My friend Peter,
You stated that, ” You cannot argue convincingly and using statistics that so many circumcised men did not contract HIV/AIDS compared with so many uncircumcised men who got infected and make a conclusion about the transmission of HIV?AIDS” That is exactly the argument used by a study done at Makerere University in Uganda where Nelson Sewankambo, Dean of Medicine concluded that “Among the 187 seronegative men who had HIV positive partners none of the 50 who were circumcised became infected compared to 40 of 137 who were not circumcised” This study was about viral load as a predictor of HIV transmission but somehow it drew conclusion on circumcision. The study was published in new England Journal of Medicine, 2000, 342: 921-929.
My argument was, “Statistics show that more cut Kenyans carry the HIV virus than the uncut. The math is very simple, 1.5 million Kenyans have the virus and HIV prevalence is only 10% in Nyanza province as per WHO”. It is simply a laymen interpretation that does not rquire any knowledge of HIV transmission. All I was tring to say if that if you add up HIV prevelance in other provinces where circumcision is practised you will find a larger number than that in Nyanza province. In addition to the fact that a large number of Nyanzians are already cut, its easy to conclude that more cut are infected than uncut. We have the data to calculate this number and I will attempt it later.
The World Health Organization recommended circumcision after holding a consultative meeting of in March 2007 in Switzerland. They cited strong evidence from three randomized controlled trials undertaken in Kisumu, Kenya, Rakai District, Uganda both funded by the US National Institutes of Health. I do not know if this is the same study done at Makerere. It will be interesting to hear from people in Kisumu or anywhere else in Kenya who know something about this study.
Like politicians in Kenya always state that, “Money has been poured to finish me”, we always use the same kind of argument when we feel our culture is threatened. That is where culture always gets into scientific discussion and I would add scientific study as one of the pressures used to change culture.
later
Nyanja
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Date:Â Mon, 25 Aug 2008 16:15:54 +0000
From:Â nyanja@ . . .
Subject:Â Â Re: Press Release – The Misleading Call for Circumcision!
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Judy Nyakwar Ragem,
You have spoken well, except that mostly we are expressing personal opinion which is very relative. Kihero oludhbor mapod kong’ad, moloyo moseng’ad, mano ber. Onge aganja mapenjo ni oludhbor mane emamit moloyo; mon’gad kose? Kendo onge oganda ma ibochun ni otit oludhbor choke! Omiyo jaodi en mana safe, kendo okwabing’eyo ni ng’ato en nyaroya kose nikech tinde ok waluokre ei aora. Kaka indiko ni, dipoka imiyo wachak dugo mach yawa, instead focusing on making a decision whether to circumcise or not.
Â
Let those who see the possible risk, or those who want to err on the safe side circumcise, particularly the children, Jakom osewacho!
Again, this debate is not about who is good at sex or who is a complete man or true Luo. It is about what needs to be done to reduce HIV. any means necessary is welcome. Waol gi safarwa ma dala mar iko jo thurwa ni wach Ayaki. Migosi Odongo Mayaka wacho maber ni “Sianda neko,” nikech mit miwachono, hasa ka oludhbor ngima, ketho parwa kendo waduaro sweko mang’eny, maketo wa at more risk.
—
Joram Ragem
wuod Ndinya, wuod Onam, wuod Amolo, wuod Owuoth, wuod Oganyo, wuod Mumbe, wuod Odongo, wuod Olwande, wuod Adhaya, wuod Ojuodhi, wuod Ragem! (Are you my relative?)
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Date:Â Mon, 25 Aug 2008 14:13:48 -0400
From:Â Joram Ragem
Subject:Â Re: Press Release – The Misleading Call for Circumcision!
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http://blog.jaluo.com/?p=1393
Date: Mon, 25 Aug 2008 10:36:53 +0300
From: “Okoth, Peter \\(CIAT-Nairobi TSBF\\)”
Subject: RE: Press Release – The Misleading Call for Circumcision!
“…a study done at Makerere University in Uganda where Nelson Sewankambo, Dean of Medicine concluded that “Among the 187 seronegative men who had HIV positive partners none of the 50 who were circumcised became infected compared to 40 of 137 who were not circumcised—
This study gets quoted again and again. What they don’t tell you is that MORE THAN ONE THIRD (29/79) of the CIRCUMCISED men were excluded from entering the study because they ALREADY had HIV.
“Let those who see the possible risk, or those who want to err on the safe side circumcise, particularly the children … It is about what needs to be done to reduce HIV. any means necessary is welcome.”
We must not let the desperate need to prevent HIV make us grasp at a straw that will break and drop us deeper into the abyss. If circumcision gives a false sense of security, if circumcision diverts time, energy, money and resources from measures that prevent HIV better, if circumcision creates risks of its own (with unclean instruments or unskilled circumcisers or wounds that transmit HIV), or if circumcision makes it harder for women to refuse unprotected sex, then circumcision is that straw.
the male circumcision issue as it is being introduced among the Luo, needs more mature, open-minded debate than “jakom osewacho”. it appears cultural practises that involve bodily changes have their origin in some health context. some school of thought believes the Luo culture of removing six lower teeth originated during the outbreak of “lock jaw” disease. now the fear of hiv is driving mc.
^^ It is about what needs to be done to reduce HIV ^^
But circumcision doesn’t prevent HIV. A half-million US men who were circumcised at birth have died of AIDS.