Monday, 23 October 2017

Medical circumcision: Hamukale’s experience

WHEN the call from the provincial administration here in Choma came that Southern Province Minister Edify Hamukale wanted to meet with journalists at his office, it wasn’t surprising.

In fact, some of us here were excited, especially knowing how the flow of news gets slow here.

Dr Hamukale is naturally a media-friendly person. 

The journalists, both from public and private media organisations, convened in his office, armed with their tools that ranged from notebooks, voice recorders and also video camera, ready to capture whatever pronouncement the provincial minister was about to make.

Then he quipped: “Now, I don’t know whether I should say this in front of Joy Sakala.” He said this in reference to a Zambia News and Information Services (ZANIS) cameraperson who was standing in front of him with her video camera pointing at him.
At that point, we then wondered what this particular press briefing was all about.He continued joking that if it were up to him, he would have felt more comfortable saying whatever he wanted to say before male scribes. But he is not that gender-insensitive and perhaps understands that today’s newsrooms aren’t either. He wittingly went on regardless, of course with a little humour to publicly declare that he had been under the knife.“I wish to publicly declare that I am circumcised. It looks very clean and I am bad news. I am just urging boys not to shun it [circumcision] because of peers,” he said.Dr Hamukale, whose wife is a nurse at the University Teaching Hospital (UTH), did not, however, disclose when he went for the surgical operation, which takes less than ten minutes. He said he decided to go public with the hope of encouraging people and to demystify the myths surrounding Voluntary Medical Male Circumcision (VMMC).
Indeed, there are a lot of myths. Others believe that circumcision reduces the chances of having children. Others also fear to be among the few cases of an operation gone wrong, while others are made to believe that they should be as they were born – any alteration on their body is regarded as sinful and against biblical teachings.But all those are mere myths. Dr Hamukale says in accordance with Government’s policy of employing preventative measures in disease control of HIV/AIDS and also cervical cancer, boys must not shun male circumcision, more so when the benefits outweigh the risks based on mere falsehoods.Before throwing the challenge onto his fellow law-makers and ministers, the provincial minister, who has since made himself available for any adverts aimed at championing the cause, says the exercise is in fact beneficial.“Consult your partners even. Fortunately for me, my wife is a nurse, so it was a lot easier. Well, who are we to refuse? Because it’s your wife’s toy anyway, so it makes sense that you consult her,” he says. He adds, “At least I also got to know my HIV status since before the operation, you are counselled and tested.”Dr Hamukale is of the view that if more prominent people come out to speak openly about male circumcision, a lot of people would be encouraged to follow suit.Well, at least he won’t have to worry about his deputy permanent secretary, Douglas Ngimbu, because he always does that at every public function he officiates.Mr Ngimbu, who hails from North-Western Province, says the practice which in his native is literally a must for all boys, does not only promote hygiene, but also plays a great role in protecting oneself against sexually transmitted diseases and it helps prevent cervical cancer in women.“I am a champion for medical male circumcision. I always spare time to talk about MC. It is very important that every man and boy does it because the benefits are just too many,” he says.The Ministry of Health has circumcised over 40, 000 men and boys across the country in the second phase of the on-going voluntary medical male circumcision campaign. Over 140, 000 boys and men were circumcised in the first phase.Ministry of Health permanent secretary for administration Kennedy Malama was recently quoted in the media as saying that the ministry intends to circumcise well over 162, 450 boys and men in all the 10 provinces in the campaign.All this is in an effort to reach zero new infections and ultimately end AIDS by the year 2030.“We have currently circumcised 45, 000 men and boys. For the April campaign, our target was 108, 002 and we managed to circumcise 147, 682,” he was quoted as saying.The Ministry of Health has dispatched health personnel to set camps at health centres and health posts to not only circumcise people, but also sensitise and educate them on the benefits that come with it. One such health centre is Makoka Rural Health Centre in Chibombo district.“In just within three days of setting up camp, the team here has counselled, tested and circumcised 45 boys and men in the on-going campaign. What’s even better is that these people are coming on their own. We expect the number to increase as time goes on,” says Zapali Mwittah, a community health assistant at the clinic.She says before the surgical operation, people are also tested for HIV and those found with the virus are put on treatment, as per new government policy of ‘test and treat’.In Choma, five health facilities have since embarked on a one month intensified campaign for HIV counsel, test and treat during which males are being encouraged to seek voluntary medical male circumcision services.“We are encouraging a lot more men to take up this bold step because it goes well with the new approach that Zambia has taken in the fight against HIV/AIDS,” says Carlistus Kayuunga, the district health director.The World Health Organisation (WHO) says medical male circumcision reduces the risk of female-to-male sexual transmission of HIV by approximately 60 percent. Since 2007, the WHO and UNAIDS have recommended voluntary medical male circumcision as an additional important strategy for HIV prevention, particularly in settings with high HIV prevalence and low levels of male circumcision, where the public health benefits will be maximised.Fourteen countries in eastern and southern Africa with this profile have initiated programmes to expand male circumcision, Zambia being one of them. Medical male circumcision offers excellent value for money in such settings.It saves costs by averting new HIV infections and reducing the number of people needing HIV treatment and care.A one-time intervention, medical male circumcision provides men life-long partial protection against HIV as well as other sexually transmitted infections. It has been considered as part of a comprehensive HIV prevention package of services and is being used in conjunction with other methods of prevention, such as female and male condoms.

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