Botswana’s Infant Circumcision Campaign

Junior in Botswana (Photo: Ann Kim)

Junior in Botswana (Photo: Ann Kim)

By Ann Kim

The southern African nation of Botswana, like its neighbor Zimbabwe, is promoting male circumcision as a way to combat the spread of HIV.

Botswana is not only encouraging men to be circumcised; it is encouraging parents to circumcise male infants.

“It can be about one tenth the cost to circumcise a baby compared to an adult,” says Dr. Rebeca Plank, an infectious disease doctor with the Harvard AIDS Initiative in Botswana. “It’s much easier to do. It’s much safer to do. It’s much quicker to do.”

Plank is studying the feasibility of a large-scale infant circumcision program in Botswana. She believes that infant circumcision is the next sensible step in the fight against AIDS in this part of the world.

But, she says, there’s one big question: “Is this going to be acceptable to parents?”

Infant circumcision is not common in Botswana. Some tribes used to circumcise teenage boys as a rite of passage, but these initiation ceremonies were discouraged by early Christian missionaries. They were also outlawed by Botswana’s first president.

In recent years, the ritual has been making its way back as a cultural practice for some tribes, but many men who come from other tribes express the view of 23-year-old Norbert Kibeenay.

“God made me like this,” he says. “I don’t want to, you know, cut anything.” And he would not want a son cut.

Rebeca Plank and her colleagues have found women far more open to the idea.

“About 90 percent of the moms we interviewed said that they would want their sons circumcised,” she says. “And the number one reason that they gave for wanting him circumcised was to prevent HIV.”

That’s the reason Untemetse Tseketi wanted to circumcise her son Junior. But she says Junior’s father was unhappy with the idea.

“He didn’t like it at all,” she said through an interpreter. “He was upset. He thought it might kill the child to circumcise.”

She went ahead with it, anyway.

“If the decision was left only to men, fewer babies would be circumcised,” she says. “I think it’s better if I decide.”

In Botswana, men usually make the big family decisions, but many mothers make the decision when it comes to circumcision.

“The moms, in the end, just have the baby circumcised and inform their partner later,” says Rebecca Plank.

Plank says one reason is that, by tradition, mothers and infants remain secluded for the baby’s first month of life. It’s believed that visitors—even the father—can bring bad luck. That gives the mother the power to choose.

Advocates for circumcision hope that this old custom will help foster a new custom and help bring this region’s HIV epidemic under control.

Ann Kim traveled to Botswana with support from the International Reporting Project.

Discussion

14 comments for “Botswana’s Infant Circumcision Campaign”

  • Anonymous

    From the USAID report “LEVELS AND SPREAD OF HIV SEROPREVALENCE AND ASSOCIATED FACTORS: EVIDENCE FROM NATIONAL HOUSEHOLD SURVEYS”:

    “There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10
    countries it is higher.”
    http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

     The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups “believe that circumcised men do not need to use condoms”.
    http://www.info.gov.za/issues/hiv/survey_2009.htm

    From the committee of the South African Medical Association Human Rights, Law & Ethics Committee :
    “the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission.”

    The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw:
    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

    ABC (Abstinence, Being faithful, and especially Condoms) is the way forward.  Promoting genital surgery will cost African lives, not save them.

  • Anonymous

    Africans, know that the so-called “studies” are a fraud. Has anybody looked at the actual numbers? What that “60%” figure comes from?

    They circumcised about 1000 men, and left 1000 men not circumcised, and
    only about 67 got HIV, 22 circumcised, and 47 non-circumcised. The “60%”
    is the difference between that subgroup of men. Taking ALL of the men
    who didn’t get HIV into account, the real difference was an
    insignificant 1.30 or so percent.

    THAT’S why they’re rolling out “mass circumcision campaigns” and violating the rights of non-consenting children? Really?

    Africans, WAKE UP! Circumcision doesn’t prevent anything. Only ABC works. Millions are being spent on NOTHING.

    According to USAID, HIV was found to be prevalent in circumcised men in
    10 out of 18 countries. Data around the world shows circumcision DOESN’T
    WORK.

    80% of American men are circumcised, and yet, America has higher STD/HIV rates than Europe, where circumcision is rare.

    These “studies” and these so-called “mass-circumcision campaigns” are a scientific scandal waiting to explode.

    The circumcision of healthy, non-consenting children is a violation of basic human rights.

    Science would NEVER justify doing the same in girls and women.

    If men were taking their daughters to get circumcised behind their mother’s back, that would NEVER be acceptable.

    Circumcising a child is a violation of basic human rights!

    WAKE UP PEOPLE!

