Global prevalence of circumcision in 2007…soon the whole of Africa will likely be entirely red with the 38 million planned circumcisions under the seriously flawed HIV prevention strategy

Sub-Saharan Africa is now the focus for this flawed HIV prevention strategy with 8 non-African organizations supporting this mass circumcision campaign…5 from the US (Department of Defense, USAID, Gates Foundation, CDC, and Office of the US Global AIDS Coordinator) and 3 international organizations (World Bank, WHO, and UNAIDS). The fact that the United States is so committed and instrumental in this agenda with 5 organizations suggests American pro-circumcisionsts’ involvement. The plan proposes that donors and governments spend $1.5 billion to circumcise a total of 20.3 million men in 16 countries by 2015, to achieve 80% circumcision among men aged 15-49 years. The 16 target countries are Botswana, Central African Republic, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe. The extensive planning across all of these nations to set in place the infrastructure required for such a major undertaking is staggering, and the cost involved could have best been spent in the distribution of condoms and Anti-Retroviral Therapy for HIV prevention for those people living in sub-Saharan Africa.

The invention of several new disposable circumcising devices to implement this initiative in sub-Saharan Africa were brought into play to fulfil this goal. Two devices gained the WHO’s endorsement, and these are the Israeli ‘Prepex’ and the Chinese ‘Shang Ring’, both of which are glorified tourniquets. When applied both will cut off the foreskin’s blood supply until the tissue dies, causing it to shrivel up, when it is then cut off and removed a week later, to reveal a circumcised penis. The makers of Prepex boast the claims that “there’s no blood, no stitches, no injection, very little or no pain”, whilst those of the Shang Ring claim that “the device can all round meet the medical requirements of safety, minimal invasion, easy performance and cosmetic results in modern circumcision”. Both manufacturers seem to trivialise the foreskin, making it sound redundant as if it were an obsolete piece of skin. Neither ever mentions the benefits of the foreskin, instead promoting the reduced chances of acquiring HIV. But that’s to be expected since the promoters of this strategy Bill Gates, the U.N and the World Bank have their agenda to implement. However it’s the average and poor men and women in the streets, towns and villages of sub-Saharan Africa who, being reliant on their community leaders to advise them on health promotional strategies who are the innocent victims of this flawed initiative. They’re being bombarded with the ‘Get Circumcised’ for free campaign and are generally succumbing to the relentless campaign being imposed on them, because they trust that they’re being given correct advice. However, as a disclaimer it is claimed by Prepex that “male circumcision provides only partial protection and therefore should be only one element of a comprehensive HIV prevention package which includes the provision of HIV testing and counseling services, treatment for sexually transmitted infections, the promotion of safer sex practices, the provision of male and female condoms and the promotion of their correct and consistent use”.

The two companies making the disposable circumcision devices stand to reap huge financial rewards from this undertaking. The Prepex devices cost $20 per disposable unit whilst the Shang Ring costs $18.21 per disposable unit.  That’s 20 million or so men which makes it a minimum of $364 million for purchasing the Shang Ring and $400 million for the Prepex. One would have to question the process of tendering for these products and the ‘ethical’ discussions which would have needed to take place to get these products through their standards and safety testing periods. On top of the cost of what the manufacturers of these plastic rings are demanding, there’s the human element cost required in the employment of doctors, nurses, theatre assistants etc to implement the procedures. Wouldn’t these health professionals best be used to treat serious health problems, instead of circumcising men unnecessarily?

The following is a direct quote from a research article entitled ‘Cost analysis of integrating the Prepex medical device into a voluntary medical male circumcision program in Zimbabwe’: “The routine surgery site had a four-bed capacity and employed one medical doctor, six nurses, three theatre assistants, and one receptionist. The doctors had overall responsibility for the surgical procedure, provided local anesthesia, removed the foreskin, stopped bleeding either using sutures or electrocauterization, and attended to post-operative complications and treatment of adverse events involving wound revisions or severe infections with abscesses.” This report seems to contradict Prepex’s claims that “there’s no blood, no stitches, no injection, very little or no pain”…and yet here is written evidence that a doctor had to administer anesthesia, stop bleeding and attend to post-operative complications and treatment of severe infections with abscesses, which sound like quite serious complications and not what was being promoted in their sales pitch.

