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South Africa outlaws circumcision, sort of

February 15, 2006

UNICEF applauds passing of South Africa's historic Children's Bill

Pretoria, 15 February 2006 - UNICEF today applauded the Government of South Africa and the National Assembly on the passing of the Children’s Bill, after years of deliberation and debate with major stakeholders.

“With the passing of this pioneering and visionary Bill, South Africa has taken an important and hopefully transformative step forward in its action and commitment to the rights of the nation’s most important resource, its children,” said Macharia Kamau, UNICEF Country Representative.

Noting the legislation’s provision to bar anyone that has been found guilty of an offence against children from working with or around children, UNICEF said the organisation was especially pleased with all the Bill’s provisions to meet the most urgent needs of vulnerable children and especially in securing their care and protection from abuse and exploitation. "When it comes to the protection of children, this Bill gets it right,” he said.

Calling the long awaited Bill “a victory for the right of children to be free to be children and to be protected as they grow up," the UNICEF Representative added, “It fills important legislative gaps and provides a valuable legal backbone for those engaged in the struggle to put children first.” The Bill, which stresses the protection of children, addresses issues of female and male circumcision, early marriage, corporal punishment and other potentially harmful cultural practices.

Full text:


A voice of sanity from Africa

The Swazi Observer
February 23, 2006

'Circumcision No AIDS Cure'

CIRCUMCISION - may result in false belief that safe-sex practices are no longer necessary. The result could be a worsening of the incidence of HIV infection, especially for women.

A paper, read at a conference in Brazil, claims that male circumcision has the potential to reduce female-to-male transmission of human immunodeficiency virus (HIV). The 'Wall Street Journal' reported that the 'Lancet,' the pre-eminent medical journal in the world, refused to publish the paper for unknown reasons.

The researchers said circumcision might help in reducing HIV transmission women-to-men. What they don’t say is that male circumcision doesn’t protect women from HIV. [And the most recent study, widely reported as showing that it does, does no such thing.] An infected circumcised man having sex with a woman is just as likely to spread the disease as an intact man. The same goes for any male partner with whom he has sex. The problem is that men and women may erroneously believe that circumcision is like a condom, which then leads to unprotected sex and transmission of the virus.

Robert Bailey, the scientist who sponsored the study, has been promoting circumcision to prevent HIV transmission since 1989. The world medical community thus far has not accepted his published studies. The present study, which was conducted in South Africa, is his latest effort. In such cases, one must be aware of possible researcher bias. [At last someone dares to say it!]

UNAIDS has cautioned against circumcision.

If circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sex practices, such as condom use. This risk is far from negligible - already, rumors abound in some communities that circumcision acts as a “natural condom. A sex worker interviewed in the city of Kisumu in Kenya summed up this misconception, saying, “I can sleep with circumcised men without a condom because they don’t carry a lot of dirt on their penis.” While circumcision may reduce the likelihood of HIV infection, it does not eliminate it. In one study in South Africa, for example, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men.

Relying on circumcision for protection is, in these circumstances, like playing Russian roulette with two bullets in a (five-shot) revolver rather than three.

The World Health Organisation (WHO) said they were concerned that demand for circumcision, as a result of misinterpreting this study, may encourage healers and witch-doctors, which could boost the risk of contracting HIV rather than prevent it due to using contaminated instruments. They also fear a false security from having been circumcised, and reduced sensitivity in the penis may cause an increase in risky, sexual behavior and a decline in condom use leading to increased transmission of the virus.

Circumcision itself is believed to be a vector for transmission of HIV in Africa due to the unsanitary condition of African hospitals, clinics, and traditional circumcisors.

Many South African tribes, such as the Xhosa, practice male circumcision as a cultural ritual, yet South Africa has an extremely high incidence of males living with HIV. Male circumcision apparently has not worked in South Africa. Recently, authorities in Eastern Cape Province arrested a ritual circumciser who was circumcising numerous youths with the same non-sterile knife.

Circumcision is a radical operation that amputates significant erogenous tissue from the penis. Many people call forced or coerced circumcisions an assault and male genital mutilation. Men must be warned of loss of sensation ñ resulting in decreased erectile power, difficulty in ejaculating, and decreased sexual satisfaction, before consent for the surgical amputation is obtained.

Two similar studies have not yet been published. Bailey’s present study has not yet been peer-reviewed. The three studies must be carefully reviewed before a determination of the value of circumcision in preventing female-to-male HIV transmission, and even then, legal and ethical issues about self-determination must be addressed before advocating the procedure.

Even if the studies prove true and accurate, Africa cannot afford to circumcise all its males. A safe circumcision costs $15, compared to the already-proven methods for stopping the spread of HIV and AIDS, education and condom use, which cost $1 (E6.50). [Of course, a condom only works once.]

