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November 2012

To more recent news

 

News items are now being copied to Circumstitions News blog (which takes comments)

- thanks to Joseph4GI

 

America's taxpayers' dollars at work

PEPFAR
November 30, 2012

PEPFAR now explicitly targetting infants

In its "PEPFAR Blueprint: Creating an AIDS-free Generation" the meaning of the word "Voluntary" seems to have been forgotten.

Action Step: Increase the number of males who are circumcised for the prevention of HIV....

10. Build the capacity of partner governments to begin planning for and financing an integrated, long-term early infant male circumcision (EIMC) program as the adult V[oluntary ]M[edical ]M[ale ]C[ircumcision] program is being scaled-up. PEPFAR’s financial support is prioritized to the adult VMMC program. However, once the adult program has progressed sufficiently, PEPFAR funds may be used to support EIMC activities. (p 23)

[There is no evidence that infant circumcision has any effect on HIV transmission]

 

Gesetzentwurf der Bundesregierung
November 27, 2012

German Pediatric Society roundly condemns infant circumcision.

Dr.Wolfram Hartmann, President of the Professional Association of Child and Youth Doctors in Germany, spoke on November 26, 2012 to the Bundestag committee considering the Government's "Draft law on the scope of child's care regulations at a circumcision of the male child" and the draft law of MPs Marlene Rupprecht, Katja Dörner, Diana Golze, Caren Marks, Rolf Schwanitz, other MPs: "Draft law on the scope of the child's care and the rights of the male child at a circumcision "

The Association opposes the first, which sets conditions for the performance of child circumcision, but no limit on who may do it, and supports the second, which sets a minimum age of 14, with informed consent.

Dr Hartmann told the committee

This statement is coordinated with the German Academy for Child and Youth Medicine (DAKJ), the umbrella organization of all pediatric associations in Germany (German Society for Child and youth medicine DGKJ, Professional Association of the Child and Youth doctors, German Society for social pediatrics and youth medicine DGSPJ), to which other organizations are co-opted (see also . I also refer to the statement of the Germany Society for Child Surgery) on that subject.

From a medical point of view, there is no reason to remove the intact foreskin of under-aged boys not capable of giving consent. In pre-school age, it is also very rare to have a true medical indication to remove (circumcise) the foreskin. At this age, the foreskin (prepuce) is physiologically more or less strongly fastened to the glans. Attempts to pull back the immature and adhered foreskin often cause inflammations and painful fissures.

"The male foreskin is part of the dermal organ and fulfills an important role in protecting the very delicate glans. ...

The repeatedly-quoted statement of the AAP contradicts earlier statements by the same organization, without being able to refer to new scientific evidence. The AAP statement has meanwhile been considered scientifically untenable by almost all pediatric societies and associations worldwide.

...

The American lawyers association for children's rights, Attorneys for the Rights of the Child also criticized the AAP statement in a letter to the Pediatrics magazine [Which was not published there, but was published here]. It [says the AAP policy] contains errors and inconsistencies and violates both the AAP's own statements regarding bioethics, and several civil and criminal law regulations in the USA.

The WHO recommendations for prophylactic circumcisions only refers to mature, sexually active men in countries with low hygienic standards and is not suitable to justify the prophylactic circumcision of under-aged boys not capable to give consent. ...

.... The government's current draft law on the scope of child's care regulations at a circumcision of the male child unwillingly opens the door for demands to legalize the circumcision of girls.

Earlier story

 

BBC
November 27, 2012

Manchester baby boy 'bled to death after circumcision'

A four-week-old boy "bled to death" after a home circumcision carried out by a nurse, a court has heard.

Goodluck Caubergs died the day after nurse Grace Adeleye carried out the procedure without anaesthetic, Manchester Crown Court was told.

The jury heard the 66-year-old only used scissors, forceps and olive oil at an address in Chadderton, Greater Manchester in April 2010.

Mrs Adeleye denies manslaughter by gross negligence.

The court heard the medic and Goodluck's parents are originally from Nigeria, where the circumcision of newborns is the tradition for Christian families.

'Dangers ignored'

Mrs Adeleye, of Sarnia Court, Salford, was paid £100 to do the operation, the court was told.

It is alleged the defendant, who is also a midwife, left a "ragged" wound that bled and her post-operative care was inadequate.

The family home, where the procedure took place, is a mile and a half from Royal Oldham Hospital.

Adrian Darbishire QC, opening the case for the prosecution, told the jury: "The allegation essentially here is that the care she provided in the course of tha t procedure was so bad that not only did it cause the death of that young baby wholly unnecessarily, but it amounted to gross negligence and a crime."

The court heard up to three children a month are admitted to the Royal Manchester Children's Hospital because of bleeding after home-based circumcisions - a danger the nurse should have been aware of.

Mrs Adeleye went to Goodluck's home on 16 April 2010, telling his mother to fetch some olive oil and a bowl of warm water and stripping the baby to his vest, the jury was told.

'No pain relief'

The defendant brought her "instruments" out of her handbag and dipped a pair of scissors into the water in a kidney dish.

She carried out the procedure with no anaesthetic or local pain relief before cleaning the wound with cotton wool and applied a bandage, the court heard.

Between 30 and 40 minutes after surgery, Mrs Adeleye left without making any proper checks on the patient, Mr Darbishire said.

