Wall Street Journal (09.07.07) - Wednesday, September 12, 2007
Male circumcision can reduce female-to-male HIV infection risk
by up to 60 percent, studies show, but several obstacles
remain to implementing the procedure safely. With modern
medical equipment and approaches, the complication rate of
male circumcision is generally under 2 percent.
In Kenya, more than 80 percent of men are circumcised. In a
2006 study of traditional circumcision in Kenya involving more
than 1,000 boys and teens, 35 percent suffered complications
such as excessive bleeding, infection and pain when urinating.
Ritual circumcisions may involve ceremonial knives, no
anesthetic, antiseptic or dressing. And while the procedure
may be offered more cheaply by culturally revered traditional
practitioners, they can lack even the most rudimentary
However, problems can persist even in medical settings. Some
medical personnel lack adequate tools, such as sharp scissors,
or methods of sterilization. The shortage of doctors leaves a
vacuum for the influx of unofficial freelance operators. And
poorly educated patients may not be able to distinguish
between doctors and nurses and dangerous quacks. In medical
settings, including private clinics, 17 percent of patients
circumcised in 2004 in Bungoma District, Kenya, experienced
adverse side effects.
Dr. Cherutich of Kenya's health ministry hopes his country
will offer circumcision free, to prevent unsafe surgeries.
There are fewer than 6,000 doctors for 36 million Kenyans, he
noted, so the circumcision task force will consider how to
train nurses to perform the surgery. However, as most nurses
are women, and there are prejudices against female
circumcisers, cultural objections may also drive some males to
unsafe or no circumcision.