To more recent news
(More recent items first)
The adamant elder syndrome ...
Times Live (South Africa)
Eastern Cape initiate stabbed, abducted
A youth was stabbed, apparently with a spear, when he tried to run away from an initiation school in the Lady Frere area of the Eastern Cape, the provincial health department said on Thursday.
Spokesman Sizwe Kupelo said the incident happened at the weekend, when the youth sought refuge at a clinic in the village of Qhashu, shutting himself into the security guard's building there.
"This group of men who were chasing after him allegedly broke the windows of the guard house, forced the initiate out, beat him and took him back to the school," Kupelo said.
"He is alleged to have been stabbed with a spear, and sustained a wound under his arm."
The youth had been admitted to Lady Frere's Glen Grey hospital in a critical condition, Kupelo said.
"Influential people from the district are alleged to have been part of this barbaric act, so it is difficult for people to go and lay charges with the police," he said.
He said the youth was an orphan.
The department had instructed its district health manager to lay a complaint of vandalism with the police, over the damage to the security building.
The department would also ask the police to investigate the stabbing and abduction.
"It does not matter what position the people responsible hold in the community. They must face the law," he said....
Head of the Eastern Cape House of Traditional Leaders Chief Ngangomhlaba Matanzima, ...
"We are trying to respect the law. We don't want to say anything about it until we are informed properly of the events in Lady Frere around that boy," he said.
"We don't want to accuse anyone. We will wait until the outcome then we'll see what to do."...
Kupelo said the circumcision season death toll had risen to 16, with the death of a would-be initiate at Mbizana on December 28.
The Swazi Observer
Health minister pumps in E16 000 for Shiselweni 11
By Gcinile Shongwe
SOCCER- Health Minister, Benedict Xaba has forked out E16 000 to be competed for by teams under the Shiselweni II Inkhundla Regional League.
The tournament has been dubbed ‘Mashanyela knockout Tournament’. the minister said the tournament started on Sunday and was expected to finish on New Year’s Day.
Xaba also revealed that 15 teams participated during the tournament in matches played at Mahlalini Sports Ground yesterday. “I was impressed with the turn out. People came in their numbers to witness what was a football festival. I cannot even estimate the numbers, there are so many people around me,” Xaba said.
He also said the main aim of the tournament was to teach the youth about circumcision. This is an annual tournament and is always played during the holidays. In January the ministry will launch a circumcision campaign so I thought it would be better if I started teaching about it here at home,” he said. Xaba said they were also promoting social responsibility amongst the youth. He said on the final day of the tournament the finalists would distribute food parcels to over 400 needy people at Shiselweni II Inkhundla.
Xaba said the champions would walk away with a soccer kit worth E4 000 plus E3 000 in cash. The runners up will take home E2 500 while the third placed side will get E1 500.
[Observers at the 2010 Vienna AIDS conference heard how a tactic to promote circumcision is to sponsor sports teams generously, but with the proviso that all who take part must be circumcised. Thus good players would be under heavy peer pressure to get cut in order to play. The word for this is blackmail.]
The Daily News (Galveston)
Billboards get snippy about circumcision
By Amanda Casanova
Tucked between restaurant and business billboards lining Broadway in Galveston and next to a church in West Texas City are signs with a message for expecting parents.
“Circumcision: unnecessary, painful and risky, causes lifelong sexual harm,” the board reads.
But the advertised organization on the board, Intact America, didn’t put it there, executive director Georganne Chapin said.
“There are many grass roots organizations out there pushing for this same cause,” Chapin said. “There are a number of people who have done individual billboards. It just takes an enormous amount of money to do the billboards. This is probably a supporter who decided to take matters into his own hands.
“But I love billboards.”
And whoever paid for the sign has the support of Intact America, an organization that opposes infant circumcision, Chapin said.
“Our mission is to do away with forced, unconsented circumcision of children,” she said. “The United States is interesting in that we’re one of the only countries in the world that does this.”
Circumcision dates back to Jewish practices, with some experts pointing to Egyptian rites of passage as among the first instances of circumcision.
The practice also has been reported to slow the spread of AIDS. [Slow? No. "Delay" perhaps.]
In a presentation at the International Aids Conference in August, a researcher noted that circumcisions have dropped to 32.5 percent of baby boys in 2009 from 56 percent in 2006.
The numbers do not include procedures outside hospitals or ones not reimbursed by insurance.
The Centers for Disease Control are expected to provide recommendations to the public about circumcision, but those studies are ongoing.
Meanwhile, a San Francisco man is pushing for a ballot measure that would make it a misdemeanor to circumcise anyone younger than 18. To make it on to the November ballot, the ordinance proposed by Lloyd Schofield needs more than 7,100 signatures by April.
City Press (South Africa)
Fewer circumcision deaths in ECape
By Nicole McCain and Loyiso Sidimba
Traditional leaders and iingcibi (surgeons) from the Eastern Cape believe their efforts have resulted in a drop in the circucision death toll this year.
Provincial health department spokesperson Sizwe Kupelo said 13 boys had died since the start of the summer circumcision season, compared with 16 around the same time last year.
However, reports at the same time last year put the figure at 23.
Chairperson of the province’s House of Traditional Leaders Chief Ngangomhlaba Matanzima said the decline was the result of their awareness campaigns aimed at parents, would-be initiates and traditional leaders.
[In fact, such variations are probably due to random factors.]
Traditional leaders are planning to increase visits to initiation schools from as early as March next year.
Figures from the provincial department of health show that 54 youths have died so far this year, compared to 77 last year.
In the winter circumcision period of this year, 41 initiates died.
Kupelo said many of the deaths this year were not related to complications during the circumcisions but rather were due to medical conditions that were not declared to the initiation school, such as diabetes and tuberculosis.
The number of deaths from botched procedures was decreasing, he said, because of the department’s role in preventing illegal initiation practices.
The department raids initiation schools and closes illegal ones, and attempts to create awareness about safe circumcision practices.
However, Kupelo maintained that the responsibility to prevent circumcision deaths did not lie with the department.
“It’s parents, traditional leaders, surgeons and nurses who should ensure the correct practices are followed, illegal schools are reported and complications are medically treated as soon as possible,” he said.
the Nation (Kenya)
Couple held in war against female 'cut'
By ELISHA OTIENO
A couple has been arrested in Kuria West District as the war against female circumcision is stepped up.
The parents were picked from their homes after they allegedly took their underage girls for circumcision.
Kuria West district commissioner James Mugwe said they were tracking down more parents who were violating the law against female circumcision.
And a woman described as a “notorious circumciser” escaped arrest narrowly after she spotted police officers and officials from the Children’s Department approaching her home....
At the same time, Mr Mugwe hit out at the management of the Kehancha District Hospital accusing it of failing to support the government to eradicate female circumcision in the area.
“The management seems to condone female circumcision because victims taken there by the police for treatment are released secretly before they record statements to help bring to book those behind the illegal practice,” the DC asserted.
However, it emerged that most workers at the hospital are from the local community and that they had a “soft spot for FGM” with some said to perform the cut in the hospital at a fee.
Recently, over 400 girls in Kuria community went through alternative rite of passage as others continued to seek refuge in Tanzania to escape from the painful experience.
Some 2,000 boys and 1,000 girls have been circumcised to date in Kuria West and East districts since early this month.
Examiner (Greenville, SC)
South Carolina to Cease Medicaid Coverage of Routine Newborn Circumcision
By Kelly Pfiefer
Effective February 1, 2011, the South Carolina Department for Health and Human Services will no longer cover routine circumcision procedures on baby boys.
On December 14, 2010, the South Carolina Department for Health and Human Services revealed a bulletin addressed to Medicaid Providers, a notice that described a number of budget reductions in Medicaid coverage. Newborn routine circumcision is one of the five services that will not longer be provided to recipients of Medicaid.
The bulletin states that “medically necessary circumcisions will continue to be covered for all male beneficiaries but must receive prior approval.”
The American Academy of Pediatrics' View on Routine Circumcision
In 1999, the American Academy of Pediatrics announced a new circumcision policy stating that because circumcision is medically unnecessary, the AAP does not recommend circumcision as a routine procedure for newborns. Parents can read the AAP's stance on circumcision at the Healthy Children web page of the AAP site.
This change in coverage only affects babies who are covered by Medicaid in South Carolina and goes into effect on February 1, 2011.
It seems trivial to even mention the cut to circumcision funding in the face of this...
South Carolina Healthcare Voices (AP)
More Pain For The Poor Of South Carolina
By JIM DAVENPORT
The state's Medicaid program plans to stop paying for adult dental, vision and hospice services and cut home health visits by a third for the state's elderly and disabled in February.
Meanwhile, the agency plans to eliminate routine infant circumcisions, cut prescription drug benefits and shoes for diabetics. The reductions even include umbrella and crutch holders for people who use wheelchairs while telling people to use powered wheelchairs for seven years instead of five before they can be replaced.
The state Department of Health and Human Services faces a $228 million deficit and hopes those cuts will help convince the state's financial oversight board on Tuesday to allow it to operate in the red for the rest of the budget year.
It's the largest single agency deficit the Budget and Control Board has considered in at least 25 years. Four of the five members on the board chaired by Gov. Mark Sanford have to agree to it.
If it fails, the agency has said it will have to stop all Medicaid payments to doctors and hospitals in March.
It's a vote that pits health care for more than 836,000 of the state's poor, disabled and elderly against a cash-strapped state's ability to pay for services to keep people healthy. And it is a financial gamble for the state: If state revenues don't grow fast enough, Medicaid's shortfall would wipe out much of the state's $347 million cash reserves.
But the Medicaid program isn't alone in seeking a budget bailout Tuesday. The Department of Social Services has a $29 million deficit even after announcing plans to cut 20 percent from welfare checks beginning in February and the Department of Corrections is $7.5 million in the red and will close a prison if it doesn't get an OK.
Meanwhile, lawmakers are dealing with an $800 million deficit for the entire state budget year that starts July 1. Forkner's agency needs $659 million more dollars just to keep existing programs at current levels.
Columbia dentist Jim Mercer, for instance, noted the state pays for adult emergency dental services only when there is pain and swelling. He questioned plans to save $3.6 million by eliminating that care for 43,500 people. "Those emergencies aren't going to go away," he said. Instead those people will likely seek care at an emergency room, which can be more expensive.
The proposed cuts include eliminating hospice care for about 1,000 terminally ill adults. The service that lets those patients spend their final days at home rather than in a hospital or nursing home typically lasts less than 40 days and would save $3.3 million, the agency said.
"There would be pressure to enroll those folks in nursing homes earlier, which probably won't happen, so they would end up back in the emergency department," said Dr. Bill Moran, a Medical University of South Carolina professor and geriatric doctor on the panel.
... Eliminating state Medicaid payments for routine circumcisions for 12,600 infants a year would save $114,800. [If that were true, a circumcision would cost $9.11!] The agency said a number of states have dropped that service.
And 8,600 children and adults would lose $2.6 million worth of rehabilitation therapy visits, including occupational and physical therapy. The agency now allows 75 visits for each of three types of therapy. The cuts would limit patients to a total of 75 sessions unless the agency approves an exception.
the Nation (Kenya)
Women's group saves 100 girls from 'cut'
By ERICK NGOBILO
More than 100 teenage girls who had been identified for circumcision in Mt Elgon have been saved by Maendeleo Ya Wanawake officials.
The girls, who were set to face the knife in Kamuneru location are now being counselled at a secondary school.
Mt Elgon District Maendeleo ya Wanawake chairperson Jennifer Mbatian said some of the girls were traumatised as they had undergone preparations for the rite.
“Some were threatened with death if they tried to escape,” she said.
“We counsel and teach them of the dangers associated with the practice,” she said.
She said some of the rescued girls had been disowned by their parents.
The girls, aged between nine to 12 years, narrated how they escaped and the repercussions.
“We will never be allowed back into our families,” one said.
Some of the girls, who are waiting for their KCPE examination results, are afraid their education will be cut short as they would be married off after they healed.
One of the girls said her mother took her to her grandmother’s home for the ritual.
“They said if I did not do it, I would never get married as no man would want me,” she said.
She was also told that education was not meant for women as they are supposed to get married and take care of their husbands.
Mrs Mbatian said they were worried about where to take the girls after training and urged to the government to set up a rescue centre in Mt Elgon.
She also appealed to the Sabaot community to abandon the culture. “Female genital mutilation is a monster destroying the destiny of the girl child,” she said.
In Marakwet, 150 girls aged 11 to 15 have undergone an alternative rite of passage.
Marakwet Girls and Women Project coordinator Mary Hilda Kiplagat said girls were educated on womanhood issues.
