Caution: male ego! (handle with care)

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.

...circumcised?... still looks edible to me...

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.

...can Zim men stomach the thought of a blade near their glorified carrots?

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.” in the US haul their parents to court over being circumcised at birth

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!

Oh, how we miss the point!

A week ago a woman gave birth at a tollgate. According to the story the woman was on her way to Gweru Hospital where she had been referred to by the Shangani District Hospital presumably because the district hospital was not capacitated to do the delivery.

But that’s just my deduction.

What was reported is that the woman was already in labor when she caught a ride from a haulage truck driver who was heading in the same direction and when the truck was stopped at the tollgate; she was on the verge of delivering; the truck driver saw it fit to leave her somewhere near the tollgate so that he could rush along and go on his way.

Can’t blame the poor fellow though – he was probably terrified that he would end up being saddled with a new born baby and all the mess that accompanies childbirth moreover, he certainly wouldn’t want his employer to find out that he had turned the company vehicle into a delivery room.

In any event the woman was unceremoniously dumped on the roadside, where she ‘rolled’ around on the ground, writhing in agony before her anguished cries attracted the attention of the police and Revenue authorities who were manning the toll gate.

With the assistance of these officials, she delivered a healthy baby and remained attached to the infant as none of them wanted to hazard cutting the umbilical cord; they couldn’t decide how many centimeters to cut off from.

In any event, an ambulance from Gweru conveniently arrived with paramedics who proceeded to cut the cord and ferry the woman to hospital where we are told the woman is recovering very well.

The story was written in the light-hearted manner of one telling an entertaining story; the tone conveying a hint of humor because – well it’s one of those stories one can tell knowing they will have an engaged and enthralled audience.

What makes it all the more appealing is that it’s all true and with a nice little ‘happy’ ending to wrap it all up – the baby is safe, the mother is recovering, the officials who were there now have a story they can one day share with their grandchildren and of course, it was suggested that the infant be named “tollgate”.

So all’s well that ends well, right? Wrong!

It seems to me that this report totally missed the point.

The point is, why on God’s green earth was the woman referred to Gweru in the first place? Why are district hospitals incapacitated and why; with less than five years to meet the Millennium Development Goals (MDGs) are we still having women’s maternal healthcare being so grossly ignored?

The point is why, in a three decade old independent Zimbabwe, are women giving birth in the open like animals?

And oh, the indignity of it!

Anyone who is well-versed on the subject of the arduous rigors involved in birthing will know that the exercise is excruciating and it is, for every woman a time of extreme vulnerability.

There is indeed, nothing trivial about it because of the high risk involved, too many women die giving birth and others die due to pregnancy related complications yet coverage given to these tragic occurrences borders mostly on nonchalance without any appreciation of the gravity of these incidents.

To my way of thinking, the story raises several issues that warrant interrogation and are basically screaming for scrutiny.

One of them is the glaring lack of sensitivity with which the subject is treated – so matter-of-factly and it somehow succeeds in making the woman’s plight almost inconsequential.

Needless to say, gender sensitivity is a notion whose import has largely gone unheeded or has not been prioritized in many sectors of our society – this is just one manifestation of this culture of indifference.

What is even more upsetting is that these attitudes permeate to all other coverage of matters that directly affect women and impact on their health and interests.

There is something wrong with a health delivery system that fails women at a time as crucial as child birth – but there is something inhumane about a society that would condone this by finding the slightest element of humor in what is clearly outrageous.

And of all the things that could be said about a woman delivering in such unusual and inappropriate circumstances; the very least one can do is remember to point out the fact that we expect more of our Government – what with the combined weight of three political parties?

It’s just sooo frustrating!!!