the number of reported cases in London continues to rise.

The illegal practice is said to be widespread in the capital, with the majority of cases said to be from the African community.

Police have intervened in 122 cases since the launch of Project Azure in 2008, but no prosecutions have taken place.

Dr Comnfort Momah, who runs a clinic in Guy’s and St Thomas’ Hospital in central London, told the BBC: "In London FGM is widely spread and in my clinic we see about 350 women and children with FGM related problems every year and do reversal in about 100 cases every year.

"We do have people calling me or calling other clinics saying I know a circumciser in Leytonstone, I know a doctor who is performing it within the community, but they won't give you the information."

"I see a lot of teenagers now, self-referring to the clinic and getting information from the internet."

Anyone convicted of carrying out FGM can be jailed for up to 14 years.

It was estimated at the launch of Project Azure that more than 1,000 young girls in the borough are at risk of this form of abuse.


, 2010

Study: Circumcision Rates Falling Fast In U.S. by NPR Staff August 22, 2010 Listen to the Story All Things Considered [3 min 29 sec] * Add to Playlist * Transcript A sleeping newborn boy Enlarge iStockphoto.com A sleeping newborn boy iStockphoto.com text size A A A August 22, 2010 New research about a steep drop in circumcisions made headlines this past week. According to one federal researcher, circumcision rates in U.S. hospitals slid from 56 percent in 2006 to fewer than a third of boys born last year. Doctors caution that those numbers aren't definitive — for instance, they don't include circumcisions not covered by insurance policies or circumcisions performed in religious settings. But Dr. Douglas Diekema, a pediatrics bioethicist at the University of Washington, tells NPR's Audie Cornish there's no doubt about the overall trend. "I think all of us agree there probably is a decrease in the number of circumcisions over time, and that's probably a result of a number of factors," Diekema says. "About 10 years ago, the American Academy of Pediatrics came out with a policy statement that was fairly neutral on whether circumcisions should be recommended for newborns or not," says Diekema. "And that probably changed the way physicians were talking to their families." In many states, Medicaid stopped covering the procedure as a result of that policy statement. And many insurance companies followed suit, meaning that more and more families might have decided to forgo circumcision just because of the expense. "It's also worth pointing out that our population is becoming increasingly Hispanic," says Diekema, "And that's a population that has not traditionally circumcised their babies." 'Intactivists' Another possible explanation for the decrease might be the anti-circumcision advocates known as "intactivists." They've lobbied forcefully against circumcision for years now, and some people compare them to anti-vaccination advocates. But Diekema criticizes their tactics. "Their arguments are largely emotional," says Diekema. "Just the fact that they insist on referring to this as 'genital mutilation' tells you that they're refusing to recognize whether there may be any medical benefit to the procedure." And the benefits are large, he says. "There is a fairly substantial, important reduction in the risk of contracting many sexually transmitted infections," says Diekema. "In newborns, there is a decreased likelihood of getting a urinary tract infection, which for a newborn baby can be a very significant illness." And, he says, "at least three well-done, randomized control trials in Africa show a substantial decrease in the transmission of HIV [due to circumcision]." Ultimately, in spite of arguments on both sides of the issue, Diekema says that male circumcision is a decision that families should make on their own. He says a doctor's role is to make sure the family is aware of the risks and benefits of the procedure. But, he says, "the risks of circumcision are considerably lower in the newborn population than they are if that child is older."


Malawi Voice
August 21, 2010

Bishop Circumcised Over Anti-Jando Sermon In Mangochi

By Austin Kakande

Bishop for Church of Christ has been circumcised against his will for preaching against Jando (yao male circumcision rite) in Yao dominated district of Mangochi.

The Bishop (name withheld) whose church is located in Sauka Village in the traditional authority Mponda, is on record for having preached to his congregation that they did not have to be circumcised for them to inherit the Kingdom of God, during his sermon on the Sunday of 8th August 2010.

And on the night of 11th and 12 August, unidentified gang stormed into his house and cut off his fore skin using a very sharp blade, leaving his member breeding profusely.

He was later rushed to Mangochi district hospital where he received medical treatment and discharged the following morning.

The 27 year old Bishop told Malawi Voice that all he preached to his congregation was that all people, circumcised or not were equal before God.

“I never said anything bad towards the rite, all I said was that we are all equal in the eyes of God whether we are circumcised or not,” he said

But Rashid Kulisinje, a member of the church said on that Sunday the Bishop attacked the rite saying people should strive to be clean in heart not body.

“So I think someone misunderstood him and brought the sermon out of the church,” he said

Last year, another man of God was also circumcised in Nkhotakota.

[These rapes should be considered in the light of the compulsion to circumcise in "civilised" communities.]


August 20, 2010

Egypt doctor 'arrested in girl circumcision death'

CAIRO — An Egyptian doctor has been arrested after she performed a botched circumcision that killed a young girl, a newspaper reported on Friday.

The independent daily Shorouk reported that police were alerted to the death of the girl, whose body was illegally buried to hide the crime, after a call to a help line the government set up to monitor female circumcision.

The doctor, from the Nile Delta governate of Menufiya, has been referred to a criminal court, the paper reported.

The sometimes deadly practice of female circumcision was banned in Egypt in 2007, but is believed still to be common.

A 2005 government report found that more than 95 percent of Egyptian women had undergone the extremely painful procedure which can severely mutilate the genitals.


Norwegian Broadcasting Coporation (NRK)
August 6, 2010

Circumcising Little Boys Is Abusive and Should Be Banned

By Tonje Grimstad

According to the Norwegian Medical Association's (Den norske legeforening) ethics committee, circumcision exposes little boys to unnecessary pain and medical risks. Each year hundreds of babies are circumcised in Norway. Circumcision of boys is widespread among Muslims and Jews in Norway. [Circumcision is rare among the majority of the Norwegian population.] Each year hundreds of babies are circumcised. "Healthy babies are quite unnecessarily exposed to pain as well as medical complications," says Trond Markestad, leader of the ethics committee and professor of paediatrics. "The surgery itself is painful, and so is the post-operational period," says Markestad.

Several boys in Norway are circumcised without anaesthetics, but even with the use of anaesthetics, circumcising healthy children is simply wrong, maintains Professor Markestad.
"There are no medical reasons for it, and it violates central principles of medical ethics." According to the professor, the children may suffer from a series of complications.
"Haemorrhages and infections are common. Speaking of my own experience, I have seen serious cases where too much skin was removed. Such cases result in a tilted penis. Lasting scars may cause additional problems."

In Favour of a Ban
In Sweden, the speaker of the Society of Paediatric Surgery, chief surgeon Gunnar Göthberg, recommends banning circumcision, which he characterizes as genital mutilation of boys.
“In my work as a paediatrician and a paediatric surgeon, I always look to the UN Convention on the Rights of the Child. There are no medical arguments for circumcising boys,” he says. Göthberg regards circumcision as an unnecessary operation.
"Strictly speaking, the removal of a small part of the body amounts to an amputation, for which reason circumcision is wrong."

"A Matter of Abuse"
Jan Helge Solbakk, professor of medical ethics, works at the universities of Oslo and Bergen, and is also in favour of a ban. “This is a matter of abuse. Circumcising boys is abusive, as is circumcising girls. In both cases, a ban is necessary,” says Solbakk.

