Russian roulette

Governments in Africa have recently embarked on a vigorous campaign advocating male circumcision through public initiatives by both governmental and non-governmental organisations. Huge billboards with pointed messages encouraging circumcision have been erected everywhere. Similar advertisements in both the print and electronic media are being played quite frequently. This was occasioned by recent studies that concluded that male circumcision can reduce the “chances” of contracting STIs particularly HIV/AIDS by around 60 per cent. That is a very significant statistic because it means that a uncircumcised male is roughly three times more likely to contract an STI than a circumcised male if both are engaged in unprotected sex with infected partners.

I don’t think these numbers make any sense to most people. It would be quite interesting to know how these empirical studies were carried out and how the conclusions were reached.

Granted, there are some provable and veritable benefits of male circumcision but they are not the motivation of the governments’ campaign. Not least, it is self-evidently more hygienic and it also does indeed reduce the probability (emphasis on probability) of getting infected by STIs just as much as wearing a seat belt in your car reduces your chances of getting killed in a collision with a train.

Rite of passage

Many African traditions require circumcision of young males as a rite of passage albeit the intentions and methods of initiation are very questionable. Western governments also encourage circumcision of their males at a young age. Perchance it could be one of the reasons why they have lower rates of infection in their societies. Jews are also obliged to get circumcised as part of the requirements of the Mosaic ceremonial laws.

Coming to the current thrust by African governments, there is very inadequate education on the pros and cons of male circumcision. There is a great danger that African governments could be taking one step forward and twosteps back. As virtuous as it is to encourage male circumcision, if it is not coupled with good education especially on the health benefits inherent, it will be ineffective. Many people on the streets have a dangerous perception about circumcision vis–vis its preventative capabilities apropos HIV. Many now hold certitudes that circumcision is a scientifically proven effective barrier to the virus. The chance and probability statistics upon which the campaign is premised have clearly made no sense to many people. To many men, it is a vindication to get circumcised and then lose all worries about getting infected regardless of sexual behaviour. It is a clear licence to go out and indulge one’s concupiscence with a scientifically cleared conscience. As historically self-imposing creatures of instinct and sexual impetuosity, some men were not very happy with having to change their promiscuous sexual habits due to the risks posed by HIV/AIDS. Because of the ostensibly proven efficacy of circumcision, they can now literally have their cake and eat it.

Some traditionalists have found a conceited justification for extolling and asserting the superiority of their own cultural traditions that have long advocated circumcision. That erroneous mentality about the effectiveness of circumcision is spreading cancerously especially among people who were already sceptical of artificial barrier methods like condoms. Some of those embracing it are also being influenced by fables about how circumcised “Zulu” men do not get infected by HIV.

Fuelling the fire

The South African President’s publicized sexual exploits and HIV status have done quite a bit in fuelling that fire. And governments in their desperate efforts to stem the tide of the disease have not really paid enough attention to all the aspects and implications of their new campaign. The benefits of circumcision are now so overrated that many circumcised males are going to be reckless in their behaviour because they now wrongfully believe that it is some kind of a bullet proof superman suit. The concomitant education has been at best airy on what the probabilities mean or downright misleading. Despite the good intentions behind the campaign, circumcision IS NOT a panacea for HIV and should not be promoted as thus. It should not be included among the educational “Methods of Prevention” in dealing with the virus. The same old, tried and tested, quaint methods of faithfulness and abstinence must continue to be encouraged instead of channelling too many funds toward circumcision.

Chance and probability statistics involve trial and error. They are tainted by too much uncertainty for them to be reliable.

Lets take some statistics for illustration purposes. The chance of being hit by a car on the highway in Zimbabwe is one in 40. The chance of winning the lottery in Zimbabwe is one in five million, but didn’t a Harare man win the jackpot twice in less than 15 attempts? The chance of lightning striking a person is one in two million, but a certain Mberengwa woman was struck twice in two different locations at two different times!

The point is chance and probability statistics can be helpful by providing guidelines in social services planning, but they should not be made a basis for policy especially on matters involving HIV/AIDS. Only incontrovertible absolute facts and figures e.g. population numbers and distribution, should be the premise for government policy.

Contestable chance and probability statistics denoted or connoted from scientific studies should not be relied upon apropos of contentious matters that have a mortal bearing on the long term health of the population. Government policy on circumcision is totally missing the point in the fight against this deadly virus. The policy is inadvertently encouraging people to play Russian roulette with this virus. Circumcision should be encouraged ONLY for hygienic purposes because that is the only health benefit that it has a 100 per cent proof of effectiveness. Proposing it as a panacea for HIV/AIDS to whatever extent it is preventatively effective, will only encourage reckless behaviour among the men. Encouraging circumcision is merely dabbling ineffectively with the symptoms of the problem rather than its cause. The root problem causing the rapid spread of HIV in African countries is people’s mindsets and attitudes towards sex.

Myths and outdated traditions inherited from antiquity are some of the direct causative factors militating against the fight against HIV/AIDS. The most prudent solution lies only in educating people with emphasis on encouraging behavioural change and continence. All the behavioural and perception change programmes that were already in place hitherto should not be neglected in favour of circumcision; in fact they should be stepped up a gear. Peoples’ health and lives should not be taken chances with like a game of blackjack or “njuga”. The stakes are just too high to rely on mathematical probability and chance. It behoves the governments to revise their policy on circumcision before they exacerbate the already uncontrollable problem. There is a (was?) a positive trend in the amelioration of HIV infection rate in Zimbabwe, testimony that behavioural change education is working. Lets not upset the momentum through careless albeit well-intentioned policies.