“Many people believe that the rite transforms girls to women, but that is outdated,” she said.
Ms Kiplagat said it was sad that 200 girls, including two two married women, had been circumcised.
Daily Despatch (South Africa)
EC circumcision deaths: 14
The summer circumcision season death toll in the Eastern Cape has risen to 14, the provincial health department said on Friday.
Spokesman Sizwe Kupelo said the latest deaths included youths in the Qumbu and Cofimvaba areas of Transkei.
The figure included a 19-year-old who died in Butterworth Hospital on Tuesday after circumcising himself with a knife on Tuesday. [If he died the same day, it would not have been of infection but probably haemorrhage.]
Every year, dozens of youths die in the Eastern Cape after undergoing traditional circumcision.
The health department says most of the deaths are related to untreated infection of the wound, or to dehydration and attendant complications.
Male Circumcision in the General Population of Kisumu, Kenya: Beliefs about Protection, Risk Behaviors, HIV, and STIs
Using a population-based survey we examined the behaviors, beliefs, and HIV/HSV-2 serostatus of men and women in the traditionally non-circumcising community of Kisumu, Kenya prior to establishment of voluntary medical male circumcision services. A total of 749 men and 906 women participated. Circumcision status was not associated with HIV/HSV-2 infection nor increased high risk sexual behaviors. In males, preference for being or becoming circumcised was associated with inconsistent condom use and increased lifetime number of sexual partners. Preference for circumcision was increased with understanding [i.e. indoctrination] that circumcised men are less likely to become infected with HIV.
Daily Sun blog
CUT CLAIMS 13 MORE!
Department doesn't know why they died . . .
By MKHUSELI SIZANI
THE number of deaths in the summer circumcision season continues to climb!
Thirteen abakhwetha have already died this season, while others are fighting for their lives in hospitals in the Eastern Cape.
Sizwe Kupelo, spokesman for the Eastern Cape Department of Health, told Daily Sun: “We don’t know what is killing these boys because we are no longer directly involved with the circumcisions and post mortems have not been done.”
The department has ended its involvement in the circumcision schools after traditional leaders blamed the department for the more than 40 initiates who died due to botched circumcisions and dozens who had lost their manhood during the winter circumcision season.
Kupelo said: “Now the circumcision is in the hands of the traditional leaders because they are the custodians of the custom.
“We only provide medical help when it is needed and if we are called to do so.”
He confirmed that 13 boys have died and others are in hospital.
The deaths happened in Port Elizabeth, Mbizana and Mount Fletcher.
Zolile Burns-Ncamashe, deputy chairperson of the Eastern Cape House of Traditional Leaders said: “We are very sad about these unnecessary deaths, but we can’t say the circumcision killed the boys because circumcision doesn’t kill.”
He said the boys may have died of dehydration or a variety of other diseases.
“It will be very interesting to see the post mortem results so that we can see why the boys died,” he said.
He said they will continue working hand in hand with the Department of Health to prevent unnecessary deaths of initiates.
Sunday Nation (Kenya)
2,500 boys and girls undergo 'cut'
By ELISHA OTIENO
About 2,500 boys and girls have been circumcised in Kuria West and East districts since the beginning of the month.
About 2,000 boys and 500 girls, some as young as nine years old, were initiated during the first two weeks of the month-long traditional rite of passage.
Parents and guardians have been playing hide-and-seek with the provincial administration and police after the government declared circumcision of girls illegal.
At least eight parents were being sought yesterday after they forced their daughters to face the knife.
Leaders and government officials led by area MP Wilfred Machage have vehemently opposed the circumcision of girls, commonly referred to as Female Genital Mutilation, and have vowed to bring the perpetrators to book.
The leaders say the tradition had retarded socio-economic development in the region.
More than 400 girls have sought refuge at two rescue camps set up by the government in collaboration with non-governmental organisations and community and faith-based organisations to shelter girls threatened with forced circumcision. [Are there any rescue camps for the boys?]
But there are fears that the efforts to save girls from the cut could be fruitless because in previous years, almost three quarters of the girls who underwent alternative rite of passage training in such rescue camps were forced by parents or guardians to undergo circumcision on returning home.
Although the Children’s Act outlaws circumcision of girls below 18 years of age, parents from this community have continued to indiscriminately mutilate their young daughters with impunity.
For the past two weeks, circumcisers have been doing a roaring business, charging up to Sh500 per initiate.
NGOs including Action Aid Kenya, Adventist Development Relief Agency (Adra) and World Vision are sponsoring the alternative rite of passage training at the two rescue camps at Komotobo and St Teresa’s primary boarding school at a cost of more than Sh3 million.
Adra programme coordinator Mr Robert Onsando said female circumcision would take time to be eradicated because it was part of the community’s culture.
The Local (Sweden)
Man jailed for illegally circumcising young boys
A 50-year-old Egyptian citizen was sentenced by Södertorn District Court on Monday to two months in prison for illegally removing the foreskin from small boys.
The man was on trial for having circumcised nine boys without a licence to do so issued by the National Board of Health and Welfare (Socialstyrelsen).
The case marked the first time that Sweden's law on circumcising boys had been tested in court since coming into force nine years ago.
He was also convicted for assault for having circumcised a boy from Tierp in eastern Sweden without sufficient anaesthesia and two counts of causing bodily harm involving two brothers from the Stockholm suburb of Botkyrka who suffered tissue damage, pain and loss of circulation from a bandage that was used as a tourniquet.
In addition to serving time in prison, the man must also pay 14,600 kronor ($2,140) in compensation to a boy from Tierp, as well as 4,600 kronor to the two other boys, the local Arbetarbladet newspaper reported on Tuesday.
According to the Swedish law, which came into force in 2001, only people with a special licence issued by the health board can perform circumcisions for non-medical reasons and only on children younger than two months old.
Doctors can also carry out the procedure, including on older children.
The 50-year-old previously had a licence to perform circumcisions, but the health board revoked it because of doubts about his abilities.
The health board doesn't think Sweden's law works, estimating that only one-third of the roughly 3,000 boys circumcised for religious reasons in Sweden each year have the procedure performed by people with authorisation.
Times Live (South Africa)
Eastern Cape circumcision death toll hits six
The circumcision season death toll in the Eastern Cape has risen to six, the provincial health department said.
Spokesman Sizwe Kupelo said an 18-year-old youth died at an initiation school in the Mount Fletcher area on Tuesday morning.
The exact cause of death was unknown, but was understood to be circumcision-related.
The department had learned that a would-be initiate died at Waterfall village in the Mthatha area on Sunday.
The 19-year-old had fallen sick at the initiation school he was attending, and was taken home, where he died.
Kupelo said 12 youths were currently being treated at Mthatha General Hospital for circumcision-related problems.
New report provides women's perspectives on medical male circumcision for HIV prevention
New York, 13 December 2010 — A new report from the Women’s HIV Prevention Tracking Project (WHiPT), a collaborative initiative of AVAC and the ATHENA Network, features an unprecedented collection of voices from Kenya, Namibia, South Africa, Swaziland and Uganda reflecting on what male circumcision for HIV prevention means for women. ...
Making Medical Male Circumcision Work for Women is the first report from WHiPT,
“Women are excited for medical male circumcision because they’re desperate for new prevention options, but they lack detailed factual knowledge of its benefits and risks,” says Cebile Dlamini of Swaziland for Positive Living. “For example, the fact that it only provides partial protection can be overlooked and some women and men believe once a man is circumcised, he is by definition HIV-negative.”
In total, nearly 500 women in HIV-affected communities completed a questionnaire, developed and administered by the women-led WHiPT teams in five countries. Almost 40 focus groups provided additional information about women’s attitudes about medical male circumcision. In each country, research took place in different locales, selected to reflect a diversity of circumcision practices, including communities that practice traditional male circumcision and those that do not circumcise, as well as those practicing female genital mutilation.
The Kenyan WHiPT team surveyed women in settings where male circumcision was evaluated in a clinical trial and subsequently introduced. Reports from women reached by the Kenyan WHiPT team underscore women’s fears that male circumcision may lead to changes in men’s behaviors and perception of risk.
“The women reported their partners either adapting or continuing risky behavior after ‘the cut’”, says Carol Odada, from Women Fighting AIDS in Kenya.
The report documents women’s concerns that medical male circumcision might lead to an increase in heightened stigma for women living with HIV. This would be a result of circumcised men’s misperceptions that they could not be HIV positive and/or could not transmit the virus. Thus sex and or safer sex would be less negotiable than before circumcision, putting women at greater risk for gender-based violence and HIV.
The report also highlights perceptions of male circumcision for HIV prevention in the context of traditional practices. Specifically, it underscores the need for communications campaigns that directly address the distinctions between medical male circumcision, traditional circumcision and female genital mutilation.
“Some women report the concern that the promotion of circumcision for men would increase the promotion of female genital mutilation,” says Allen Kuteesa from Health Rights Action Group in Uganda.
The myths and misunderstandings identified by WHiPT teams — such as the perception that medical male circumcision is directly protective for women — underscore the urgent need for adequate education campaigns directed at women.
... To download the report and/or a recording of the global report launch teleforum with the report authors, go to http://www.avac.org/WHiPT.
Tara Klamp roll-out not suspended - DOH
By Fidel Hadebe
Contrary to recent media reports, the Minister of Health Dr Aaron Motsoaledi has not given any instruction to anyone to discontinue the use of the Tara Klamp device in the medical male circumcision currently being conducted in the country.
Medical Male Circumcision (MMC) has been identified as one of the key interventions in the fight against HIV and AIDS in South Africa. Studies have shown that MMC can reduce the risk of infection by up to 60 percent.
The Department of Health would like to place it on record that the use of the Tara Klamp as a device to conduct MMC will continue while investigations are being conducted regarding other possible methods. The Department of Health also remains fully committed to the roll-out of medical male circumcision as policy and intervention in the fight against HIV and AIDS.
Statement issued by Fidel Hadebe, Department of Health, December 9 2010
Infozine (Kansas City)
Medical Male Circumcision As HIV Prevention
The Case for Aggressive Scale Up
Washington, D.C. - infoZine - Leading infectious diseases scientists in global health released a new issue brief today discussing the benefits of medical male circumcision (MC) – a one-time, cost effective intervention already proven to reduce a man’s chance of acquiring HIV through vaginal sex by up to 60 percent. The report, entitled “Medical Male Circumcision as HIV Prevention, Follow the Evidence: The case for aggressive scale up,” discusses the case for scaling up MC in countries with high HIV prevalence and low rates of MC, with a predominantly heterosexual epidemic.
“This monograph discusses best practices and highlights some of the recent successes in enhancing access to MC,” said Kenneth H. Mayer, MD, Director of the Brown University AIDS Program and co-chair of the Center for Global Health Policy’s Scientific Advisory Committee. “MC is the first biomedical intervention with demonstrated efficacy for HIV prevention, but making it accessible to populations where the epidemic is expanding has proven to be challenging.” [- at least partly because not all men want to have part of their genitals cut off.]
Scientific advancements in HIV prevention have gained the focus of many in the past several months; most recently with the announcement of positive results from the CAPRISA and iPrEx clinical trials, which explore different methods of administering antiretroviral drugs in HIV-negative persons to prevent the spread of the disease, known as pre-exposure prophylaxis or PrEP. But while PrEP and other prevention methods such as condoms rely on the user’s consistent adherence to proper usage and/or dosage instructions, MC is a proven one-time, low-cost intervention that can save millions of lives and significant resources if fully implemented. Moreover, while other promising interventions require further research, medical male circumcision is ready to roll out now. [Not according to the 2009 Cochrane review.]
And the results could be dramatic. “We expect a drop in [HIV] prevalence,” said U.S. Global AIDS Coordinator Eric Goosby, MD. “It will look like a vaccine has entered the community.”
Mathematical modeling predicts incredible [= unable to be believed] reductions in HIV incidence over time, with scale and pace of implementation directly proportional to the impact. In Zimbabwe, by scaling up medical MC to 80 percent of the male population in five years, the country could see a decrease in HIV incidence of 42 percent by 2025, averting nearly 800,000 new infections. A similar five-year scale up in South Africa could reduce HIV incidence by 19 percent, and prevent more than 1.2 million new HIV infections by 2025.
These same mathematical models utilized by the U.S. Agency of International Development predict that scaling up MC to reach 80 percent of adult and newborn males in 14 African countries by 2015 could potentially avert more than 4 million adult HIV infections by 2025, and save $20.2 billion by 2025.
The issue brief is available on the Center for Global Health Policy website.