    • http://www.facebook.com/people/Hugh-Intactive/100002216540067 Hugh Intactive

      “According to USAID, HIV was found to be prevalent in circumcised men in
      10 out of 18 countries”
      - MORE prevalent in circumcised men than non-circumcised men, that is. In Zimbabwe in 2005, 14.2% of non-circumcised men had HIV, compared to 16.6% of circumcised men,

      These figures at least need to be explained before undertaking a vast and dangerous experiment on African men – let alone African babies.

  • Anonymous

    Circumcision hasn’t stopped HIV in our own country.
    http://data.unaids.org/pub/Report/1998/19981125_global_epidemic_report_en.pdf

    And, it hasn’t stopped other STDs either.
    http://www.reuters.com/article/2009/01/13/us-infections-usa-idUSTRE50C5XV20090113?pageNumber=1&virtualBrandChannel=0

    In America, the majority of the male population is circumcised, approximately 80%, while in most countries in Europe, circumcision is uncommon. Despite these facts, our country does poorly.
    http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=419&Itemid=177

    In fact, AIDS rates in some US Cities rival hotspots in Africa. In some parts of the U.S., they’re actually higher than those in sub-Saharan Africa. According to a 2010 study published in the New England Journal of Medicine, rates of HIV among adults in Washington, D.C. exceed 1 in 30; rates higher than those reported in Ethiopia, Nigeria or Rwanda.
    http://www.nejm.org/doi/full/10.1056/NEJMp1000069

    The Washington D.C. district report on HIV and AIDS reported an increase of 22% from 2006 in 2009. “[Washington D.C.'s] rates are higher than West Africa… they’re on par with Uganda and some parts of Kenya,” says Shannon L. Hader, HIV/AIDS Administration, Washington D.C., March 15, 2009. She once led the Federal Centers for Disease Control and Prevention’s work in Zimbabwe.
    http://www.washingtonpost.com/wp-dyn/content/article/2009/03/14/AR2009031402176.html

    One would expect for there to be a lower transmission rates in the United States, and for HIV to be rampant in Europe; HIV transmission rates are in fact higher in the United States, where most men are circumcised, than in various countries in Europe, where most men are intact. It is telling that the HIV epidemic struck in our country in the 1980s, 90% of the male population was already circumcised. Somehow, we’re supposed to believe that what didn’t worked in our own country, or
    anywhere else, is going to start working miracles in Africa.

  • Anonymous

    Malaysia
    According to Malaysian AIDS Council vice-president Datuk Zaman Khan, more than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims. In Malaysia, most, if not all Muslim men are circumcised, whereas circumcision is uncommon in the non-Muslim community. 60% of the
    Malaysian population is Muslim, which means that HIV is spreading in the community where most men are circumcised at an even faster rate, than in the community where most men are intact.
    http://www.mmail.com.my/content/39272-72-percent-aidshiv-sufferers-malaysia-are-muslims-says-council

    The Philippines
    In the Philippines, the majority of the male population is circumcised, as it is seen as an important rite of passage. In the 2010 Global AIDS report released by UNAIDS in late November, the Philippines was one of seven nations in the world which reported over 25 percent in new HIV
    infections between 2001 and 2009, whereas other countries have either stabilized or shown significant declines in the rate of new infections. Among all countries in Asia, only the Philippines and Bangladesh are reporting increases in HIV cases, with others either stable or
    decreasing.
    http://globalnation.inquirer.net/news/breakingnews/view/20110102-312124/Philippines-HIVAIDS-problem-worries-UN

  • Anonymous

    Many professionals have criticized the studies making such claims. Circumcision
    causes physical, sexual, and psychological harm. Other methods to prevent HIV
    transmission (e.g., condoms and sterilizing medical instruments) are much more
    effective, much cheaper, and much less invasive. Please see http://www.circumcision.org/hiv.htm
    for more information.For infants circumcision causes significant pain and trauma, behavioral and neurological
    changes, potential parental stress from persistent crying (colic) of
    infants, disrupted bonding between parent and child, and risk of surgical
    complications. Other consequences of circumcision include loss of a natural,
    healthy, functioning body part, reduced sexual pleasure, potential psychological
    problems, and unknown negative effects that have not been studied.

    Some circumcised men resent that they are circumcised. Sexual anxieties,
    reduced emotional expression, low self-esteem, avoidance of intimacy, and
    depression are also reported. Some doctors refuse to perform circumcisions
    because of ethical reasons.

    Relying on the presumed authorities (e.g., American Academy of Pediatrics or
    doctors who echo AAP views) is not sufficient (see http://www.circumcision.org/misleading.htm).

    For more information see http://www.circumcision.org.

