Men urged to go for circumcision to protect against HIV

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Rundu

Kavango East health director Timeya Ngwira has called on boys and teenagers, aged 15 years and up, who are uncircumcised to get circumcised during the voluntary medical male circumcision (VMMC) ‘holiday special’ programme.

According to her the campaign forms part of the ministry’s overall goal of seeing an HIV-free generation.
“The region has adopted the male circumcision strategy as part of a comprehensive HIV-prevention intervention package and it is available to all males who voluntary request it,” Ngwira, who is the health director for the two Kavango regions, said.

Medical male circumcision involves the surgical removal – under local anaesthesic – of the foreskin covering the head of the penis. This medical procedure makes it less painful than severing the foreskin by traditional means.
Medical male circumcision is performed in a sterile setting by trained doctors and nurses. The operation typically takes between 20 and 30 minutes. There may be some bleeding and a little pain, but that is all.

“They make sure that the whole skin is removed, because the skin is where the problem is. The membrane, which is in the skin, is where the virus easily gets attached to. That is the part of the skin which is being removed, so even if a small piece is left on the skin then the virus can get attached. That is why we encourage people to get circumcised at the hospital, because our professional staff will ensure that the whole membrane is removed, unlike the traditional way of doing circumcision,” Ngwira explained.

She said circumcised men are less likely to become infected with HIV compared to uncircumcised men, with the reduction in risk estimated at 60 percent. “Research has found that male circumcision could reduce the risk of HIV-transmission from women to men considerably,” Ngwira said.

She further said that between 2009 and 2013 the two Kavango regions circumcised only 3 514 men, which is far below the targeted 12 800 men that should have been snipped during that period.
“Our target for 2015/2016 is 5 920 and out of that only 1 910 men were circumcised [thusfar], which can be translated to 32 percent. So, in our quest to increase male uptake in the programme, we are conducting a ‘holiday special’ and we’re calling upon all men, aged 15 and above, to come and get circumcised, as our overall goal is aimed at the realisation of an HIV-free generation,” Ngwira said.

“This is a holiday special campaign, but we always advise people to participate throughout the year. People should not think that this can only be done in winter; we operate in our hospital all year round and people do heal, so they should come. Especially during the school holidays we urge the boys to come in, because then they cannot be disturbed when it comes to school, this is a longer holiday and they should visit our health centres,” she advised.

According to Mbunga Tughuyendere, the voluntary male medical circumcision (VMMC) regional coordinator for the two Kavango regions, they have selected health facilities where they will conduct the VMMC and they want people to go and book for the VMMC procedure in advance.

“But people who have not booked can also come, provided they come early, because we will be guided by the number of people present at health facilities,” Mbunga said.
Mbunga further emphasised that people who plan to go to a hospital or clinic for the VMMC programme should bring along their health passports. If they do not have any, they will be given new ones, as hospital staff have to record all the medical procedures.

“We have a problem with some people who come without health passports. It is very important, because when you cut [someone] you need to do a thorough examination. We start by checking the records of the patient [to see] what are the underlying conditions the patient has, so that at least we are at liberty to say: ‘We have made a sound decision to cut that person.’”

“Some people have a fear that the wound won’t heal because of the scorching heat, but in the hospitals we are doing major operations. It doesn’t matter what season and people do get healed. This procedure is a minor one so they should not worry,” he said.

HIV-positive patients, who are on treatment can also be circumcised after a thorough medical evaluation that will exclude other underlying conditions, such as bleeding disorders, untreated STIs (sexually transmitted infections) or low CD4 counts, and should thus be certified as fit for the procedure.
Some of the selected health facilities in Mukwe Constituency include Andara Hospital, Omega Clinic, Divundu Clinic, Divundu Correctional Services Facility, and in Ndiyona Constiuency the service will be offered at Nyangana Hospital and Mabushe Clinic. In Rundu it will be done at Rundu Hospital, at the VMMC Clinic and in Nkurenkuru Constituency at Nkurenkuru Health Centre, Mpungu Health Centre and at Nankudu Hospital, while in Musese Constituency the VMMC procedure will be offered at Rupara Health Centre.

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