Dramatic MC Scale Up in Swaziland
With the help of the President’s Emergency Plan for AIDS Relief (PEPFAR), Swaziland is engaging in a one-year, massive scale up of medical MC services, aiming to circumcise 80 percent of men 18 to 49 years of age, with an end goal of reaching approximately 150,000 HIV-negative men. The Accelerated Saturation Initiative includes funding for 20 or more mobile medical units that will travel to remote areas of the country to perform the surgery on-site. The government is planning to launch the program in January 2011, and mathematical modeling predicts that this initiative may prevent 88,000 new adult HIV infections, reducing the annual HIV incidence by approximately 75 percent, by 2025. One new HIV infection could be prevented for every 3 to 4 MCs performed.
[- when one was delayed for two years - perhaps - for every 39 performed in the randomised controlled trials. Where did this ten-fold increase come from? Ex recto?]
The final savings in HIV care and treatment costs to the Swazi government would be approximately $650 million.
Five years demanded for female circumcision
The Dutch public prosecution office has demanded a five-year prison sentence for a man who carried out female circumcision on his own daughter.
According to the PPO, thirty-one-year-old Mustapha El M. seriously mutilated his five-year-old daughter in October 2008. He allegedly used a scissors to cut away her genitals.
Last year, a court in Haarlem acquitted the man. It is clear that the little girl has undergone female circumcision as her labia and part of her clitoris are missing. However, the court ruled that it could not be proven beyond doubt that her father was responsible. The PPO appealed against the verdict.
The man was arrested after the girl told her foster mother that her father had cut her genitals with "a big scissors". The man with a Moroccan background has consistently denied performing a circumcision on his daughter.
The court did sentence the man to three months in prison for physical abuse. He repeatedly bit the girl's cheek and beat her. The father has appealed against this sentence.
The court will deliver its verdict on 23 December.
Cleric Says Female Circumcision Recommended by Islam
SULAIMANI, Iraqi Kurdistan: The Imam of Hajji Osman Alaf Mosque in Iraqi Kurdistan’s second largest city, Sulaimani, has told his followers that anyone who believes female circumcision is not a recommendation from the prophet Mohammed is “ignorant.”
During his Friday sermon on December 3rd, Imam Mala Yassin Hakim Piskandi said female circumcision was a “Sunnah," a term used to refer to the practices carried out or recommended by Mohammed, the prophet of Islam.
[Well, if it was, the messenger must have misheard the message from the Compassionate, the Merciful. Rather to believe it was not.]
He said, the Sunni Shafeyi, a school of jurisprudence which most Kurds follow, took a tougher stance regarding female circumcision, considering it an “obligation," but that the other three Sunni schools of jurisprudence regarded it merely as a Sunnah, meaning it was recommended, but not compulsory.
The Islamic practice of female circumcision, known among rights groups as Female Genital Mutilation (FGM), has a deep history dating back to the prophet Abraham. [Where does this idea come from? FGC is not, of course, mentioned in the Bible.] Prophet Mohammed followed in Abraham’s footsteps by remaining silent about the prevalence of the practice in the city of Medina, where he established the first Islamic system of law, said Piskandi.
“When men and women have intercourse, their sexual organs should be circumcised and clean,” he quoted Prophet Mohammed as saying.
He added that practicing a Sunnah act is “good,” but that not practicing it is “not sinful.” But in some cultures, including among some Kurds, uncircumcised women are regarded as unclean and are not allowed to cook.
Female circumcision has been practiced in Iraqi Kurdistan for years, mostly in rural areas. According to statistics published by Kurdistan’s Ministry of Health last week, 41 percent of Kurdish women had been circumcised. The data points to a decline in the number in recent years.
Imam Piskandil, who holds a master’s degree in Islamic jurisprudence, said Islam does not condone the killing of women, adding that men “should not be blamed so much for women who burn themselves to death.”
The Nation (Kenya)
Two mothers among 168 girls circumcised
Two women, including a mother of four, were among 168 teenage girls circumcised in Marakwet East and Pokot Central districts on Tuesday.
Nineteen girls were the first to go through the outlawed rite at Tigenuo Village in Kombases sub-location in the Kerio Valley.
They were circumcised early in the morning, following observation of the position of the moon, a traditional indicator.
A 37-year-old mother of two, who had resisted the rite, gave in at Karamwar Village after her husband allegedly demanded that she be circumcised or he would not continue living with a “child” any more.
Another mother of four, 39, consented to the cut in Chepsigot Village in Kerio Valley, saying she had been ridiculed for far too long.
A woman who is not circumcised in the area is not recognised as an adult.
The mother joined teenage initiates in seclusion where they will stay until mid-January, next year, when they will graduate.
The other initiates were girls aged between nine and 11 years, from villages in the area, even though circumcision of girls is banned by the government.
A number of girls have fled their homes for fear of being forcibly subjected to the rite of passage.
Lobby groups accused the local district children’s department of doing little to protect the rights of innocent and under-age children
However, the Marakwet district children’s officer, Mr Peter Kutere was, not available for comment.
S. Africa halts rollout of circumcision device
By JENNY GROSS
JOHANNESBURG – The South African government has halted the rollout of a controversial male circumcision device, health department spokesman Fidel Hadebe said Wednesday.
Hadebe said more research was needed into the plastic device, known as Tara Klamps, which has been used in the circumcisions of 9,000 South African men since April as part of an initiative to stop the spread of Aids.
Treatment Action Campaign, a Cape Town-based advocacy group for people with HIV, welcomed the government's decision, calling the device dangerous and painful.
South Africa has more people living with HIV than anywhere else in the world, with 5.7 million of 50 million people infected.
Circumcision, in conjunction with using condoms and remaining faithful to one partner, has been shown to cut the risk of contracting the AIDS virus by as much as 60 percent.
While circumcision reduces the risk of HIV transmission, the devices cause excessive swelling and severe pain, said Lihle Dlamini, the deputy secretary general of Treatment Action Campaign.
The director of KwaZulu-Natal's male medical circumcision division, however, said they will continue to purchase the circumcision device. In October, the KwaZulu-Natal government bought 22,500 devices, director Sandile Tshabalala said.
He said the clamp "is as good as any other method." [So much the worse for any other method...]
The New Age
New move to circumcise infant boys
By Chris Makhaye
Kwa Zulu Natal
The provincial department of health is to start an ambitious and controversial programme by circumcising infant boys from April next year as part of a strategy to minimise their chances of contracting HIV.
Where infant circumcision is done for religious or cultural reasons, it has often by criticised by child rights activists, who argue that it deprives a child of the opportunity to choose. Punitha Naidoo of the Medical Rights Advocacy Network said the department''s child circumcision initiative was on very shaky legal ground.
"The Children''s Act states very clearly that a child cannot be subjected to bodily mutilation without his/her consent. It also states that the child must be older than 16 years of age for cultural circumcision to be allowed," she said.
Health MEC Sbongiseni Dhlomo told The New Age that infant circumcision would be done only surgically. The Tara Klamp would not be used on babies. The provincial health department has used the Tara Klamp during medical male circumcisions despite safety concerns raised by the Treatment Action Campaign.
Dhlomo said KZN would circumcise 10% of all boy infants. "Parents would not be compelled to submit their infant boys to do circumcision. We will just make this procedure available to those who need it," he said. "We will inform parents and educate them about how convenient and safe (it is) for their sons to be circumcised in their first few days of life," Dhlomo said.
Naidoo said the Children''s Act allows Muslims and Jewish infants to undergo circumcision and "even here parents have to sign special forms". She said child rights organisations could take the government to court if it was go ahead with the programme. "The parents and the government could be sued by the child later in life if he experiences problems with his genitals due to the circumcision," said Naidoo.
The department launched its medical circumcision programme early this year and so far more than 18000 – mainly young – men, have undergone the procedure. The head of HIV programmes in the provincial health department, Sandile Shabalala, said that the department was getting legal opinion and training staff for the roll-out of the infant circumcision programme in April.
Flogging a dead horse
Circumcision may [does] not curb gay HIV transmission
NEW YORK (Reuters Health) – While circumcision has been shown to lower a man's risk of contracting HIV through heterosexual sex [Don't they love to throw that in at every opportunity?] , a new study indicates that the value of circumcision for gay and bisexual men remains questionable.
In a study of more than 1,800 men from the U.S. and Peru, researchers found that overall, the risk of contracting HIV over 18 months did not significantly differ between circumcised and uncircumcised men.
Over the study period, 5 percent of the 1,365 uncircumcised men became HIV-positive, as did 4 percent of the 457 circumcised men, according to findings published in the journal AIDS.
All of the men in the study reported having sex with other men and were considered to be at increased risk of HIV infection because they were already infected with the genital herpes virus (herpes simplex type 2), which can make people more susceptible to HIV.
Male circumcision is far more common in the U.S. than in most other countries, and 82 percent of the 462 American men in the study were circumcised, compared with just 6 percent of the 1,360 Peruvian men. [So what did they do to correct for the many confounding factors between US men and Peruvian men?]
The researchers did find some hints that circumcision could be protective among men who primarily had insertive sex with other men. Among men who said they'd had insertive sex with their last three male partners at least 60 percent of the time, circumcision was linked to a 69 percent lower HIV risk.
That difference, however, was not statistically significant, which means the finding could be due to chance.
Taken together, the results "indicate no overall protective benefit from male circumcision" when it comes to male-to-male HIV transmission, write the researchers, led by Dr. Jorge Sanchez of the research organization Impacta Peru, in Lima.
They add that studies should continue to look at whether circumcision affects HIV risk from insertive sex and do so in larger, more diverse study groups.
[What? So that insertive men can get circumcised and infect receptive men at less risk to themselves? There is no such thing as "insertive sex" without receptive sex. This is scandalous!]
In general, the researchers write, public-health messages for gay and bisexual men should "reinforce the importance of condom use for HIV prevention."
The findings may help inform debate over whether circumcision could stand as a weapon against HIV transmission among men who have sex with men.
[What debate? After Gust, Grulich, Jozkowski, Jameson, Millett, and McDaid have independently found circumcision offers no protection to gay men, and none found significant protection, what's to debate? Circumcision does not protect gay men. Get over it.]
In 2005 and 2006, three clinical trials in Uganda, South Africa and Kenya showed that circumcision can reduce a man's risk of HIV infection through heterosexual sex by up to 60 percent.
The World Health Organization now recommends medically supervised circumcision as one way to lower men's risk of HIV in countries where heterosexual transmission is common.
But the public-health value of circumcision in other countries, including the U.S., is a contentious issue. Most HIV infections in the U.S. are related to homosexual sex or IV drug use and studies have yet to find strong evidence [actually, any evidence] that circumcision lowers HIV transmission among men who have sex with men.
Circumcision is thought to lower the heterosexual transmission of HIV and other sexually transmitted diseases through several mechanisms. One is by reducing the amount of mucosal tissue exposed during sex, which limits the viruses' access to the body cells they target. Another theory is that the thickened skin that forms around the circumcision scar helps block the viruses' entry.
One reason circumcision might have little effect on homosexual HIV transmission is that it would have no impact on the risk from receptive anal sex. [Another is that the above theory is wrong.] Experts have also pointed out that in wealthier countries, many HIV-positive people are on powerful anti-viral drugs that reduce the risk of transmission, and any added effect of circumcision might be small. [Or there never was any.]
Currently, the American Academy of Pediatrics does not recommend routine circumcision for newborns, citing insufficient evidence of overall health benefits. The U.S. Centers for Disease Control and Prevention, meanwhile, is in the process of developing recommendations on adult and infant circumcision for lowering HIV risk.
The Soweatan (South Africa)
Honour over circumcision
THE 18000 men circumcised recently in KwaZulu-Natal are to be honoured by being conferred the status of a regiment.
Zulu monarch King Goodwill Zwelithini has invited the men to his palace for the honouring. It is scheduled to take place next week Friday.
The king sees the circumcision programme in the province as an important campaign against HIV-Aids.
More than a million of the country's estimated 5,5million HIV-positive people live in KwaZulu-Natal. The province has the highest HIV prevalence in the country.
It has been tradition before for the king to honour important achievements of groups by naming them regiments.
Historically, male circumcision has been practised for various reasons, including hygiene, religion, tradition and culture.
In late 2006, two randomised controlled trials on whether male circumcision reduces HIV transmission were halted because interim results showed an overwhelming protective effect, validating the results from an earlier South African trial conducted at Orange Farm. Based on the weight of the evidence from both observational studies and randomised trials, public health leaders have concluded that male circumcision - when performed by well-trained and well-equipped health professionals - can significantly reduce the risk of HIV infection among adult men, and thus the number of new infections a year.
Provincial department of health spokesperson Chris Maxon said the king had invited all circumcised males to come to his palace during the Ukweshwama ritual next week. The Ukweshwama ritual is where men kill a bull with their bare hands.