  • Tom Tobin

    The father had a real concern, that circumcision might kill the child.
    Do a web search on “circumcision+wrongful death”, if you think it can’t happen down the street from you.
    Try a web search on “Injuries linked to circumcision clamp”.  They can no longer manufacture some clamps, due to removing the babies’ head, but the clamps are still commonly used in the US.
    I can only imagine what is going on in Africa, where the conditions are less hygenic, and the equipment typically less modern.

  • John Solis

    Men make the “big” decisions?  Amputating part of a penis is a BIG decision!  The report was written by a female reporter and HER cavalier attitude roars throughout the article.
    My body MY CHOICE!

    • http://pulse.yahoo.com/_A3OAMIFG5YR26RGPMLRRYEYEJM mich

      I agree it is a ‘big’ decision, but your display of misogyny is uncalled for. Most likely the key fact here is that this was written by an AMERICAN reporter, and, in the US, (male) circumcision is written off as a ‘snip’ by the ignorant majority.
      Actually, it’s more common for American mothers to take a stand *against* this barbaric tradition while the circumcised fathers insist their sons should ‘look like’ them. It looks like the same situation in reverse is occurring in Botswana, where mothers are open to new (in this case, mis-)information, while the fathers are more concerned about maintaining the status quo.

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  • http://www.facebook.com/people/Hugh-Intactive/100002216540067 Hugh Intactive

    There is NO evidence whatsoever that INFANT circumcision has any effect on HIV. The three studies in Africa were of ADULT men, volunteers to be circumcised. There is every reason to suppose that the differences they found had to do with behaviour (including dropping out of the study) rather than any direct effect of circumcision itself.

    ““It’s much easier to do. It’s much safer to do. It’s much quicker to do.” Easier for the doctor, that is. There is NO evidence that it is safer. (A baby’s body holds only 350 ml of blood, as much as a soft-drink can. He can only afford to lose 10%, two tablespoonsful, before he’s in danger.)

    • http://pulse.yahoo.com/_A3OAMIFG5YR26RGPMLRRYEYEJM mich

      The studies didn’t even account for the inability of the recently circumcised men to have sex until their wounds healed, if I recall correctly.
      What a joke.

  • http://www.facebook.com/MichaelWarriorOfLove Michael Intactivist

    The people deceiving Circumcisers and their victims who in this case are also the deceived parents and people in general, even our judges and politicians, are obviously not aware or they purposely hide the fact that CIRCUMCISION IS OUTLAWED.
     
    Everybody needs to know that they are breaking the most basic laws of every Democracy, the US Constitution and the International Laws of the United Nations’ Universal Declaration of Human Rights and the Rights of the Child which clearly state that inflicting preventable injuries on others is a Human Rights violation and a severely punishable crime.
     
    THE MOST DESPICABLE CRIME AGAINST HUMANITY IS THE
    TORTURE & MUTILATION OF CHILDREN
     
    The First International Symposium on Circumcision in Anaheim, CA on March 1-3, 1989 and again at the Fourth International Symposium on Sexual Mutilations held at the University of Lausanne, Lausanne, Switzerland on August 9-11,1996,  affirms that the genital mutilation of children is torture and is in violation of Article 5 of the Universal Declaration of Human Rights that states: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment; …
     
    … and Article 37 of the U.N. CONVENTION ON THE RIGHTS OF THE CHILD: (a) No child shall be subjected to torture or other cruel, inhuman or degrading treatment or punishment.
     
    U.S. Federal Law makes female genital mutilation a crime and baby boys/children are protected by “the equal protection of the laws” of the 14th Amendment to the U.S. Constitution.
     http://ttfuture.org/blog/1181/all  Any intelligent and compassionate person easily understands that this is criminal, sadistically perverted, cruel and barbaric and they agree that freedom of religion does not mean that you can harm others.  Circumcisers purposely misinterpret the First Amendment of the US Constitution as they want to force their religion onto others by deceiving and coercing religious people with lies about God and medicine so they can mark their child victims in the flesh.  They torture and mutilate for profit and to make obedient and dumbfounded little slaves out of people and with it they also break the First Amendment of the US Constitution and the basic laws of every Democracy. They take away their victims’ right for intact genitals, their body integrity and the choice not to look like belonging to certain religions. Awakened people from all over the world are uniting to bring all perpetrators to justice if they don’t stop preaching and committing this crime immediately.  All their further actions are being recorded and their data is being kept as evidence for the day when they are getting sued, arrested and trialed by the people. Nobody will be exempt from punishment if they further preach, promote, enable, contribute and commit this crime on defenseless and non-consenting children. We ask everybody to stop all these cruelties immediately and to report all the perpetrators. We demand from our governments to obey and enforce our existing superior laws. 
    All those who continue to torture and mutilate innocence and all those who enable and contribute to this corporate child torture holocaust shall be brought to justice for breaking the highest laws of this world and this universe.

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