Monday, December 01, 2008

The Independent should expect letters

The kindest cut: How circumcision is the secret weapon in the battle against HIV/Aids - The Independent

Here's a long article about the success of circumcision in Africa as a preventive step to dramatically reduce HIV transmission:
Flooding Africa with condoms and trying to change sexual behaviour has had little demonstrable impact. Research on an Aids vaccine has foundered and an effective microbicide is still not in sight.

The toll from the disease is staggering – an estimated 33 million people infected with HIV, and 25 million dead. Even more alarming, however, is that new infections are growing by 2.7 million a year, outnumbering the annual two million deaths. For every two people put on drug treatment, five more become infected.

Against this litany of despair there is now, for once, a message of hope – a chance of curbing, and even reversing, the epidemic. Circumcision, if rolled out across the continent, offers the first real prospect of saving lives by preventing infection on a significant scale. Estimates suggest that if universal circumcision were introduced across sub-Saharan Africa, it could prevent 300,000 deaths in the next 10 years and three million deaths over the next 20 years. It is sometimes described as a "surgical vaccine" – with good reason.

What's the bet that this will still not satisfy the very strange anti-circumcision movement, the believers in which will no doubt be writing letters to The Independent this very minute.

3 comments:

Mark Lyndon said...

What's so strange about a movement to stop parts of children's genitals being cut off? It's far stranger that anyone would want to do it in the first place. It's even more important now that resources in the fight against AIDS are being diverted from things that work to things that don't. There is no doubt in my mind that promoting circumcision will result in more deaths from AIDS not fewer.

If circumcision was so effective, then why are there six African countries where the circumcised men in those countries are more likely to be HIV+ than the intact men in those countries?

Circumcision can only possibly help men who have unsafe sex with HIV+ partners, so why this bizarre obsession with genital surgery when we know that ABC works better than circumcision ever could? (ABC=Abstinence, Being Faithful, Condoms).

The studies which allegedly show a reduction in HIV among circumcised men are highly questionable. Not one of them was finished, despite the protective affect appearing to decline well below the oft-reported 65%, and several of the subjects disappeared. The fact that one study described circumcision as "equivalent" to a "vaccine of high efficacy" seems to show clear bias. They appear to have been seeking a certain result. One has to wonder how many of the people promoting circumcision in Africa are themselves circumcised. Many of them have been promoting circumcision for years for a variety of different reasons.

Other epidemiological studies have shown no correlation between HIV and circumcision, but rather with the numbers of sex workers, or the prevalence of "dry sex".

The two continents with the highest rates of AIDS are the same two continents with the highest rates of male circumcision. Rwanda has almost double the rate of HIV in circumcised men than intact men, yet they've just started a nationwide circumcision campaign. Other countries where circumcised men are *more* likely to be HIV+ are Cameroon, Ghana, Lesotho, Malawi, and Tanzania. Something is very wrong here. These people aren't interested in fighting HIV, but in promoting circumcision (or sometimes anything-but-condoms), and their actions will cost lives.

Circumcised male virgins are more likely to be HIV+ than intact male virgins, as the operation sometimes infects men.

The latest news is that circumcised HIV+ men are more likely to transmit the virus to women than intact HIV+ men (even after the healing period is over). Eight additional women appear to have been infected during that study, solely because their husbands were circumcised.

Female circumcision seems to protect against HIV too btw, but we wouldn't investigate cutting off women's labia, and then start promoting that.

Africa hasn't been "flooded with condoms" btw. In Malawi for instance, only 57% know that condoms protect against HIV/AIDS, and only 68% know that limiting sexual partners protects against HIV/AIDS. There are people who haven't even heard of condoms. Btw, Malawi is one of the countries where circumcised men are more likely to be HIV+ than intact men (13.2% v 9.5%). It just seems really misguided to be hailing male circumcision as the way forward. It would help if some of the aid donors didn't refuse to fund condom education, or work that involves talking to prostitutes. There are African prostitutes that sleep with 20-50 men a day, and some of them say that hardly any of the men use a condom. If anyone really cares about men, women, and children dying in Africa, surely they'd be focussing on education about safe sex rather than surgery that offers limited protection at best, and runs a high risk of risk compensatory behaviour.