Wife divorced over sons' circumcision
By DICKSON KAMINDA
A MAN of Lufwanyama’s Nkana village has divorced his wife of 20 years for circumcising their two children without his consent.
Isaac Fungulo of Nkana village in Chief Nkana’s area narrated before Kitwe No. Two local court that although he underwent circumcision, he did not allow his wife Lwiza, to circumcise his children. ...
The court granted divorce and ordered Fungulo to pay K6 million [$US 1,254] as compensation to Lwiza ...
New Vision (Uganda)
The law alone will not stop FGM
SABINY women are flocking to Kenya to be circumcised. They are doing this because the Female Genital Mutilation (FGM) Act that was passed into law by Parliament in June makes the practice a crime in Uganda.
Offenders face jail terms ranging from five to 10 years or life imprisonment upon conviction.
FGM is internationally recognised as a violation of the human rights of girls and women. FGM has no health benefits for girls and women. Instead it can cause severe bleeding and problems when passing urine and later, childbirth complications and death of newborns.
Why are some Sabiny women risking prison, their lives and those of their unborn babies to be circumcised? It is not hard to see why. It is a classic clash between law and culture.
FGM has been practised for ages in their culture. It is considered a rite of passage to womanhood. It is, therefore, part of their cultural identity. They do not know anything else. One new law is not going to change it overnight. A lot more work needs to be done.
The law alone, however well-intentioned, is woefully inadequate to cause cultural change. The real change must begin in the hearts and minds of the people.
For the law to work, the people must own it and see it as something that helps rather than oppresses them. There are no quick fix solutions. The law must be accompanied by public education within the cultural context of the Sebei. The message must permeate to every level of the society.
It will not be easy. It will take time, but it can and must be done. Indeed with public education, a growing number of girls and women have been saved from this harmful practice.
RH Reality Check
Urgent Effort Underway to Prevent Imminent Circumcision of More Than 150 Girls in Uganda 36Share
By Jodi Jacobson
In November, leaders in the Ugandan districts of Bukwo and Kapchorwa made clear their intention to perform a mass genital mutilation this month on over 200 girls despite a new law in the country banning the practice.
This week, it was believed that 150 to 200 girls from the districts had been transported to Kenya to facilitate the mass operation, but amid what may be purposeful confusion on the part of the district leaders, it now appears that the process of mutilation of these girls has begun inside Uganda. One advocate reports:
A frantic effort is now underway to stop the mass "circumcision" as it is euphemistically called [no euphemism], and advocates report that teams from both UNAIDS and UNICEF are en route to the districts to try and stop it.
The Ugandan Parliament passed a law last December banning FGM. President Yoweri Museveni signed it into law on March 17, 2010 and it took effect on April 9, 2010.
According to AllAfrica.com:
The law argues that FGM infringes on the rights of the woman and also leads to health hazards, including excessive bleeding, death, birth complications and exposure to illnesses. The law criminalises the practice, calls for prosecution of offenders and protection of victims. Anyone caught doing it faces 10 years in jail or life imprisonment if the victim dies.
AllAfrica.com also reported that last month the elders swore "that the whole tribe would rather go to prison than abolish a custom they inherited from their ancestors." [Sound familiar?]
Female genital mutilation (FGM) is a tradition among the Sabiny in Uganda. FGM refers to the removal of the external female genitalia, i.e. the clitoris, labia, and other portions of the genitalia. The United Nations Population Fund has extensive materials on the practice, and approaches to end FGM.
The vice-chairman of Bukwo district, John Chelangat, told AllAfrica.com that:
As in other countries, including the United States, women's rights, health, and lives are considered fair game for male political ambitions:
Translation: If I step up and do the right thing to prevent 200 girls from being mutilated for the rest of their lives, I might lost my political seat.
Still in some quarters, education and advocacy efforts to stop this horrific practice have taken hold:
Alice Chemutai, 17, another resident of Matibeyi, was convinced by her aunt to undergo female circumcision. But because she is educated she refused and her father supported her.
She recites an endless list of young girls who have dropped out of school to get married after the ritual and those who have had birth complications, bleeding and infections after.
"I will never get circumcised because this will not only infringe on my rights of womanhood but will also expose me to long-term health hazards. I am happy my father and mother support me against other relatives," adds Chemutai, a Senior Three student at Amananga High School in Suam.
International and Ugandan groups have been working strenuously to prevent this mass mutilation from taking place. We are in contact with advocates on the ground and will report back as new information becomes available.
Eye-for-an-eye revenge for boys' botched circumcision
By Lulamile Feni
A BOGUS Transkei traditional surgeon got a taste of his own medicine when the family of two teenage boys circumcised him in revenge for his illegal operations on the pair.
Four brothers, aged between 16 and 24, were arrested on Tuesday after they allegedly stabbed and circumcised the 18-year-old at KuNgobozi Village near Ngqeleni.
The four are expected to appear in the Ngqeleni Magistrate’s Court today.
“The revenge attack came after the victim apparently illegally gave the two young brothers of the suspects a botched circumcision at about 5am.
“The boys he circumcised were 15 and 16 years old,” said police spokesman Captain Zamukulungisa Jozana.
He said the bogus traditional surgeon had undergone initiation and circumcision last year.
But he was “forcefully recircumcised” after operating on the two boys without the permission of their parents, health officials and the area’s traditional leader.
“The poor man was left in a lot of pain,” Jozana said. He said the suspects had found the man sitting near an initiation hut at the village with the two boys.
When questioned, the boys admitted they had been illegally circumcised.
“The suspects then drew a knife and circumcised the man after assaulting and stabbing him,” Jozana said. The “surgeon” was later admitted to the Nelson Mandela Academic Hospital. The two boys were also admitted for treatment.
Provincial Health Department spokesman Sizwe Kupelo said another incident was reported at KwaMbiza Village in Ngqeleni, where a 19-year-old man from Mkhenketho Village in Libode illegally circumcised a younger boy. “The local traditional leader’s council are now in the process of fining his family a cow as is the custom,” he said.
Fresno Criminal Lawyer blog
Fresno Tattoo Case Ends with Dad Getting Stiff Prison Sentence
By Michael E. Mitchell (Defence counsel)
Last week, a Fresno father who allowed his son to get a tattoo of a dog's paw was sentenced to six years in prison. ...
Jewish Circumcision Under Fire in Second Foreskin Man Comic Book
Foreskin Man battles the ritual circumciser Monster Mohel in a follow-up story from MGMbill.org.
MGMbill.org released a new Foreskin Man comic book today that deals with the controversial practice of Jewish infant circumcision. The 12-page book introduces Miah Redstone, who belatedly makes plans to attend her nephew’s bris when she learns that his circumcision has been canceled. But will someone in the family have a change of heart? In the meantime, a rash of circumstraint thefts from California hospitals has the news media buzzing, and Miles Hastwick celebrates the opening of his new brit milah exhibit at the Museum of Genital Integrity.
The story in Foreskin Man #2 is written by Matthew Hess, with commissioned artwork by the same creative team that illustrated the first issue. Hess is president of San Diego based MGMbill.org, a group that has authored proposed federal, state, and local legislation to protect boys from medically unnecessary circumcision.
“Brit milah is child abuse in a religious context,” said Hess. “Why should an eight-day-old infant boy be forced to give up his foreskin for someone else’s spiritual beliefs? We need laws to protect male children from this painful and scarring blood ritual, and our second Foreskin Man comic book was created to get that point across.”...
The Anti-Defamation League and three other Jewish groups are now mobilizing in opposition to the San Francisco MGM Bill Ballot Initiative, which is in the signature gathering phase. San Francisco resident Lloyd Schofield, the ballot measure’s proponent, says he is undeterred.
“Federal and state laws rightfully protect girls from even the mildest form of ritual genital cutting,” said Schofield. “Parents are free to alter their own genitals if they wish, but they should not be free to force this mutilation onto their children. It makes no difference whether the child is male or female.”...
ATCC Introduces Normal Human Primary Dermal Microvascular Endothelial Cells
ATCC (American Type Culture Collection), the world’s largest and most diverse bioresource center, offers normal human primary dermal microvascular endothelial cells derived from neonatal foreskin (HDMVECn). These cells are suitable for research related to drug screening/uptake, angiogenesis, oncology, inflammation, and intercellular communication.
HDMVECn from ATCC are rigorously tested to be free of bacteria, yeast, fungi and Mycoplasma. The cells are cryopreserved in the third passage to ensure the greatest purity coupled with high viability and plating efficiency.... Scientists can expect cell cultures with functional expression of relevant biomarkers, normal morphology and superior growth and proliferation. [Isn't it marvellous how the foreskin is a cesspit of disease as long as it's on its owner's body, but a fountain of health as soon as it's removed?] ... To learn more go to http://www.atcc.org/PCS2. [Where we learn that one millilitre of HDMVECn, containing > 500,000 viable cells, costs $559] ... ABOUT ATCC ATCC maintains the largest and most diverse biorepository in the world. The innovative, not-for-profit organization develops and provides products for life science research, ...
Times of Swaziland
'Skoon sex' crisis looming after male circumcision
EZULWINI – There is fear that male circumcision has led to people not using condoms and engage in ‘skoon sex’.
As a result, there have been calls for a study to be conducted to determine whether the numbers between circumcision and condom distribution add up.
"I’m concerned about male circumcision. Last year there was a circumcision campaign. I would like to see if the numbers tally between circumcision and condom distribution. If the condom distribution is low then we have a problem which probably means that the circumcised are not using condoms. We need to carry out research. If the circumcised don’t use condoms then we are heading for disaster because of those that are HIV positive," submitted Vusi Nxumalo.
A participant of the indaba said it was obvious the circumcision concept had not been properly communicated to the puplic.
"A sibling at home is now telling us he is circumcised and therefore has ‘skoon’ sex," she submitted.
Another participant, identified as Magagula, made a statement that threw everyone into laughter when he said the penis foreskin was good for masturbation.
"Now without the foreskin you can’t satisfy yourself but women can still do that through use of vibrators," he said.
However, Bertram Auvert said he had never heard of masturbation concerns from those that had circumcised. [Well he's heard now.]
...16% of pupils have sex with four or more partners
EZULWINI - Sixteen per cent of surveyed pupils in the country are reported to be having sex with four or more sexual partners.
This was revealed by Mzwethu Nkambule, Campaigns Manager of Lusweti, when making a presentation on Multi-Concurrent Partners (MCPs) and the HIV incidence in Swaziland.
He said this was seriously perpetuating the spread of HIV/ AIDS, to the extent that Swaziland had become the leading country in the level of HIV/AIDS prevalence in the Southern Africa region.
Nkambule also divulged that, "among the 15-19 year olds who had sex about a third had more than one partner,"
He also disclosed that more women, according to statistics, are reported to have acquired HIV as compared to men.
"Sixty-two per cent of the overall infections in 2008 were recorded among females while 38 per cent were recorded among men," he said, while shedding light on the urgency of crafting initiatives that will lead to a Swazi HIV free generation.
Senegalese villages abandon female circumcision
KOLDA, Senegal — Seven hundred villages on Sunday declared an end to female circumcision and forced marriages in the southern province of Kolda where the rate of practice is the highest in Senegal.
After a march by nearly 3,000 people from the region bearing signs and other effigies denouncing the rites, a colourful ceremony took place with traditional music, dancing and theatre.
Young girls from the region dressed in pink wraparound skirts and bright headdresses performed for the crowd "to show how important it is to the young girls that these practices be abandoned," said Molly Melching, head of the Tostan NGO.
The public denunciations come after extensive work by the government and non-governmental organisations in communities to encourage an end to the cultural or religious practice of deliberately mutilating female genitalia....
According to UNICEF, the practice is a deeply entrenched social convention which millions of girls in Africa are subjected to every year, with religious beliefs cited even though it is not prescribed by any religion.
Tostan believes that with this kind of pressure it is important for entire communities to abandon the practice, to prevent stigma between villages on girls who are not cut and face becoming outcasts.
In Senegal, two types of excision are prevalent, according to a US State Department report.
These include just the removal of the clitoral hood, with or without removal of the clitoris, or the most extreme kind: excision of part or all of the external genitalia and the stitching of the vaginal opening to allow only for the flow of urine and menstrual blood.
Female genital cutting leads to severe pain, infections, shock, hemorrhage, infertility and can cause massive problems during childbirth....
One death, and so they ban it
Colombian tribe bans female circumcision
BOGOTÁ - Eastern Colombia's Embera-Chami tribe Wednesday announced it was banning its centuries-old practice of female circumcision, after a girl died from the mutilation three years ago, a tribal elder told AFP.