Circumcision has many risks, including infection, penile loss, hemorrhage, hypovolemic shock [in babies], and death. The claimed benefit must be balanced against these very real risks -


Almost old enough to say what he wants. Why not wait till he is?

Yahoo news
February 18, 2006

Circumcision battle lands parents of eight-year-old in US court

CHICAGO (AFP) - A clash over of their son's circumcision [not yet it isn't, it's a clash over his foreskin] has landed the parents of an eight-year-old Illinois boy in a US court where there is no apparent precedent.

A Cook County judge ordered the mother in the case not to have her son circumcised until the court can hear arguments from the child's father, who opposes the operation, and decide if it is in the boy's best interest. Jews and Muslims circumcise their sons for religious [and a variety of other] reasons.

But this case instead involves shifting medical and cultural preferences, which have recently become [which have long been] a matter of debate in the United States.

The mother, 31, is a homemaker from Northbrook, Illinois. She says two doctors recommended the procedure for health reasons.

But her ex-husband, 49, a building manager in Arlington Heights, Illinois, has called the procedure an "unnecessary amputation" that could cause his son physical and emotional harm.

In the 1900s [no, not until the mid-20th Century], surgical circumcision, in which the foreskin of the penis is removed usually before a newborn leaves the hospital, was the norm in the United States.

But the percentage of US babies being circumcised has plunged from an estimated 90 percent in 1970 to some 60 percent now, data show.

The American Academy of Pediatrics no longer recommends routine neonatal circumcision [it never did - it has always sat on the fence] but says the decision should be left to the parents. That has added fuel to the fire where until recently there was little debate on the issue at all among the US Christian [or rather, gentile] majority.

Some staunch opponents of the procedure see it as akin to female genital mutilation. They argue that the procedure is medically unnecessary and morally wrong. Still others have launched support groups for those who have been circumcised and would rather not have been; some have even pursued surgical [and more often, non-surgical] options for restoration.

Legal experts however say that there are no published US opinions to serve as precedents in this case. As such it normally would be determined based on the best interests of the child.

When the divorced parents appeared Friday in Cook County Circuit Court, Judge Jordan Kaplan got the two sides to agree that the child would not be circumcised "until further order of (the) court."

He also also ordered them not to discuss the case with their child.

Tracy Rizzo, an attorney for the mother, said the father scared the child by telling him frightening stories about what might happen if he were circumcised.

The father's lawyers, John D'Arco and Alan Toback, have argued that the couple's divorce agreement provides that the father must be consulted before any non-emergency medical care.

Male circumcision is much more widespread in the United States, [the Philippines, South Korea,] Canada [no, not Canada], and the Middle East than in [the rest of ] Asia, South America, Central America, [Scandinavia, Britain, the Commonwealth] and most of Europe .

[The question arises, why now? The role of the mother's new partner comes into focus. It would be an act of unbelievable cruelty for a court to order that a boy suffer an unnecessary operation on his genitals now, when he is well able to understand what is being done.]

The big business of circumcision

Metro (Boston) March 1, 2006 - My view by Andrew Tavani

An 8-year-old boy in Chicago is at the center of a battle over — of all things — his foreskin. The boy’s mother, who said two doctors advised circumcision following repeated infections, wants the young man to be circumcised. His father, who’s vigorously opposed to the idea, requested a restraining order to block his ex-wife from having their son circumcised. A Cook County judge has temporarily sided with the father and ordered circumcision proceedings halted until the court can decide if the operation is in the best interests of the child.

As a man — and a circumcised one at that — I appreciate the father’s compulsion to protect his son’s manhood. A neonatal circumcision, one performed before a newborn boy leaves the hospital, is a frightening concept in and of itself, but circumcising an 8-year-old is nothing short of nightmarish and brutal when you consider its potential health implications. I lament the circumcision of my foreskin. A circumcision removes about 70 percent of genital nerve endings. That sounds like a party in my pants. There is no telling what lingering psychological effects I’ve suffered as a result of the pain experienced during my neonatal circumcision.

It’s vexing that the medical community allows the removal of a body part we could actually find useful. Why not circumcise my appendix at birth instead of my foreskin? My appendix could potentially kill me one day if it bursts and I don’t receive medical attention swiftly.

My foreskin posed no such diabolical threat. The boy’s mother undoubtedly wants the best for her son, but considering that she is not the natural owner of a penis, I’m wary of her qualifications to make such a critical decision. Clearly her son’s health concerns complicate the issue beyond the cosmetic or religious reasons behind most circumcisions in our culture.

Circumcision has long been a controversial issue, but anti-circumcision sentiment in America has been growing and the number of actual neonatal circumcisions being performed is sharply declining as myths about circumcision are debunked.

It’s no surprise that circumcision is rooted in religion. Puritanism run amok has led to the mutilation of boys throughout history, while religious leaders explained away the bizarre ritual as an important covenant with God, among other deity-related rationales. Seriously, do you think God wants us to chop off part of our genitals to appease him?

