KENYA: Rising demand for male circumcision

KISUMU, 9 October 2008 (PLUSNEWS) - Health facilities in Nyanza Province in
western Kenya are struggling to meet the demand for medical male
circumcisions since politicians threw their weight behind efforts to
promote the procedure as a way of reducing HIV infections.

The campaign initially faced opposition by community elders of the ethnic
Luo community that makes up the bulk of the province's inhabitants and does
not traditionally practice circumcision. But local leaders, swayed by calls
from Kenya's Prime Minister, Raila Odinga, and research demonstrating the
HIV prevention benefits of being circumcised, have since said they would
set an example by undergoing the procedure themselves.

"I think it is a good thing that people are now seeing the benefits that
will come along with male circumcision. After all, this has nothing to do
with culture because it is a medical procedure," said Oburu Odinga, a local
legislator who is among those who have volunteered to be circumcised. "The
day I go for it, I will let all know that I have done it."

The sudden increase in demand for medical male circumcision in the province
has forced health officials to rapidly roll out a programme to train health
workers in the procedure.

"We have so far trained over 100 trainers of trainees, who will in turn
train health workers," said Wycliffe Omondi, a clinical instructor at the
Nyanza Reproductive Health Society, part of a joint project by UNIM - the
Universities of Nairobi in Kenya, Illinois in the US, and Manitoba in
Canada - in Kisumu, provincial capital of Nyanza.

Trainers receive two weeks of training; health workers - clinical officers,
nurses, counsellors and infection prevention assistants - receive five
days, which includes counselling and the detection of dangerous conditions
that might arise during surgery, such as excessive bleeding.

"Research assistants are also trained to follow up on clients after
circumcision to monitor the healing process," Omondi told IRIN/PlusNews.

Fred Oduor, another instructor with the UNIM project, noted that "We will
not turn away those seeking circumcision services even though they are
already infected [with HIV]," he said. "The only difference is that they
will be required to come along with their partners. This also applies to
those with sexually transmitted infections."

Awareness campaigns have also been launched to address the misconception
that male circumcision provides complete protection against HIV infection,
and to encourage married men to attend counselling sessions with their
spouses before the procedure.

"We insist on spousal involvement for married men because that is very
critical in the success of the whole process," said Omondi. "This is
important for the man because the wife needs to understand that there is
post-circumcision abstinence."

One issue that may lessen the success of the circumcision drive is the
perception among wives that their husbands intend to be unfaithful. "The
moment I mentioned to her that I wanted to be circumcised, she went mad at
me and insisted that I have been unfaithful to her all along," Erick
Otieno*, 35, told IRIN/PlusNews.

"You know it is difficult to convince her that you want to reduce your
chances of contracting HIV without making her feel cheated on. I think it
is important to create awareness among women that seeking male circumcision
is not a sign of infidelity."

Irene Aluoch*, 28, said her husband was not circumcised but she would
support him if he wanted it. "I know it is a difficult thing to think that
your husband might be going for circumcision because he sleeps with other
women, but you would rather be safe than to regret," she said. "Maybe he
wants to do it just for reasons that are purely hygiene related."

The provincial AIDS coordinator, Dr Charles Okal, said such matters should
be properly dealt with during counselling before surgery. "Issues of
infidelity among married couples are very serious and the concerns being
raised by women about them cannot be wished away. We are working very
closely with the providers to try to pacify such feelings in a genuine
way," he said.

"If you talk about circumcising large numbers of people, but in the process
have equally large numbers of broken marriages, then there is no success to
write home about."

*Not their real names

ko/ks/he
[END]



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