Zambia's male circumcision campaign in hot water

The government was hoping to see 250,000 men circumcised each year between 2009 and 2015

The government was hoping to see 250,000 men circumcised each year between 2009 and 2015

LUSAKA – Zambia will most likely miss its target of having nearly two million males between the ages of 15 and 49 voluntarily circumcised by 2015.

"We are not happy with the response people are making to the call for male circumcision," Health Minister Joseph Kasonde told the Anadolu Agency in an exclusive interview.

He admitted that, despite high levels of optimism when the voluntary male circumcision program was initially launched in 2009, Zambia still falls short – by about 75 percent – of the target.

"The actual figure of circumcised men could be less than 700,000, but the figure needs to be verified," said the minister.

"This shows that the response to the male circumcision program is still low," he asserted. "It is extremely low in regions where circumcision is not practiced among the people."

Zambia has a population of nearly 13 million, with an HIV/AIDS prevalence rate of nearly 15 percent among adults aged between 15 and 49.

Like in many other African countries, the Zambian government – with the help of $11.4 million from the U.S. President's Emergency Fund for AIDS Relief – wants to use circumcision as a tool to fight the scourge of HIV and cervical cancer.

When the voluntary male circumcision program was launched in 2009, the government had hoped to see some 250,000 men circumcised each year.

Over 300 sites were set up to provide male circumcisions and hundreds of medical personnel were trained to carry out the procedure.

-Challenges-

Minister Kasonde believes the program is hampered by the fact that Zambians do not traditionally practice circumcision.

"Circumcision in Zambia is only practiced among a few communities; the rest of the communities don't," said Kasonde.

"The major challenge our officers meet when they go into the field is to convince men from cultures where circumcision is not practiced to get circumcised," he added.

According to Kasonde, of the nine provinces in Zambia, which is home to 73 different ethnic groups, circumcision is practiced only by tribes in North-Western Province, along with the Kaonde and Lamba people.

"It has been tough to sell the idea of male circumcision to older men, including those who are married in provinces where circumcision is not practiced," the minister told AA.

"It is against this background that the government is looking for other ways of reaching out to this key demographic, as many new infections occur within marriage," he said.

Kasonde noted that recent efforts to promote the practice had failed to gain any traction.  

"This means we have to change the approach to marketing male circumcision, including making changes to our communication strategy," he said.

"These changes should be aimed at convincing men who are still not sure about medical male circumcision," the health minister added.

George Chiyobolabalima, a professor of social sciences, believes the involvement of women in the male circumcision process is also serving to hinder the campaign.

"In many cultures, male circumcision as a rite of passage is exclusively performed on boys who reach maturity by men who themselves have undergone the initiation ceremony," he told AA.

"This rite has a religious connotation in terms of rituals involved, and no women are allowed to see what takes place when the ceremony is underway," said Chiyobolabalima.

"When women get involved in the process, men tend to shy away," he asserted. "Obviously, people who cannot stomach the idea of women circumcising men are discouraging other men from getting circumcised."

HIV/AIDs campaigner Dr. Mannasse Phiri acknowledged that male circumcision was performed by trained professionals – regardless of sex.

"But if the problem is about who should perform the circumcision according to tradition and culture, we have no option but to go by the demands of the people," he told AA.

"There is no harm in doing what the people want the government to do to achieve the goal of preventing new heterosexually-acquired HIV/AIDS," Phiri asserted.

"If, for example, communities where male circumcision is exclusively done by men who themselves have undergone an initiation ceremony, there is no harm in bringing on board such people to perform the act – provided they are given basic clinical hygiene," he said.

Health Minister Kasonde, however, remains hopeful that by the end of 2015, the target will have been achieved.

"The year 2015 is a very long period," he said. "We cannot just give up on this huge intervention in the fight against HIV simply because we are faced with this problem."

"We will eventually get there," he added. "All we need to do is go beyond the 75 percent of the target population."

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