"We've arrived at this decision after a three-year investigation and consulting with midwives, tribal elders and the community at large," said Risaralda province Regional Indigenous Council leader Martin Siagama.
"We realized that (cutting off the clitoris) is not traditional practice in our indigenous community, but was brought here by Europeans more than 500 years ago," he said.
"Not even the midwives knew what it was for," Siagama added.
He said he undertook a personal quest to ban the practice after a young girl died three years ago from the crude operation. He said the United Nations helped in his investigation that resulted in the Embera-Chami's ban.
However, Siagama said it would take time for his people to adapt to the change.
"It's difficult to eradicate a centuries-old practice overnight, so we can't say it will stop immediately. But we're committed to... promoting the decision among all the members of our community."
Seventy-seven deaths ...
Weekend Post (South Africa)
New strategy put in place to prevent circumcision deaths
By Lulamile Feni
TRADITIONAL leaders and the Eastern Cape government have launched a new strategy to monitor and control circumcision this season, to curb the high number of deaths in Pondoland.
The Monitoring and Intervention Strategies On Male Initiation plan was launched in Lusikisiki yesterday and marked the beginning of the summer circumcision season in the province.
Of the 60356 boys who were circumcised in the province during the summer and winter circumcision seasons last year, 641 needed hospital treatment, 77 died and 24 had penile amputations. Twenty-one traditional nurses and surgeons were arrested.
In Pondoland alone, 8374 boys underwent the rite in that period, 38 died and 17 had penile amputations.
A total of 263 were treated in hospital and seven traditional surgeons and nurses were arrested....
Saturday Post Online (Zambia)
Boys see circumcision as a licence for unprotected sex
By Lenganji Sikapizye
THE recent headlines that circumcision has made are too loud for anyone to ignore....
Critics say circumcision is brutal and robs males of sexual sensation, but many in the medical community point to research that suggests circumcision reduces the risk of sexually transmitted infections including HIV.... school headmistress Catherine Mutale expressed disappointment at the decision by personnel at the health centre to enlist the pupils for circumcision without the school authorities’ approval.
Mutale learnt about the circumcision campaign at her school through the posters that had been stuck on trees within the school premises and that a parent to one of the pupils had also called the school earlier inquiring on how their child had been circumcised without their approval.
‘We found posters promoting circumcision stuck on trees and by the time the deputy head pulled them out ,the pupils had already read the message on the posters and were booked in for circumcision the next day,” Mutale said.
The headmistress said she then approached health personnel at Kafue Rural Health Centre over the matter who responded defensively, saying the boys were old enough to make their own decisions.
“By the time we had gone there, five had already been circumcised, and five more were awaiting circumcision,” she said.
Mutale complained that the practice had disturbed some pupils because they were absconding classes due to the nature of the operation.
“Some have been missing class because they are having problems in walking and sitting. Our other concern is on the cleaning of the wounds; we don’t know whether the boys are doing the right thing. They are targeting boys because they want to meet the target.
Why are they are targeting pupils in boarding schools?” The headmistress queried.
She also sadly noted that there was a misconception amongst pupils that once circumcised they could have unprotected sex without contracting STI’s and HIV.
“These pupils think circumcision is a lee-way to indulge in unprotected sex and now my worry is they may decide to practice this whilst at home during holidays because then the school will have no control over them,” Mutale said....
And one of the pupils who spoke on condition of anonymity said he went for circumcision because it was advantageous in that it kept one in good hygienic condition and protects one from contracting STI’s.
“To be honest, some of the reasons were sexual because as boys, we talk a lot about such issues and some of them say that’s when you become a real man. ...
Herald Sun (Melbourne)
Doctor barred but still at work
By Anne Wright
A DOCTOR reprimanded four times by authorities will return to work today.
A DOCTOR who has been reprimanded four times by the Medical Practitioners' Board of Victoria, most recently for the botched circumcision of a two-year-old boy, will return to work today.
Indian doctor Mohammed Mateen Ui Jabbar has been suspended for three months over his attempted circumcision of a 26-month-old boy which resulted in gross swelling and severe scarring of the toddler's genitals.
But to avoid disruption to patient bookings over the next week, Dr Jabbar is still allowed to practise until November 22, when the suspension of his medical registration starts....
In the latest decision handed down last week by the Victorian Civil and Administrative Tribunal, Dr Jabbar, 57, ... admitted his misconduct circumcising the boy on January 29, 2008.
It resulted in the child needing six operations, including plastic surgery.
The application of the plastibell device, a vital step in the procedure, was botched and Dr Jabbar failed to do a visual check that the urinary passage was clear afterwards, the tribunal found.
The boy failed to pass urine during the night and his parents took him to the Royal Children's Hospital where he had surgery to remove the plastibell device.
The tribunal findings stated: "It is clear Dr Jabbar has failed this boy and his parents at each step in the process resulting in what can only be described as a tragic outcome."
[This is exactly the same botch as caused the death of a baby in Ontairo in August 2002. ]
San Francisco Examiner
Ban-happy SF targets male circumcision
By Joshua Sabatini
The Board of Supervisors just banned toys in Happy Meals, which drew worldwide attention.
Now the latest ban being proposed in San Francisco is on male circumcision.
A proposed ballot measure for the November 2011 ballot – when voters will be electing the San Francisco’s next mayor – would amend The City’s police code “to make it a misdemeanor to circumcise, excise, cut or mutilate the foreskin, testicle or penis of another person who has not attained the age of 18.” [This wording closely parallels the existing legislation outlawing female genital cutting.]
Doing so would result in a fine of up to $1,000 and up to one year in jail, according to the proposed measure submitted to the Department of Elections.
The measure was submitted by San Francisco resident Lloyd Schofield, who has spoken up on this issue in the past.
He was not immediately available for comment.
For the ordinance to make it on to the November ballot, it would require the collection of 7,168 valid signatures by April 26, 2011.
It's unknown if Schofield approached members of the Board of Supervisors asking them to vote on such a measure before deciding to take it to the voters.
Ban on circumcision proposed in SF
SAN FRANCISCO, Nov. 12 (UPI) -- A San Francisco man is trying to get an initiative on an upcoming city ballot that would ban male circumcision, officials said.
The proposed measure for the November 2011 ballot would amend the city's police code "to make it a misdemeanor to circumcise, excise, cut or mutilate the foreskin, testicle or penis of another person who has not attained the age of 18," The (San Francisco) Examiner reported.
Under the proposed measure submitted to the Department of Elections, doing so would result in a fine of up to $1,000 and up to one year in jail.
The initiative, which would require the collection of 7,168 valid signatures by April 26, 2011, was submitted by San Francisco resident Lloyd Schofield, who argues it is genital mutilation.
"You shouldn't be performing cosmetic surgery for other people," said Schofield, who points out that female circumcision is banned."Tattooing a child is banned as a felony and circumcision is more harmful than a tattoo," said Schofield, who believes religious traditions should change. "People can practice whatever religion they want, but your religious practice ends with someone else's body," Schofield told CBS news. "It's a man's body and … his body doesn't belong to his culture, his government, his religion or even his parents. It's his decision."
New Vision (Uganda)
Over 200 Sabiny girls to be circumcised
By Frederick Womakuyu
ELDERS in Bukwo and Kapchorwa districts are preparing to circumcise over 200 girls next month despite a new law banning the practice.
They swear that the whole tribe would rather go to prison than abolish a custom they inherited from their ancestors....
Kokop Chebet, 70, a mentor from Matibeyi village in Suam sub-county-Bukwo, says she has received applications from over 20 girls wishing to be prepared for the ritual....
Twenty-year-old Ana Chebet is a resident of Matibeyi village in Suam. Married with three children, Chebet has always been scolded by the community for not undergoing circumcision that passes her from childhood to adulthood.
“I cannot milk a cow or climb into the family granary. Whenever I go to the well, other women throw scorn at me because I am not cut,” adds Chebet, who will be one of the candidates this December....
The Sabiny people claim they do not fear the law and they are ready to die for FGM. “This law was not initiated or brought by the people of Sebei. It was brought by the people who do not understand why we carry out circumcision,” adds Alice Kokop.
According to Sabiny customs and traditions, female circumcision has been around for over 2,000 years and it is carried out to convert a female from childhood to adulthood. Females who are not circumcised are not called women and they are not supposed to carry out certain home activities like milking a cow, climbing into a family granary and talking with the elders.
Circumcision programme a success ... at circumcising
AFP via Yahoo! (South Africa)
S.Africa's Zulu circumcision programme a success: officials
JOHANNESBURG (AFP) – A push by the king of South Africa's Zulus to revive the practice of circumcision among his people has had impressive success in fighting the spread of HIV, health officials said Friday.
"We have circumcised 17,690 men and we are pleased to report that 99.5 percent tested negative for HIV," KwaZulu-Natal provincial health department head Sibongile Zungu told a workshop on the programme, the Sapa news agency reported.
[This snapshot tells us nothing about the effectiveness of circumcision in preventing HIV/AIDS, since the programme has been going for less than a year.]
Health officials in the northeastern province launched the large-scale circumcision programme this year after King Goodwill Zwelithini called for a revival of circumcision among young Zulu men, saying it would help fight the spread of AIDS.
A number of studies have shown that circumcising men can halve their chances of contracting HIV.
An estimated 5.7 million of South Africa's 48 million people are HIV positive. [That's a national rate of 11.9%]
KwaZulu Natal, the homeland of the Zulu nation, has been the country's worst affected province. A 2008 study found that 38.7 percent of all pregnant women tested for HIV were infected, 9.4 points higher than the national average. [Clearly the risk to women is several times the risk to men.]
Health Minister Aaron Motsoaledi said other provinces should follow in the footsteps of KwaZulu-Natal's circumcision programme.
"No other province has done what you have done. I am very impressed. I am saying to other provinces please adopt this method," he said.
Zulus practised ritual circumcision until the start of the 19th century, when the legendary King Shaka put a stop to it because it deprived him of young warriors for months at a time.
Flanders News (Belgiium)
Female circumcision: a growing threat here
Some 8,000 women have been circumcised in Belgium or are in danger of becoming a victim of this practice. The figure is an estimate by researchers at the Tropical Medicine Institute in Antwerp.
The largest number of victims live in Brussels and Antwerp. ...
Few reliable figures are available. Belgian research dating from 2003 came to the conclusion that 3,000 women had undergone female circumcision in this country, though the figure did not take account of women who had acquired Belgian nationality and asylum seekers.
The latest research does and also includes the daughters of women who have been circumcised born during the past twelve years. This is because they are at risk of undergoing this form of mutilation.
Researchers have identified 1,190 girls under five years of age who are at risk as well as 1,690 girls in the 15 to 20 age category who are in danger of undergoing the practice during a holiday in their mother's country of origin.
An estimated 5,000 women are believed to have actually undergone female circumcision in Belgium. ...
Real story: 1 in 6 circumcised men continue with unsafe sex
KENYA: Counselling key to success of male cut
KISUMU - When Kenya launched its national voluntary male circumcision campaign in 2008, critics worried that it could lead to greater sexual risk-taking - but men in the western Nyanza Province seem to be disproving this theory.
"When I heard people say male circumcision helps in reducing HIV infection, I went there with the sole purpose that it would lessen the burden of having to use a condom," said 23-year-old Victor Oluoch. "But after that, I have known a lot through the counselling I received; I use a condom every time with anybody... I am not married so I am not going to trust anybody."
A key component of Kenya's programme, which aims to circumcise more than one million men by 2013, is HIV testing and compulsory counselling on HIV prevention, including messages about the importance of continued condom use, as circumcision does not offer full protection from the virus. This counselling appears to have been effective in preventing a phenomenon known as "risk compensation", whereby an intervention that lowers an individual's HIV risk may cause them to take greater risks through other behaviours.
A small 2010 study by the University of Illinois in Kisumu, capital of Nyanza Province, found that most respondents - whether circumcised traditionally or in health facilities - reported either no behaviour change or improved protective behaviour, such as increased condom use and fewer sexual partners.
The research revealed an understanding among the 30 [only 30!] respondents surveyed that male circumcision only provided partial protection against HIV.
The authors speculated that the low levels of risk compensation were due to the effects of counselling, HIV testing and condom availability.
Five of the study's  respondents reported that they did engage in risky sexual behaviour after circumcision; one man continued to have unprotected sex with his primary girlfriend but reported using condoms with his two other girlfriends.
Circumcision in the Slums
Circumcision, a traditional passage to manhood for many of the tribes in Kenya, is one still widely practiced throughout the country. With hundreds of thousands of people now living in urban slums, however, such traditional practices have evolved to take on entirely new forms.