"Unreasonable Criticism"
Rolf Kirschner, chief physician at the gynaecological department of the National Hospital (Rikshospitalet), is a previous leader of the Jewish synagogue of Oslo. He thinks the criticism is unreasonable.
"Firstly, I want to be clear that I am talking about male, not female, circumcision. Secondly, I find it hard to understand why this particular issue is brought up over and over again, considering the fact that the rights of children are brutally violated in many other circumstances. Finally, I claim that many of my fellow physicians are criticizing something they are not capable of fully understanding," says Kirschner. He thinks that ancient traditions, which have been around for thousands of years, should be respected.

Administration of Cognac
However, Trond Markestad is well informed on the circumcision of boys, as he has previously worked as a paediatrician in the US, where neonatal circumcision is [was almost] universal.
"Indeed, I have performed several circumcisions, and I have observed serious complications following the surgery. In the US, we circumcised without the use of anaesthetics, administering a mixture of sugar and cognac into the mouth of the babies. The pain was obvious, and so was the pain following the surgery. I would never do this again," says Markestad.


They have scotched the snake, not killed it

Clacton Gazette
August 6, 2010

Botch op doc keeps job

A GP who botched circumcision operations on five boys after telling their parents there were no risks has been allowed to keep his job.

The children had to be hospitalised after urologist Dr Aziz Chaudry messed up the £150 procedures at his surgery in Clacton.

The GP failed to tell the parents of the boys cutting would be necessary and asked one father who could barely speak English to sign a consent form.

Chaudry was found guilty of misconduct for his “serious omissions” and a total of 13 conditions were placed on his registration.

Until a review in 12 months he is banned from carrying out surgical procedures, including circumcisions, and from carrying out any private work.

Dr Ian Neale, General Medical Council panel chairman, said: “The panel is of the view the failings are capable of being remedied, though it has some concerns about your limited insight.

“However, the panel considers there is some evidence to suggest you have the potential to address your failings.

Chaudry admitted various aspects of his note keeping were not in the best interests of the patient and below the standard of care expected of a registered medical practitioner.

He was cleared of allegations that he forcibly restrained two of the boys while carrying out the procedure without anaesthetic.

Chaudry can continue working as a GP at the Old Road Surgery, Clacton, subject to the conditions.

He is banned from private work, cannot carry out any surgical procedures, including circumcisions, must develop a personal development plan and undertake communication skills course.

Chaudry has 28 days to appeal.


Where's the drop?

AIDS 2010, Vienna
August , 2010

Rates of selected neonatal male circumcision-associated severe adverse events in the United States, 2007-2009

C. El Bcheraoui, J. Greenspan, K. Kretsinger, R. Chen

Background: Three African randomized controlled trials recently showed that adult male circumcision (MC) conferred approximately 50% protection against HIV acquisition. Several countries, including the United States, are updating their HIV prevention recommendations to include adult and neonatal MC. [They wish!] In the United States, nonrepresentative published cohort studies have reported rates of MC adverse events (AEs) ranging from 0.2 to 2.0%. Representative data on rates of MC AEs, particularly rare and severe AEs, are needed to guide these recommendations.

Methods: We retrospectively analyzed discharge data from any hospital setting (inpatient or hospital clinics) from SDIHealth, the largest U.S. consolidator of electronic healthcare reimbursement claims (eHRCs). SDIHealth obtains data on all patients from 21% of U.S. short-stay hospitals. We used a) International Classification of Diseases (ICD-9) codes to identify circumcised boys born between November 2007 and October 2009, and b) ICD-9 and Current Procedural Terminology (CPT) codes to identify selected AEs recorded during the birth hospitalization or in any subsequent hospital setting within 60 days of birth.

Results: During the 24 month observation period, 330,845 newborn circumcisions occurred during the birth hospitalization (approximately 12% of 1.4 million total annual infant MC in the US). [That represents no drop in the circumcision rate.]
Within 60 days of these circumcisions, 3 partial penile amputations (9.0/million circumcisions), 78 penile post-circumcision adhesions (2.3/10,000 circumcisions) and 243 repairs of incomplete circumcisions (7.3/10,000 circumcisions) were recorded for 308 unique patients in hospital settings (9.8/10.000 circumcisions overall). No complete penile amputation or deaths were recorded.

Conclusions: We found low incidence rates of the selected AEs after MC in hospital settings, taking advantage of administrative eHRC datasets, with large sample sizes and longitudinal design. We plan next to study other MC AEs, such as bleeding and infections, that may be treated in other outpatient settings, to provide a better understanding of the risks of MC for parents and providers.

This greatly underestimates the real complication rate.

  • Complications occurring or discovered after 60 days are not counted.
  • Only a small range of possible complications are counted.
And of course even 25 (3/0.12) partial penile amputations a year represents 25 badly damaged lives.


Intact World!

July 31, 2010

Genital Autonomy for an Intact World!

A new umbrella group to unit all genital integrity causes was announced at the closing session of the Eleventh International Symposium on Genital Integrity today. The group, called Genital Autonomy or GA, will be based in England.

July 31, 2010

Conference tells AAP, CDC: “Don’t cut babies”

An international conference has delivered a clear message to US medical bodies not to recommend any infant genital cutting that is not strictly necessary, organizers say. The 11th International Symposium on Genital Integrity ended at the University of California at Berkeley this evening.

“We learned how circumcision does much more harm and less good than most people imagine,” co-organizer Marilyn Milos said, “and how circumcision instruments have particular risks—as we were reminded last week when a boy was awarded $10 million for a tragic botch.”

The American Academy of Pediatrics and the Centers for Disease Control are both considering revising their currently neutral advice about neonatal circumcision in the United States, following claims from trials in Africa that it reduced the rate of HIV transmission from women to men by 1.8%. Over three trials, the rates were 2.49% of non-circumcised men and 1.18% for circumcised men.

“We heard how the African trials are irrelevant to the US, where HIV is mainly transmitted by sharing IV drug needles and sex between men,” Milos said.

“The AAP should have learned from its recent experience with female cutting, that even a token nick is not acceptable, and male circumcision and intersex reassignment are much more extensive than a token nick,” Milos said.

Tomorrow the National Organization of Circumcision Information Resource Centers (NOCIRC), one of the conference organisers, marks 25 years in existence.

July 31, 2010

Surprize! Circumcision makes the penis smaller

Circumcising babies in America always causes disfigurement in men, a family physician told an international conference this afternoon.

“By any cosmetic or surgical-outcomes criteria, their penises are harmed—twisted, bent, or scarred,” Christopher Fletcher MD of Santa Fe said, “And though it is counter-intuitive, they are smaller and skinnier than those of intact men.”

Assistant clinical professor of family and community medicine at the University of New Mexico School of Medicine, Dr Fletcher’s conclusions arise from a study of men 18 years and older seeking medical care. The vast majority of the circumcisions had been done soon after birth for non-medical reasons.

Dr Fletcher told the 11th International Symposium on Genital Integrity at the University of California, Berkeley, that these men are almost universally unaware of their disfigurements and think of their penises as completely normal.

“This obvious physical damage is universally ignored by the patient, his parents, and physicians,” he said.

Another study found that the adult penis of men circumcised as children is 8mm (3/8?) shorter.

Dr Fletcher has delivered more than a thousand babies and dissuaded the parents of all but 10 of the boys from having them circumcised.

July 30th, 2010

Hospitals risk legal action over circumcision

Hospitals and medical providers face special legal risks when they allow healthy newborn babies to be circumcised, a conference on genital cutting was told today.

Zenas Baer, a Hawley, Minnesota lawyer with extensive experience in circumcision cases involving informed consent, says our society is morally and legally committed to the principle of self-determination, which implies the right of every person of sound mind to determine what shall be done with his or her own body.