Later, the parents found the bandage had come off the wound and there was blood in Goodluck's nappy. [US: diaper]

Mr Darbishire said even a small amount of blood loss is dangerous and the loss of just one sixth of a pint of blood can be fatal for a newborn.

A post-mortem examination revealed Goodluck's death was caused by a loss of blood.

The trial continues.

Earlier story

 

The Intactivism Pages suffered a computer outage from November 26 to December 4, 2012, during which news items were not posted and some mail was lost.

 

Men don't want the best part cut off....

NewsDay (Zimbabwe)
November 24, 2012

Men fear circumcision

By Pamela Mhlanga

THE male circumcision programme that was launched in 2009 has only seen 10% of the targeted 1,2 million men by 2015 being circumcised, a government official said yesterday.

The programme’s national coordinator in the Health and Child Welfare ministry, Sinokuthemba Xaba, was speaking during the opening of a voluntary medical male circumcision clinic in Bulawayo’s Lobengula suburb.

He said most males feared getting circumcised due to a number of factors.

“More and more men have heard about the benefits of male circumcision, but have various concerns that prevent them from getting circumcised,” Xaba said.

“Males have questions like; what if something goes wrong?

“Will the wound heal? Where will my foreskin go? These are some of the fears that we hear every day from men who are considering going for the procedure.”

...

Xaba also said the ministry wanted to expand male circumcision services to all districts nationwide.

...

Xaba said government was still a long way from reaching its target of having 1,2 million men circumcised by 2015.

...

 

The Voice
November 23, 2012

MP welcomes improved laws on female circumcision

There are currently no prosecutions on female genital mutilation

LABOUR POLITICIAN Diane Abbott fully supports an action plan that will be published on improving prosecutions for female genital mutilation (FGM).

Director of Public Prosecutions (DPP) Keir Starmer QC is publishing his action plan on improving prosecutions for FGM following his round table meeting with experts in September.

FGM has been a specific criminal offence in England and Wales since 1985, but no prosecutions have ever been brought.

In September, a round table meeting on prosecuting cases of FGM with more than 30 interested and expert parties was hosted by the DPP at the Crown Prosecution Service (CPS) Headquarters in London, including the Association of Chief Police Officers, individual police forces, Members of Parliament, medical professionals, the NSPCC and other third sector organisations.

Speaking on how to tackle FGM, Abbott said: “I really welcome this. The issue has lurked in the shadows for too long, and I think it’s got to be brought into mainstream consciousness more.

“About 20,000 children in England and Wales are deemed "at risk" every year. The situation is similar in France, yet whereas some 100 parents and practitioners of this have been convicted in France, there has never been a single prosecution in the UK.”

Abbott continued: “I think many of the people who are affected by this are voiceless and unprotected, and we’ve got to do more to understand it.”

The DPP has established a steering group to oversee the progress on the action points ahead of his next FGM prosecution round table in summer 2013.

Starmer said: “It’s critical that everything possible is done to ensure we bring the people who commit these offences against young girls and women to justice and this action plan is a major step in the right direction.

“Everyone who can play a part in stopping FGM – from the doctor with a suspicion that an offence has been committed and the police officer investigating the initial complaint to the prosecutor taking a charging decision – needs to know what to do to improve detection rates, strengthen investigations and, for the part of the CPS, to start getting these offenders into court.

“I am determined that the CPS should play a key role in ensuring that the impunity with which these offenders have acted will end.”

The action points include gathering more robust data on allegations of FGM, so the scale of the problem can be gauged.

 

The Times of India
November 23, 2012

7-year-old loses genitals after circumcision, fighting for life

By Rajendra Sharma

ALWAR: A seven-year-old boy is battling for life after a circumcision surgery went horribly wrong at a private hospital in Alwar on Thursday. The boy's genitals had to be cut off in an attempt to save his life, said sources. An FIR has been lodged against the hospital authorities after the relatives of the boy created a ruckus.

The boy, Imran, was admitted to Sania hospital in Alwar town on November 10 for circumcision. According to sources, after the operation, some equipment was used to prevent bleeding. However, electric current accidentally passed into his private parts and the boy suffered serious injury. [In other words, they used monopole electrocautery and cooked his penis from the inside. This is malpractice.] On November 13, the boy was referred to a private hospital in Jaipur. After investigating the case, the doctors in Jaipur advised the boy's relatives to remove his genitals as it was necessary to save his life. The operation was conducted and his genitals were removed. Three days after the operation, the boy was again admitted to Sania hospital in Alwar.

The boy is now fighting for life while his relatives are protesting outside the hospital in Alwar.

Imran's grandfather Ayub Khan said: "The circumcision was carried out by Dr Tayyab Khan, a physician at Sania Hospital. He is not a surgeon. The licence of the hospital should be cancelled for carelessness."

Imran's uncle Fakruddin Khan said that the operation was to be completed in just 30 minutes but the doctors took four hours. "Two days after the circumcision, the doctors advised us to take the boy to Jaipur. When we took the boy to Jaipur, the doctors there immediately informed us that the boy's private parts were completely damaged and his genitals had to be removed. After operation, we tried to admit the boy in different hospitals but no hospital admitted him. The last option for us was Sania hospital. So we brought him here back after his genitals were removed in Jaipur."

However, denying the allegation, Dr Tayyab Khan said the circumcision was carried out by a surgeon Hariram Gupta. He said it was just an accident. [Just? Should the parents be relieved he wasn't castrated deliberately?]

