We have mobilized them in large numbers, we have circumcised them; let’s encourage women to firmly wield the surgical knife.

Male circumcision or ‘peni-surgery’ is selling like a proverbial hot cake. Hospitals and private clinics are minting money out of this exercise. Surgeons are smiling all the way to the bank by merely making people lose their body parts. All you need to do is to project yourself as a ‘peni-surgeon’, and those craving for the knife will flood your clinic in numbers. The euphoria with which male circumcision was met is almost overwhelming the medical facilities that offer such services. 

The government of Uganda has also joined the male circumcision mantra. Priority populations for male circumcision include: all male adults, young male adults, adolescent males, male newborns, and men at higher risk HIV exposure. Service delivery modes that have been identified include: hospitals, clinics, outreach, mobile vans, public and private non-governmental organisations, and other licensed bodies. The task of male circumcision implementation has been vested in the hands of: surgeons, family physicians, and clinical officers.

Male circumcision is spreading like bush fire. More than 360 young males were circumcised in less than one week in Arua district alone, while more than 200 turned up for the same operation in Rukungiri district in just the month of May. You get to know the magnitude of a campaign when people in upcountry areas vehemently adhere to the call. BUT the question is: why are people clamoring for male circumcision? What is the magic in circumcision that has ignited this bravery in men to face the knife?

 Young boys lining up for circumcision in Arua District (Photo by Clement Aluma, The Daily Monitor)

Well, a number of reasons have been fronted. There is a section of society that is circumcising for purely health purposes. Unarguably, majority of males are flooding health centers for circumcision because of popular belief that male circumcision significantly reduces the risk of HIV/AIDS acquisition during penile-vaginal sex. There is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60% (WHO). Health experts believe that male circumcision shrinks chances of acquiring HIV/AIDS on grounds that: "removal of the foreskin reduces the ability of HIV to penetrate the skin of the penis, immunological cells such as langerhans are prime targets of HIV, small tear during sexual intercourse could allow a portal of entry for HIV, and men with foreskin are prone to sexually transmitted infections." (NTV Uganda, June 11,2012).

It seems the blissful euphoria about male circumcision is soaked in the trendy credence that ‘peni-surgery’ is the solitary waft to HIV/AIDS bane. This mindset has to be encouraged and discouraged. Discouraged in the sense that the already circumcised and those in the circumcision queue have to be reminded that “Male circumcision provides only partial protection, and therefore should be only one element of a comprehensive HIV prevention package” (WHO). Circumcision alone does not mean that a person can have sexual marathons across different villages/neighborhoods, towns and cities with impunity. Like big brother, HIV/AIDS is out there watching; he is sophisticated and constantly set to pounce on any lackadaisical prey. 

HIV/AIDS is a challenge that is still feasting on our demographic fabric. We cannot just armpit this fact. In his 2012 state of the nation address, President Museveni lamented that “Ugandans have relaxed on HIV/AIDS.  I hear the prevalence rate has gone up to 7%.  More dangerously, new infections were 129,000 in 2011 up from 115,000 in 2007.  This is an increase of about 3,500 new infections per annum. What a big shame!  Why should anybody get HIV/AIDS today when all the information on prevention is available?  HIV/AIDS only is transmitted through promiscuity.  Close this gap.  Some of the interventions cover up this failure.  Anti-promiscuity measures must be emphasized.” Museveni’s dirge is not farfetched!  Exhilaration about male circumcision as emerging precautionary gizmo against the deadly virus threatens to undercut the efficacy, and desire to apply other methods of HIV/AIDS control. 

Yet, if HIV/AIDS scourge is to be deterred from spreading, other methods of preclusion such as abstinence use of condom and faithfulness between couples, have to be plainly and consistently articulated and promoted.

The male circumcision theme song or/and prayer should be composed and sung or/and recited for and by the freshly circumcised. The lyrics of this song or/and prayer should emphasise that: “HIV/AIDS is still with us. It is still an existential reality. It is so much alive, and its jaws are wide open to clip whoever boogies in its territory. Losing a sheath is not a guarantee that a person is well shielded from its venomous transgression. A surgical knife alone cannot surrogate condom usage, abstinence, and faithfulness between couples.”

I personally do not believe in programs that exclude women especially when it comes to issues where they are key stakeholders. Male circumcision is one of the programs that have kept women on the sidelines.  Yet women can play a key role in making the anti HIV/AIDS message sink in the heads and hearts of men before and after circumcision.

In this bend, women should be encouraged to always wield a double bladed, triangularly edged surgical knife with abstinence, use of condom and faithfulness between partners at each apex, and circumcision at the center. They should persistently sharpen this knife with reminder to the ‘foreskinful’ and ‘foreskinless’ men that HIV/AIDS is still on rampage. And they need to always keep this knife near that male body part that is in constant hankering for circumcision and what follows after that.