Normally Spillhaus clinic is dominated by women seeking medical solutions for their varied reproductive health challenges.
Barely half an hour later after I had arrived, a small queue had pushed out of the building. At first some men in the queue whispered to each other about their reason for being there. Later those whispers grew to bold and excited discussions on the common purpose of the more than a dozen men that had come to Spilhaus that morning.
The core business at this family planning clinic, these days, is male circumcision. An average 20 men and boys have been visiting this clinic on a daily basis in the past two weeks, according to clinic staff.
They are coming to be circumcised under a government programme launched a few months ago as a means to combat the spread of HIV.
“It did not take me any effort to make this decision,” said Mark Magariro, a teacher from nearby Southerton suburb.
“I read about it in the papers and when my wife mentioned it to me and explained how circumcision prevents HIV infection, it was only a matter of organizing off days from work before I came. I am sure when more people get to know about this programme the queues will resemble those of the 2008 food shortages,” quipped Magariro.
His ‘neighbour’ in the queue chipped in with an excited and unsolicited contribution. To him, circumcision was a saviour, the only light he had ever seen in the dark alley of AIDS through which he had been stumbling through with little hope of coming out alive.
“This is the best thing that this government has done in many years,” said Trynos. “Look, I am still a young man. I am prepared for the operation as long as I am going to be resistant to that deadly virus.”
My brief interviews with several more of the men revealed that while the circumcision programme had generated excitement, among those that have heard about it, there was still a lot of misunderstanding among both the young and older men about the effectiveness of circumcision against the virus that causes AIDS.
Most of them believe circumcision is the magic bullet. Some proponents of the programme must take the blame for selling it as such.
Loveridge Mutasa, who had just emerged from the surgery and seemed to have some difficulty walking, said the operation was “smooth and painless”.
“I don’t feel anything even now. It’s still numb, but of course I must be careful with the bandages. I am very happy to have gone through this but it does not mean I am going to sleep around. I will remain faithful to my wife especially as I am still HIV negative,” said Mutasa.
About 5 000 men have gone under the knife since the government of Zimbabwe launched the free circumcision programme mid-2009 as a new weapon to fight the ravaging AIDS pandemic.
The programme aims at covering at least three million men, about 80 percent of Zimbabwe’s young men. The programme target is the country’s military, where the pandemic has wrecked havoc.
Although it has not been declared compulsory, government is encouraging all soldiers to get circumcised and the project has been deliberately taken to the barracks.
According to the Minister of Health and Child Welfare, Dr. Henry Madzorera, research has proved that circumcision, the removal of the foreskin from the penis, reduces the risk of man contracting HIV by 60 percent.
Zimbabwe has fought a staggering 25.8 percent HIV prevalence down to the current 13.7 percent through vigorous prevention campaigns including abstinence, faithfulness and the use of condoms.
Circumcision appears to have taken over as the key weapon and it has proved very popular.
Over 3 000 Zimbabwean men aged between 13 and 29 have been circumcised in the pilot project whose target had been 1 000 men.
Dr. Owen Mugurungi, head of the Aids and Tuberculosis Unit in the Ministry of Health and Child Welfare told this Radio VOP reporter that funds permitting, up to 100 000 men would have been circumcised by end of 2010.
Southern African Development Community (SADC) health officials have met to discuss the issue of male circumcision and there are plans to take the project regional. Dr. Mugurungi confirmed discussions were underway to take the project to regional defence forces with a view to having male soldiers in Zimbabwe , South Africa , Zambia , Malawi , Botswana and the DRC, circumcised.
Zimbabwe has so far set up five permanent circumcision centres countrywide, with many more expected to be up and running by end of year. The existing points include Manyame Military Hospital which serves soldiers.
A soldier from an infantry battalion based in Harare said many soldiers were taking off days to visit Manyame for the surgical procedure, followed by a fortnight healing period.
A scientific research found that soldiers, by nature of their job and their average ages, were a high HIV risk group and SADC health ministers have agreed in principle to undertake the circumcision project.
Albert Marufu, a 30-year old young father, who had also come to Spilhaus that morning left a very disappointed man.
“You see, they did some blood tests first and after, waiting for a while for results, I was told I could not be circumcised. They said it would not be good for my health. I don’t know what to do now,” said a distraught Marufu.
An official at the Health ministry said an HIV test is done before the operation and those that are positive could not undergo surgery for fear of complications.
There are however many men in Zimbabwe that will not be circumcised for anything.
“What are you talking about? Getting circumcised and losing all the feeling? Look, when we grew up we used to laugh at the boys that were circumcised and I can’t voluntarily go and do that now. I will lose all my sexual appetite,” remarked a 25-year old vendor, who was having a beer with friends at a local joint in Chitungwiza.
His friends concurred, with some even suggesting the operation was not safe as one could bleed to death.
“Going into surgery is always not a safe thing and getting cut that side of the body is definitely dangerous,” said another.
Medical experts that researched on the effectiveness of circumcision against the HIV virus, argue the skin on the inside of the male foreskin is “mucosal”, like that found inside the mouth or nose. This mucosal skin is said to have a high concentration of Langerhan cells, which are HIV target cells rich in white blood cells or doorway cells for HIV.
“HIV looks for target cells like the Langerhans – its lock and key,” a senior researcher at Harvard University, Edward G. Green was reported as saying in medical journals. “The rest of the skin on the penis is armour-like.”
John Zinyama, a medical expert with an Aids prevention non-governmental organization in Zimbabwe, confirmed the vulnerability of the foreskin to HIV attack but urged those that were circumcised not to bask in the false glory of newfound armour.
“HIV cannot be completely stopped from entering the blood system just because you have lost your foreskin. Remember circumcision has only proven to be around 60 percent effective. Now 60 percent is not 100 percent,” he warned.
The operation is carried out under local anaesthetic using a cost-effective technique known as the forceps method. It costs about US$40 (R340) for each patient according to a nurse at Spilhaus.
Writing several years ago when the use of circumcision as a weapon against HIV was first mooted, Zimbabwe’s former Health Minister, now President Mugabe’s health advisor, Dr. Timothy Stamps, said the positive benefits of male circumcision were not limited to the narrow prevention of HIV infection.
“Holy Scripture endorses it,” he said. “ Abraham and his household were circumcised as a bodily sign of God’s covenant (Genesis 16). In fact, he was 99 years old when he got circumcised, and lived on a good few years after that. My interpretation of that recorded fact is that age is no barrier, and it doesn’t affect one’s future health. (Ishmael, by the way, was 13, and his half-brother, Isaac was a baby.)
“Our Lord, Jesus Christ, was circumcised, according to the customs of that time, on the 8th day – i.e. the 1st of January, A.D.1. Yes, I mean, 01.01.0001. That was the first day of our present era.”