Monday, May 4, 2015

SWAZILAND: More "Circumcise and Conquer" clients at HIV clinics

The Swazi Observer
April 30, 2015

Soka Uncobe got more men on HIV services

by Winile Mavuso
WHILE most HIV positive Swazis do not enroll for pre-ART services because they feel well and don’t see the need to go to the clinic, the Soka Uncobe Male Circumcision campaign ran in 2011-12 saw more men enrolling for HIV care services.

This is contained in a study conducted by ICAP in 2011-2012 with support from the Centre for Disease Control (CDC) and the President’s Emergency Plan For AIDS Relief (PEPFAR). The study was presented to stakeholders during a breakfast meeting at Mountain Inn yesterday.

The objective of the study was to evaluate whether key linkage procedures were implemented in accordance with the new set of standard operating procedures on linkage and retention (National SOP) introduced by the ministry of health. The study explored early enrollment and retention in HIV care among clients newly diagnosed with HIV from two HTC settings (home- and MC-based HTC), as well as finding client, clinic and SOP characteristics that might be associated with early enrollment and retention in care.

Hence, the National SOP was implemented in the Soka Uncobe Male Circumcision campaign during which testing was facility based and the Swaziland HIV Incidence Measurement Survey (SHIMS) during which testing was home based.

HIV testing was a requirement for men to get circumcised and those who took up the services also got to know their HIV status. According to the study, from 13 Soka Uncobe sites visited, it was found that many MC files of HIV positive clients included completed readiness assessment forms.

“Interestingly, although similar enrolment rates were observed between study-gender groups overall and within 18 months of diagnosis, proportionally, more Soka than SHIMS clients enrolled in HIV care within three to six months,” reads part of the document.

This could be attributed to the fact that many Soka sites were co-located at HIV care facilities, hence clients were easily linked to expert client counselors.

[Or could this be because more Soca Uncobe ("Circumcise and Conquer") clients got HIV?]
...
Earlier story

Sunday, May 3, 2015

UGANDA: Cutting men does increase the HIV risk to women

Medindia
April 29, 2015

Male Circumcision Curbs HIV Spread but Risk of Transmission High While Wound Heals
Real news: Male Genital Cutting INCREASES Risk To Women

by Bidita Debnath
While circumcision reduces the risk of human immunodeficiency virus (HIV) transmission by infected men [that has NOT been established], there is actually a possible increased risk of infecting female sexual partners while the circumcision wounds heal, warns a new research.

The World Health Organization (WHO) recommends male circumcision (the surgical removal of foreskin from the penis) [for consenting adults] which reduces HIV acquisition by 50-60%. [They have to include their mantra.]
 
"There is a window of a few weeks after circumcision when the risk that an HIV-infected man could transmit the virus to a female partner actually increases," said the study's first author Aaron Tobian, associate professor of pathology at the Johns Hopkins University School of Medicine. "During that time, more HIV-infected men are shedding the virus, and on average they are shedding greater amounts of it, than before circumcision," he noted.

However, scientists report that a new study of HIV-infected men in Uganda has identified a temporary, but potentially troublesome unintended consequence of the procedure: a possible increased risk of infecting female sexual partners while the circumcision wounds heal.

[See the weasel-words and euphemisms: infecting more women with HIV is exactly contrary to what this whole campaign is supposed to be about.] 

The study examined 223 HIV-positive Ugandan men who were medically circumcised. Circumcision reduced the number of HIV-positive men who were shedding the virus more than five-fold over the long term, but it had the opposite effect in the weeks right after the surgery. Case by case, the likelihood of HIV transmission from a newly-circumcised man to his female partner is less than one-tenth of one percent, the researchers estimated.

But with the WHO seeking to circumcise nearly 29 million men, the study projects that this small increase could add up to 17,000 new infections among female partners of newly circumcised HIV-infected men.

"Although we're counseling men not to have sexual intercourse while their wounds are healing, we know that they are," Tobian said.

The solution, he says, may lie in another one of the study's findings. "If the men are on anti-retroviral drugs, this reduces the risk of their shedding the virus by about 90%," he pointed out. The study was published in the journal PLOS Medicine.

[But if the men are known to be HIV-positive, WHY CUT THEM? It is TOO LATE. This just underlines how this whole campaign is not about preventing the spread of HIV/AIDS, but promoting the spread of male cutting.]
 
Source: IANS
[Wawer et al. started to find this six years ago, but they cut that study short "for futility" - it didn't find benefit - before it could be confirmed.]