COMPLICATIONS…All’s not as it’s claimed by the manufacurers of Prepex that “there’s no blood, no stitches, no injection, very little or no pain”… From these photos it seems that there are serious complications for many men who undertook the ‘Get Circumcised’ campaign

The photos to the left show that there are indeed serious complications which do arise from the use of disposable Prepex devices. At the 20th International AIDS conference in 2014, a presentation was given on the ‘Unusual complications following adult male circumcision using the Prepex device’. The following is a direct quote of the ‘lessons learned’ from a study of PrePex for Male Medical Circumcision among 427 men age 18-49 in western Kenya:

“1) We observed 5 device displacements. Depending on when during the 7-day wear period these occur, they can be dire and require urgent intervention for surgical completion of Male Medical Circumcision (MMC).
2) We observed 3 cases of early sloughing of foreskin tissue. These may not imperil the man, but the appearance is disturbing.
3) We observed 2 cases of a long foreskin obstructing urine flow as it became necrotic.
4) We observed 9 cases of insufficient foreskin removal, caused either by invagination of foreskin tissue under the device, or by asymmetrical marking of the circumcision line prior to device placement. Insufficient foreskin removal is noted at Day 7 device removal, and may require surgical completion, depending on the amount of residual foreskin and client preference.”        

Nobody seems to talk about the human factor cost of these cases ‘gone wrong’ as it’s not in the interest of the promoters of this campaign to do do. But what about the anguish, worry, physical and emotional pain caused to those individuals who find themselves with complications. What compensation do these men receive, if any, for having their penises damaged and possibly become dysfunctional from these botched circumcisions? What will Bill Gates do about these men’s penises which were perfectly functional before having been damaged by these supposedly researched and ‘safe’ devices? What happens to those people whose lives get wrecked and ruined in this almighty, so called ‘altruistic’ undertaking? What will the WHO do about it?

VMMC – Voluntary Medical Male Circumcision promotion

Since 2007 the goal to circumcise more than 20 million men, 80 percent of 15-to-49-year-olds, in 16 African countries, by 2015 has been in place, but as already mentioned this goal has fallen behind schedule. There is also an agenda to mass circumcise infants and male children across those same countries as the 15-to-49-year-olds. The following is a direct quote from the introduction of the U.N’s publication WHO Technical Advisory Group (TAG) on Innovations in Male Circumcision: “By the end of 2013 a cumulative total of 5.8 million circumcisions, out of a target of 20 million, had been performed. Of those, 2.7 million were performed during 2013. As of end 2014 a provisional estimate of an additional 2.2 million male circumcisions had been performed, with a cumulative total of 8 million. Most countries have focused on circumcising males 15–49 years old as part of the catch-up programme. Several countries, however, have considered how to move to sustaining a high prevalence of male circumcision by offering circumcision to annual cohorts of adolescents and infants. This transition has implications for the TAG’s work, which in the future will turn towards the safety and acceptability of male circumcision innovations in adolescents.” Whatever way it’s looked at, the future of sub-Saharan African foreskins looks bleak. If adults seem to be reluctant to get their foreskins cut off, then the plan seems to focus as usual on those who cannot give consent nor fully understand the implications of not having a foreskin…the babies, children and adolescents. It would appear that the U.N seems complicit in it’s ambivalence over its own charter on the ‘Convention on the Rights of the Child’ and the circumcision of babies, infants and children, which this campaign targets, as a staggering physical, ethical and moral contradiction of its role as a benevolent and altruistic organisation.

