Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
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New Vision (Kampala) - August 30, 2009
Irene Nabusoba and Halima Shaban
Baffled, he sought medical assistance at Kayunga Hospital. He was advised to get circumcised. "I do not know why my mother did not do it when I was a baby.
Circumcision is good for our health but my problem is the pain and the time the wound takes to heal. Six weeks of the healing period is long because every morning a normal man gets an erection.
I can not imagine feeling that pain every morning for that long," Mukisa says. Having learnt that circumcision could reduce his chances of contracting HIV/AIDS, he finally put his fears aside got circumcised at the Walter Reed Project in Kayunga.
Three randomly controlled trials conducted in Kenya, Uganda and South Africa show that circumcised men are less likely to contract HIV/AIDS through sexual intercourse.
In Uganda, this study was done in the Rakai Project. Speaking at the official launch of the mass Medical Male Circumcision (MMC) programme in Kayunga recently, Prof. Fred Wabwire Mangeni, the principal investigator said MMC in conjunction with the existing prevention programmes can significantly reduce HIV infection.
MMC is a surgical process that removes all or part of the skin that covers the tip of the penis.
The soft layer inside the skin that covers the tip of the penis is usually wet, keeping viruses alive and active. Removing the foreskin reduces the ability of HIV/AIDS from entering a man's body.
The programme that was supported by the Makerere University Walter Reed Project with funding from the US Presidential Emergency Plan for AIDS Relief was heavily attended by representatives from the Kayunga District Health Authority, Ministry of Health officials, and officials from the US.
Dr. Ahmad Matovu, the Kayunga Hospital superintendent says they have circumcised 320 men since February this year, adding that the numbers are overwhelming.
John Ssonko, one of the beneficiaries of the programme says: "I went for MMC because a friend told me MMC gives partial protection against HIV/AIDS. When done in hospital, one gets treatment free of charge until they get cured."
Matovu says given the convincing epidemiological evidence and biological support, routine circumcision should be highly recommended by health professionals.
"Not everyone can carry out circumcision. We trained over 15 medical, clinical officers and midwives in conducting the procedure which is largely considered a minor surgery.
We gave them training in counseling, HIV/AIDS testing and post-procedure care," he says. Matovu says if MMC is conducted in a hygienic environment and in accordance with the standard surgical procedures, complications are rare and very minor.
However, if the procedure is performed by untrained persons, under unclean conditions it can damage the penis or cause serious illness.
"After the operation, it is advisable to return for a check up before having sex," says Mangeni.
It is estimated that about one in every four men in Uganda is circumcised, though largely for cultural or religious reasons.
Dr Zainab Akol, the director, National AIDS Control Programme at the Ministry of Health hailed the initiative saying medical male circumcision is in the process of becoming a national policy.
"We have not finalised a national policy to guide the process but if it works for our people, then go ahead and do it," Akol says.
When passed, the policy that could take another year will ensure that males delivered in hospital are circumcised before the mothers are discharged. "Circumcision has social-sexual benefits and reduces sexual problems with age.
It has no adverse effect on penile sensitivity, function, or sensation during sexual arousal," Mangeni says. The Government is currently conducting an assessment to find out what would be needed to begin MMC on a wide scale.
The World Health Organisation and Joint United Nations Programme on HIV/AIDS have recognised circumcision as an important method to reduce HIV/AIDS infection.
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