He told the 11th International Symposium on Genital Integrity in Berkeley today that patient self-determination is only meaningful if the patient receives sufficient information, and the information that must be disclosed is a standard set by law for physicians — not one they may, or may not, impose upon themselves.

Baer said a hospital’s corporate duty of care to a patient is separate and distinct from its duty of care to a medical practitioner.

The conference includes presentations about the human rights and legal issues involved in female genital cutting and the surgical re-assignment of intersexed babies and children.

July 30, 2010

“Concerted effort” to promote circumcision

A secretive lobby group of physicians, researchers, and others is making a concerted effort to promote neonatal circumcision world-wide, an international conference on genital cutting was told this morning.

Atlanta, Georgia, attorney David Llewellyn told the 11th International Symposium on Genital Integrity this morning that since the mid-1980s they have been looking for “medical” reasons to cut off baby boys’ foreskins. And that they want to have circumcision approved as a public health measure by national and international medical organizations.

“Their latest efforts seem to have resulted in the recent circumcision trials in Africa,” he said. “These have been erroneously labeled as the ‘gold standard’ in medical research, and have formed the basis for suggesting a revision of medical organization statements to favor universal male circumcision.”

Llewellyn won a $10.7 million lawsuit last week from the manufacturer of the Mogen circumcision clamp for a boy whose circumcision was botched by the clamp. The firm has now gone out of business. He has been litigating wrongful circumcision, circumcision damage and related cases for 15 years, and it now makes up the majority of his practice.

He discussed the pro-circumcision lobby in detail, with particular reference to their journal publications and their involvement with pro-circumcision and circum-fetish websites. “The urge to circumcise boys has some deep and sometimes murky roots, and those who promote it for ‘medical reasons’ are not necessarily immune to those influences,” he said.

July 30, 2010

Don’t foreclose kids’ options with surgeries

Children are entitled to an “open future,” with no options foreclosed that could not wait for the child’s expressed preference, a conference on genital cutting was told this morning.

Seattle attorney John Geisheker successfully argued the case of a 14-year-old Oregon boy who did not want to be circumcised after his father’s religious conversion.

Geisheker, Executive Director of Doctors Opposing Circumcision, said courts pay undue deference to parental discretion - cultural and religious – at the expense of the child’s human rights. He suggests the best guiding principle is the “open future” articulated by philosopher Joel Fienberg.

The Feinberg Principle, Mr. Geisheker argues, should apply even more strongly where the child is subject to irreversible and non-therapeutic bodily alterations of any kind, which include many other interventions than male circumcision, though that is easily the commonest. They include operations to flatten the ears, Europeanize Asian eyelids, assign gender to intersexed children and “normalize” boys’ and girls’ genitals.

July 29, 2010

African circumcision experiments “like Tuskegee”

Health care in Africa is a risk for HIV transmission, a conference at Berkeley was told today.

The World Health Organisation and UNAIDS warn UN employees of this, but it has been kept from ordinary Africans for 25 years, Dr David Gisselquist said.

He told an International Symposium on Genital Integrity at Berkeley, California, the current push for circumcision is an example of the distracting emphasis on sex alone as the cause of Africa’s AIDS disasters.

“The key to stopping AIDS in Africa is to trace and investigate suspicious infections in children and adults to find their source,” he said. “When Africa’s medically-caused HIV outbreaks have been investigated and uncovered, it will be possible to have a rational discussion about circumcision in Africa.”

Dr Gisselquist compared experiments in Africa, where HIV researchers followed HIV-positive adults who did not know they were infected in order to study sickness, death, and transmission, to the infamous 40-year Tuskegee trial of black Americans infected with syphilis.

“The health-aid industry needs distractions to keep people from seeing that unsafe health care spreads HIV in Africa,” he said “Among Americans, the health-aid industry hides behind pervasive racial stereotypes of African sexual behavior. In Africa, it spends billions of dollars to blame the victim for unwise sexual behavior.”

Medical Anthropologist Dr Gisselquist of Hershey, Pennsylvania, has worked on HIV in Africa and Asia and has assisted field research on HIV in India and Kenya.

Speakers have come to the symposium from Australia, Brazil, Canada, Egypt, England, Ireland, Italy, and New Zealand. It includes presentations about the human rights and legal issues involved in female genital cutting and the surgical re-assignment of intersexed babies and children.

July 29, 2010

Intersex surgery not for parents or doctors to decide

Whether to operate on an intersexed child is not a simple clinical decision, an international conference on genital cutting was told this morning.

An official Australian children’s advocate said the decision was not one to be taken by doctors, nor by frightened parents following clinical advice, nor the dictates of culture or religion

Paul Mason told the 11th International Symposium on Genital Integrity that children are children first and girls and boys second.

“If genital surgery on an intersex child is not necessary to preserve the child’s life, or to treat or prevent a likely and serious illness, the decision whether and how to operate can be put off until the child is old enough to express an informed view about the options, and in a forum that addresses any conflicts of interest,” he said. “That age depends on the intervention and the risks.”

In 2005 the San Francisco Human Rights Commission called for an end to medically unnecessary interventions on intersex children – those born with genitals not typically male or female. About one child in 100 has some degree of intersexuality, but only about one in 5000 is fully intermediate.

Paul Mason is Commissioner for Children for the Australian island state of Tasmania, a state appointment independent of the elected government, responsible for advising the government about all matters concerning the health, welfare, development and education of children and their protection from all forms of abuse and neglect.

July 29, 2010

Circumcision device ‘like BP in Gulf’

Many devices have been invented for circumcising boys and men, but none overcomes all its problems, a researcher from New Zealand told an international conference on genital cutting today.

“No device takes full account of the actual structure it is designed to remove,” Hugh Young said. “Only one even acknowledges that the cut is not exactly circular.”

He was particularly scathing of the Accu-circ, a new single-action disposable chopper that resembles a cork-puller, works like a stapler and conceals the penis when it cuts.

“In poor countries, if it can be dismantled, it will be re-used, raising the risk of cross-infection - including HIV,” he said.

“If it fails to cut completely, or sticks part-way, the operator is left like BP in the Gulf of Mexico, but perhaps with blood leaking out instead of oil. A newborn baby is in danger after losing only two tablespoons of blood."

The Accu-circ has been cleared by the Food and Drug Administration for use in the US on babies up to ten days old, on the basis that it is “substantially equivalent … to legally marketed … devices” but Young says in fact it is radically different.

Speakers came to the symposium, at the University of California at Berkeley, from Australia, Brazil, Canada, Egypt, England, Ireland, Italy, and New Zealand, as well as all parts of the United States.


NOCIRC, Intact America
July 29, 2010

Recent events give focus to Genital Symposium

Recent events give a special edge to an international conference on genital cutting being held next weekend, organisers say.

The 11th International Symposium on Genital Integrity begins at the University of California at Berkeley on Thursday, July 29.

“In May, the American Academy of Pediatrics flirted with approving a kind of female genital cutting, even though that is illegal in the United States. Scores of boys have died of tribal circumcision in South Africa in the last few weeks. And a Cornell doctor has been testing a new method of cutting back the genitals of intersexed children - without knowing what sex they might want to be when they grow up,” co-organizer Marilyn Milos says. “We see events like these as related; all are breaches of the simple right of people to control the destiny of their own bodies.”

“On the plus side, the Dutch Medical Association has came out unequivocally against male genital cutting and several more countries have passed laws against female cutting,” co-organizer Frederick Hodges adds.