In the slum's of Kenya the ceremony for circumcision is one that takes place in the streets, for all to see, over an entire morning. Firstly the boy being circumcised is covered in a paste made up of millet, usually used to make local beer, and is paraded through the streets for everyone to see. Together with his friends and men of his tribe each corner of the slum is visited in order to collect donations for the week after the operation, in which the circumcised male will not be allowed out of his house.
After a sufficient amount of money has been collected, the boy is then taken to a river in order to be washed. Finally after being washed the male is then taken to an open clearing outside his house, where his foreskin is cut off with a regular kitchen knife, and his penis then covered with dirt to stop the bleeding. If the male in question cries during the whole process, he is considered a coward by his community and will not be considered a man.
Though this ceremony is largely similar to that which is done in rural areas, the fact that it is done within an unhygienic urban environment adds huge risks to the circumcised male. With no clean water sources, the washing of the victim beforehand exposes the male to a host of diseases. Furthermore, with none of the instruments sanitized and the dirt from the ground made up of other people's refuse, there is simply no end to the number of risks in such a procedure.
Despite the number of risks involved, tradition and tribal practices continue to dominate many aspects of urban life. Perhaps this is because, in the new cities of Africa where so little is familiar, tradition is still one of the few things that still allows for people to retain their identity.
Money from mutilation: The Tara KLamp Story 1
By Nathan Geffen and Marcus Low
Sandile Tshabalala of the KZN Health Department was quoted by SAPA claiming that "More than 5000 people have been circumcised by this clamp and not even a single person has died. ... No-one has complained that his penis has been cut."5
Meanwhile, TAC has received reports, including cell phone video clips, of people injured by the Tara KLamp. We also have a first-hand account of the immense pain a man experienced. We release photos of Tara KLamp caused injuries in KZN over the last few months. Please note these are very disturbing (see here and here).
It has also been reported that the KZN Health MEC has committed to rolling out the Tara KLamp in prisons and that 148 such circumcisions have already been carried out in Qalakabusha Prison.6 But the reasoning behind this decision is difficult to understand. Medical male circumcision has been shown to reduce the risk of HIV-positive women transmitting the virus to men. No prevention benefit has been shown in populations of men who have sex with men.
The Local (Sweden)
Sweden set for first circumcision law trial
A 50-year-old man is the first person to be charged in Sweden on suspicions of performing illegal circumcisions.
The man, an Egyptian citizen, is believed to have circumcised nine boys without a licence from the National Board of Health and Welfare (Socialstyrelsen).
Sweden’s law on circumcising boys hasn’t been tested in court since it came into force nine years ago.
“This is the first time. We haven’t reported any other case to the police,” the health board’s Torsten Mossberg told TT.
The man is also charged with several cases of assault. During the trial, a film will be shown to support allegations that a boy from Tierp in eastern Sweden wasn’t sufficiently anesthetized during the procedure.
According to the indictment, two brothers from the Stockholm suburb of Botkyrka suffered tissue damage, pain, and loss of circulation from a bandage which was used as a tourniquet.
The man has denied committing any crimes.
The 50-year-old previously had a licence, but the health board revoked it because of doubts about his abilities.
“My client feels like this happened for no reason,” the man’s defence attorney, Leif Silbersky, told TT.
According to the law, only people with a special licence issued by the health board can perform circumcisions for non-medical reasons, and only on children younger than two-months old. Doctors can also carry out the procedure, including on older children.
The health board doesn’t think Sweden's law works, estimating that only one third of the roughly 3,000 boys circumcised for religious reasons in Sweden each year have the procedure performed by people with authorisation.
The remaining circumcisions are carried out by people who lack qualifications, according to the agency.
Cruel and unusual punishment...
Times Live (South Africa)
KZN government to circumcise prisoners
The KwaZulu-Natal government will soon start circumcising prisoners to reduce HIV infections among inmates, says health MEC Dr Sibongiseni Dhlomo.
[Circumcision is only claimed (probably falsely) to reduce (somewhat) HIV transmission from women to men. How many women are in prison with those men?]
“We will soon start circumcising prisoners in our campaign to reduce infections,” he said.
A total of 10, 229 male circumcisions had been done since the provincial government started the male medical circumcision programme in April this year.
Dhlomo said the department had a target of 2.5 million circumcisions by June 2014. Previously circumcisions among Zulus were conducted traditionally. With the permission from King Goodwill Zwelithini, government would be conducting them medically.
The provinces' male circumcision programmes are to get a R40 million boost in the current financial year, as part of the fight against Aids.
The Malaysian-made device, Tara Klamp is used to conduct circumcisions.
“In order to improve on the number the department is embarking upon various strategies and engaging with traditional leaders, churches, tertiary institutions and prisons,” said Dhlomo.
He said 148 circumcisions had been done at Qalakabusha Prison, 118 at Durban University of Technology and 157 at the University of Zululand in September.
KwaZulu-Natal's major circumcision drive has been supported by the central government.
According to the Medium-Term Budget Policy Statement tabled on Wednesday, the provinces' male circumcision programmes would get a R40 million boost in the current financial year, as part of the fight against Aids.
The money is part of an extra R100 million to scale up HIV and Aids prevention.
Dhlomo said he was happy that no one had been hurt during circumcisions.
His comments followed criticism from the Southern African HIV Clinicians Society and the Treatment Action Campaign, who said that while they supported male medical circumcision, they had concerns about the Tara Klamp.
They said the plastic device was associated with a very high rate of unpleasant events and pain compared to the standard medical forceps-guided circumcision technique.
Dhlomo said they would also circumcise priests.
“We believe that if we circumcise them, they will encourage members of their congregations to test.”
[To test? That would be worthwhile. How about testing the priests?]
No Law on Male Circumcision After All
Finland has decided not to regulate male circumcision. A bill legalising the practice has been in the works for seven years, but Minister of Health and Social Services Paula Risikko has decided not to bring it before Parliament.
In Finland circumcisions are carried out for religious purposes by members of the Jewish, Muslim and Tartar communities. Estimates are that currently about 200 operations are performed annually.
While Finnish law classifies female genital mutilation as serious abuse, no legislation has been passed on the practice concerning boys.
With no clear rules on male circumcision, doctors carrying out the procedure as well as parents may be slapped with abuse charges.
In 2006, a Muslim mother in Tampere was convicted for circumcising her son, however, the Finnish Supreme Court eventually dropped the charges.
After seven years of drafting a bill legalising male circumcision, the Ministry of Health and Social Services decided not to pursue the matter.
“We’ve deliberated over this for a long time at the ministry, and after many discussions and evaluations, we’ve reached a decision that a separate law isn’t needed,” Risikko told YLE.
Many physicians, police officials and NGOs in Finland oppose male circumcision. Critics say they want clarity on the issue and say the practice doesn't have a place in Finnish society.
A working group under Migration Minister Astrid Thors is now faced with drawing up guidelines on circumcision for public health clinics. The main questions are where circumcisions should be carried out and who should pay.
Botched circumcision leaves three-month-old Portland boy in critical condition
A three-month-old boy was taken to an area hospital in critical condition after his mother tried to circumcise him at her Portland home Sunday, the Portland Police Bureau reported.
Officers were asked to respond on a medical call at a home near East Burnside Street and 127th Avenue after 2 a.m. Sunday, said Sgt. Pete Simpson, a bureau spokesman.
A woman at the home told investigators that she tried to perform a circumcision on her son, then, when she realized the boy was in trouble, called 9-1-1. The boy is expected to survive.
Child abuse detectives were called to the scene to investigate. No arrests have been made, and no other children are thought to be in danger, Simpson said.
[It is legal for anyone to circumcise a male child, as long as they don't pretend to be a doctor.
One version of this story was headed "Baby Injured During At-Home Circumcision" as though a baby is not injured at every circumcision.
One version of this story was headed "Baby Injured During At-Home Circumcision" as though a baby is not injured at every circumcision. ]
Mail & Guardian (South Africa)
Tara KLamp director faces extradition
By LIONEL FAULL
Zambia's drug-busting agency has approached Interpol to help bring the man behind the controversial Tara KLamp circumcision device back home to answer criminal charges.
Ibrahim Sildky Yusuf, a Zambian national resident in South Africa, is the main director of a company the KwaZulu-Natal department of health appointed to supply the circumcision devices for use in its HIV/Aids prevention campaign.
By the end of September the department had bought 22 500 of the devices at a cost of R4,37-million.
At R195, excluding VAT, each device is approximately R35 more expensive than the surgical kit for a conventional forceps-guided circumcision. The Tara KLamp is not approved by the World Health Organisation.
The Mail & Guardian reported earlier this month that Yusuf had been detained in Zambia in the 1980s in connection with a high-level Mandrax-smuggling network.
It also reported that he faced charges of fraud and theft dating back to 2002 and that he had fled Zambia to avoid arrest. But Yusuf denied the allegations put to him by the M&G and said he had visited Zambia "a number of times" since 2001.
"South Africa has an extradition treaty with Zambia and surely if [Yusuf] was a wanted person, as you allege, he could have long been extradited to face whatever criminal charges in Zambia," Yusuf said through his lawyer, Tshepo Mathopo.
The M&G has since received a document on Yusuf prepared by the Zambian Drug Enforcement Commission (DEC), which confirmed the allegations outlined in the M&G's article.
It also included other details, alleging that he had been arrested in July 1989 in connection with the unlawful importation of vehicles and trafficking in Mandrax and again in December 1997 in connection with money-laundering and illegally importing vehicles.
Media meet in Jo’burg on male circumcision
By Calsile Masilela
COUNTRIES where more males are circumcised have a low HIV prevalence rate. [WRONG]
Those with few circumcised men have a high HIV prevalence rate, particularly in Sub Saharan Africa. [WRONG]
This was revealed during a media workshop on promoting male circumcision held in Johannesburg last week and organised by Media Institute of Southern Africa (MISA) head office in Namibia with the support of UNICEF, UNAIDS and UNFPA South Africa.
MISA’s Reagan Malumo said they had embarked on programmes to train media practitioners with reporting skills on male circumcision.
Misa has trained journalists on child reporting as well.
The media needed to report positively on issues that affect people’s lives, adding that male circumcision had been added as one of the prevention methods in place to help reduce new HIV infections. [Brainwash the media and the public will follow.]
They would like to stage awards for best reporting on male circumcision in the other Misa chapters. In Namibia, such awards are there already - to motivate journalists. UNICEF South Africa Communication for Development Specialist Adebayo Fayoyin said it was important that journalists be given the right information so they could write on topical issues with understanding.
Judge rejects pleas for leniency, imposes 12-to-19-year sentenceFather of boy who died gets prison
By WILLIAM BROWNING
CASPER — Samuel Eugene McGehee shut his eyes in court Friday when his attorney played a recording of the police interrogation made the day his son died.
The recording revealed the then 38-year-old McGehee sobbing uncontrollably hours after his 9-month-old son died of asphyxiation. The courtroom, with every aisle full, remained silent as the chilling sound of a father, struggling to catch his breath in the wake of a child’s death, piped out of the courtroom’s speakers.
Authorities say McGehee wrapped the child’s head in a coat in an attempt to get him to take a nap on the afternoon of Nov. 15. ...
For another charge McGehee pleaded guilty to — felony child abuse dating back to 2008 — he received an additional two to four years in prison. That charge came about after McGehee attempted to circumcise another one of his children at home. He used a fillet knife to carry out the procedure, and the boy, 3 months old at the time, has undergone extensive reconstructive surgeries as a result.
District Attorney Michael Blonigen asked for a 15- to 20-year sentence for the manslaughter charge and a three- to five-year sentence for the child abuse.
“The lives of two young boys were forever changed before the age of 1,” the prosecutor told the court. “One lost his life, one was mutilated by his father.”
Defense attorney Rob Oldham, though, painted a different picture of McGehee.
... Turning to the circumcision, Oldham said McGehee and his wife attempted to carry out the procedure at home because they were struggling financially, had deep religious convictions and were facing growing pressure from family members.
... Earlier story
Court grants Gambia anti-female circumcision leaders bail
By Yankuba Jambang, Editor & Publisher, Senegambianews.com
A magistrate’s court in Banjul has granted bail to the two leading campaigners against female circumcision in the Gambia on Wednesday.
Dr. Isatou Touray, director of a non-governmental organization called GAMCOTRAP (The Gambia Committee Against Traditional Practices) and her assistant Mrs. Amie Bojang-Sissoho, were taken into police custody on October 11 for allegedly embezzling funds meant for the organization. Both have denied any wrong doing.
Prosecutors say the two activists have diverted about 30,000 Euros from a Spanish NGO Yolacomba Solidaridad to personal use. But officials of the NGO in Spain have asked the government of President Yahya Jammeh to immediately release the women.
Lies, Damned Lies, and Medical Science
Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong. So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.