LOS ANGELES: Lawsuit against Mogen clamp maker

And about time too!


Law 360
April 22, 2015

Circumcision Clamp Makers Sued Over Amputated Penis

by Y. Peter Kang
Los Angeles (April 22, 2015, 4:00 PM ET) -- Companies associated with the production of a clamp used in performing circumcisions were hit with a product liability suit in Pennsylvania state court on Wednesday alleging that the medical instrument's poor design led to the amputation of the tip of an infant's penis.

California resident Victoria Hoekstra, the mother of a minor child, filed the suit against Misdom-Frank Corp. and related entities Sklar Corp. and Medco Group Inc., accusing the Pennsylvania-based companies of negligence and product liability in connection with the partial amputation of her week-old infant's penis in 2010 in what was supposed to be a routine circumcision procedure, according to the complaint.

Hoekstra says that the companies' product, known as a Mogen clamp, has a design defect that does not provide any protection for the head of the penis, unlike other circumcision clamps, and contains a second defect that does not allow for the doctor to be able to visualize the head of the penis when applying the scalpel to the foreskin.

These design defects "are well known and have long been identified and published in medical literature," according to the complaint.

"The Mogen clamp, unlike other circumcision devices, has a long history of penile amputations," Hoekstra alleges. "Defendants have misrepresented the efficacy and safety of their Mogen clamp through various means and media, actively and intentionally misleading the medical community, patients and the public at large."

[The Mogen Company went out of business in 2012 after losing two lawsuits to the value of $18.3 million. A subsequent suit was worth $4.6 million.]

Hoekstra says that her son has sustained permanent injury and will require future corrective surgeries and brings claims for strict liability, negligence and breach of warranty against the companies, seeking more than $50,000 in damages.

An attorney for the plaintiff told Law360 on Wednesday that the clamp should be pulled from the market.

"Circumcision is an ancient ritual that has been performed safely for centuries without incident [BS!]," said co-lead counsel Daniel Balaban of Los Angeles-based Balaban & Spielberger. "This case is about a defective product that has left our client mutilated and maimed. This dangerous device should be pulled off the market or fixed before another infant is harmed."

...

--Editing by Stephen Berg.

KENYA: 30 boys cut by force

How is this not sexual abuse?


Daily Nation (Kenya)
April 22, 2015

Anxiety in Eldoret after NGO ‘forcibly’ circumcises 30 boys

by Copperfield Lagat
Anxiety has gripped Eldoret in Uasin Gishu after an estimated 30 children were forcibly circumcised by a non-governmental organization based in Kisumu and which has a clinic in Eldoret.

The Impact Research Development Organisation is alleged to have performed the circumcision on the school-going children last week in various parts of Eldoret, when learners came home for the April holiday.

The mood was tense Wednesday evening at Kapsoya Estate as mothers wailed uncontrollably after realising that their sons, some as young as six years old, were circumcised by the organisation without their consent.

Lucy Ekwong said she had gone to town but did not find her two sons upon arriving home in the evening.

She would later find out that they were nursing pains at a Sudanese neighbour’s house.

“I had gone to town but when I came back in the evening, my two children, aged six and eight were in my neighbour’s house.

LURED WITH SWEETS
“The young one said they were offered sweets and taken to a clinic in Langas where many boys were circumcised,” the bitter mother said.

“I was shocked but immediately took up to caring for them. I later talked to a police officer who denied knowing of such an activity.

“I am so confused because the surgery itself is not according to the requirements of the Kalenjin traditions.

“My people in the village, upon learning of that, are accusing me of doing it on my sons,” said Ms Ekwong.

Some of the children were from the South Sudan Nuer community which does not perform circumcision on their boys.

The community regards the act of circumcision as a taboo and anyone conducting it is banished.
Only two children, who were from Islamic Center, were Kalenjins while close to 30 others were those from South Sudan.

A Sudanese national, Madol Anyief said: “Our Dinka Bor community does not perform circumcision. Anyone who is circumcised is banished and disowned.

“It is said these people were going around saying the government has directed circumcision but we have later been assured that the county has no such programme,” Anyief said, adding that she did not question much because she was a foreigner and feared for her life.

According to reports corroborated by the circumcised boys, sweets were used by people who were in cars to lure them.