Former minister Nasru Khan also reached the spot to calm down the situation but all his efforts went in vain. Nasru Khan and the protestors were involved in a heated argument at the spot. The protestors alleged that he was taking the side of the hospital.

The hospital administration assured the relatives of the boy that the hospital would bear the expenses of the boy's treatment. [His life is ruined. How will they treat that?]

 

DeutcheWelle
November 22, 2012

German parliament debates circumcision law

By Kay-Alexander Scholz

Germany's parliament has started debating a draft law on infant male circumcision. The government wants legal security for Muslim and Jewish traditions in Germany.

In May 2012, a Cologne court ruled that the circumcision of a young boy on religious grounds amounted to grievous bodily harm and therefore illegal.

...

The draft law foresees amending the German Civil Code by article 1631d, which is to be dedicated entirely to male infant circumcision. The operation would be legal if it is carried out according to "appropriate medical procedures" and does not endanger the child's health, for instance in the case of a hemophiliac. Persons other than doctors who are trained in the art of circumcision, such as Jewish mohels, will be allowed to practice the rite during the first six months of a child's life.

...

The Bundestag, or lower house of parliament, began its discussion on the legislation on Thursday (22.11.2012). An alternative draft law handed in by a group of opposition left-wing lawmakers was also on the agenda. They propose that parents should have to wait until their son is 14 so he can give informed consent for the procedure. After all, they argue, circumcision involves a grave operation in which the "foreskin is amputated."

This draft takes into account criticism by children's protection organizations and the Association of Pediatricians, which approved of the Cologne court's ruling. In this scenario, circumcision on the eighth day after birth, as is Jewish custom, would be impossible.

The Bundestag Legal Committee is scheduled to examine the medical risks circumcision entails at a hearing on November 26.

...

Earlier story

 


November 20, 2012

New H.I.V. Cases Falling in Some Poor Nations, but Treatment Still Lags

By Donald G. McNeil

New infections with H.I.V. have dropped by half in the past decade in 25 poor and middle-income countries, many of them in Africa, the continent hardest hit by AIDS, the United Nations said Tuesday.

The greatest success has been in preventing mothers from infecting their babies, but focusing testing and treatment on high-risk groups like gay men, prostitutes and drug addicts has also paid dividends, said Michel Sidibé, the executive director of the agency U.N.AIDS.

“We are moving from despair to hope,” he said.

Despite the good news from those countries, the agency’s annual report showed that globally, progress is steady but slow. By the usual measure of whether the fight against AIDS is being won, it is still being lost: 2.5 million people became infected last year, while only 1.4 million received lifesaving treatment for the first time.

“There has been tremendous progress over the last decade, but we’re still not at the tipping point,” said Mitchell Warren, the executive director of AVAC, an advocacy group for AIDS prevention. “And the big issue, sadly, is money.”

Some regions, like Southern Africa and the Caribbean, are doing particularly well, while others, like Eastern Europe, Central Asia and the Middle East, are not. Globally, new infections are down 22 percent from 2001, when there were 3.2 million. Among newborns, they fell 40 percent, to 330,000 from 550,000.

The two most important financial forces in the fight, the multinational Global Fund for AIDS, Tuberculosis and Malaria and the domestic President’s Emergency Plan for AIDS Relief, were both created in the early 2000s and last year provided most of the $16.8 billion spent on the disease. But the need will soon be $24 billion a year, the groups said.

“Where is that money going to come from?” Mr. Warren asked.

The number of people living with H.I.V. rose to a new high of 34 million in 2011, while the number of deaths from AIDS was 1.7 million, down from a peak of 2.3 million in 2005. As more people get life-sustaining antiretroviral treatment, the number of people living with H.I.V. grows.

Globally, the number of people on antiretroviral drugs reached 8 million, up from 6.6 million in 2010. However, an additional 7 million are sick enough to need them. The situation is worse for children; 72 percent of those needing pediatric antiretrovirals do not get them.

New infections fell most drastically since 2001 in Southern Africa — by 71 percent in Botswana, 58 percent in Zambia and 41 percent in South Africa, which has the world’s biggest epidemic.

But countries with drops greater than 50 percent were as geographically diverse as Barbados, Cambodia, the Dominican Republic, Ethiopia, India and Papua New Guinea. [...where circumcision is not prevalent.]

The most important factor, Mr. Sidibé said, was not nationwide billboard campaigns to get people to use condoms or abstain from sex. Nor was it male circumcision, a practice becoming more common in Africa.

Rather, it was focusing treatment on high-risk groups. While saving babies is always politically popular, saving gay men, drug addicts and prostitutes is not, so presidents and religious leaders often had to be persuaded to help them. Much of Mr. Sidibé’s nearly four years in his post has been spent doing just that.

Many leaders are now taking “a more targeted, pragmatic approach,” he said, and are “not blocking people from services because of their status.”

Fast-growing epidemics are often found in countries that criminalize behavior. For example, homosexuality is illegal in many Muslim countries in the Middle East and North Africa, so gay and bisexual men, who get many of the new infections, cannot admit being at risk. The epidemics in Eastern Europe and Central Asia are driven by heroin, and in those countries, methadone treatment is sometimes illegal.