By David H. Freedman
In 2001, rumors were circulating in Greek hospitals that surgery residents, eager to rack up scalpel time, were falsely diagnosing hapless Albanian immigrants with appendicitis. At the University of Ioannina medical school’s teaching hospital, a newly minted doctor named Athina Tatsioni was discussing the rumors with colleagues when a professor who had overheard asked her if she’d like to try to prove whether they were true—he seemed to be almost daring her. She accepted the challenge and, with the professor’s and other colleagues’ help, eventually produced a formal study showing that, for whatever reason, the appendices removed from patients with Albanian names in six Greek hospitals were more than three times as likely to be perfectly healthy as those removed from patients with Greek names. “It was hard to find a journal willing to publish it, but we did,” recalls Tatsioni.
... One of the researchers, a biostatistician named Georgia Salanti, fired up a laptop and projector and started to take the group through a study she and a few colleagues were completing that asked this question: were drug companies manipulating published research to make their drugs look good? Salanti ticked off data that seemed to indicate they were, but the other team members almost immediately started interrupting. One noted that Salanti’s study didn’t address the fact that drug-company research wasn’t measuring critically important “hard” outcomes for patients, such as survival versus death, and instead tended to measure “softer” outcomes, such as self-reported symptoms (“my chest doesn’t hurt as much today”). Another pointed out that Salanti’s study ignored the fact that when drug-company data seemed to show patients’ health improving, the data often failed to show that the drug was responsible, or that the improvement was more than marginal.
Salanti remained poised, as if the grilling were par for the course, and gamely acknowledged that the suggestions were all good—but a single study can’t prove everything, she said. Just as I was getting the sense that the data in drug studies were endlessly malleable, Ioannidis, who had mostly been listening, delivered what felt like a coup de grâce: wasn’t it possible, he asked, that drug companies were carefully selecting the topics of their studies—for example, comparing their new drugs against those already known to be inferior to others on the market—so that they were ahead of the game even before the data juggling began? “Maybe sometimes it’s the questions that are biased, not the answers,” he said, flashing a friendly smile. Everyone nodded. Though the results of drug studies often make newspaper headlines, you have to wonder whether they prove anything at all. Indeed, given the breadth of the potential problems raised at the meeting, can any medical-research studies be trusted?
... “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.
This array suggested a bigger, underlying dysfunction, and Ioannidis thought he knew what it was. “The studies were biased,” he says. “Sometimes they were overtly biased. Sometimes it was difficult to see the bias, but it was there.” Researchers headed into their studies wanting certain results—and, lo and behold, they were getting them. We think of the scientific process as being objective, rigorous, and even ruthless in separating out what is true from what we merely wish to be true, but in fact it’s easy to manipulate results, even unintentionally or unconsciously. “At every step in the process, there is room to distort results, a way to make a stronger claim or to select what is going to be concluded,” says Ioannidis. “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.”
Perhaps only a minority of researchers were succumbing to this bias, but their distorted findings were having an outsize effect on published research. To get funding and tenured positions, and often merely to stay afloat, researchers have to get their work published in well-regarded journals, where rejection rates can climb above 90 percent. Not surprisingly, the studies that tend to make the grade are those with eye-catching findings. But while coming up with eye-catching theories is relatively easy, getting reality to bear them out is another matter. The great majority collapse under the weight of contradictory data when studied rigorously. Imagine, though, that five different research teams test an interesting theory that’s making the rounds, and four of the groups correctly prove the idea false, while the one less cautious group incorrectly “proves” it true through some combination of error, fluke, and clever selection of data. Guess whose findings your doctor ends up reading about in the journal, and you end up hearing about on the evening news? Researchers can sometimes win attention by refuting a prominent finding, which can help to at least raise doubts about results, but in general it is far more rewarding to add a new insight or exciting-sounding twist to existing research than to retest its basic premises—after all, simply re-proving someone else’s results is unlikely to get you published, and attempting to undermine the work of respected colleagues can have ugly professional repercussions.
In the late 1990s, Ioannidis set up a base at the University of Ioannina. He pulled together his team, which remains largely intact today, and started chipping away at the problem in a series of papers that pointed out specific ways certain studies were getting misleading results. Other meta-researchers were also starting to spotlight disturbingly high rates of error in the medical literature. But Ioannidis wanted to get the big picture across, and to do so with solid data, clear reasoning, and good statistical analysis. The project dragged on, until finally he retreated to the tiny island of Sikinos in the Aegean Sea, where he drew inspiration from the relatively primitive surroundings and the intellectual traditions they recalled. “A pervasive theme of ancient Greek literature is that you need to pursue the truth, no matter what the truth might be,” he says. In 2005, he unleashed two papers that challenged the foundations of medical research.
He chose to publish one paper, fittingly, in the online journal PLoS Medicine, which is committed to running any methodologically sound article without regard to how “interesting” the results may be. In the paper, Ioannidis laid out a detailed mathematical proof that, assuming modest levels of researcher bias, typically imperfect research techniques, and the well-known tendency to focus on exciting rather than highly plausible theories, researchers will come up with wrong findings most of the time. Simply put, if you’re attracted to ideas that have a good chance of being wrong, and if you’re motivated to prove them right, and if you have a little wiggle room in how you assemble the evidence, you’ll probably succeed in proving wrong theories right. His model predicted, in different fields of medical research, rates of wrongness roughly corresponding to the observed rates at which findings were later convincingly refuted: 80 percent of non-randomized studies (by far the most common type) turn out to be wrong, as do 25 percent of supposedly gold-standard randomized trials, and as much as 10 percent of the platinum-standard large randomized trials. The article spelled out his belief that researchers were frequently manipulating data analyses, chasing career-advancing findings rather than good science, and even using the peer-review process—in which journals ask researchers to help decide which studies to publish—to suppress opposing views. “You can question some of the details of John’s calculations, but it’s hard to argue that the essential ideas aren’t absolutely correct,” says Doug Altman, an Oxford University researcher who directs the Centre for Statistics in Medicine.
Still, Ioannidis ... zoomed in on 49 of the most highly regarded research findings in medicine over the previous 13 years, as judged by the science community’s two standard measures: the papers had appeared in the journals most widely cited in research articles, and the 49 articles themselves were the most widely cited articles in these journals.... Of the 49 articles, 45 claimed to have uncovered effective interventions. Thirty-four of these claims had been retested, and 14 of these, or 41 percent, had been convincingly shown to be wrong or significantly exaggerated. If between a third and a half of the most acclaimed research in medicine was proving untrustworthy, the scope and impact of the problem were undeniable.
... even highly regarded researchers at prestigious institutions sometimes churn out attention-grabbing findings rather than findings likely to be right. But Ioannidis points out that obviously questionable findings cram the pages of top medical journals, not to mention the morning headlines.
Of those 45 super-cited studies that Ioannidis focused on, 11 had never been retested. Perhaps worse, Ioannidis found that even when a research error is outed, it typically persists for years or even decades. He looked at three prominent health studies from the 1980s and 1990s that were each later soundly refuted, and discovered that researchers continued to cite the original results as correct more often than as flawed—in one case for at least 12 years after the results were discredited.
Black Country plastic surgeon struck off for sex acts
A Black Country plastic surgeon has been struck off by the General Medical Council (GMC) for indecently assaulting six patients.
Aivar Bracka denied the charges, but the GMC found his actions were sexually motivated, improper and inappropriate.
Bracka, of Balmoral Road, Wordsley, was cleared of indecently assaulting five of his patients at Wolverhampton Crown Court last year.
The General Medical Association then held its own investigation.
It said he was opportunistic and had grossly abused his patients' trust.
Its findings concluded that Bracka's conduct was "fundamentally incompatible with his continuing to be a registered medical practitioner".
The GMC heard evidence that Bracka had performed inappropriate sex acts during a 13-year period with six young men in his care, including two boys aged under 18.
Bracka told the GMC he had exposed himself to patients in limited circumstances but never to a juvenile.
The offences took place between 1987 and 2000...
Mr Bracka specialised in hypospadias repair and circumcision. In 2001, he co-authored a paper (Tucker SC, Cerqueiro J, Sterne GD, Bracka A. Circumcision: a refined technique and 5 year review. Ann R Coll Surg Engl. 2001; 83(2):121-5.) in which he described his technique for performing circumcisions "with the penis fully erect".
At his trial, Mr Bracka claimed hundreds of slides showing male genitalia recovered from his home were to help document all his patients on a "before and after" basis.
At his trial, Mr Bracka claimed hundreds of slides showing male genitalia recovered from his home were to help document all his patients on a "before and after" basis.
YouTube shafts risque Antwoord video
B Sameer Naik
They became an overnight, worldwide internet sensation with their first video, Enter the Ninja, which went viral on YouTube with over a million views this year.
Die Antwoord’s explicit lyrics and edgy approach won them respect from international artists such as Limp Bizkit and Lady Gaga, but now the hip-hop group from Cape Town, who’ve gained millions of fans worldwide through the internet, have another first – YouTube has banned their latest music video, Evil Boy, and removed it from the popular website.
The new video single, which features explicit lyrics and a lavish screening of rubber dildos as the band rap about male circumcision, was removed within days of being uploaded for apparent “terms-of-use violations”.
The three-member group, consisting of lead rapper Ninja, Yo-Landi Vi$$er and DJ Hi-Tek, teamed up with an 18-year-old Cape Town street child known only as Wanga for their new single, in which the youngster raps out against ritual male circumcision.
The video has the young man rapping in Xhosa: “andifuni ngencanca yami incanca yami eyentombi qha” (I don’t want you to touch my penis, it’s for women only) against a |background of explicit images of male genitals.
Ann Roberts, spokeswoman for Terraplane, the producers of Die Antwoord’s latest single, said that although the video had been temporarily removed, she expects it to be back up in a few days.
“The video is of course very controversial. However, it will be back on YouTube as soon as the website puts an over-18 age restriction on the video,” said Roberts. ...
Roberts said that despite the video being controversial, the producers had received only|a handful of complaints and were now busy working on a cleaner version of Evil Boy, which will soon make its debut on TV.
“Wanga is an amazing young kid who is extremely smart. Die Antwoord gave Wanga an opportunity to tell his personal story, which in turn has made him much stronger,” said Roberts.
“This video might be misunderstood by people as offensive, but there are children who die each year from ‘going to the bush’,” said Yo-Landi.
Freedom Newspaper (Gambia)
Gambia Detains Head Of Anti Female Genital Mutilation Campaigners!
Dr. Isatou Touray, And Amie Bojang Sissoho Charged With Theft?
By Staff Reporter Bakary Gibba & Pa Nderry M’Bai
Authorities in The Gambia have begun cracking down on women rights campaigners against Female Genital Mutilation. The Executive Director of The Gambia Committee Against Traditional Practices (GAMCOTRAP) Dr. Isatou Touray, and her Assistant Amie Bojang Sissoho were arrested on Monday by police for unexplained reasons, the Freedom Newspaper can report.
... Dr. Touray and Mrs. Sissoho are expected to reappear in court on Tuesday for plea taking.
Sources said the detainees were alleged to have been charged with theft, but would not elaborate further on the main substance of the case. But prior to their arrest, Dr. Touray, who is known as a prominent anti FGM activist said she was being pursued by the state with people reporting her to the President. She said some people were "out to get her" with false accusations, but would not elaborate on the nature of the said accusations. She told delegates at a recent workshop that she was privy to the scheme that was hatched to get her arrested.
Dr. Touray, and her fellow FGM campaigners have recorded a significant success in the area of FGM education in The Gambia. Many local circumcisers have laid down their tools—thanks to GAMCOTRAP’S grassroots education campaign against the deadly cultural practice.
GAMCOTRAP’S efforts to discourage FGM in The Gambia has been greeted with strong opposition by some religious leaders—who openly advocate for female circumcision. One of them is the controversial State House Imam Alhagie Abdoulie Fatty, who told Freedom Radio in a recent interview that FGM is not being practiced in The Gambia as painted by local activists. Imam Fatty accuses FGM activists of blowing things out of proportion. He said Islam supports female circumcision.
“There is nothing wrong to circumcise our kids. Islam supports Female circumcision. Don’t mind the so called FGM activists. They are spreading wrong information about female circumcision. It is a cultural practice recognized by Islam
“There is nothing wrong to circumcise our kids. Islam supports Female circumcision. Don’t mind the so called FGM activists. They are spreading wrong information about female circumcision. It is a cultural practice recognized by Islam,” Imam Fatty said.
