MBABANE, 4 December 2009 (PlusNews) - A steady stream of young
men from urban townships and rural farms are lining up for a
procedure that few Swazi men have undergone since the custom of
removing a man's foreskin died out in the 19th century.
"We are happy with the turnout - it shows our outreach efforts
are working," said Sibusiso Simelane, Assistant Clinical Director
at Litsemba Letfu (SiSwati for Our Hope) Male Clinic in Matsapha,
halfway between the capital, Mbabane, and the central commercial
hub of Manzini.
"They come for MC [male circumcision], but 92 percent of the men
get tested for HIV," Simelane said. Every day 35 patients are
circumcised by appointment at Swaziland's first clinic
specifically for men, but walk-in patients are also welcomed; the
procedure is free and those who arrive early can be out by
When the Ministry of Health and Human Services opened the
facility in October 2009, it committed to making Swaziland the
first country in the world where 80 percent of males in the age
group most vulnerable to HIV infection (15 to 29 years) would be
circumcised by 2014.
Clinical Director Dr Khumbulani Moyo attributed the procedure's
low complication rate - 2 percent - to extensive counselling of
patients and adherence to quality assurance standards established
by the World Health Organization. "It all starts with the
counsellors," said Simelane. "We cover the risks and benefits of
Counsellors emphasise that MC only reduces a man's chances of
contracting HIV by about 60 percent and should be combined with
other prevention strategies. "We ask the patients to come with
their partners, so they will also understand the procedure, and
know why they cannot engage in sex for six weeks during the
recuperation time," said Simelane.
Sipho, 20, a farm worker, silently deliberated for several
minutes before completing the form consenting to the elective
surgery. "The health motivator told me about this place; she told
me about circumcision and even arranged transport," he said.
The next step is a counselling session, during which he is told
the results of his HIV test before undergoing the 20-minute
procedure. He is given a local anaesthetic, and tries "not to not
think of the doctor cutting" while he listens to soothing music
on the radio. Soluble sutures are used to save him a return trip
to the clinic.
With funding from the Bill and Melinda Gates Foundation and the
US President's Emergency Plan for AIDS Relief, health motivators
are sent around the country to raise awareness about the clinic's
services by Population Services International (PSI), a non-profit
social marketing organization.
"They go to rural areas and find patients at schools and
community centres. Private companies request presentations to be
made to their staff," said Jessica Green, the clinic's Technical
The health motivators collect contact information from men
expressing an interest, and clinic staff follow up to make
appointments. The clinic will start offering treatment for all
sexually transmitted infections in 2010.
"A clinic for men is exciting because it gives men a chance to
come together and discuss their health," said Bongiwe Zwane, a
communications officer at PSI Swaziland. "They tell their friends
about this place, which is very professional and confidential;
word-of-mouth has been very positive."