Circumcision is the latest strategy in the never-ending bid to curb the spread of HIV and those tasked with coming up with messages and slogans for the latest campaigns targeting our men folk certainly have their work cut out for them.
By and large, reproductive health issues have focused on women and their messaging has largely been prescriptive because women, particularly Zimbabwean women, are accustomed to being told what to do about and with their bodies.
It doesn’t take much to persuade women to take up any number of health interventions availed to them because they are more predisposed to health-seeking behavior.
Men, on the other hand, will want to preserve the ‘alpha male’ façade by suffering in silence rather than enduring the probing inquisition of a health practitioner particularly in matters relating to their sexual health.
It will require unprecedented levels of toadying to come up with the kind of messaging that will persuade men to entrust their precious ‘cargo’ to the surgical ministrations of the circumcising health practitioners.
Cold facts backed by impressive statistical figures and research findings resting on the formidable credentials of scientists and academics might not be enough to persuade the average Zimbabwean man to part with an inch of skin on his body – much less the skin placed on the tip of such a prized body part.
Clearly the challenge now lies with campaigners to find a way of ramming the message home – that giving up that piece of skin means giving up a 60% chance of contracting HIV – quite an alluring thought considering the toll that AIDS has taken on sub-Saharan Africa.
Metaphors of winning, conquering, being victors and champions are now used to induce men in anticipation that such packaging of the male circumcision message will see men charging to the nearest circumcision clinic.
We are yet to see our menfolk swarming to the circumcision clinic to gladly undergo the 20 minute surgical procedure that will guarantee that their sex lives are ‘closed for renovations’ for at least six weeks while the wounds heal.
Circumcision as a preventive measure in HIV mitigation has invited much debate with some South African AIDS experts being accused of jumping the gun as far back as 2007 when delegates attending a national AIDS conference in Durban called for “a mass circumcision programme to be introduced to fight the country’s growing AIDS crisis”.
Forced and mandatory circumcision of ‘all adult males’? Not a very tactful approach.
At the time, Neil Martinson, the deputy director of the Perinatal HIV Research Unit in the University of Witwatersrand in Johannesburg, stated that there was now a lot of evidence showing that male circumcision was so effective that it was “almost like a vaccine”.
In any event, critics quickly dismissed the idea arguing that mass circumcision does not help women, does not discourage multiple partners, and could even encourage men and women to take risks thinking that circumcision conferred immunity and removed the need for condoms.
In the US, the issue has attracted controversy following the introduction of circumcision lawsuits where men can sue parents who authorized hospitals to circumcise them at birth asserting that ‘the only person who can legally consent to a circumcision is a person making this personal decision for himself’.
By claiming that the decision infringed on their constitutional rights to enjoy the “inalienable body ownership rights of infants and children” these lawsuits have led to the recognition of genital ownership rights while “thousands are now undergoing foreskin restoration, either medical or surgical, to reconstruct what they consider was violently taken from their bodies early in their lives.”
Roping in women to encourage their partners and sons to get circumcised is one way of ensuring that the message is sent home because couples stand a better chance of engaging in health-seeking behavior than isolating men and addressing them as individuals.
Granted, few women can convince their partners to use condoms, some have to drag their ‘significant other’ kicking and screaming for couples’ HIV counseling and testing so it might just be a tall order to hope that they can influence their partners to undergo circumcision.
But what influence women cannot exert on their husbands or partners they can probably exert on their sons and other male relations.
Patriarchal induction has ensured that women become the most accomplished apple polishers; capable of astronomical levels of sycophancy that would make them the most qualified group to ‘handle with extreme care’ the rather fragile egos of the men in our society.
Trained from birth on how to stroke the male ego, women can give campaigners and programmers a tip or two on how to broach the topic of men subjecting their privates to the surgical blade.
In Zimbabwe, the circumcision discourse is only just ripening with the Ministry of Health and Child Welfare (MOHCW) ambitiously setting a target of circumcising 1.2 million males by 2012 as a measure of significantly cutting the number of new HIV infections in the country.
Over 3000 males had been circumcised in the 6 sites countrywide with Bulawayo totaling 1239 as at 31 January.
Like taking the proverbial horse to the water but failing to make it drink, the Ministry’s target will not be realized unless it finds a way to encourage men to take a swig from the latest HIV prevention tributary and get circumcised.
Caution must be exercised because the male ego is very very fragile!