MORE THAN A HUNDRED
One of them said they were more than a hundred only that some were hiding in their homes.
Uasin Gishu County’s Chief Officer for Health Mr Silas Boit said the revelation came during a normal supervision at Kapsoya Health Centre on Tuesday when they met a young boy who was walking in pain.

“We asked further and we were told that there was a forceful circumcision that the NGO had conducted. The boy had a urinal retention complication due to the surgery,” Mr Boit said.
The health officer said they went round the estate and got over 30 other boys in pain in their various homes.

Some who were suspected to be developing infections were referred to Moi Teaching and Referral Hospital for medication.

Mr Boit said police and the county officials managed to arrest three officers from the NGO who were booked at Kapsoya Police Post.

Mr Boit said: “We were shocked after realising that the car in which the suspects had been arrested was released and was going around collecting the boys to ferry them to hospital,” Boit said.

He added that the OCS had promised to take the suspects to court.

Meanwhile, parents have been urged to keep a close watch on their children.

OXFORD, ENGLAND: Babies feel pain "like adults"

Science Daily
April 21, 2015

Babies feel pain 'like adults': Most babies not given pain meds for surgery

The brains of babies 'light up' in a very similar way to adults when exposed to the same painful stimulus, a pioneering Oxford University brain scanning study has discovered. It suggests that babies experience pain much like adults.

The study looked at 10 healthy infants aged between one and six days old and 10 healthy adults aged 23-36 years. Infants were recruited from the John Radcliffe Hospital, Oxford (UK) and adult volunteers were Oxford University staff or students.

During the research babies, accompanied by parents and clinical staff, were placed in a Magnetic Resonance Imaging (MRI) scanner where they usually fell asleep. MRI scans were then taken of the babies' brains as they were 'poked' on the bottom of their feet with a special retracting rod creating a sensation 'like being poked with a pencil' -- mild enough that it did not wake them up. These scans were then compared with brain scans of adults exposed to the same pain stimulus.

The researchers found that 18 of the 20 brain regions active in adults experiencing pain were active in babies. Scans also showed that babies' brains had the same response to a weak 'poke' (of force 128mN) as adults did to a stimulus four times as strong (512mN). The findings suggest that not only do babies experience pain much like adults but that they also have a much lower pain threshold.
The research was funded by the Wellcome Trust and is reported in the journal eLife.

'Up until recently people didn't think it was possible to study pain in babies using MRI because, unlike adults, they don't keep still in the scanner!' said Dr Rebeccah Slater of Oxford University's Department of Paediatrics, lead author of the report. 'However, as babies that are less than a week old are more docile than older babies, we found that their parents were able to get them to fall asleep inside a scanner so that, for the first time, we could study pain in the infant brain using MRI.

'This is particularly important when it comes to pain: obviously babies can't tell us about their experience of pain and it is difficult to infer pain from visual observations. In fact some people have argued that babies' brains are not developed enough for them to really 'feel' pain, any reaction being just a reflex -- our study provides the first really strong evidence that this is not the case.'

The researchers say that it is now possible to see pain 'happening' inside the infant brain and it looks a lot like pain in adults.

As recently as the 1980s it was common practice for babies to be given neuromuscular blocks but no pain relief medication during surgery. In 2014 a review of neonatal pain management practice in intensive care highlighted that although such infants experience an average of 11 painful procedures per day 60% of babies do not receive any kind of pain medication.

'Thousands of babies across the UK undergo painful procedures every day but there are often no local pain management guidelines to help clinicians. Our study suggests that not only do babies experience pain but they may be more sensitive to it than adults,' said Dr Slater. 'We have to think that if we would provide pain relief for an older child undergoing a procedure then we should look at giving pain relief to an infant undergoing a similar procedure.'

Dr Slater added: 'Recent studies in adults have shown that it is possible to detect a neurological signature of pain using MRI. In the future we hope to develop similar systems to detect the 'pain signature' in babies' brains: this could enable us to test different pain relief treatments and see what would be most effective for this vulnerable population who can't speak for themselves.'
...

GHANA: Girl banished for refusing genital cutting


MyJoy online
April 16, 2015

13-year-old girl banished for refusing to undergo circumcision

Despite efforts to combat the cultural practice of Female Genital Mutilation (FGM) in Ghana, reports indicate that some traditional leaders in some districts of the Brong-Ahafo Region are still encouraging it.

According to The Chronicle newspaper, some communities in the Tain and Banda districts of Brong-Ahafo indicates that the cruel act against girls is still ongoing under the charade of custom.

