As medical male circumcision rates around the country struggle to rise to the level government and its donors hope for, Mmegi contributor, ISHMAEL MBULAWA* notes that instead of worrying about the impact on pleasure, men need to guard against infection
Globally, circumcision was performed or is still performed for cultural or religious reasons and it is respected and valued.
In Botswana, circumcision grew in popularity in recent years, as it was introduced as an alternative method of combating the spread of HIV/AIDS and other opportunistic infections and illnesses.
It is high time more Batswana, both male and female, come together regarding the importance and need for the circumcision programme. We are all living in an era where our loved ones are perishing, millions of people are infected every year, many are discriminated against and the pandemic is also causing depression and other mental illnesses.
Governments and civil society are using billions to combat the disease and every effort made needs to be appreciated and taken into consideration by citizens.
The very important component of this whole programme is not simply the removal of the foreskin. It is the sharing of information, ideas and knowledge about the long-term benefits associated with the Safe Male Circumcision programme.
The public needs to be given the opportunity to understand, analyse and decide based on the knowledge acquired from educational campaigns. Circumcision is just like any other prevention method in place, such as condom use, trust, abstinence, being faithful and behaviour change.
All these are not compulsory, but add value in the reduction of infection rates. The results of circumcision today, will be visible in the next 10 to 15 years even though for now circumcision is used as a preventative measure.
We all agree that knowledge is power, and as long as it is correct, meaningful and accurate, the information issued to the public on this programme will be successful and yield positive results.
Before I narrate the benefits of circumcision, I must stress the importance of educating men on issues of intercourse satisfaction or pleasure after circumcision, as these are still major obstacles to circumcision.
The main goal of undergoing male circumcision has nothing to do with pleasure during intercourse or the satisfaction of sexual partners. That is a misconception of the whole programme of medical male circumcision.
Intercourse issues have been in the picture before the division of men into circumcised and uncircumcised. The main aim here is to perform medical male circumcision for safety and protection among partners by limiting the degree of exposure and reducing the chances of possible transmission.
The physiology of intercourse has nothing to do with foreskin, but the transmission of the HIV virus and foreskin goes hand-in-hand.
Chances of transmission or infection are high, especially in the soft tissue of the foreskin as it tears easily during intercourse. Safety and protection must come first.
Circumcision is not the cure to HIV/AIDS and STIs, as being circumcised is not a free platform to performing unprotected intercourse.
As I mentioned before, circumcision is an alternative prevention measure, not a cure. People are still encouraged to use condoms and be faithful to their partners. The general public must have the full picture on this programme’s importance. Imagine, people are not paid to donate blood or organs, which save many lives, but a lot of funds are needed to educate, mobilise and sustain these programmes.
For medical male circumcision, engagement can be done through local media, newspapers, magazines, television, social networks and local cellphone network companies. Let’s have a toll free number so that the message can be spread. Let’s use our community leaders, church leaders, school heads and principals, councillors, legislators, cabinet ministers, social clubs and celebrities to help with the campaign for the programme to be successful. Unemployed graduates can be recruited, empowered, trained and used on a temporary basis to help with the medical male circumcision campaign in house-to-house visits, looking at their communication skills and approach.
HIV/AIDS has become a significant figure in our daily life decision-making, planning and outcomes. It affects all of us in a personal, community, national and global capacity.
Circumcision is not only about removing the foreskin, but the information acquired or given prior counselling, testing as well as the legal ethical steps on how human tissues are handled and discarded. Medical male circumcision is not a seasonal procedure and can be performed in all weather conditions as opposed to cultural circumcisions, which are only done during winter. Like any other operations or procedures done in hospital under general anaesthetic, medical circumcision also comes with post-operation advice and management.
Benefits of medical male circumcision
The benefits include the following:
l A nation informed in its HIV/AIDS status
l Empowered knowledge on behaviour and attitudes toward HIV/AIDS and STIs
l Screening of other illnesses before the procedure such as diabetes, hypertension, prostate cancer, cardiac diseases and STDs
l Free education on family planning and attitude change
l Restoring dignity and privacy
l Protection and prevention of cervical cancer in women
l Promoting hygiene among males
l Reducing reinfection in HIV-positive patients
l Sixty percent reduction in the chances of transmitting of HIV/AIDS and STIs from woman to man
l Encourages couples or partners to seek counselling, education and testing of STIs
In conclusion, medical male circumcision is one of the preventative strategies to combat the spread of sexually transmitted diseases and is a weapon in the fight against HIV/AIDS.
The programme will also help government in future, in terms of reducing the high spending on the treatment and care for STIs.
The only cure to HIV/AIDS is through prevention and the methods of prevention must be free and easily accessible by the majority.
Prevention is better than cure.
*Ishmael Mbulawa is a 29-year-old from Maitengwe based in Nelspruit, South Africa. He volunteered in the fight against the Ebola outbreak at the beginning of the year and also worked in the Medical Male Circumcision with four years of experience in the health sector.