Steve said...

Ahem. I would like to point to readers that the above comment was made within 30 minutes of the post.

Anonymous said...

From another Blog:

Of creed, colour and a clamp

I'll start off with the clamp first.

It is now the school holiday season here in Malaysia. During this time, Muslim parents who have young sons are planning for the `rites of passage' ritual for their boys. It is circumcision time... an anxious time of their life for the young boys. Sometimes the parents, especially the moms, are filled with anxiety and worries too.

The process of circumcision has changed a lot. The trade of the traditional Tok Mudim is dying away as most parents nowadays send their sons to private clinics. Doctors can even now offer their young patients the option of using circumcision clamps as opposed to the standard` snip and stitch' method. The clamp is a device that helps simplify the process because there is no need for sutures or dressings. The cut also tend to heal faster.

I've read some negative reviews about this particular method but having chosen this option for my youngest son's circumcision a few years ago, I can attest to its advantages. The clamp method is now widely used in Malaysia and some other developing countries. Not many people know that this device, commercially known as the Tara Klamp, was invented by a Malaysian doctor.

We'll come back to this subject a little later. I want to touch now on the subject of creed and colour.

Creed and colour relates to religion and race. In Malaysia, these two issues are so intertwined in the fabric of society and hardly a day pass by without something about race or religion being discussed in the mainstream media. The last few weeks have been no exception. I'm of course, talking about the decision of the National Fatwa Council regarding yoga.

Many blogs have touched on this issue and I do not wish to delve too deep into the merits of the decision itself. I just wish to share my observations based on what has been reported in the papers and the views and opinions of other bloggers. So here goes, in simple point form :

1. The National Fatwa Council cannot issue a fatwa or edict that is enforceable nationwide. Jurisdiction on Islam is a state matter.

2. The practice of yoga is not haram as long as it is not accompanied by mantras or chants that equates with the divinity of Allah swt.

3. The announcement by the council is a case of poor planning and foresight. Otherwise the Prime Minister and some Sultans would not have seen fit to publicly give their views on the matter.

4. The announcement has caused over-reactive response from both supporters and detractors. The response has come from non-Muslim individuals and communities too.

I do not think that this is the end of the story yet. I believe the Council could have handled this issue in a much better manner. While I appreciate their intent in issuing the directive (primarily that the Muslims who perform yoga do not become deviated in their faith - terpesong dari aqidah), they could have adopted a more thoughtful approach. The Gazer of Navels has an excellent example of how it could've been done -> here.

As I've said, many non-Muslim groups and bloggers have entered the discussion on this directive. This has prompted some Muslim groups to react by saying that `This is none of your business!'. Many Muslims are even chiding other fellow Muslims for questioning the ruling.

In my view, when it comes to issues like this, we Muslims cannot prevent non-Muslims from airing their opinions. Malaysians are not an exclusive society of this or that race only. What ever happens to one race could affect another... it's just a question of degree. We cannot fault our non-Muslim friends from showing their concern. What's important is the way this concern is raised... again we are back to the question of approach.

Similarly, Muslims cannot hold on to the position of exclusivity. By shutting out discussion, we are hindering the process of understanding. If we wish to attract other people to our religion or at least to understand it better, we should be encouraging interaction rather than building walls. We have to recognise that opinions and efforts of individual non-Muslims have their merits too.

Which now brings me back to the story of the humble circumcision clamp. After sending their sons to be circumcised using the clamp method, not many Muslim parents realise that the inventor of this device is a non-Muslim doctor. Dr Gurchran Singh won the Gold Award for his invention at the Geneva Exhibition in 1996.

Dr Gurchran donated thousands of his clamps to the young boys of Acheh in the aftermath of the tsunami. It's simplicity of use meant that the clamp was ideally suited to the non-hospital environments available in Acheh. This story of the good doctor helping out our neighbours in need was recorded by the Discovery Channel. Something that all Malaysians can be proud of.
Posted by Oldstock at 1:32 PM