Male circumcision gaining ground as anti-AIDS weapon in Kenya

KISUMU, Kenya - Sitting underneath the bright murals at a clinic, 22-year-old Elijah Ochanda gestures at his shorts and explains: "When they remove this thing, it makes you safer."

He is talking about the circumcision he is about to undergo at the urging of his older brother. He has watched several friends die of AIDS, and has come to believe the science that says circumcision can prevent men from being infected.

Dr. Robert Bailey, an epidemiology professor from the University of Illinois, is helping to roll out Kenya's first free circumcision project, which offers operations at public health facilities. Such projects are already running in Swaziland, Rwanda and Zambia, other countries where a large percentage of the population traditionally do not circumcise.

Bailey's study in Kisumu, western Kenya found infection rates were cut by 60 per cent among men who were circumcised. The study, funded by the U.S. Institutes of Health and the Canadian Institutes of Health Research, was one of several that led the World Health Organization to include circumcision in its prevention policies a year ago.

It prompted the Kenyan government to form a task force to promote voluntary, medically safe operations.

But it's not that simple. Circumcision has become entangled in the violence that followed the disputed presidential election last December.

Supporters of President Mwai Kibaki, whose Kikuyu tribe circumcises its men, clashed with supporters of opposition leader Raila Odinga, who is Luo, a tribe that does not circumcise. The rite took on political significance, with Odinga's rivals publicly saying he wasn't a complete man. Many Luo were forcibly circumcised in the violence.

The violence has subsided, but Bailey says it has made the new power-sharing government, with Odinga as prime minister, wary of taking a public stance on circumcision. The disruption initially delayed the launch of the task force's program.

Still, it's noteworthy that Ochanda has overcome the tradition issue in opting for circumcision. And the Luo tribe's council of elders doesn't forbid it outright although they do say it is contrary to their traditions and worry it will promote promiscuity.

"If you want to do that on your own, no one will question you, but it is not our custom," said elder Odungi Randa.

James Morton
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