Getting people on antiretroviral drugs makes them 96 percent less likely to infect others, studies have found, so treating growing numbers of people with AIDS has also helped prevent new infections.

Ethiopia’s recruitment of 35,000 community health workers, who teach young people how to protect themselves, has also aided in prevention.

...

Mr. Warren’s organization said in a report on Tuesday that the arsenal of prevention methods had expanded greatly since the days when the choice was abstain from sex, be faithful or use condoms. Male circumcision, which cuts infection risk by about 60 percent [They can never resist saying that, with ever increasing certainty, can they? Or failing to mention it is only from women to men?], a daily prophylactic pill for the uninfected and vaginal microbicides for women are in use or on the horizon, and countries need to use the ones suited to their epidemics, the report concluded.

 

The Calgary Herald
November 16, 2012

Father who circumcised his son on the kitchen floor loses high court appeal

OTTAWA - The Supreme Court of Canada has abruptly dismissed the appeal of a British Columbia man who tried to circumcise his four-year-old son on his kitchen floor with a carpet-cutting blade.

The boy needed corrective surgery to repair the damage from the botched procedure.

In a 7-0 ruling from the bench, the justices left intact a Court of Appeal ruling convicting the man of aggravated assault and assault with a weapon.

The man, identified only as DJW, was convicted at trial in October 2009 of criminal negligence causing bodily harm and acquitted on the two assault charges.

The appeal court restored convictions on the assault counts and stayed the negligence charge, conditional on the conviction for aggravated assault.

The man's appeal to the Supreme Court sought to have the assault charges thrown out again, but the justices dismissed the case from the bench, saying their reasons would be available in 48 hours.

The original trial was told the man felt his religious beliefs required that his son be circumcised. Doctors advised him to wait until the child was older and stronger before performing the procedure.

In its factum on the case, the Crown dismissed the religious reasoning.

"This is a case about child abuse," the Crown argued. "This is not a case about the applicant's religious freedom or circumcision generally." [But how do the material circumstances of the operation bear on the man's religious freedom or circumcision generally? If he had done it "properly" would it no longer be child abuse? How does this differ except in detail from Dr Andrew Freedman of the AAP Task Force on Circumcision, who circumcised his own son on his parents' kitchen table?]

DJW's lawyer argued that the man took safety precautions, including extensive research on the topic of circumcision.

"The appellant's actions were performed with reasonable cause ... and without intent to assault or in any way harm his son," the factum said.

The trial judge found the kitchen was not a sanitary place for a surgical procedure [Someone should tell Dr Freedman], that the blade used wasn't as sharp as a surgical instrument and it was inappropriate to use a veterinary product to try and staunch the bleeding from the boy's partly severed foreskin.

DJW's religious background was as a Jehovah's Witness, although he was "disfellowshipped" by his family and the church. The Crown said his religious education and associations later led him to believe that male circumcision was a covenant with God.

He attempted to circumcise himself in 2005 and could not stop the bleeding. He had to go to an emergency room where a doctor sutured the wound.

His name is under a publication ban to protect the child's identity.

Earlier story

 

Canada.com
November 15, 2012

Top court hears botched home circumcision case Friday

By Natalie Stechyson

OTTAWA — The Supreme Court of Canada will hear on Friday the dramatic case of a B.C. father who, for religious reasons, tried to circumcise his four-year-old son on his kitchen floor with a carpet blade and a blood coagulant meant for horses.

Among the many issues the court will have to consider is the meaning of criminal negligence, and whether religious beliefs can go into the determination of what is reasonable behaviour, said Carissima Mathen, a law professor at the University of Ottawa.

“When you have something like this where, on an objective basis, the benefits of this procedure are mixed, and it seems like the primary motivation for circumcising your son is cultural or religious, are those beliefs something that we should factor into whether this a reasonable thing for someone to have done?” Mathen said.

“It raises questions such as why is it, in fact, that we permit infant circumcision?

A trial judge found that over the years after his son’s birth, the father known only as D.J.W. decided to “make things right with God” by following the laws of Moses, according to court documents. This included circumcision.

The trial judge found that D.J.W. had consulted with two rabbis and four physicians, and had asked several doctors to perform his son’s circumcision. None would do it because the boy would have required a general anesthetic, which could not be justified for a child so young.

In 2007, after giving his son some homemade honey wine, D.J.W. attempted to circumcise the boy on the kitchen floor, according to court documents, wounding him in the process.

The boy later had to have corrective surgery.

D.J.W. was found guilty in 2009 of criminal negligence causing bodily harm, but was acquitted of two other charges. The B.C. Court of Appeal stayed the conviction and upped the charge to aggravated assault and assault with a weapon.

In delving into the case, the top court will also look at whether the injury D.J.W. inflicted was a “wound” and if the blade he used on his son, known only as D.J., can be considered a “weapon,” said Marie-France Major, a partner at Ottawa’s Supreme Advocacy LLP.

D.J.W. is seeking an acquittal, maintaining that the trial judge was wrong to convict him of criminal negligence, but right to acquit him of aggravated assault and assault with a weapon, according to court documents.

Counsel for D.J.W. will argue that the man’s actions were performed with “reasonable care” and without intent to harm his son.

The Crown will argue that this is a case about child abuse, not D.J.W.’s freedom of religion or even about circumcision.

