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INTERMEZZO: Ismet Dural Circumciser

Healthy People by Grey a Turkish advertising agency based in Istanbul created this advert for Ismet Dural a circumciser who owns a clinic and wanted a cheap way to advertised his business in his local area.

“We created a poster with perforated edges. This way the consumer was also participating to the idea. The part which remained in the consumer hand was also the circumcised part which included Ismet Dural’s contact details”

Source: Ads of the World

duralcircumciser

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HIV prevention: Time to ditch cultural sentimentality?

The circumcision of Jesus (stainedglass window)Reporting on the role of circumcision in the “combination prevention” discussed during the 2008 AIDS conference, Roger Peabody from Aidmaps noted that “In response to several criticisms of the recommended roll-out of circumcision, Catherine Hankins from UNAIDS insisted that circumcision had to be seen as part of combination prevention” – in other words, it is one extra choice, rather than the replacement for another intervention.”

But in the same session, Mogomotsi Supreme Mafalapitsa noted that circumcision is often imbued with religious and cultural meanings, and very often forms part of ceremonies that mark a transition from boyhood to manhood” and “warned that attempts to change practices around circumcision are fraught with difficulties. Health officials may prefer circumcision to take place at a different age, or under medical supervision in a sterile environment, but Mafalapitsa said that “cultures who are already circumcising adolescent males do not take kindly to the possibility of alteration of their culture by medical circumcision and neonatal circumcision.”

When faced with a exceptional epidemic, isn’t it time to take exceptional measures and in this case to ditch cultural sensitivity, or rather cultural sentimentality?

Interestingly, “drawing on his experience in South Africa, [Mogomotsi] said that these traditional circumcision rituals often emphasise specific ideas of masculinity which can be harmful to women.”

More than 25 years into an exceptional epidemic, isn’t it time to recognize the role of cultural sensibility in fuelling the HIV epidemic? Isn’t it cultural sensibility that cast out those most at risk, such as sex workers, drug users and denies them treatment? Isn’t it cultural sensibility that put women’s sexuality under the control of men? Isn’t it cultural sensibility that put entire nations in a state of denial about the danger and extent of a generalised HIV epidemic?

Despite acknowledging the potential nefarious effect of culture on women, isn’t it blind cultural sensibility that informs the discourse of Mogomotsi? To the point that we are now afflicted with the new buzzword of “gender transformative programmes” rather than gender equality or gender mainstreaming.

Exceptional times require exceptional measures and the time has come to get ride of the cultural blinds that have hindered the response to the HIV epidemic during the last 25 years. Loosing life or loosing face, how long are we going to waffle?

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Cut it! Male circumcision as an HIV prevention method?

A substudy of the randomised controlled trial (RCT) of male circumcision as an HIV prevention method in Kisumu, Kenya has found that there were virtually no differences in risk behaviour or in STI infections between circumcised and uncircumcised men (lay discussion).In the last two years three RCT of male circumcision where stopped prematurely when interim analysis showed that circumcision was highly efficacious in reducing HIV incidence (that is the number of new cases observed over a period of time).

However, concerns were raised that the perceived protective effect of circumcision would be counterbalanced by a behavioural disinhibition in the context circumcision protecting from HIV (Risk reduction does not equate protection).

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