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Luo elders say male circumcision cannot be introduced in the community

Luo elders to consult over ‘cut’

Published on April 22, 2008, 12:00 am

By Jack Nduri and Obote Akoko

Luo elders say male circumcision cannot be introduced in the community without consultation.

Luo Council of Elders chairman, Mr Riaga Ogallo, said the Government’s proposal could not be implemented without an agreement on the way forward.

“Anyone interested in circumcision should do so as an individual. NGOs are not allowed to undertake the initiative on behalf of the community until consultations are done,’’ said Riaga.

Early this month, the Ministry of Health recommended male circumcision following last year’s findings of World Health Organisation-sponsored studies in Kenya, Uganda and South Africa. The studies showed that circumcision offered up to 60 per cent protection against HIV.

The ministry launched a five-year pilot programme covering Nyando, Kisumu-East and Kisumu-West districts at Ahero Sub-district Hospital on April 1.

During a two-day workshop in Oyugis at the weekend, the elders said any change to Luo culture needed consultation.

The workshop co-sponsored by Nyanza Reproductive Health, Health Policy Initiative and Aphia Nyanza sought to introduce circumcision into Luo culture as a medical intervention to reduce the spread of HIV/Aids.

“We are neither contradicting the scientific findings nor rejecting male circumcision,” Riaga said.

He emphasised that if it was to be adopted by Kenyans for the sake of saving lives, a convention would decide for the Luo.

More than 30 elders attended the meeting in which Ministry of Health officials backed the male cut.

“We told the health experts to wait for the stakeholders’ meeting instead of asking us to give them the green light,” Riaga said. “This thing has not been in our culture. We must go easy on it,” he added.

At the meeting, the elders lamented that male circumcision per se was not the solution to the HIV/Aids pandemic, especially in Nyanza Province, which has had the highest prevalence rate.

Although HIV infections in the province have reduced (prevalence of 15 per cent in 2004), it is not yet out of the woods.

Dr Agot Kawango, the director of Nyanza Reproductive Health, said studies done in Kenya, Uganda and South Africa revealed that circumcision reduces chances of contracting HIV/Aids.

But elders said the Luo community would not embrace the method as a means to contain the scourge.

About 30 million people in Africa are believed to be HIV positive and more than 90 per cent of HIV infections in adults result from heterosexual intercourse.

One of the practices blamed for HIV/Aids prevalence among the Luo is wife inheritance.

This prompted WHO to select Kisumu as a centre for the research that was carried out by the Universities of Nairobi, Illinois and Mannitoba (Unim) Project under Prof Kawango Agot.

In the study, 3,000 HIV-negative men were circumcised and followed up for five years.

Among them, 54 per cent did not get infected with HIV.

In South Africa, male circumcision produced 60 per cent protection to men who were enrolled for the study while a similar trend was observed in the study at Rakai in Uganda.

Last year, the fourth international conference of the Social Aspects of HIV/Aids and Health Research Alliance took place in Kisumu. The conference was attended by 420 delegates from 40 countries. Prof Ndeye Niang, from Senegal, cautioned Africans against embracing wholesale prescriptions from the west without considering their anthropological and spiritual ramifications.

Niang said male circumcision could only be adopted as an intervention in controlling the spread of HIV/Aids after consultation with specific communities.

He said drastic cultural changes, even on the advice of experts, would fail if stakeholders in communities are not engaged.

A study by Dr A Kamau, in Central Province, revealed that adolescents were psychologically coerced into having unsafe sex after circumcision, a practice known as kwihura mbiro (wiping soot) in Kikuyu.

It was observed that older peers told new initiates to have sex with girls or die, fall sick or have the wound forever.

 


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About SG

Secretary general of Chama Cha Mwananchi. This blog www.chamachamwananchi.wordpress.com, is based in Sweden.

Discussion

2 thoughts on “Luo elders say male circumcision cannot be introduced in the community

  1. Your article has some serious errors. You say, “In the study, 3,000 HIV-negative men were circumcised and followed up for five years.”

    No, 1,391 were circumcised and 1,393 were left intact (“controls”). 87 circumcised men and 92 controls were “lost to study”, their HIV status unknown, creating an uncertainty much greater than the supposed benefit.

    They were followed up for two years, not five, but the study was cut short (it was not thought ethical to carry on – though it was thought ethical to test men for HIV and not tell them they had the disease) and now we will never know what the long-term outcome will be.

    “Among them, 54 per cent did not get infected with HIV.”

    No, 22 circumcised men and 47 controls got HIV – that is the basis of the claim of 54% relative risk reduction. The absolute risk reduction (IF circumcision is actually responsible) is only 1.79% (from 3.37% to 1.58%).

    They ignored men who said they hadn’t had sex, preferring to assume that sex was responsible for all infections, yet we know there are several other ways, especially injection with dirty needles. One possiblity for several is infection from the circumcision itself.

    Bravo to the Luo elders for urging restraint! We need to know much more about these studies before using them as a basis for action.

    Posted by hugh7 | April 23, 2008, 10:15 am
  2. If the Ministry of Health is recommending male circumcision, they would be foolish to not wait for detailed descriptive statistics on the present state of AIDS in the region, carefully compiled for various demographics. How will they know if the initiative was a success or failure?

    The studies which the W.H.O. is relying upon were carried out by long-time circumcision justifiers. None of the studies was double blinded. All of the studies were halted prematurely while the rates of infection among cut and uncut were still converging following the cut men’s post-surgical period of abstinence.

    It is very unlikely that circumcision indeed fights AIDS. Most of the dead US men who suffered from AIDS were circumcised at birth. In non-circumcising Japan, AIDS is more rare than in 95%-cut Israel. In several African nations (e.g. Cameroon, Ghana, Lesotho, Malawi, Rwanda, Tanzania) the AIDS rate is markedly higher among the circumcised population.

    When people are given the message that circumcision can protect them from HIV, and then you amputate over half of their sensual nerve endings, what are the chances that they will use condoms? What are a woman’s chances of inducing her partner to use a condom? What is the W.H.O.’s opposition to condoms?

    Posted by tlctugger | April 23, 2008, 4:48 pm

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