Using women to coerce men to get their foreskins cut off through a harassment campaign

The circumcision campaign promoters have been using women to influence men through means of coercion to go get circumcised. For some time, programs like PEPFAR (President’s Emergency Plan for AIDS Relief – United States) have been trying to sell circumcision as “beneficial to women”. Actually, research shows that women are 50% more likely to acquire HIV from a circumcised partner, but this information doesn’t get mentioned. In sub-Saharan Africa, women constitute 60% of people living with HIV, according to the WHO. Circumcision promoters, however, still insist that male circumcision eventually benefits women “because less men being infected with HIV means less women will be infected.” To be quite sure that women will be interested in making sure their partner is circumcised, other claims are added into the mix, such as a claimed reduction in HPV, which affects women, and other STDs. Actually, studies are conflicting regarding the HPV claim. But now, it seems, circumcision promoters are through with trying to use pseudo-scientific alibis to get women to influence the men, and are now turning to flat-out harassment and coercive bullying. (http://joseph4gi.blogspot.co.uk)

As of December 2014, over 9 million medical circumcisions had been performed in the priority sub-Saharan African countries. Recently, there has been a particularly rapid scaling up in Voluntary Medical Male Circumcision with 3 million circumcisions performed in 2014 alone. Despite this progress, it is unlikely that the ambitious target of 20.8 million circumcisions by 2016 will be reached. The new UNAIDS Fast-Track strategy demands that an additional 27 million men are circumcised by 2020 on 2014 levels.

Female Genital Cutting awareness in Uganda…but what about Male Genital Cutting? What about the hundreds of male deaths that occur through MGC in Africa each year?

The mass male medical circumcision plan for sub-Saharan Africa sends an strong, contradictory and ironic mixed message because it is in direct opposition to the Female Genital Cutting (FGC) programme which the WHO currently promotes. On the one hand the U.N is promoting FGC as wrong, unacceptable and needing to be eradicated whilst on the other it’s actively promoting Male Genital Cutting (MGC). So the message is don’t interfere with female genitalia but it’s okay to interfere with male genitalia. It would seem that the U.N is giving a very confused and mixed message which invalidates the cutting off of foreskins as a HIV prevention strategy. For certain FGC is utterly wrong and unacceptable, but so is MGC. There seems to be a major disregard for male pain and suffering through the sexual torture of cutting off foreskins because it’s been seen for quite a long time that male genital cutting is okay and acceptable. This simply reflects the general ignorance and lack of understanding concerning the foreskin, which is considered unnecessary by many African cultures who already circumcise their males. This double standard of condemning FGC and yet condoning MGC highlights the WHO to be confused and unreliable on this situation which in direct contravention of Article 19 (Protection from all forms of violence) of the U.N’s ‘Convention on the Rights of the Child’. How ‘humanitarian’ and ethical is it for the World Health Organization to send the message that African men and women shouldn’t enjoy the pleasures derived from foreskins, because they don’t need them.

Between 65 to 75% of Africa is already circumcised with the pre-dominance of African Islamic nations and those nations who circumcise males for ‘cultural’ and ‘Rite of Passage’ reasons. And now those African men who possess foreskins have being targeted to have their foreskins cut off, under the guise of HIV prevention. This flawed and deceptive strategy becomes yet another campaign to prevent men and women from enjoying the foreskin. The use of condoms and Anti Retroviral Therapy ought to be the way to deal with HIV in sub-Saharan Africa…not circumcision. The current campaign to circumcise African boys and men can only succeed if sub-Saharan people accept it. To say an emphatic no to this agenda and resist the circumcisionist agenda is what’s required, thus exercising the will and the right to say “I’m keeping my foreskin”. So sub-Saharan African men keep your foreskins and don’t get circumcised, because once it’s cut off, you cannot get it back and your penis will never, ever experience the blissful sensations and enjoyment that the foreskin provides and it will never be the same again…and you will undoubtedly regret your decision. Resist Circumcision.