A survey conducted by GAMCOTRAP says about 80 percent of The Gambian population practice FGM, but that figure had decline significantly thanks to educational awareness campaign spearheaded by the Organization. Those engage in the practice cite religious, and cultural reasons in support of FGM. But anti FGM campaigners disagree. They said the practice endangers the life of the girl child. For example, they argued that dozens of young girls are circumcised with one blade, and that in most cases the blade is never sterilized. This to some extent made the circumcised girls vulnerable to sexually transmitted diseases known as (STI), including HIV/Aids, the virus that causes aids.
According to anti FGM activists, some of the circumcised kids died during the process. They said FGM violates the right of the girl child. They also opined that the practice undermines women’s sexual feelings.
Up to the time of going to press Dr. Isatou Touray, and Amie Bojang Sissoho were still detained at the police head quarters in Banjul. They are expected to appear in court on Tuesday in Kanifing. They have not been accorded with the right to bail.
Botched Circumcision Leads to Court
By CHRIS COUGHLIN
BRIDGEPORT, Conn. (CN) - Parents claim that a doctor who botched a circumcision and partially amputated their son's penis obtained confidential medical information from their child's pediatrician to bolster his defense for the resulting medical negligence lawsuit.
Joseph and Robin Biondo say they took son to Dr. Daniel. Gottschall, who works for Alliance for Women's Health, for a circumcision in June 2004.
"While performing the procedure Dr. Gottschall partially amputated the penis, causing traumatic injury to [their son's] penis and severing his glans and urethra.
"On October 1, 2007, despite the fact that [their son's] lawsuit against Dr. Gottschall was pending and that Dr. Gottschall's treatment relationship with [the boy] had ended three years earlier, Dr. Gottschall knowingly and intentionally contacted a partner of Main Street Pediatrics, Dr. Schutzengel, for the purpose of gathering information about [the boy's] condition," according to the complaint.
The Biondos seek damages from Gottschall and the Alliance for Women's Health, alleging inducement of breach of physician-patient relationship and of fiduciary duty, breach of fiduciary duty and tortious interference with contractual relationship.
They seek damages from Dr. Schutzengel and Main Street Pediatrics for breach of physician-patient relationship, breach of fiduciary duty and breach of contract.
Mail & Guardian
The blunt truth about new circumcision device
By Ilham Rawoot
Circumcision is a touchy business. And writing about it has proven to be even touchier, especially when nobody wants to talk about it.
When the KwaZulu-Natal health department decided to go ahead with using the TaraKLamp (a device that strikes me as the penile equivalent of a nail clipper) to circumcise men as part of an HIV-prevention project, a few questions arose.
Firstly, why is the department using a device that has not been approved by the World Health Organisation and which some doctors have warned against citing the higher risk of complications involved compared with standard surgical procedure?
On a deeper note, who is making money out of this device?
Once the Mail & Guardian discovered it was being promoted by a company that didn’t have an office, and that no one had heard of before, we decided to dig a little bit.
We found that no tender process was followed in obtaining the Malaysian-made device even though there are competing versions.
We found that the Zambian man in charge of the company that has the local distribution rights had once been accused — mentioned in a Zambian high court judgement — of dealing in Mandrax, though he was never charged and protests his innocence.
Surely the KZN health department should thank us for our hard work, for helping them make informed decisions that will help find the best option for South Africans. But that’s not what happened.
Instead they called us “disingenuous” for asking for tender documents and expenditure values in relation to the TaraKLamp.
Here’s KZN’s health spokesperson, Chris Maxon: “In the first instance; we wish state that we find it disingenuous for you to ask for these documents without providing reason. These are contract document that are kept to protect their authenticity. We therefore cannot release them with proper procedure being followed and, above all, to a person who is not honest about the reasons for requesting these.”
Even when we explained that the reasons were quite simple — public money is used to pay for these devices and we have a right to know how much is spent and why it is going into the pocket that it is. Obvious, one might say.
This wasn’t a good enough reason for them and they subsequently chose to ignore further requests for information.
When we called the supplier to ask him questions he threatened to take us to court for defamation. We just want to understand things, really.
If people are acting in good faith, then answering questions should be a simple and professional process. But that rarely happens.
The TaraKLamp saga seems to carry some echoes of Virodene, the controversial Aids “cure” that caused a ruckus in the 90s. That case was marked by dodgy science and political meddling from former president Thabo Mbeki and the ANC. The drug was totally rejected by the scientific community.
It seems we don’t learn from history. The decision to use the TaraKLamp seems similarly marked by closed doors and politicking, but the government doesn’t want to acknowledge that. They’d rather cover their ears when probed on new health methods, always wanting to be pioneers and highly advanced in the field, with no room for criticism.
Die Antwoord to [?] bush circumcisionsThe band's newest member raps about his fears on 'getting cut'
By GABISILE NDEBELE
Controversial music group Die Antwoord are more than a just a trio of ''Zef" weirdos who spit and swear and wear pyjamas on stage.
The three-member group consisting of lead rapper Ninja, Yo-Landi Vi$$er and DJ Hi-Tek, performed an hour-long show at the Bassline in Johannesburg on Saturday, and they've taken a new member under their wing - an 18-year-old street child known only as "Wanga".
"I've known him since he was 13. Recently he told me that he was 'going to the bush' and explained to me what it was he was going to do there," said Ninja.
"The laaitie sounded scared and told me that he would never be able to go to the townships as he would get beaten up, because he would be seen as a boy and not a man, as he had not been 'cut' (circumcised)," said Ninja.
Ninja, 35, then advised Wanga not to go if he was scared, but rather to vent his feelings in a song explaining why he didn't want to go.
Following that came their new single and a music video called Evil Boy , in which Wanga expresses his views on being circumcised. The video has the young man rapping in Xhosa: "andifuni ngencanca yami incanca yami eyentombi qha " (I don't want you to touch my penis, it' s for women only), against a background of e xplicit images of male genitals.
"This video might be misunderstood by people as offensive, but there are children who die each year from 'going to the bush'.
"That's the point we are trying to put across. Just in a different way, with an in-your-face effect," added Yo-Landi.
Hundreds in north may undergo circumcision corrections
Chief Rabbinate to hold hearing on rabbi from Haifa area suspected of not removing entire foreskin during brit ceremony. Following discovery, dozens of concerned parents contact experts to check if their children's circumcision was performed thoroughly. No concern for medical complications
Israel's Chief Rabbinate suspects that a mohel (ritual circumciser) from the north performed hundreds of circumcisions in recent years that did not comply with Jewish Law. Some of the children circumcised by the rabbi have already undergone surgery to correct the brit, thus rendering it kosher. There is significant concern that others will be forced to undergo a similar procedure.
Ynet learned that the mohel oversight committee instructed the rabbi not to conduct additional circumcisions until the Rabbinate's hearing on his case, expected to be held this week, is completed.
According to the item published on ladaat.net, suspicions were aroused after a number of senior rabbis from the Haifa area were present at a brit milah performed by L. – a rabbi affiliated with the local Chabad – were surprised to find out that he did not remove the foreskin around the penis, as is required by halacha. The guest rabbis notified the Chief Rabbinate, and word spread throughout the community.
Following these revelations, dozens of concerned parents contacted expert mohels to examine their children's circumcision. A number of circumcised children even had to undergo a surgical procedure under full anesthesia to correct the botched circumcision. Each such surgical procedure costs thousands of shekels.
The said mohel is well-known and performs hundreds of circumcisions a year. Estimates are that the scandal will likely have implications for thousands of children. For instance, the Chief Rabbinate may decide to summon the circumcised children for an examination whether the circumcisions meet kosher standards.
However, it is important to note that there is no concern of medical complications. The issue is a purely halachic and aesthetic one.
Rabbi Moshe Weisberg, a member of the inter-ministerial committee of the Health Ministry and Religious Affairs ministry for oversight and training of mohels, told Ynet that he does not remember any such instance. "It can happen to anyone because no one is an angel, even if he is a mohel or a doctor," he explained. "But on such a scale? This is already in the realm of the abnormal."
Weisberg added that a number of worried parents have already contacted him on the matter. In most cases, he ruled that though their sons' organ may look "weird," by his definition, it can be ruled retrospectively that the brit milah was kosher. However, in some cases, he recommended that the corrective surgery procedure be performed.
"If it were my son, I wouldn't think twice," he said. Other mohels and doctors from the north have also performed the "corrections" on a number of children.
'Brit milah must be done performed in entirety'
N. said that he specifically chose L. to perform the brit milah because he heard that babies don't cry when he does the procedure. Now, three years later, he understands why.
"Whenever I bathed the children, I saw there was something weird with him, but I didn't make a big deal about it," he added. "I told myself it could just be a difference between one child and the next. Only when my wife told me about the Rabbinate's investigation did the other shoe drop."
Despite this, N. emphasized that the said mohel is "a God-fearing adherent," and that the botch, if there was one, was done innocently.
Head of the Chief Rabbinate's brit milah department Rabbi Moshe Morsiano told Ynet, "There is no medical damage, but it is a halachic matter. Circumcision is a commandment and must be done in its entirety. There is concern here that this was not the case. This is a serious, well-known, and highly regarded man who apparently made a mistake."
Royal Australasian College of Physicians
RACP resists endorsing circumcision
CIRCUMCISION OF INFANT MALES
The Paediatrics & Child Health Division, The Royal Australasian College of Physicians (RACP) has prepared this statement on circumcision of infant boys for doctors and to assist parents who are considering having this procedure undertaken on their male children.
Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years and it remains an important ritual in some religious and cultural groups.
In Australia and New Zealand, the circumcision rate has fallen in recent years and it is estimated that currently 10-20% of newborn male infants are circumcised. [This estimate is far too high. It is nowhere as high as 20%, and in several states and New Zealand, well below 5%]
Recently there has been renewed debate regarding both the potential health benefits and the ethical and human rights issues relating to infant male circumcision.
Circumcision is generally a safe procedure but there are risks of minor complications and some rare but serious complications [including death].
The most important conditions where benefits may result from circumcision are recurrent urinary tract infections in children; and Human Immunodeficiency Virus (HIV) plus some other sexually transmitted infections in adults from populations with a high prevalence of these conditions; cancer of the penis in men with a history of phimosis, and cancer of the cervix in women whose partners engage in sexual practices known to increase the risk of Human Papilloma Virus (HPV) infection. The protection against Sexually Transmitted Infections (STIs) and HIV is less clear-cut in Australia and New Zealand than in high prevalence countries.
Ethical and human rights concerns have been raised regarding elective infant male circumcision because it is recognised that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent.
After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand. However it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons. [Clearly "routine" in the first sentence means "without medical indication" but the second sentence endorses just that.]
When parents request a circumcision for their child the medical attendant is obliged to provide accurate unbiased and up to date information on the risks and benefits of the procedure. Parental choice should be respected.
When the operation is to be performed it should be undertaken in a safe, child-friendly environment by an appropriately trained competent practitioner, capable of dealing with the complications, and using appropriate analgesia.
ETHICAL CONSIDERATIONS OF NEONATAL CIRCUMCISION
Some of the risks of circumcision are low in frequency but high in impact (death, loss of penis); ... Evaluation of the significance of high-impact low-frequency risks is ethically contentious and variable between individuals. [Even so, it is striking that the RACP offers no estimate of of the probability of death.] Some are more risk averse than others. However, a statistical risk of death is not generally regarded as an absolute barrier. Most patients and most people in general accept the very low probability of death as a risk they are willing to take in pursuit of medical benefits, lifestyle, recreation, employment, and so on. [They accept that probability of death for themselves. We have no way of knowing that the newborn is willing to accept that possibility] The benefits of circumcision (or disadvantages of non-circumcision) are not readily assessable by doctors (unless they happen to belong to the same religious or social community as the parents), as they depend upon the role of circumcision within that community. [The benefits and risks of circumcision to the baby are not readily accessable by doctors or parents either, and therefore it would be advisable to err on the side of caution.]
Doctors who have a conscientious objection to performing infant male circumcision should make this known and refer parents to another doctor. [But they don't have to find them one who'll do it.] (p15)
The option of leaving circumcision until later, when the boy is old enough to make a decision for himself does need to be raised with parents and considered. This option has recently been recommended by the Royal Dutch Medical Association. [They went much further, saying "circumcision is not justifiable except on medical/therapeutic grounds."] The ethical merit of this option is that it seeks to respect the child’s physical integrity, and capacity for autonomy by leaving the options open for him to make his own autonomous choice in the future. (p15)
A boy circumcised as an infant may deeply resent this when he grows older; he may want what he cannot have – not to have been circumcised. But it is also possible that a boy not circumcised as an infant (so that he can make his own decision later), may also deeply resent this. He may also want what he cannot now have – to have been circumcised as a baby. [These two outcomes are not ethically equivalent, and the chance of the former outcome is much greater than the latter.] (p16)
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