[“The result,” according to court documents submitted by the Crown, was “the foreskin on D.J.’s penis stuck out like two arms.] “D.J. was not circumcised. He was disfigured,” the Crown’s factum reads.

A decision from Friday’s case is not expected for some time.

Earlier story

 

The Science Codex
November 13, 2012

Western media coverage of female genital surgeries in Africa 'hyperbolic' and 'one sided'

There is widespread condemnation of female genital surgeries and it is considered a form of mutilation and a violation of human rights, but an international advisory group argues that poor understanding and unfair characterizations of the practice are not really helping. In a public policy statement in the Hastings Center Report, the Public Policy Advisory Network on Female Genital Surgeries in Africa, a group that includes doctors, anthropologists, legal scholars, and feminists, argues that media coverage of the practice is hyperbolic and one sided, "painting the now familiar portrait of African female genital surgeries as savage, horrifying, harmful, misogynist, abusive, and socially unjust."

The advisory network's statement takes no position on whether the practice should continue, but aims to "move the coverage of the topic from an over-heated, ideologically charged, and one-sided story about 'mutilation,' morbidity, and patriarchal oppression to a real, evidence-based policy debate governed by the standards of critical reason and fact checking."

Three commentaries responding to the article, written by three bioethicists and an obstetrician-gynecologist, also appear in the journal.

Female genital surgery – a neutral [no, positive] term used by the advisory network instead of other terms, such as female genital cutting [really neutral] and female circumcision – has been condemned as a violation of the human rights of girls and women by a wide range of experts and organizations, including the World Health Organization and the United Nations. In several African countries, including Egypt, Guinea, Sierra Leone, and Somalia, more than 90 percent of women ages 15 to 49 have undergone such surgeries.

["Surgery" today implies

  • a professional operator
  • surgical instruments
  • sterile conditions

These are seldom fulfilled in tribal or much of ritual genital cutting. Here is (Muslim, male) genital cutting where the gloveless operator handles money (0:54) and bystanders are heard coughing during the course of the operation:

Is that "surgery"?]

In its statement, the advisory network focuses mainly on two types of female genital surgery, which they state comprise 90 percent of procedures in Africa. These practices involve reducing the clitoral hood and tissue and reducing or eliminating the labia and the clitoris. A third type, referred to as infibulation or sealing, involves narrowing the vaginal opening with stitches or some other sealing method. [Actually three types, each radically different from the others. Only the first may be considered minimal.]

The authors put forth seven facts that they hope will change the scope of media coverage and lead to a better understanding of the cultural complexities underlying female genital cutting:

  • Medical research has found that a high percentage of women who have had genital surgery "have rich sexual lives, including desire, arousal, orgasm, and satisfaction, and their frequency of sexual activity is not reduced."
  • Reproductive health and medical complications linked to female genital surgery happen infrequently.
  • Those who value female genital surgery view it as aesthetic enhancement, not mutilation.
  • In almost all societies where female genital surgery is performed, male genital surgery also takes place. [Since the Pokot people of Kenya resuumed male cutting, "almost all" has become "all".] Broadly speaking, then, such societies "are not singling out females as targets of punishment, sexual deprivation, or humiliation." [No, they're equal opportunity oppressors.]
  • The link between patriarchy and female genital surgery is unfounded. Almost no patriarchal societies adhere to the practice and, at the same time, the practice is not customary in the world's most sexually restrictive societies. [Islamic societies are not patriarchal?]
  • Women manage and control female genital surgery in Africa and the practice "should not be blamed on men or on patriarchy." Ironically, the authors contend, groups that fight against female genital surgery weaken the power of women.
  • An influential WHO study about the "deadly consequences" of female genital surgery is the subject of criticism that has not been adequately publicized. The reported evidence does not support sensational media claims about female genital surgery as a cause of perinatal and maternal mortality during birth

The authors outline the following seven policy implications:

  • The media, activists and policy-makers must "cease using violent and preemptive rhetoric" that paints a sensational image of African parents mutilating their daughters and damaging their reproductive and sexual health.
  • It should be acknowledged that female genital surgery is not unique to African women; the authors liken it to "genital piercings on college campuses" and "vaginal rejuvenations requested by some Western women." [But for the crucial issue of informed consent by the person being cut]
  • Advocates fighting for safe, hospital-based female genital surgery should be given a voice in public policy forums.
  • "Zero tolerance" slogans promoted by anti-mutilation groups are counterproductive. Not only do they limit thoughtful, respectful dialogue, but they can make genital surgery more dangerous by driving the practice underground.
  • Legislation and regulations that criminalize female genital surgery for adult women are discriminatory, because they deny women's autonomy "to choose what makes them happy with their own bodies."
  • Studies of genital surgery should be multidisciplinary, and there should be support for a network linking researchers and advocates who have diverse points of view.
  • Women and girls who have undergone genital surgery as children and are now living in countries where the practice is nonexistent or illegal should not be subjected to discourse that stigmatizes them or teaches them to expect sexual dysfunction. Such discourse "may provoke what could be called 'psychological mutilation,'" potentially compromising the development of a normal and healthy psychosexual life. [Hyperbole. Actual cutting is not mutilation while purely mental action is?]

While agreeing with the international network's call for accurate information about female genital surgery and its criticisms of inflammatory language, three commentaries disagree with the policy advisory statement.

