Male Circumcision Initiatives: Will We be on the Right Side of History?

WHO states that male circumcision provided by well trained health professionals reduces the risk of heterosexually acquired HIV infection in men by approximately 60%. Recommendations emphasize that male circumcision should be considered an efficacious intervention for prevention resulting in significant investment in the promotion in male circumcision in Africa.  What I want to know is how is this message interpreted by the people it is meant to protect because I fear the implications if we do not get it right at the implementation stage?

A False Sense of Security

Fantastic news for men! A one-time medical intervention can provide men with life-long partial protection against HIV as well as other sexually transmitted infections. What about the rest of the population? Women are not directly protected by this intervention and could potentially put us at higher risk. It can already be difficult to negotiate with a man to use a condom. My concerned is that if men believe they are protected against HIV/AIDS, women will be left with reasonable less clout in the already sexually charged everyday debates.

Reasonable Doubt

Many professionals have questioned the reliability and validity of studies claiming that circumcision reduces HIV transmission. African national population surveys in eight countries found a higher rate of HIV infection among circumcised men compared to men who were not circumcised and there are at least 17 studies that have not found any benefit from male circumcision.  Some studies suggest it is counterproductive. Misconceptions about the procedure – specifically the widespread notion that circumcision alone, without taking additional precautions, significantly protects people from HIV/AIDS – was actually encouraging the disease to spread in Uganda where the circumcision campaigns have been piloted since 2010.

 ‘Circumcision Industrial Complex’

UN and WHO, foreign and national governments, and a variety of NGOs have spent billions of dollars on circumcision promotion diverting resources for more effective measures. It is big business for those involved.  I pray that this flood of money has not made donor dependant NGOs comprise prevention for profit.

Cost Benefit?

Condoms are more than 99% effective, prevent other sexually transmitted diseases and unwanted pregnancies, they are less invasive, and the cost of one circumcision in Africa can pay for 3000 condoms. Even pro-circumcision studies recommend using condoms in addition to circumcisions. In that case, circumcision adds no significant additional protection value.

Kidnapped in Nyimba

I travelled to Zambia last month to attend a workshop on Local Learning and Value Chains, visit the VSO Zambia Office, the Dairy Association of Zambia and write a case study in a little village called Nyimba 450km outside of Lusaka. It’s not a very big place and I think people were pretty excited to have someone new to talk to.  On the first day we travelled to a little chiefdom to monitor one of the Nyimba District Farmer Association projects and the chief himself said “who are we to receive such a visitor’. The only thing that made me special in that situation was that I am a foreigner. Don’t believe the hype, I’m actually nobody.

When I found out that Fridays were half days at the association I decided to bring all my bags to the office so that I could go straight to the bus depot and get to Lusaka by dinner because I was damn excited to see all my friends after a year’s hiatus. My colleagues were not pleased with the sight of me with all of my bags and despite only knowing me for two days they shamelessly guilt tripped me about wanting to leave the entire morning and played the song One More Night. Eventually they convinced me to stay for lunch by saying that there were buses running from Chipata until 17:00.

While we waited for lunch to be prepared I had to go around the room posing for photos as if I was every guy’s girlfriend and after lunch they went through the motions driving me to the bus depot and waited around for a bit despite the fact they had knowingly lied to me about the bus which stops running at noon! So I stayed for one more night in Nyimba. We went out dancing and I had to hide half of the beers people bought for me in my purse so I would be capable of catching the 6am bus. Zambians are my fav!

Malawi Council for the Handicapped (MACOHA)

As a part of my Knowledge Management role with VSO Malawi, I travelled to the south of the country to visit Secured Livelihoods Volunteer, Dinali De Zoysa based in the MACOHA Bangwe Factory which offers employment and community rehabilitation for people with disabilities. As a love-child of the disability rights movement in Canada, I felt at home the moment I stepped through the gates of MACOHA`s weaving, tailoring, screen printing, tie and dye- Textile Factory in Bangwe, Malawi. I was raised by a community of quadriplegics, ‘thalidomide babies’, people with Tarettes, mental health issues, learning disabilities, chronic illnesses…( you get the point) and in all the places I have been in the world I have always found a home away from home in the local disability community.

Dinali has been working with the factory’s production unit to reduce wastage, increase efficiency, access markets and become financially sustainable, as the participants are being currently being paid with government funds. The factory has been selling their garments in outlets on a consignment basis and producing promotional items for companies. Roughly 75 people with disabilities are employed here presently.

Dinali is a friendly, outgoing long term volunteer warming a cold cement office in the 1970`s era building that houses MACHOA. Her offices is off the screen printing department dominated by Deaf people, where I was happy to get a chance to brush up/show off the sign language skills learned in Zambia. I loved the translation of the sign names: Cheer, Cutting Grass, Crying and Sweeping all to do with habits and occupations. I could have spent the rest of the day practicing my sign language and filling in the gaps with theatrics but there was a Partnership Development Process meeting to attend with my bosses I had travelled down from the capital city with.

Past the store front in the first building and up the halls we were greeted by many smiling faces. One of the issues Dinali faces in improving production and developing the factory to be a competative market enterprise is that people seem to be too comfortable here.  Our tour guides brought us onto the weaving room where we were met by blaring music and many blind people in shades. We (the Secured Livelihoods Team) listened to the director’s facts and stats and subtly guided the passers by from bumping into the doorframes since we were taking up so much room and distorting the staff’s orientation with their workspace.  

The Bangwe Factory manufactures a wide selection of products from clothing, hand bags, hats, mats, etc. and supports the local economy by using locally produced materials whenever possible. The factory is also commissioned to screen print logos on uniforms and craft visions inspired by an up and coming fashion designer. Personally, I fell in love with vibrant hammock but there is something for everyone.