The daily newspaper reported in its April 16, 2015 issue that a 13-year-old pupil of the Brohani D/A Primary School security has been banished from Brohani in the Tain District by the queen mother for reporting to police an attempt to mutilate her genital.

Read the rest of the story as published in the newspaper below:
Narrating her ordeal to The Chronicle, the 13 year old pupil who is currently seeking refuge at the expense of a Good Samaritan at Nsawkaw said she was lined up with another girl waiting to have their genitals mutilated.

After hearing the cry of the other girl, who underwent the cruel act, she fled and went to inform her teacher, who subsequently reported the issue to the Girl Child Coordinator of the Tain District Directorate of the Ghana Education Service (GES), Ms. Comfort Maanu.

Ms. Comfort Maanu, together with the girl and the teacher, reported the case to the Department of Social Welfare, and subsequently, a formal complaint was lodged with the Nsawkaw Police, which led to the arrest of the alleged perpetrators, including the Queenmother of Brohani, a relative of the girl, and the executor of the FGM.

After the arrest of the three, the Nsawkaw Police referred the case to the Domestic Violence and Victim Support Unit (DOVVSU) of the Ghana Police Service in Wenchi and the alleged perpetrators have since been released on bail.

The Queenmother of Brohani is alleged to have threatened to have the girl killed anytime she steps foot in the community, a threat which has frightened the girl compelling her to seek refuge with a Good Samaritan at Nsawkaw.

Sources at the Department of Social Welfare and Community Development in the Tain District has hinted The Chronicle that some opinion leaders of the community, including politicians in the District, have been pushing for the case not to be sent to court, and hence, after almost two months of the incident, the matter has not been to court.

When the Deputy Regional DOVVSU Officer, ASP Setina Aboagye, was contacted, she said the regional office was yet to ascertain the case.

According to ASP Setina Aboagye, she would personally go to Nsawkaw on Friday, April 17, 2015, to follow up the matter.

However, investigations by The Chronicle has revealed that Brohani is the hub of FMG in the Tain and Banda districts, where young girls are sent for the practice to be undertaken, under the supervision of the Queenmother, hence the urgent need for the Ministry of Gender, Children and Social Protection to intervene.

FLORIDA: Injunction against 4 1/2 year old's genital cutting

WSBTV (Florida)
April 14, 2015

Woman filed federal suit to block son’s circumcision

by Jane Musgrave WEST PALM BEACH —
A Boynton Beach, Florida, woman who went into hiding with her 4 1/2-year-old son rather than abide by a judge’s order to have him circumcised has filed a lawsuit in federal court, claiming a forced circumcision would violate her son’s constitutional rights.

In the lawsuit filed Monday in U.S. District Court, Heather Hironimus claims there is no medical justification to circumcise her son, identified as C.R.N.H., and many legal and medical reasons not to do it.

“(The) application of Florida law to impose unnecessary, elective, cosmetic circumcision upon C.R.N.H. at the age of 4 1/2 years old for no religious reason violates (the boy’s) fundamental right to privacy and bodily integrity secured by the due process clause of the 14th Amendment to the United States,” her attorney Thomas Hunker wrote.

Hunker also claims the circumcision, sought by the boy’s father, constitutes “assault, aggravated assault, battery and aggravated battery.” It would cause irreparable psychological damage and provide few health benefits, Hunker says in the suit to be heard by U.S. District Judge Kenneth Marra.

Heather Hironimus, 30, and her son have been in hiding since last month when Palm Beach County Circuit Judge Jeffrey Gillen ordered her to bring her son to court to turn him over to the boy’s father, Dennis Nebus. When she didn’t appear at the hearing, Gillen signed a warrant for her arrest.

The federal lawsuit is the latest volley Hironimus has fired in the long-running legal fight to block the circumcision.

Three months after the boy was born in 2010, Nebus, 47, of Boca Raton, filed suit to establish his parental rights. In 2012, Hironimus signed a parenting agreement, allowing Nebus to have the boy circumcised as long as he paid for it. Soon after, she said she had second thoughts about allowing her son to undergo the procedure.

She launched a court battle and one on social media seeking to persuade Gillen not to enforce the agreement. After various court hearings, Gillen in May ruled that the agreement trumped her reservations. The 4th District Court of Appeal upheld his decision without comment.

Protests by those who identify themselves as “intactivists" have been held throughout the county to support Hironimus’ efforts to spare her son from circumcision.

Earlier story