our man in cameroon

The post below was never meant to be a post at all.  

It was originally written as a comment to a couple of earlier posts on the Global Health section at change.org. These covered the fact that apparently circumcision vastly reduces the chances of contracting AIDS. (Post 1 and post 2 and post 3)

The good people at Global Health then asked if I’d be okay with it becoming a post in its own right.  I was.

Following that I was also requested to post it here.

I have to admit I was a little concerned about the reaction to my post on the basis that I am none of the following things: a) a doctor, b) a scientist or c) a “real” development worker with that scary list of qualifications that even the lowliest  NGO jobs seem to  require.

But I guess the good reaction to date shows that a little local knowledge and experience goes a long way.

You can find me at Global Health here – my comment/post also cut and pasted below.

I’m not going to argue with the science behind these circumcision pieces. 

That’s not to say I either agree or disagree with it – I think the science is beside the point because this is not even remotely practical. I work for an organization in Cameroon that supports local villages in helping to stop the spread of AIDS while assisting people living with HIV/AIDS to hopefully have as normal lives as possible.

If you can imagine what we are battling with in terms of getting messages across – I have some issues with ABC (abstinence, be-faithful, condom).  Personally I’d go with condom, condom, condom and let people choose their own ideals – but I can work with this. Now even within that area I can show you this picture. This is proudly on display at a local Catholic church.  And people believe this stuff. Recently the Pope decided to pay this country a visit and told everyone that condoms were making the problem worse.

On top of that you have traditional healers – recently my boss told me of one that had claimed to have cured two AIDS patients. It turns out where it said “negative” on their medical records was next to Malaria not HIV. But these claims and rumors take hold. I haven’t seen it here but we’ve all heard African tales of how having sex with a virgin will cure you of AIDS.

People have sex with partners who they know to have HIV.  Even with the threat of being infected people take that risk. My point is this – there are already so many rumors and half truths and downright lies that people are entirely confused.

People are already willing to risk sex with people they know to carry the disease.  You start telling them a simply surgical procedure will make them less likely to contract the disease and it will soon be widely understood that you CAN NOT become infected if you are circumcised.

And how would that circumcision take place?  It’s not like there are mobile, sterile, clinics on hand.  How long before it becomes an extension of the body mutilation that is practiced here (not heard of female genital mutilation in this area but there is a practice of breast ironing which is quite horrific).

In other words – how long before circumcision is carried out by a traditional healer, witch doctor, family member etc – in entirely unhygienic circumstances? Hugely painful for an adult – hugely dangerous for a child.

I am saying this without any doubt at all – if you tell people that circumcision helps reduce the risk of AIDS then they will think they can have sex without danger.  The problem would get worse.

On top of that I do have huge ethical issues with this piece – and I do think that it has been treated relatively lightly.  Certainly if we were talking about female genital mutilation I am not sure if either the research, or the reporting of it in such a positive manner, would have ever occurred.

If you want to fight AIDS then you need foolproof methods.  It’s not enough to just lower the odds.  People here are already having sex with infected partners and taking the risk.  You cannot further encourage people to take risks.  Sexual practices have to be virtually 100% safe before people can be educated in such methods and ways of living.

And if we are unable or unwilling to provide the developing world with condoms and the consistent education to use them correctly – then why waste our time on circumcision – a less effective, more costly, more painful, more dangerous method?

This idea that – “say it won’t work but don’t deny the science” – is entirely beside the point.

If it won’t work it won’t work. So let’s move on.

Truth is there is already perfectly good, cheap ways to defeat the spread of HIV/AIDS we just have to stop the misinformation (much of it coming from the developed world) and commit to teaching the same methods and same practices.

There are already enough red herrings without introducing another one.

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This entry was posted on June 9, 2009 at 7:52 am and is filed under africa, cameroon. You can subscribe via RSS 2.0 feed to this post's comments.

Tags: africa, aids, cameroon, circumcision

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