Alvine Kapitako
Windhoek
For a very long ago time it was believed by many that men could only be circumcised for cultural purposes.
But now more and more men are embracing the notion of having their foreskins cut for health reasons.
“We thought that it’s only OvaHerero (men) and other tribes that cut,” said 33-year-old Elia Mundesha who was circumcised last year in July.
According to Mundesha some men do not entertain the idea of circumcision for fear of being seen in hospitals for that purpose. It is believed that circumcision should be done at a tender age, he adds.
Also, the fear that some men will be mocked based on the size of their manhood is another misconception.
“It is not necessarily the procedure they fear because it is not very painful – they (men) are not brave enough to be seen at hospital,” Mundesha opined.
Meanwhile, Tulonga Fillemon Josef, better known as Shotgun, said some men fear when they undergo the ‘smart cut’ their penises will become small.
“There is nothing like that. They don’t cut anything else apart from the foreskin,” said the 31-year-old musician.
Shotgun performs alongside award-winning musician, The Dogg, who is the ambassador of the Voluntary Medical Male Circumcision (VMMC) programme which has set a target to circumcise at least 330 000 men and boys in five years. Shotgun said he first heard about male circumcision about ten years ago while living at his home village in northern Namibia.
“We were laughing at cattle herders from Angola because they were circumcised but they retaliated by informing us of the hygienic benefits of circumcision,” said Shotgun.
That is when he started doing research by reading newspaper articles, watching documentaries and getting information on circumcision. But it was only in 2015 after going for an HIV test that he made the decision to be circumcised.
“The counsellor saw how nervous I was before she tested me for HIV and afterwards she gave me information on voluntary medical male circumcision and how my chances of contracting HIV are reduced by 60 percent,” explained Shotgun.
He did not hesitate. He adds, “That was a bonus. Before that I had given up because it was costly at private hospitals and I had no idea that the procedure could be done at a state facility.” Contrary to some views, the procedure was not painful, said Shotgun. It was not long either.
“And within seven days I could see I had recovered,” Shotgun adds.
But he only indulged in sexual activities after two months of being circumcised. “I witnessed an incident where a man complained of being lied to by the doctors because he had not recovered from the surgical procedure. But it was later discovered he had engaged in sex seven days after the procedure because he lives with his girlfriend,” said Shotgun.
Both Mundesha and Shotgun had the support of their families. In fact, their siblings followed in their footsteps not long after they underwent the ‘smart cut’.
“My big brother also got cut and so did my friends and cousins because of my experience,” said Mundesha.
Meanwhile, Shotgun who has since composed a song titled ‘Free circumcision’ said charity begins at home. “I started encouraging those close to me to be circumcised because I can’t clean outside while my house is dirty.”
Health benefits
According to the World Health Organisation (WHO) the surgical removal of the foreskin – the retractable fold of tissue that covers the head of the penis – is recommended.
The inner aspect of the foreskin is highly susceptible to HIV infections. Trained health officials can safely remove the foreskin of infants, adolescents and adults, according to WHO.
“It is medically proven that a circumcised man reduces his chances of contracting HIV by 60 percent. I’m not saying people should be reckless because the aim is to bring HIV infections to zero,” said Shotgun.
Men who are HIV-positive may feel left out, he adds. But, they do not have to because they too can be circumcised.
HIV has various strains so an HIV man can be circumcised to reduce his chances of re-infection but importantly to minimise contracting other sexually transmitted diseases and cancer. Shotgun says circumcised men have a lesser chance of getting penal cancer.
“And for the ladies, when your man is circumcised the chances of getting cervical cancer are reduced,” he adds, urging women to encourage their partners, brothers and male relatives to consider circumcision for health benefits.
Mundesha says circumcised men maintain better hygiene. “An uncircumcised man cannot go a day without bathing because he will smell very bad.”
“A man may find himself in a situation where he is unable to bath but for a circumcised man that is a bonus because the smell won’t be that much,” according to Shotgun.
VMMC in Namibia
Since 2007, WHO and UNAIDS (the joint United Nations Programme on HIV/AIDS) have recommended voluntary medical male circumcision as an additional important strategy for HIV prevention, particularly in settings with high HIV prevalence and low levels of male circumcision, where public health benefits will be maximised.
In response to this recommendation, the potential impact of a national medical circumcision campaign on future HIV incidence rates in Namibia was modelled.
It was estimated that scaling up voluntary medical male circumcision to reach 80 percent of adult and male newborns would avert almost 35 000 adult HIV infections between 2009 and 2025, according to the Ministry of Health and Social Services’ policy on male circumcision for HIV prevention.
Shotgun says many people are embracing the circumcision message.
“When we started I realised that people in the rural areas far in Zambezi Region were shunning our message.”
The cultural beliefs were strong there, but when they heard that contracting HIV is reduced by 60 percent, they are slowly embracing it, he says, stressing the importance of reaching people at grass-roots level.
Johannes Haufiku, the manager for Demand Creation and Social Mobilisation in the Ministry of Health and Social Services, said the message of voluntary medical male circumcision is travelling very fast.
“Even on social media we see people responding positively. Women are equally open to the idea of male circumcision. We see women bringing their sons and partners to be circumcised at our clinic.”
Haufiku, who also touched on the health benefits, said voluntary medical male circumcision is part of a comprehensive programme aimed at reducing HIV infections.
Other interventions include behaviour change campaigns through community mobilisation where young people are urged to behave responsibly. Statistics show that HIV remains the number one killer in Namibia with up to 3 900 deaths annually.
“It is hard to pick up how many people got infected after being circumcised unless you do research because we don’t keep contact with the men when they fully recover,” Haufiku said.
“We are campaigning for people to know what’s good for them. We are meeting them halfway but the decision still lies with them to be responsible and make sure they prevent HIV as there is a 40 percent chance of infection when you are circumcised,” Shotgun said.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund supports HIV programmes in Namibia.