Topics at the symposium include the psychology of genital cutting and the people who do it, circumcision and HIV, how a prayer is being used to end female cutting in Somalia, and the complications of “routine” circumcision seen in a United States family practice.

Speakers are coming to the symposium from Australia, Brazil, Canada, Egypt, England, Ireland, Italy, and New Zealand.


24 Hours (Vancouver)
July 25, 2010

Comedian pushes foreskin education


A local comedian spent many years considering what he’d like to do with his foreskin.

Now he knows.

Having gained inspiration from the performers behind Puppetry of the Penis, Glen Callender will stage demonstrations to promote foreskin education, appreciation and stimulation in a private tent during Vancouver Pride festivities.

“It’s not the wrapper, it’s the candy,” he explained. “Circumcision removes 75 per cent of the nerves of the penis. It makes a huge difference in the sensations a man will have in his penis through his life.”

But it’s not just sexual stimulation Callender is concerned about.

“Women’s breasts get cancer a lot more often than men have serious problems with their foreskins, but we would never consider cutting one off when it’s healthy,” he said. “We would wait until there is a problem, then you treat the problem and if you can’t treat the problem then you go to the extreme of amputation.”

To see and learn much more, visit the Canadian Foreskin Awareness Project at the Davie Street Party on July 30 and at Sunset Beach on Aug. 1.


The Edge (Boston)
July 22, 2010

Study: Adult Circumcision Minimally Effective [= ineffective] at Controlling U.S. HIV Transmission

by Kilian Melloy

Circumcision would not significantly reduce the spread of HIV in the United States, a new study suggests.

The study, carried out in San Francisco, indicated that circumcision as a tactic for reducing HIV transmission would only be minimally effective, reported an article posted at Scientific Computing.

Although studies in Africa have indicated that circumcision might help reduce the spread of HIV in straight men by removing foreskin cells that are vulnerable to the virus, the new study -- which focuses on gay American men -- does not arrive at the same conclusion, in part because circumcision is already so prevalent in the U.S. Moreover, only a very small minority of men surveyed for the study said that they would undergo circumcision even if it were proven to reduce their risk of contracting HIV. [Some real numbers would be useful at this point.]

some numbers...

Web newswire

Circumcising gay men would have limited impact on preventing HIV

VIENNA, Austria, July 22 – Adult circumcision has been proposed ...

The study was based on surveys of 521 gay and bisexual men in San Francisco. Findings indicated that 115 men (21 percent) were HIV-positive and 327 (63 percent) had been circumcised. [Yes, but how many of each group had HIV?] Of the remaining 69 men (13 percent), only three (0.5 percent) said they would be willing to participate in a clinical trial of circumcision and HIV prevention, and only four (0.7 percent) were willing to get circumcised if it was proven safe and effective in preventing HIV.

The researchers extrapolated these findings to the entire gay and bisexual male population of San Francisco, an estimated 65,700 people, and determined that only 500 men would potentially benefit from circumcision. ...

Study co-authors include H. Fisher Raymond, M.P.H., Willi McFarland, M.D., Ph.D., Susan Buchbinder, M.D., and Jonathan Fuchs, M.D., all of the San Francisco Department of Health. The study was funded by the Centers for Disease Control and Prevention.

"Our study indicates that any potential benefit may likely be too small to justify implementing circumcision programs as an intervention for HIV prevention," said Chongyi Wei, a post-doc with University of Pittsburgh Graduate School of Public Health, which carried out the study, and an author of the paper on the results, which was presented at this week’s International AIDS Conference in Vienna.

Previous studies have also indicated that gay men do not benefit from circumcision the way [73] heterosexuals seem to when it comes to HIV transmission. One study by the U.S. Centers of Disease Control and Prevention showed that circumcision seemed to make no difference in HIV transmission rates when it came to anal sex, an AP story from Aug. 26, 2009 reported.

That article also noted that circumcision is more than a medical procedure, freighted with religious, political, and social significance. It is part of some religious traditions, but also excoriated by some political groups. One anti-circumcision group, Intact America, views the procedure as a violation: "It’s removing healthy, functioning, sexual and protective tissue from a person who cannot consent. You’re mutilating a child," Intact America’s executive director, Georgeanne Chapin, told the AP.

Last year, the CDC floated the controversial idea of recommending circumcision as a standard part of neonatal care as part of an effort to combat HIV in the United States. The proposal anticipated that the next generation will include more uncircumcised males than the current generation. Moreover, more Hispanics and African Americans are choosing not to have their male babies circumcised; studies indicate that those populations are harder hit by HIV and AIDS than are Caucasians. [A poor excuse for an attempt to find a correlation where there is none.] Worldwide, only about 30% of all men are circumcised.

Although circumcision is commonplace in some parts of Africa, it is often not conducted until adulthood. A June 30 AP article reported that the traditional circumcision rite, which is not typically performed by physicians or carried out in a sterile environment, can result in potentially fatal infections. [Why the double weakening? Has resulted in scores of fatal infections in the last two months.]

Elsewhere in Africa, circumcision is not so commonplace, partly because there are too few qualified medical professionals to carry out the procedure. [...but mainly because they won't have a bar of it.] However, a new medical device, called a ShangRing, simplifies the procedure and reduces discomfort and pain to a minimum, the AP reported last Feb. 16. Use of the ShangRing reportedly involves a much lower incidence of infection or other complications. [... accordng to the people who sell it.]


IOL news (South Africa)
July 22, 2010

Botched op on toddler: Charges dropped

By Sinegugu Ndlovu

A KwaZulu-Natal doctor charged with unprofessional conduct after allegedly performing a botched circumcision on a one-year-old boy was cleared of the charge on Wednesday.

Malcolm Rivett, a general practitioner at Kokstad Private Hospital, appeared before a professional conduct committee of the Medical and Dental Professions Board in Durban. The charge concerned Rivett's circumcision of the boy on October 24, 2008. He was charged with incompetence and unprofessional conduct because skin attached to the glans of the boy's penis caused it to angulate after the procedure.

Rivett's lawyer, Altus van Rensburg, argued that a post-penile adhesion was a well- documented complication of a circumcision, which did not constitute unprofessional conduct. Dr Kuthula Khuluse, who treated the boy after the procedure, said he corrected the angulation. The committee found that the adhesion was a common complication and dismissed the charge.

[van Rensburg is right that adhesions and skin bridges, where a foreskin remnant heals back on to the torn glans, are a common complication of circumcision, sometimes unnoticed until adulthood - but the fact that they are common does not mitigate the harm.]

* This article was originally published on page 3 of The Mercury on July 22, 2010


My Joy Online
July 22, 2010

Time to halt the UNAIDS gravy train

In his address to this week’s international AIDS conference in Vienna, Bill Clinton told some home truths about aid for HIV: “In too many countries, too much money pays for too many people to go to too many meetings and get on too many airplanes to do too much technical assistance.” A good start to cutting the waste derided by the former US president would be to close down UNAIDS, the UN’s lobbying organization that costs tax-payers the best part of a billion dollars a year.

It was set up in 1996 by UN agencies claiming that HIV was so special it should be removed from the purview of the World Health Organization. From the start, UNAIDS has been self-serving, providing the UN with data and arguments for massively expanding HIV funding regardless of HIV’s place in global health priorities or the cost-effectiveness compared with other health needs.

Much of its data and arguments have been proved wrong and much of its lobbying has been based on alarmist prevalence figures (in 2007 it had to halve its estimates for India and other countries) and misleading projections, like the pandemic long-predicted to be just about to hit East Asia and which never has (no thanks to UNAIDS). This has contributed to disproportionate HIV spending across Africa in countries such as Ethiopia, Rwanda and most of West Africa where prevalence is low, stable or declining.

