Male Medical Circumcision in Rural South Africa

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Last year, I wrote about traditional circumcision and the dangers thereof.

The government has started an MMC-drive. MMC = Male Medical Circumcision. Non-traditional circumcision has its own benefits such as HIV-prevention, STI-prevention and apparently hygienic benefits too.

The goal is also to have traditional circumcisions performed in hospital, where health care workers are trained in the procedure and where infection control is better managed. It will take a while to achieve this in Africa, because having the procedure done in the hospital is often viewed as being “unmanly”.

Yesterday, the clinic in the rural town where I am now did an MMC-outreach. Initially we were only supposed to observe, but our supervisor decided we could assist. Which was totally super cool! I feel more confident with sutures and blades now.

I have to say, the patients were remarkably calm for the type of surgery they were going through… and it is done using only local anaesthesia. Brave, brave people.

You may recall that I hated surgery last year. Mayhaps it was just because we weren’t taught so eagerly.

Edit: I have become aware of a raging debate for and against circumcision. I am in the process of becoming more informed and will then, at some point, post my views and findings.

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5 thoughts on “Male Medical Circumcision in Rural South Africa

  1. Nice blog, you seem like a cool person. I like a lot of what you’ve posted, but found you because of what I don’t like– medical fraud.

    Non-therapeutic circumcision isn’t real medicine. Especially RIC. If I could share just one paper explaining this push to prune Africa, it would be this one: http://www.cirp.org/library/disease/STD/fleiss3/

    “It was an American circumciser in 1986 who first hypothesised that circumcision prevents HIV infection.49 In an attempt to verify this theory, others have published numerous epidemiological surveys, conducted primarily in Africa. A review of these surveys, however, does not support their assertion. Of the 36 published studies examining the relationship between the circumcised penis and HIV infection, 15 found a negative correlation50-64, four found a positive correlation,65-68 and 16 found no statistically significant difference.2,69-83″ (http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf also found that in 10 of 18 countries surveyed circ’ed men had HIGHER rates of HIV)

    So why? N. American circumcisers with an agenda to legitimize circumcision, backed by big money. Obviously RIC is a violation of all medical ethics, but when spurious research claims lead to conclusions contrary to empirical real-world data– the “informed consent” these men are receiving can hardly be called such. My wife (pediatrician) regrets she was never taught about the male prepuce and its function, like most Americans learned little more about male genitals than how to cut them, and once provided this “service.”

    You’re starting out in the field, please don’t buy into this frenzy.

  2. Thanks for your comment. I’m sorry it took me so long to reply, I would have liked to give an intelligent and well-researched response – but unfortunately my critical analysis of research is not really up to scratch. I appreciate your input, even though it is quite contradictory to the science I’ve been taught. We are taught that Langerhans cells are very good CD4 receptors of the HI-virus, and we’ve been taught the physiology thereof as well.

    Furthermore, I’d like to at some point critically appraise the stats in the articles you cite. For example, I’d want to look at populations of the studies. There are many things that affect probability of STI’s; and a lot of the very traditional African cultures that perform traditional circumcision are also traditionally polygamous and against condom use. So it would be interesting to see such a study done in a Western population.

    Anyways, what I’m getting at is that you’ve given me something to think about. Next year we will have a course on research and critical appraisal, and I think I know my topic. When I know more, and can answer your comment more thoroughly, I will post an updated blog post about it.

  3. Please, please, please read more about circumcision. Don’t wait for your critical analysis class. You can find information by googling “Doctors against circumcision” or “Intact America”. Male genital mutilation is an atrocity and should never be done on an infant (infants are not sexually active). Circumcision does not prevent HIV infection. Circumcision removes the most sensitive part of a man’s penis and changes his sexual and that of his partner for life. Please put down the knife and consider becoming a conscientious objector.

  4. Pingback: A Botched Circumcision | Whispers of a Barefoot Medical Student

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