Ruth Macklin, a bioethicist and professor in the department of epidemiology and population health at the Albert Einstein College of Medicine of Yeshiva University, takes issue with its depiction of the facts and points to crucial information that is missing from the statement, including numerous statements and resolutions by the International Federation of Gynecology and Obstetrics opposing the performance of female genital cutting and opposing any efforts to medicalize the procedure, and studies documenting significant harm to women who have undergone the procedure, as well as a change in attitude among younger women in countries where the prevalence of female genital cutting is high.

In another commentary, Nikola Biller-Andorno, director of the Institute of Biomedical Ethics at the University of Zurich, and Verina Wild, the institute's deputy director, argue that enough evidence now exists to define the conditions under which female genital cutting is morally unacceptable. They state that it would be unimaginable to conduct a randomized, controlled trial of the practice or to undertake long-term cohort studies, because such research would in fact condone female genital cutting. "Requiring more data before committing to a stance against clearly unacceptable forms of female genital cutting is not a proof of neutrality," they conclude. "It means failing to protect a very vulnerable population." The authors also call into question the Advisory Network's depiction of women's autonomy, suggesting instead that women may be compelled to undergo female genital cutting, because they cannot deviate from their local customs and social structures.

In the third commentary, Dr. Nawal M. Nour, an obstetrician-gynecologist and director of the African Women's Health Center (AWHC) at the Brigham and Women's Hospital in Boston, writes that her patients have endured both major and minor long-term complications from female genital cutting. Nour also states her concern that the Advisory Network's presentation of data is biased. For example, she writes that the statement that "a high percentage of women have rich sexual lives" would be more plausible if "high" were changed to "some." Nour cites a large meta-analysis showing that "women who had undergone genital cutting were more likely to report dyspareunia, no sexual desire, and less sexual satisfaction." "Speaking as both an African woman and an obstetrician-gynecologist," she writes, "I hope that this practice ends during my lifetime."

 

NECN.com
November 12, 2012

German lawmakers want circumcision ban under 14

BERLIN (AP) — Left-wing lawmakers in Germany are threatening to oppose government efforts to keep male infant circumcision legal.

More than 50 lawmakers from three parties are proposing that parents should have to wait until their son is 14 so he can give informed consent for the procedure.

The proposal obtained by The Associated Press on Monday would radically amend a government bill that would give parents the power to decide.

The bill was prompted by a regional court ruling that circumcision could amount to criminal bodily harm. The government has enough votes to pass the bill and defeat amendments.

The June court ruling prompted outrage in Germany's Jewish and Muslim communities. Jews circumcise boys on the 8th day after birth and Muslims usually perform the procedure early in a boy's life.

Earlier story

 

Gestetner News
November 10, 2012

Due to Sandy 'Metziaza Be'Peh' Hearing Postponed, Injunction Extended

A Manhattan court has postponed a hearing against the new requirement that parents whose children undergo ritual Jewish circumcision in New York City sign a consent form before the “metzizah be’peh” aspect of the Jewish bris ceremony can be performed. The hearing, part of an action brought by rabbinical groups against the requirement, was delayed last weekend, the court said, because Hurricane Sandy has caused a backlog of cases, and the courts must dispose of old cases before starting new hearings. As a result, an injunction against the enactment of the consent rule has been extended.

The New York Board of Health and Mental Hygiene in September approved the regulation,

...

Earlier story

 

And all entirely preventable...

Courthouse News Service
November 9, 2012

Circumcision Goes Horribly Wrong

By Erik De La Garza

EDINBURG, Texas (CN) - A doctor botched a circumcision of a 4-year-old boy so badly that the boy pleaded to "just cut it off and (he) can be a girl," the parents claim in court.

Rafael and Vanessa Deleon sued Dr. Jennifer J. Garza, of McAllen, in Hidalgo County Court. They claim they learned from specialists that Garza over-cauterized the penis to try to stop the bleeding, damaging their son's urethra and requiring reconstructive surgery to close the holes.

But after the 90-minute surgery, the Deleons claim Garza told them, "'the circumcision was successful.' She also told them that 'there was a little bleeding, but that she and her staff were able to stop it,'" according to the complaint.

Then a nurse appeared and told Garza that the boy "still had a lot of bleeding and that the bleeding did not appear to be stopping," the complaint states. Garza told that that "their son 'needed to go back into surgery in order to find out what was happening and to stop the bleeding,'" the Deleons say. They were then given a consent form, but "the consent papers were for a different patient," according to the complaint.

It continues: "After taking the plaintiff into the operating room for a second time, the defendant came out and told Ethan's parents that she had managed to stop the bleeding using cauterization around the penis area where she thought the bleeding was coming from. The defendant then had the plaintiff remain overnight at the hospital. During the course of that night, hospital staff had to change the plaintiff's gauze around his penis multiple times. Plaintiff's parents also noticed that the plaintiff oozed blood every time he urinated."

The next day, after seeing lab results, Garza told them that "'Ethan's penis was going to look beat up for the next couple of weeks, but that as the weeks go by it would look normal again,'" according to the complaint.

But that didn't happen, the family says: "The days following the surgery, the plaintiff's parents had to change the plaintiff's gauze repeatedly because he kept bleeding so much. During this time, the plaintiff's parents were shocked when they saw the plaintiff urinate from more than one hole in his penis. It appeared that Ethan had two streams of urine. After seeing this, the plaintiff's family decided to visit Doctor Segundo Lizardo, Ethan's pediatrician, the same doctor who referred them to Dr. Garza."