[All these indicate that UNAIDS was an organisation ripe for infiltration by interested parties with - literally - an axe to grind, and that is what has happened.]

Data from a few hard-hit southern African countries has been used to secure an excessive 25% share of global funding for health, depriving the fights against bigger killers such as malaria and diarrhoea.

In addition to claims of impending disaster, UNAIDS has been slow to listen to scientific evidence that was inconvenient. This includes the UNAIDS mantra that HIV is a “disease of poverty,” wilfully ignoring the evidence of many years that prevalence is higher in the middle classes of Africa than the poorer.

On prevention, the record of UNAIDS has been dismal. It has resisted admitting the key role of concurrent sexual partners in driving transmission, instead promoting broad prevention schemes aimed at the general population, most of whom are at minimal risk. [Did UNAIDS pay for the 80-year-old prince of Swaziland to be circumcised?]

UNAIDS has not hesitated to take credit for recent data showing global declines in HIV rates but in fact HIV has been declining in Africa since the late 1990s, before UNAIDS was working and before the huge input of money. The decline is more a result of the natural course of the disease.

How important is HIV? Globally it is insignificant, accounting for less than 3% of deaths. Even in Africa, HIV is not significant for the vast majority of the continent’s 53 countries. Excluding just five countries with the highest number of HIV deaths (South Africa, Swaziland, Botswana, Lesotho and Zimbabwe) relegates HIV for the rest of Africa to around 6% of deaths--below deaths from diarrhoea, childhood diseases, malaria, respiratory infections, cardiovascular diseases, maternal and perinatal conditions, and accidents and injuries.

Yet this week in Vienna UNAIDS continues with its misleading propaganda that, globally, AIDS is the biggest killer of women of reproductive age, when this is true in only a handful of southern African countries.

For the cost of putting four million people on expensive HIV treatment, we could save the lives of 10 million children every year from pneumonia and diarrhoea that are simple and cheap to treat--and no less fatal. It is a tough choice--but most people don’t even realise it is a choice or who has been doing the choosing and why.

President Barack Obama is right to shift new aid to supporting all health needs not just one disease, an approach mirrored by the UK’s Department for International Development. The self-serving lobbying of UNAIDS, by contrast, illustrates vividly the folly of a single-disease UN agency. Time to put those billions of dollars to better use.

Roger England is Chairman of the Health Systems Workshop, an independent think-tank promoting health systems reform in poor countries. He has worked for several international agencies including secondments to the World Bank and the World Health Organization.


July 21, 2010

Foreskin Man Comic Book Takes on Male Circumcision

A new comic book from MGMbill.org pits Foreskin Man against the obsessed circumciser Dr. Mutilator.

San Diego, California

As comic book fans from around the world descend on this sun-drenched city to attend the 41st annual Comic-Con, San Diego's own MGMbill.org has launched a new 8-page comic book entitled Foreskin Man.[pdf, 3.5MB] The comic spins the fictional tale of an intactivist superhero who attempts to rescue a young boy from being circumcised by his arch enemy Dr. Mutilator.

When not protecting children from dangerous circumcisers, Foreskin Man assumes his secret identity of Miles Hastwick, a former corporate scientist who runs the newly opened Museum of Genital Integrity. The museum's opening exhibit is a full size replica of an American style infant circumcision - something so lifelike that even the museum's supporters have a difficult time looking at it.

Foreskin Man #1 is written and created by Matthew Hess, who is president of MGMbill.org. The group is pushing to enact U.S. legislation that would protect boys from forced circumcision the same way that girls are protected.

"The Foreskin Man comic book uses popular art to shine a spotlight on the practice of infant circumcision," said Hess. "Over the years there have been a lot of rationalizations and justifications to keep it going, but the bottom line is that forced circumcision violates human rights. I hope this story will help convince some people of that in a way that words alone cannot."

Although Hess wrote the story in Foreskin Man #1 himself, he had the artwork commissioned to give it a professional comic book feel.

"I've been a fan of comic books since before I could even read the words in them, so I wanted the art to be at least as good as the story," said Hess. "I'm very happy with how it came out, and I hope readers enjoy it."

Foreskin Man #1 is available to read and download for free at www.foreskinman.com. Printed copies may also be purchased online, or by ordering through a local comic book store.

[Foreskin Man is reminiscent of Sherwin Carlquist's Captain Uncut]


The Atlanta Journal-Constitution
July 19, 2010

Atlanta lawyer wins $11 million lawsuit for family in botched circumcision

By Ty Tagami

The maker of an instrument used in circumcisions claimed that injury was impossible with its use, but after an infant lost a portion of his penis during an operation with the Mogen clamp, a judge awarded $10.8 million in damages against the company.

[Every baby who is circumcised loses a portion of his penis, of course]

The judgment handed down Friday in New York involves an Atlanta lawyer who has been crusading against circumcision as a dangerous and unnecessary practice.

Attorney David Llewellyn won a similar case in Atlanta last year and the injury behind that prior lawsuit in Fulton County Superior Court put the New York clamp manufacturer on notice about the danger of the device, his current lawsuit said.

The baby in the current case, identified in court documents only as L.G., lost the entire glans, or head, of his penis after it was pulled into the jaws of the clamp, according to a federal magistrate's order. On Friday, U.S. District Judge Jack B. Weinstein ordered Mogen Circumcision Instruments of New York to pay $10.8 million in compensatory and punitive damages to the Florida boy, now 3, and his parents.

The parents "are extraordinarily distraught and angered that this company tells people it can't happen," Llewellyn said.

It's unclear whether they will ever collect the money. Mogen is already in default on a $7.5 million judgment in 2007 from a Massachusetts lawsuit, Llewellyn said.

The company is going out of business, according to a woman who answered the phone at its Brooklyn headquarters Monday. The woman, who said she was a secretary and would identify herself only as D. Rotter, the person whom Llewellyn said was served papers in the lawsuit. She said increased competition has undermined their business.

"It's just kind of dwindling down to nothing," she said, adding that the phones at the Mogen office were scheduled to be disconnected Tuesday. Mogen didn't defend itself in court, and Rotter said it was because the company couldn't afford it.

She said the Mogen clamp is "painless and safe" when used properly. The case involving the Florida boy was "unfortunate," she said, adding that "any medical mishap is unfortunate."

In this case, a New York mohel, or Jewish ritual circumcisor, performed the operation in the baby's home, Llewellyn said. The mohel negotiated a separate settlement, the terms of which Llewellyn would not disclose.

Llewellyn won another circumcision case in 2009 over an operation at South Fulton Medical Center. In that case, which involved a baby identified only as D.P. Jr., the mother contended that the doctor who circumcised him removed too much tissue and that his pediatrician failed to respond when a nurse complained of excessive bleeding.

The tip of the penis was placed in a biohazard bag and might have been reattached if he'd gotten attention in time, Llewellyn said in 2009. His lawsuit in New York says D.P. Jr. lost a third of his glans.

The jury found that both the pediatrician and the physician who performed the circumcision were negligent, and awarded $2.3 million to the plaintiffs. South Fulton Medical Center was absolved of liability.

In Friday's decision, the court determined that Mogen had to pay for medical expenses and for the years of psychotherapy that will be needed. The boy suffers pain when he urinates, the court order says. He will eventually be able to have sex, but he is likely to be embarrassed and will likely have trouble forming "meaningful" relationships with girls, it adds. "At 3 years old, L.G. is aware that he looks different from other boys based on both his own observations and comments from other children which make him feel inferior ."

