Malawi wants 1.8 million men uncircumcised by 2018
By Moses Michael-Phiri
BLANTYRE, Malawi – Rumors and popular misperceptions are scaring many Malawian men away from a Voluntary Medical Male Circumcision (VMMC) program launched in the country last year.
“We want more men to come for circumcision,” Dr. Frank Chimbwandira, the Health Ministry’s director for HIV/AIDS and head of the VMMC program, told Anadolu Agency.
The ministry launched a voluntary medical circumcision campaign last year in hopes of seeing 1.8 million men between the ages of ten and 34 take part in it by 2018.
The campaign initially kicked off like a marathon, with hundreds of men rushing to receive the free service.
By September 2014, some 150,000 Malawian men had undergone the procedure under the program.
Surprisingly, however, these figures began falling early this year.
“We will surely need a scale-up of the VMMC to achieve the targets we set,” said Chimbwandira.
“[Popular] perceptions of medical circumcision are what are slowing the program down,” he asserted.
Some men who underwent the procedure, he said, were spreading false information, leading other as-yet-uncircumcised men to fear the operation.
Rumors include the notion that foreskins obtained through circumcision would be sold or used as magical charms.
“The [1.8-million] target is farfetched, as only 300,000 men have been cut since the campaign kicked off,” Dr. Kondwani Chalulu, a Health Ministry expert directly involved in the VMMC program, told Anadolu Agency.
Medical circumcision in Malawi is being carried out as an HIV/AIDS-prevention measure.
The VMMC program, it is hoped, will halve the rate of HIV transmission through unsafe circumcision rituals, which are performed during traditional rite-of-passage ceremonies known locally as “jando”.
Under the program, Malawi hopes to circumcise 60 percent of the country’s HIV-negative males between the ages of ten and 34.
According to Chalulu, achieving this target would help prevent nearly 91,746 new HIV infections by 2020.
He is doubtful, however, that this goal can be met if uncircumcised men continue to shun the procedure.
Over the past two years, Malawi has registered some 35,000 new HIV/AIDS infections annually, 80 percent of which can be attributed to unprotected sex.
Timothy Kapale, a 34-year-old from Blantyre’s Manje Township, is one of the many men reluctant to get cut.
“I hear it takes time to heal,” he told Anadolu Agency. “Some say the circumcision is for research, so I am not interested.”
He added: “There is no difference if I get circumcised now. Maybe I already have HIV and will therefore end up losing my private parts as well as my life.”
To encourage such men, the Health Ministry and its partners are using mobile phone messages, radio, social media, television and mobile vans to inform the public that free circumcision is available at government facilities.
“Randomized control trials conducted with men in Africa have shown that VMMC reduces the likelihood of female-to-male HIV transmission by 50 to 60 percent,” said Chalulu, the health expert.
He added that the trials – conducted in Kenya, Uganda and South Africa – had also revealed reduced risk from some sexually transmitted diseases among men, especially ulcerative diseases like cancroid, herpes and penile cancer.
In order to debunk myths about foreskins being used as magical charms, Chalulu said that program organizers were allowing men to take their severed foreskins home with them following the circumcision procedure.
“Just like at the dentist, where you are allowed to take home the extracted tooth, we allow them to take it [the foreskin]. But we tell them how they should dispose of it, because they can’t keep it,” he told Anadolu Agency.
Despite the declining numbers of men turning up to get cut, Malawi is expanding the scope of the VMMC program from a current eight priority districts to all districts nationwide.
“Services will have to be ramped up to achieve VMMC coverage in 60 percent of all the [country’s] 28 districts,” said Chalulu.