My 6’1’’, Bearded, Pathfinder Pops

My Grandparents, met in the Kenya Regiment during the Mau Mau Uprising in the 1950’s. They had my father in Eloret, Kenya and commenced a series of attempts to make a life for themselves at various sites through Northern and Southern Rhodesia and eventually back to South Africa where they raised their family of 5 children. They were not a wealthy family, to say the least, so the family worked side by side with the African farm labourers and became fluent in local languages. Living in the wrath of his rigid Afrikaans father my dad said that he loved boarding school because it was the only time he could rest and he dreaded school holidays. At 18, he was conscripted to the Equestrian Division of the military and god knows what shit was endured there. I only receive short cryptic versions and there are few fading black & white photos I have to refer to.

 In the eighties, my dad went to work at the South African Tourist Board Office in soft, sterile, politically correct Toronto. This is when he met the younger version of my gorgeous, free-spirited mother and so they lived between the US, Canada and South Africa for the next 9 years, dragging their shaggy New York City mutt over oceans and continents with them.  After which he returned to SA to live and has been operating tourism companies introducing wild Africa, its colourful cultures, languages and absurd circumstances that only the African continent can concoct to visitors from around the world ever since.

When I visit my dad we spend the majority of our time driving in a 1980’s Land Rover (although now days he has upgraded to a 1990 something) over great distances, perilous rock formations and sorry excuses for bridges in the shadows of Laurens Van der Post. We would last for days without refuelling the double gas tank or replenishing our water reserves below the body of the vehicle. My dad says that animals see tents as solid formations and as long as I zip it up tightly a lion would never drag me out, so I peacefully dozed to the symphony of hippos, lions, hyenas and zebras.

I celebrated one New Year’s Eve in Swaziland with my brother and my dad, squatting in the grass with a tin cup of white wine listening to the grinding teeth of a grazing bull elephant 10 feet from my toes. When the wind shifted behind us, the elephant smelt our presence it began to charge, I saw my brother’s true colours as we bolted and he pushed me aside to get a head start. The visit continued to be coloured by vibrant animal personalities including Elma the Lonely Ostrich who stalked us for 3 days making us fall for her (actually a he) persistent pursuit despite her hideous ‘Muppet from hell’ exterior, and Swazi the kitten we found and ended up smuggling over the border, who turned out to be half African Wild Cat and still lives with my little sister.

 Anyway, if you would like a similar, yet unpredictably distinct experience you should check out his website.


http://www.dundiditafrica.co.za/

A Dog Named Dog

Dog and his dog, Puppy.

I inherited these dogs with open sores on their ears that wouldn't heal in the damp of the rainy season and the constant biting from the flies. Many dogs’ ears here look like this here. But I tackle them to the ground everyday to put ointment on them and they are looking much better. I am so madly in love with Dog that if he weren’t such a filthly beast I would have him in my bed.

Clucky:

When a woman is feeling broody. This means that she is starting to see babies, and all that having one entails, in a much more positive light. She may start mentioning things like her ‘biological clock’ and maybe even do something as drastic as adopting hoards of children and starting a Branglina Style- Rainbow Family to satisfy her maternal urges.


Clucky like a mother hen. 

A Coming of Age Story

In 1997, my mom started fundraising to have a little boy named Roman come to Canada from a Belarusian orphanage, in order to have break from the contaminated atmosphere caused by the Chernobyl disaster (http://en.wikipedia.org/wiki/Chernobyl_disaster)  He was 7¾ years old, 3 days younger then my baby brother, when he first arrived; skinny, yellow skin, covered in warts and a pungent smell trailing him throughout the house. I swear he was radioactive. He showed up with a carton of Marlboro cigarettes and in the 35 degree heat, he would suck back a whole cigarette in 2 minutes blowing O’s. Only those of you who have previously smoked will know how painfully disgusting that is. Roman had elf like features with small eyes placed close to his pixy nose which was dwarfed by his gigantic ears, surely signs of Fetal Alcohol Syndrome. At first his face was flat affect, I am assuming from neglect. How can you learn expressions, if an adult isn’t constantly cooing in your face as an infant? Due to that neglect, he would suck his thumb and violently rock himself to bed at night.

 At 7 he was a harden criminal, who had to fight for clothes and food his whole life in that freezing cold orphanage. I don’t know what kind of education he received there, but within a day of arriving he could count to three in English and say ‘Mommie eat Tampax’. Roman quickly became part of the family calling our mother mommie and our step father Steve. Why would he call him dad if the other kids weren’t? For 6 years he would return to our home. My mom fundraised for the air tickets and had dentist and doctors donate their services. She navigated through the gruelling bureaucratic paper work to try to adopt him and just when we thought we had him the dictator put a stop to all international adoptions unless the child was disabled, because so many people were trying to escape the oppression. 2003 was the last year we saw him. He calls my mother all the time and she sends food, clothes and money and sometimes wonders if he is worse off he knows about how good life is here.

Now, I am living my dream working internationally, hard pressed to find anything that stresses me out. My brother, Jake is nearly 23 living like a hippy out of a van with his girlfriend in Australia and working for a famous artist. As for Roman, he was married and had a baby girl by the age of 19, was drafted into the Belarusian army and shortly after was arrested for ‘fighting’. He has spent the last 2 years in a 3^rd world jail. He is losing his English so it is difficult to know what really happened but I have read about the horrific acts committed in the army initiation practices, perhaps he fought back.

This is a portrait of me that he drew from his jail cell.