NY Post
July 18, 2010

$10M for circum-slicing


It was the unkindest cut of all.

A Brooklyn federal judge has awarded $10 million to the victim of a circumcision gone horribly wrong.

The money is to be paid by the maker of the Mogen clamp, a forceps-like device commonly used in circumcisions and shown in a medical journal to have been involved in other partial amputations.

Given that record, Magistrate Judge Marilyn Go found that a warning should have been included with each device. Instead, the instruction manual promised a risk-free procedure.


July 17, 2010

Promotion of Male Circumcision at AIDS 2010 Vienna Is a Dangerous Mistake

The human rights group Intact America (IA), in cooperation with the International Coalition for Genital Integrity (ICGI), is exhibiting at the AIDS 2010 conference in Vienna, Austria, July 18-23. Both groups are urging policy makers to halt male circumcision rollout, calling the plan exorbitant, dangerous and unethical.

“The promotion of male circumcision sends the wrong message, creates a false sense of protection, and places women at greater risk for HIV. Men are already lining up to be circumcised in the belief that they no longer need to use condoms,” said Georganne Chapin, Director of IA. “It is troubling that scarce resources could be squandered on this prevention method when new research shows that the use of antiretrovirals (ART) reduce transmission by 92%. Our resources need to be devoted to ARTS, plus condom programs and vaccines.”

New studies released since three highly-publicized randomized clinical trials (RCTs) on HIV and circumcision show that RCT results cannot be applied to the general population of sub-Saharan Africa or any other region. A 2008 study concluded that male circumcision is not associated with reduced HIV infection rates in the general sub-Saharan population. Another recent study analyzed circumcision rates and HIV incidence in South Africa, finding that: "Circumcision had no protective effect on HIV transmission.”

“The RCTs are questionable. The only conclusion that can be safely drawn from them is that circumcision might delay HIV infection.” Dan Bollinger, Director of ICGI said. “A 2008 study found that increased use of condom promotion is 95 times more cost-effective than male circumcision in preventing new HIV infections.”

“Especially troubling is the extraordinarily high rate of complications from male circumcision in Africa,” Chapin added.


“We believe it is unethical for circumcisions to be carried out on adult males unless fully informed consent has been obtained,” said Bollinger. “The number of reports of African males agreeing to circumcision so that they no longer need to use condoms reveals that they are consenting to the surgery without knowing all the facts. The world is desperate for a “silver bullet” to end the HIV epidemic, but male circumcision is not the answer that we have been waiting for.”



July 14, 2010

The tale of a lonely outcast

Luyolo Mkentane recalls the tragic story of a young man tormented and ostracised

WHEN I went through circumcision, it was in 2006 after I raised money by working for an RDP (low-cost housing) project.

I was 25. I did not go through the official channels like getting the required letter of approval from the government, nor did I go for a medical check-up.

The circumcision was performed by an ingcibi (traditional surgeon) called Tyani, from Xulu Village.

Two other guys were with me, and stayed in the same ibhoma (hut) as me.

We ran away every time we heard health inspectors were coming to our hut. Three days after my circumcision, I experienced problems. My leg became sore and my penis started swelling.

My traditional nurse used to assault me. He started by giving me lashes, then it went to body shots.

When our chief visited our hut, I told him of the abuse. He said I should not allow anybody else to change my dressing from then on. He could sense there was something wrong with my wound.

A couple of days later, the front third of my penis fell off.

After noticing that I had a problem, men from my village decided I should be sent home before the time had come. (Initiates leave the mountain when a ceremony is held, to officially welcome them as men). I was limping.

When I got back home, I was taken to hospital. That helped. That saved my life. I thought I was going to die. I was so weak. I was bandaged and my wound was treated.

When I came out of hospital, I was treated as an outcast in the community. They say I am a bat – neither a rodent nor bird – neither a man nor boy.

Till this day, nobody wants to mix with me. Even at parties, nobody wants to drink with me. This is frustrating because I lost a big part of my penis’s functionality. I hide it when I pee because I don’t want people to notice. Although I can still get an erection, and have sex, it is just not the same.

My girlfriend has noticed the difference since I went to the mountain. She does not ask questions and we don’t talk about it. But we fight a lot and I know it’s because of my problem.

Maybe she talks about it to other people. One day she did blurt it out.

“You are a boy”, she told me. She must have heard from other people that I had a problem.

I went through a tough circumcision. Sadly, after it all, I will never have a proper penis like other people again.

When things were bad in the bush, I thought I was going to die – I gave up hope. I really thought I was going to die.

But now my organs are of little reproductive use. I don’t think I will ever have children.

Something must have happened or something must have blocked off somewhere. I have been trying for a child unsuccessfully. I want children, I really do.

My situation worries me and I don’t have money to go to the doctor. The clinics here can’t handle such a medical problem, it requires a doctor.

My situation could have been avoided. This custom needs responsible elders to oversee it. Every time an initiate dies it’s a painful reminder of what I went through. [It's not much fun for them, either.]

The man who was supposed to look after me in the mountain went “jolling” instead of looking after me.

When he came back, he was drunk and all he wanted was to beat me up.

I also regret running away from the health inspectors. Things would have gone much better had I stayed and waited for them. But then they would have taken me to hospital, meaning I would not have avoided being branded ilulwane (a bat). That’s what people like me are called.

I am jobless, an outcast and I am lonely.


VOA News
July 9, 2010

New World Bank AIDS Chief Says Prevention Challenges Remain

Joe DeCapua

The new head of the World Bank’s Global HIV/AIDS Program says much more needs to done to lower infection rates.

Dr. David Wilson, a Zimbabwean national, takes over the job just prior to this month’s 18th International AIDS Conference in Vienna.

... ["}But I think we’re starting to see some really exciting prevention developments in Southern Africa,” he says.

This includes increasing acceptance of male circumcision.

“We know that male circumcision is the single most effective prevention tool that we have,” Wilson says. And countries in Southern Africa are now really seriously beginning to expand their male circumcision programs. There’s a determination and a desire to succeed.”

[Is he out of his mind? Circumcising 5,400 men may have prevented 73 men contracting HIV from women in less than two years. That is the sum total of its "effectiveness" to date.]

... Some have called for concentrated safe sex programs by individual countries. For example, South African professor Alan Whiteside agrees that innovative thinking is needed. He and Oxford professor Justin Parkhurst say perhaps intense national month-long campaigns that really promote safe sex – including condoms and abstinence – could greatly interrupt infection cycles in many countries.

Dr. Wilson says, “The focus on concerted behavior change is very necessary. I think it needs to be sustained rather than simply for a month. I think what we’ve seen with HIV prevention after 30 years is what a tenacious and dogged virus this is. And it doesn’t let up and our prevention programs have to be equally sustained.”

[He's missing the point. Abstaining/concentrating on safe sex for a month is doable, and could break the back of the cycle of infection. Trying to sustain it is a counsel of perfection.]

AIDS 2010

The 18th International AIDS Conference – the world’s largest AIDS gathering – will be held in Vienna from July 18th through the 23rd and will place an emphasis on the epidemic in Eastern Europe and Central Asia. The theme is “Rights Here, Right Now.”

“Vienna was chosen as the conference venue partly as a gateway to Eastern Europe. And in Eastern Europe, we have epidemics, which are overwhelmingly driven by injecting drugs use, which in cases of countries such as Ukraine are significant epidemics,” he says.