The only defendant in the complaint is Dr. Garza and her office.

The family consulted a third doctor, Catarina Posada, who "could not explain to the family why the plaintiff was urinating from two holes in his penis, but she however prescribed the plaintiff some medication," according to the complaint.

It continues: "In the coming days, the plaintiff screams and cries every time he has to urinate. The plaintiff is also in tremendous pain. The plaintiff refuses to drink anything because he does not want to urinate. The plaintiff also becomes very upset with his parents. He begins to blame them for his pain and predicament. The plaintiff goes so far as to say that he is a girl now because he has to urinate sitting down. The plaintiff also asks his parents 'to just cut it off, and he can be a girl.' The plaintiff's parents also have to change the plaintiff's sheets nightly because the sheets become stained with blood."

A week after the circumcision, the Deleons took their son, still bleeding and in pain, to the emergency room at Rio Grande Regional Hospital where Dr. Christopher Bristow told them "that the plaintiff's penis looked over cauterized."

That led to a visit with a pediatric urologist, and more lab tests.

Dr. Lizardo then prescribed him morphine so he could sleep, the family says.

"On or about April 3, 2011, at 2:30 a.m., the plaintiff went to urinate and his parents noticed that a stream of blood was running down his leg. The plaintiff's parents call 911. The ambulance takes the plaintiff to the Knapp Medical Center Emergency room. There Dr. Jorge Martinez sees the plaintiff and gets Dr. Lizardo to show up to the emergency room. According to the plaintiff's parents, when they questioned Dr. Lizardo on why this was happening to their son, Dr. Lizardo told them something had to have gone wrong during the circumcision surgery for this to be happening to Ethan," the complaint states.

Five days later, a pediatric urologist told them "that Ethan's urethra is damaged. He tells the plaintiff's family that the circumcision surgery created fistulas - holes in Ethan's penis. He tells them that the plaintiff will need reconstructive surgery to repair the fistulas," the complaint states.

"On or about September 23, 2011, the plaintiff underwent reconstructive surgery to close the fistulas (holes) on his penis. The doctor tells the plaintiff's family that he closed the holes; however sadly, he indicated that the plaintiff may need more surgeries in the future," the complaint says. (Parentheses in complaint.)

The family seeks punitive damages for medical negligence, deceptive trade, breach of warranty and misrepresentation.

They are represented by Pamela S. Alexander and Efrain Molina Jr. of Edinburg.

 

When persuasion fails, bribery, and force


November 6, 2012

Push to meet 2013 male circumcision targets

KISUMU, 6 November 2012 (PLUSNEWS) - With just over one year left to achieve its [arbitrary] target of having some 1.1 million men circumcised as part of HIV-prevention efforts, Kenya's government is ramping up efforts to bring more men into clinics, compensating them for their time and encouraging them to bring friends in for the procedure.

Medical male circumcision programmes have started giving men vouchers worth 100 Kenya shillings (about US$1.17) when they complete the procedure; these vouchers are redeemable for cash once the man returns for a follow-up visit. The men are encouraged to return with a friend or relative also wishing to be circumcised.

"Compensation for time lost to such persons has seen many of them turn up in large numbers to get circumcised," Walter Obiero, the clinical manager at the Nyanza Reproductive Health Society [an astroturf creation of Dr Robert Bailey], told IRIN/PlusNews.

...

Male circumcision has been scientifically proven to reduce a man's risk of contracting HIV through vaginal intercourse by as much as 60 percent. ["Scientificall proven" now? The claims get stronger and stronger. And no worries about the increased risk to women.] Follow-up studies have found that the effectiveness of male circumcision for HIV prevention is maintained for several years.

In 2011, UNAIDS and the US President's Emergency Plan for AIDS Relief (PEPFAR) launched a five-year plan to have more than 20 million men in 14 eastern and southern African countries undergo medical male circumcision by 2015.

"To ensure that we achieve our target, the government will increase sensitization [an ironic expression] and mobilization efforts to ensure we can have more people embrace male circumcision as an HIV prevention method," Athanasius Ochieng, VMMC programme manager at the National AIDS and Sexually Transmitted Infections Control Programme (NASCOP), told IRIN/PlusNews.

The role of women will also need to be increased. ...

Casting a wider net
The government is considering integrating male circumcision, currently offered as part of its HIV prevention package, into outpatient services in public hospitals, as well as starting infant male circumcision, which studies have found to be cost-effective. [There is no evidence whatever that infant circumcison has any effect on HIV transmission.] A recent study carried out among 1,200 infants in Nyanza Province concluded that infant male circumcision was safe, and an earlier study concluded that it was acceptable to most parents. [They never ask the babies.]

"We are carrying out studies on infant male circumcision, and once we have this, then we will find out the possibility of rolling out nationally," Ochieng said.

Currently, the programme focuses on males aged 15 and above, though private hospitals do carry out the procedure on infants at parents' request. [...while the rest of the the world begins to question the ethics of this.]

...

 

Raising the double standard higher

The Citizen (Tanzania)
November 5, 2012

Elders unrelenting on FGM

By Anthony Mayunga

Serengeti. Elders in Mara Region have embarked on a campaign to convince boys to boycott circumcision as a protest against global condemnation of female genital mutilation (FGM) whose season starts in December.