In modern America circumcisions are primarily performed for non-religious reasons. Business is the driving force behind the myth that circumcision is necessary for proper hygiene. In 1999 the American Academy of Pediatrics reversed its position on routine circumcision because the practice “is not essential to the child’s well-being.” Circumcisions run about $400 for a procedure that takes roughly fifteen minutes. $400 may not seem like a lot, but multiply that number by all of the baby boys born every year and it adds up to big revenue for hospitals.

Nowhere in the world is circumcision as prevalent as it is here in America. Perhaps, one day, our culture will cease practicing this antiquated ritual and reserve the procedure for worst-case scenarios that leave no other less invasive alternative. I say, save the foreskins.

Also in his blog, February 22, 2006


Study fails to find circumcision protects women, but ...

Khaleej Times (United Arab Emirate)

Male circumcision protects women from AIDS: study

8 February 2006
DENVER - Male circumcision, which has been shown to protect men from infection with the AIDS virus, appears to protect women, too, US and Ugandan researchers reported on Wednesday.
Circumcising men reduced infections in their female partners by 30 percent, the researchers found. One said the difference may be related to the structure of the foreskin, which is removed in circumcision.
In the study of more than 300 Ugandan couples in which the man infected the woman, the researchers found that 299 women caught HIV from uncircumcised partners and only 44 were infected by circumcised men.

[This is absolutely false and a complete garbling of the facts: ]

The incidence of HIV infection was measured in 44 women with circumcised HIV-positive partners and 299 women with uncircumcised HIV-positive partners. [So the 299 and the 44 were the totals, not the number infected] Data were also collected on the incidence of syphilis, herpes simplex virus-2, gonorrhoea/chlamydia, human papilloma virus, bacterial vaginosis and trichomonas.

The incidence of HIV infection was just under seven infections per 100 person years for women with circumcised male partners compared to ten infections per 100 person years for women with uncircumcised partners. Although women with uncircumcised partners had a greater risk of being infected with HIV, the difference was not statistically significant (p = 0.22).

AIDSmap news, February 14, 2006

[If the study lasted the same length as the rest of the Rakai study, 30 months, the 44 women amounted to 110 person-years, and "seven infections per hundred person-years" amounts to just EIGHT women infected. Just THREE women more, and there would have been no difference (the rate among the circumcised would also be 10 per 100 person-years). That is what "not statistically significant" means in real terms.]

[Therefore, the following speculation about the role of the foreskin is irrelevant.]

Circumcision also reduced the risk of infection with other sexually-transmitted diseases such as trichomonas and bacterial vaginosis, but not syphilis, gonorrhea or chlamydia, the researchers told an AIDS meeting in Denver.
Dr. Thomas Quinn of Johns Hopkins University in Baltimore has been leading a team that studies 12,000 volunteers in Rakai, Uganda. They have been studying transmission of the human immunodeficiency virus that causes AIDS.
Last year they reported that circumcised men were less likely to become infected with HIV. Now, they told the Conference on Retroviruses and Opportunistic Infections, it appears that among infected men, circumcision reduces the likelihood they will transmit the virus through sex.
They also presented more evidence that circumcision protects men. They reanalyzed previous studies and found that circumcision reduced the risk of HIV infection in men by 50 percent -- and by 70 percent in the highest-risk men.
The findings will have to be confirmed in other groups before being used as the basis for recommendations, Quinn said. However, he said, “early indications are dramatic.” If borne out, for every 15 to 60 circumcisions, one case of HIV infection could be prevented, he said.
Circumcision’s benefits may stem from the structure of the foreskin of the penis. Its inner lining, or mucosa, carries cells that are vulnerable to the AIDS virus.
“Also that mucosal layer does not have the thick keratin (skin) that the outside skin of the foreskin has,” Oliver Laeyendecker, who worked on the study, said in an interview.
“Not only do you have more virus there because of the types of cells that are there, but the barrier is easier to go through from the man to the woman on that skin surface because it doesn’t have to go through a lot.”
The AIDS virus is transmitted by semen, blood and breast milk and via sex, shared needles or other contacts with infected blood.
Semen can transmit the virus, but levels in the semen drop over time, while remaining elevated in the blood, Laeyendecker said.
The theory is that the virus can pass in tiny amounts of blood in the foreskin. “Because of the nature of that membrane, because it is thin, because it is susceptible to micro-tears, you have a lot of openings,” Laeyendecker said.
“Plus you have more cells with virus there, so it lends itself to being a more transmissible surface.”
The AIDS virus infects close to 40 million people globally, most of them in Africa. It kills 3 million people a year and infects 5 million new people every year. It is eventually fatal and there is no cure or vaccine, although drug cocktails can keep patients healthy for years. Laeyendecker said the Uganda volunteers have access to at least some of the drugs through a US program.

To more about circumcision and HIV.

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