[Against which circumcision will of course have no effect.]



news24 (South Africa)
July 9, 2010

KZN defends circumcision clamp

Durban - The KwaZulu-Natal health department on Friday insisted that the Tara KLamp method used to circumcise males was safe.

This was after Aids activists and doctors called for the use of the Malaysian-made circumcision device to be put on hold until safety concerns had been addressed.

"We don’t have any evidence that suggest that the Tara KLamp method is more unsafe that the forceps method," said Chris Maxon, spokesperson for KwaZulu-Natal health MEC Sibongiseni Dhlomo.

The KwaZulu-Natal health department had set up circumcision camps around the province in a drive to minimise sexually transmitted infections and the risk of contracting HIV/Aids.

Maxon said the department had used the Tara KLamp method on about 600 people.

“Only four people complained of swelling, all those cases were managed in hospital. None of them indicated to deaths or amputation of the penis,” said Maxon.

In a joint statement on Thursday, the Treatment Action Campaign (TAC) and the Southern African HIV Clinicians Society said they encouraged voluntary male circumcision.


“At the moment we are not using the Tara KLamp method. It is out of stock and (we are) waiting for more stock to arrive,” said Maxon.

When the circumcision camps were set up the government said it had a target of circumcising about 4 000 males before schools reopen.

Earlier story


The Despatch (South Africa)
July 9, 2010

Circumcision device comes under fire

THE Southern African distributors of the Tara KLamp circumcision device have rejected a call for it to be put on hold until safety concerns had been addressed.

The call was made yesterday in a joint statement by the Treatment Action Campaign and the Southern African HIV Clinicians’ Society.

Tony Lawrence, spokesperson for distributors Carpe Diem Enterprises, said however that the statement contained numerous allegations about the clamp which were “totally inaccurate, unjustified and unfounded”.

These would require some time to respond to in detail, with input from the manufacturers, he said.

The Treatment Action Campaign said the device was being aggressively marketed in several southern African countries, including South Africa. However, a controlled trial of the Tara KLamp at Orange Farm, in Gauteng, had found a high rate of “adverse effects”.

Men circumcised using the clamp had also reported worse pain than men circumcised using the forceps-guided method of medical circumcision.

The trial was stopped early due to the unacceptably high rate of adverse effects, and the researchers had “strongly” cautioned against using the clamp on young adults.

Earlier story.


informanté (Nambia)
July 8, 2010

Circumcision leaves boy badly scarred

Written by Faith Sankwasa in Oshakati

AN Oshakati family is embroiled in a nasty feud after an illegal circumcision on a 17year old boy went horribly wrong last month when the boy continuously bled until he sought medical help. Johannes Kamati is claiming the illegal circumcision on his brother was conducted by the boy's distant relative who claimed it was his ancestral right to do so.

Kamati alleged that Kandjimi Mungunda, the boy's uncle, performed the act without notifying the family which only discovered it when the boy complained to his mother.

“The family is fighting because we were not informed of the uncle’s intention to circumcise the boy. He bled and it almost cost him his life. All this in the name of culture,” said Kamati.

He further said the boy is doing well but is scarred and that the family is contemplating taking legal action against Mungunda

The boy said his uncle told him that it is his birth-right to get circumcised because it was in the interest of his health too.

He also said the uncle advised him not to tell his mother as they would all be against the idea.

“I did it because I trusted him but did not think it would end up like this. He has been doing it for ages so that made me trust him even more,” said the boy.

Mungunda denied responsibility for the botched up circumcision saying that he is a professional on the job.

He, however, blamed the boy for poor after operation care.

Mungunda added that in their Herero culture a boy is supposed to be circumcised when he is still young.

“I do not know why the family is fighting me. I have circumcised some family members before but none reacted the way this one did so blame it on the way he cared and dressed the wound,” said Mungunda.


Politics Web
July 8, 2010

TAC, doctors warns against self-circumcision device

AIDS organisations call for withdrawal of Tara KLamp from the market
Voluntary Male Medical Circumcision is Safe and Effective
But beware of unsafe devices

The Southern African HIV Clinicians Society and the Treatment Action Campaign support the implementation of a country-wide voluntary male medical circumcision (VMMC) programme.

... The success of VMMC is dependent on public confidence in the programme's safety.

We are therefore deeply concerned that a Malaysian company, Taramedic Corporation, and its South African partner, Carpe Diem Enterprises, are aggressively marketing a circumcision device called the Tara KLamp (TK) to several sub-Saharan African countries, including South Africa, Lesotho, Kenya, Botswana and Zimbabwe. A randomised controlled trial in adolescents and adults found a very high rate of adverse events and much greater pain associated with this device compared to the standard forceps-guided circumcision technique.

The TK must be withdrawn from sale and distribution for adolescent and adult circumcision throughout sub-Saharan Africa until the device's safety concerns are addressed.

A review of the Tara KLamp (TK)
The TK is a circumcision device that is clamped onto the foreskin with the purpose of necrotising it. After approximately seven days the device, along with the foreskin, usually falls off. In some cases the device does not fall off forcing the patient to have the TK removed surgically.

The Orange Farm clinical trial showed that VMMC can reduce a heterosexual male's risk of contracting HIV by 60%. In 2005 the Orange Farm researchers performed a randomised controlled trial to see if the TK could be used as an alternative method of circumcision. 35 men were circumcised with the TK and 34 with the standard forceps-guided technique that was used during the original trial.

Adverse events from use of the TK were far higher: 37% compared to 3.4% for the forceps-guided method. This was a statistically significant result (p=0.004). Men circumcised using the TK also reported worse pain than men circumcised using the forceps-guided method. Furthermore, the device clearly causes consternation: 97 men refused to participate in the trial, 94 of them giving the reason that they did not wish to use the TK.

The TK trial was stopped early due to the unacceptably high rate of adverse events. The researchers concluded, "Given the high rates of adverse events in this study and the low number of available studies, we strongly caution against the use of the TK for young adults, and we recommend careful evaluation of the procedure when performed on children."

Safety must be proven before any new medical intervention is implemented. Currently, the balance of evidence shows that the TK is unsafe for use on adolescents and adults. We cannot find any published studies of the TK being shown to be safe for adolescents and adults. Two studies, neither of them randomised and consequently of questionable quality, indicate that the device might be safe for young children.

The marketing practices of Carpe Diem Enterprises
Carpe Diem Enterprises is the distributor of the TK in South Africa. The company has disregarded the safety concerns raised in the Orange Farm study. The device's website states, "This invention enables circumcisions to be performed not only safely and easily but also - for the first time in surgical history - enables circumcisions to be performed just as aseptically, at home, on the roadsides or out there in the bush, as in an operating theater. "

The device is marketed as a faster method of performing circumcisions, as it can be carried out in less than 10 minutes. This is not much faster than the medical forceps-guided method of circumcision and certainly does not outweigh safety concerns. It also does not take into account the additional time needed to surgically remove the device from some patients.

The TK is also more expensive than the forceps-guided method of circumcision. ...