The elders believe that their move to prevent boys from getting the cut will evoke anger among practitioners who will react by enforcing a revival of both types of the cut (female and male) and pretend it is an order from ancestors to cleanse the community, failure of which will lead to punitive measures. [Imagine if it were to backfire, and genital cutting simply ended!]

A survey by The Citizen in Serengeti, Tarime and Rorya districts found that campaigns for the revival of FGM appealed to clan elders and most of them would gladly support the practice.

"Some of the boys have threatened to boycott the initiation rite unless girls are also involved. They claim that during initiation boys and girls walk together as couples, a situation they believe makes the process colourful," said one of the anti-FGM parents who preferred anonymity.

The source said there were conflicting groups of elders who differed on FGM in the region. While some groups support the practice, a majority joined the government and NGOs to vehemently condemn it. The government condemned FGM which violates the Child Act enacted in 2009 and the Sexual Offences Special Provisions Act (SOSPA 1998).

Kalamu Hussein, one of the educators advocating against gender-based violence under the Christian Church of Tanzania (CCT) at Kisumwa Ward in Rorya, said he feared that genital mutilation would be widely practised in several districts, especially in the area.

"Some of them perform initiation during the night to avoid law enforcers," said Mr Hussein on the practitioners.For her part, the coordinator of a project launched to fight gender-based violence in Serengeti District, Ms Sophia Mchomvu, said the campaign to revive FGM persuaded several elders who had initially denounced circumcision to reverse their attitude.

"FGM campaigners target elders who have vowed before government officials that they will support it to eradicate the harmful practice," she added.

[So female genital cutting is gender-based violence, but male genital cutting is not?]

 

Bailey again

AllAfrica.com
November 5, 2012

Kenya: Scientists Give Infant Circumcision Go-Ahead

By Samuel Otieno

RESEARCHERS have given a nod to infant male circumcision. A recent research of more than 1,200 infant male circumcisions performed at government hospitals in Nyanza province shows the procedure is safe among infants.

The study suggests that the best time for performing the procedure is below one month to avoid complications. The study was conducted by chief investigator Marisa Young of the University of Illinois at Chicago's School of Public Health and colleagues.

Others are the Nyanza Reproductive Health Society, CARE, International and Impact Research and Development Organisation. It was funded by the Male Circumcision Consortium, with support for co-author Professor Robert Bailey from the Chicago Developmental Centre for AIDS.

The study is part of the wider programme to fight HIV/Aids through circumcision. Research shows that circumcision reduces HIV infection by more than 60 per cent. [No study has shown that infant circumcision has any effect on HIV transmission.]

 

He's not the first, and he won't be the last...

Bulawayo24 (Zimbabwe)
November 4, 2012

Man demands his foreskin back after circumcision

A Chiredzi man who claims to have lost erection after being circumcised in the Pinda Musimati HIV and Aids Campaign has become a bother at the Family Aids Caring Trust (FACT) in Chiredzi where he is demanding his foreskin back.

FACT executive director for Chiredzi, Ropafadzo Magwaza confirmed the story and said she was happy that the man had not become violent. ...

Magwaza said she quickly organised a stakeholders meeting to clear the man's issues. The man confronted FACT Chiredzi volunteers working in the area and demanded that they give him back his foreskin as he had experienced weak erection since he went through the knife. He said he had become weak and could not get the erection that he used to and even accused the organization of taking people's foreskins for ritual purposes because other newspapers had refuted the claim that circumcision reduces HIV and AIDS by 60%.

"Yes, we received the report but we are happy that the man never became violent but is always nagging our staff over his foreskin. This prompted us to call for an urgent stakeholders meeting where we called the National Aids Council (NAC), Zimbabwe Aids Network (PSI), NANGO, traditional leaders including Chief Chilonga, Chief Chitanga Chief Tshovani, a medical doctor from Hippo Valley and councilors.

"FACT Chiredzi does not carry out circumcision but we only mobilize people and do all the Voluntary Counselling and Testing (VTC), while the hospital carry out the circumcision. We are happy that Chief Chilonga managed to explain to participants fully about male circumcision. It was a relief to hear words of wisdom from a traditional leader," said Magwaza. [And did the words of wisdom give the man back his erections - or his foreskin?]

Confusion over circumcision hit the head lines as newspapers ran conflicting stories on the advantages of circumcision, with President Robert Mugabe's health advisor Timothy Stamps rubbishing the survey and calling it baseless and misleading.

[Memo to circumcision advocates and providers: Include

"I understand that circumcision is irreversible and I can NEVER get my foreskin back"

in informed consent forms.

And he could be shown with this model what is removed:

Penis model - before
[Before]
Penis model - after
[After]

 

More evidence babies are being left intact...

Arutz Sheva
November 2, 2012

Warsaw Hilton to Allow Circumcision Ceremony

The Hilton hotel in Warsaw, Poland, has retracted its refusal to allow a Jewish family to hold a circumcision ceremony and party in the hotel this coming Sunday.

According to a Kol Yisrael radio report on Thursday, the hotel had initially informed the family of the Chabad emissary to Poland that it will not allow the ceremony because a circumcision does not seem hygienic and does not meet the standards of the hotel.

Chabad members were angered by the refusal because such a celebration is rare among the local Jewish community. Hotel management eventually changed its mind and announced that it would allow the ceremony.

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