ZAMBIA: A snip in time can save lives

Lusaka, 16 March 2006 (PlusNews) - Fifteen year-old Chitambu Kalezyi recently came back from a month-long bush camp where he participated in the mukanda traditional ceremony, practiced by the major ethnic groups of the Northwestern province of Zambia.

The mukanda also known as circumcision camps, are traditional "schools" where local boys - aged from 12 to 17 - are circumcised.

"We were not only circumcised," Kaleyzi told PlusNews, as the ceremony involved tests of courage for the initiates and lessons on their future role as men and husbands.

The Lusaka-based teenager had travelled to his father's home village in Solwezi, the administrative capital of Zambia's Northwestern province, to be part of a group of school-going initiates during the school holidays.

The latest demographic and health survey shows that the Northwestern and Northern provinces have the lowest HIV prevalence rates in the country.

Back in the capital, Lusaka, where circumcision has never been a traditional requirement, more of Kalezyi's friends and even older men are now queuing to have the operation.

The growing popularity of circumcision has been attributed to research indicating that the old, if controversial, custom has shown signs of effectiveness against the spread of HIV.

More than 30 studies around the world have suggested that circumcision can offer some protection against HIV, but the first randomised, controlled study, recently carried out near Johannesburg, South Africa's economic hub, found that slicing off a man's foreskin appears to reduce his chances of contracting HIV by up to 65 percent.

Earlier this year, researchers in Rakai, Uganda, found that male circumcision also reduced the risk of HIV transmission to female sexual partners by approximately one-third.

Simon Hanyama, who was making an appointment for his operation at a clinic at the University Teaching Hospital (UTH) in Lusaka, Zambia's largest referral hospital, said he was motivated by hearing of these developments.

"We are seeing a lot of people coming for clinical circumcision. In fact, we now have a backlog," said Kasonde Bowa, a consultant at the Urology department of the UTH and an assistant dean in charge of post-graduate training at the University of Zambia's School of Medicine.

He noted that his department had performed over 400 circumcisions this year, and that the practice's impact on the spread of HIV across different populations has accelerated the demand for clinical circumcision.

The procedure is thought to work by removing the microclimate that exists under the foreskin, which can not only provide a comfortable environment for bacterial and fungal growth, but also an enabling environment for HIV to enter the body.

UNAIDS and the World Health Organisation (WHO) have been more cautious: "If male circumcision is confirmed to be an effective intervention to reduce risk of acquiring HIV, this will not mean that men will be prevented from becoming infected with HIV during sexual intercourse through circumcision alone. It will therefore be essential that it be part of a comprehensive prevention package, which includes correct and consistent condom use, behaviour change, and voluntary counselling and testing."

Dr Isaac Zulu, UTH's chief of internal medicine and an expert on HIV/AIDS treatment, stressed that "we promote circumcision because it reduces one's chances of being infected, otherwise it is not hundred percent fool proof".

Theme (s): Gender Issues,

[This report does not necessarily reflect the views of the United Nations]