The attitude of the company towards critical research of its device is exemplified by Dr. G. Singh, the inventor of the TK, who made the following threat in an email exchange with one of the authors of the Orange Farm study, "All it needs is a simple withdrawal of your manuscript and gracefully accept the reality. I am even not asking for an apology, for I am a very forgiving man..... but there is a limit!"1

The TK has also been used throughout the region as a part of the evangelical mission of the marketers of the device, Tony Lawrence and Magda Van Der Walt. A book promoting the device and the work of Tony Lawrence states the following:

"Twice per year... young male initiates in South Africa alone take an important step toward manhood by undergoing circumcision during a time of initiation ... But what should be a glorious occasion for these teenagers often turns out to be a nightmare. One out of five boys end up with their genitals partially or fully amputated.... The Seize the Day foundation is rescuing these children in a holistic way. Among other things, Tony Lawrence and the seize the day volunteer distribute a pack to each initiate. (The pack contains a TK and a bible) ... The solution is to circumcise and evangelize."2

The TK is being aggressively marketed and, at times, with an inappropriate religious agenda. The marketers of the device make unsubstantiated claims and disregard safety concerns. They have threatened researchers who published data critical of the TK. The TK must be withdrawn from use throughout sub-Saharan Africa for adults and adolescents until its safety concerns are addressed.

1 This correspondence was forwarded to TAC by Carpe Diem Enterprises

2 W Cambell et al., ‘Be a hero: The battle for mercy and social justice.' 2004. Pg. 204

Joint statement by the Treatment Action Campaign (TAC), SECTION27 and the Southern African HIV Clinicians Society, July 8 2010


Jakarta Post
July 7, 2010

Fatayat seeks to level field with NU clerics

Women's activists within Nahdlatul Ulama (NU), dubbed the most influential Islamic organization in Indonesia, on Sunday said more discussion was needed between them and the NU's male-dominated board of clerics to prevent the issuance of edicts that discriminated against women.

During its national congress in Makassar, NU clerics issued an edict supporting the practice of female circumcision, widely regarded as a cruel practice that harms women's reproductive health. The congress also ruled that underage marriage, according to Islamic teaching, is acceptable.

Maria Ulfah Anshor, a former chairwoman of Fatayat, the NU women's wing, said information regarding women's health, including the negative effects of female circumcision and minor marriage, had not been properly discussed with NU clerics.

"Fatayat was not doing enough to inform the clerics *about the negative impacts of these edicts*," Maria said during the Fatayat XIV Congress in Jakarta on Sunday.


In deliberating women's issues, the clerics' lack of understanding of women's reproductive health and their tendency to only refer to the literal meaning of the Koran and hadiths had led them to overlook women's rights, Maria said.


"Fiqh [Islamic philosophy of law] states that if something poses more danger than benefit, it should not be done," she said.

Fatayat members decided that female circumcision was mubah, or allowed but not recommended.

"But, in practice we prohibit the practice of female circumcision because it disadvantages women," Maria said.



The Age (Melbourne)
June 6, 2010

Siblings given religious freedom of choice

A FATHER has won the right to stop his children from taking part in Jewish coming-of-age ceremonies, after a court agreed with the man that they should be able to make their own religious choices.

The mother wanted her children to participate in their bar and bat mitzvahs - ceremonies that mark the beginning of boys and girls taking responsibility for their Jewish faith.

But the father, a Catholic who irregularly attends church, wanted them to choose their own religion in a ''voluntary and informed'' way when they were old enough.

The dispute played out in the Federal Magistrates Court in Melbourne where the separated parents, known as Mr and Mrs Macri, asked the court to determine the religious future of their children: a 10-year-old and eight year-old twins.

Mr Macri, 44, did not oppose his children observing Jewish holidays and events. The children had undergone some classes in Hebrew, but the lessons had lapsed at their request. In accordance with traditional Jewish practice, the son had undergone circumcision.

Mrs Macri had enrolled the children in a religious youth group for two hours each Sunday. But Mr Macri was concerned this had ''an element of political content'' and wished for them not to attend.

He also asked for an injunction, stopping Mrs Macri from committing their children to the Jewish faith through the bar and bat mizvah ceremonies until they were older. Jewish girls usually undergo bat mitzvah aged 12, while boys have their bar mitzvah at aged 13.

Federal magistrate Terry McGuire allowed the mother to take the children to the youth group but ordered her not to let her children participate in the ceremonies until they made the choice or their father agreed to it.

''Australia is a multicultural and secular society,'' Mr McGuire said. ''These children are fortunate in that they have the opportunity to directly experience the culture and traditions of the religions practised by each of their parents.''

Mr Macri had not pitted one religion against the other but had wanted his children to participate in the culture and traditions of both religions without committing to either at this stage, he said.

In contrast, Mrs Macri wanted to commit the children to Judaism immediately.

He said there was no evidence that deferring the decision would later stop the children choosing to enter the Jewish religion.


The Sowetan
July 5, 2010

Expert supports initiation school

Canaan Mdletshe and Frank Maponya

A CULTURAL expert from KwaZulu-Natal, Professor Jabulani Maphalala, has explained the actions of the ingcibi or initiation school head who concealed the death of an 18-year-old boy at an initiation school in Vrede, Free State.

Maphalala was commenting after a KwaZulu-Natal parent, Mpume Buthelezi, complained that she was not informed of her son’s death during circumcision.

Sthembiso Khumalo of Nquthu, northern KwaZulu- Natal died on Saturday, soon after circumcision, which left his mother furious and devastated.

Since the circumcision period started this winter, 40 initiates have died in the Eastern Cape alone.

Though Sthembiso died in Free State, he is the first KwaZulu-Natal resident to die during circumcision.

“I am heartbroken. When my son went to the initiation school I was informed and gave my blessings. But when he had complications and died inside the camp, I was not told and this has caused so much pain to me,” she said.

As if that was not enough for the family, they will not be able to bury their loved one.

“We have been informed that since he died inside the initiation school, he has to be buried according to the tradition, where only men would attend the funeral and not me because I am a woman.

“ I have no say in my son’s burial,” she said sobbing.

Maphalala stood by ingcibi. “The family has just to accept the situation as it is-because that’s exactly what happens. Traditionally, if someone has died at the initiation school, he is buried there and the family is not even informed and there’s nothing one can do,” he said.

Meanwhile, parents in Limpopo province are complaining about high fees being charged at circumcision schools.

This follows allegations that some schools were charging at least R1 000 [$US118.50] an initiate.

Parents said the exorbitant fees deprived boys from poor families passage to manhood.

One parent said he respected that traditionally it was compulsory for boys, especially those living in rural villages, to go through the passage.

“But if the practice of charging exorbitant fees continues we will be left with no option but to take our children to hospitals.” he said.


IOL News (South Africa)
July 2, 2010

Circumcision sacred to many, despite deaths

By Vuyo Mabandla
Staff Reporter

As the death toll in some of South Africa's circumcision schools continues to rise, traditional leaders remain adamant that the tradition will not be abandoned.

The Eastern Cape Department of Health has reported 49 initiate deaths during the winter season so far. On Wednesday another initiate died in the Tsolo region.

Eastern Cape health spokesperson Sizwe Kupelo said the deaths occurred mostly in the Ntabankulu and Engcobo rural towns, as well on farms in the Chris Hani district.

More than 100 initiates were also being treated in hospitals in the Eastern Cape, 20 of whom needed special care.

The deaths have provoked fury from religious leaders, some of whom have slammed the custom as "barbaric".

But the National House of Traditional Leaders has hit back, saying it will not abolish the practice.

Chief Gcinikhaya Gwadiso, head of the house's national campaign for safe initiation schools, said the sacred custom had been upheld "for ages".

"We are aware that there are dangers involved and we are working with the government and the community to rectify all that."

The custom is seen as the passage from boyhood to manhood.

Cape Town's social development manager, Lungelo Nokwaza, said there had been no reported deaths or hospital admissions in Cape Town.

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