Evans Chifamba believes that getting circumcised was the smartest decision he has made to protect himself and his partner from HIV and cervical cancer.
Chifamba, who was circumcised five years ago under Zimbabwe’s free voluntary male circumcision services, says he went through the procedure the first time he heard about its benefits. These include reducing the risk of female to male transmission of HIV by around 60 per cent, although the World Health Organization emphasises the importance of still using condoms.
“I have always been cautious of my health and, after learning about the benefits of getting circumcised, I had to protect myself,” says Chifamba who is a chef in Harare.
“At first I thought the medical procedure was targeting only those who are promiscuous since they are at high risk of contracting HIV but, through awareness campaigns, I realised that the procedure offers a lot of other benefits, such as protecting my wife from cervical cancer.”
On advantages of the procedure Chifamba says: “When I compare with the past in terms of hygiene, I am cleaner and more confident in myself.”
Voluntary circumcision campaign
Male circumcision is the surgical removal of the foreskin from the penis and is widely practiced globally for religious, cultural and medical reasons.
Doctor Shingirai Makaure, a medical practitioner, explains: “Research has proven that the HIV infection rate is low in cultures that insist on compulsory male circumcision.”
The revised Zimbabwe Policy Guidelines on Voluntary Medical Male Circumcision of 2014 estimated the number of circumcised men to be just 10 per cent. But in January 2015, Zimbabwe launched an ambitious US$100 million male circumcision programme which aims to get 80 per cent of Zimbabwean men (around 2 million men) circumcised voluntarily by 2018.
In order to increase male participation in circumcision, it will be provided alongside other male sexual and reproductive health services. But to achieve these ambitious targets, the government needs to ensure people have access to accurate information. According to the guidelines on male circumcision, “This shall entail broad community engagement, initially to introduce, and later to scale up male circumcision services.”
Zimbabwe has also introduced the non-surgical method of circumcision in some towns and centres. This consists of a device made of a plastic and rubber ring that stops the flow of blood to the part of the foreskin that is to be removed. After seven days the foreskin and the device are removed. Because this procedure can be performed by nurses, it means it can potentially be offered in many more places.
According to Makaure, the method is “more acceptable to men as it is proven to be less painful, blood-free and can be performed outside a surgical theatre.”
Contrary views about male circumcision
Although there is compelling evidence that male circumcision offers health benefits, some communities have mixed feelings about it.
According to research commissioned by the University of Zimbabwe and Ministry of Health and Child Care, there are various reasons why some men in Zimbabwe shun the procedure. These include fear of poor wound healing and fear of knowing one’s HIV status, which is one of the standard tests done when providing voluntary male circumcision.
Allenah, 27, who grew up in a polygamous family, argues that male circumcision is alien to his culture. “My father was not circumcised but lived a healthy life with his three wives. This is against our culture,” he said.
Eunice, a married woman from Harare, says she is not comfortable with her husband getting circumcised. She is concerned that the idea of “being safe” is likely to influence him to become sexually active outside of the marriage.
“I know these men. Once he knows he is safe he will start behaving like a bull. For me, I think it is better he stays this way [uncircumcised] as this is the only insurance I have against his wild behaviour,” she says.
Although such beliefs are common, there is no research evidence to suggest men’s sexual behaviour changes after circumcision.
Other Nathan Mutendi, a university student, believes circumcision is an unnecessary process as it is not as effective as wearing a condom when having sexual intercourse.
“I do not see the reason why I should get circumcised to protect myself from HIV and then later wear a condom which is proven to be more than 99 per cent safe,” says Mutendi.
But, as Dr Makaure explains: “There are incidents in which a condom is worn in a wrong way and, due to friction, breaks down. In such cases, uncircumcised men are at a higher risk than those who are circumcised.”
Importance of raising awareness
Makaure emphasises that poor perceptions about male circumcision are in most cases a result of wrong information spread in communities and there is need to dispel misconceptions.
To ensure a successful awareness campaign, there is need for exchange programmes in which circumcised men can share their experience and encourage those who have not taken part in the programme.
Brian Muzunze, a counsellor, says: “There is evidence to prove that men with circumcised friends are likely to be circumcised compared to those without a circumcised friend. Therefore, circumcised men are a strategic tool that, if well informed, can be used to share important and valid information about the procedure.
“Team leaders involved in raising awareness should educate, encourage and give circumcised men tools such as reading materials so that they take up the key role within their communities to encourage others to follow suit.”
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