The emergence of HIV and Aids, which has resulted in the death of many, has forced many, including scientists, to try and find urgent solutions.
Although there is no cure for the disease, scientists have never stopped researching on ways of getting rid of the scourge.
Research has shown that medical male circumcision reduces the risk of female-to-male sexual transmission of HIV by approximately 60 percent. Since 2007, the World Health Organisation (WHO) and UNaids have recommended voluntary medical male circumcision (VMMC) as an additional strategy for HIV prevention, particularly in high HIV prevalence and low levels of male circumcision areas.
The Malawi government has also established a VMMC strategy for 2012 to 2016, one of whose purpose is to improve awareness, knowledge, attitude and practice of Malawians regarding the effectiveness of VMMC in reducing HIV incident levels.
A number of non-governmental organisations (NGOs), including reproductive health experts Banja La Mtsogolo (BLM) and Population Services International (PSI), have taken leading roles in circumcising willing men.
It should be pointed out that circumcision has been practised in the country for a long time, particularly among the Yao and Lomwe tribes and others along the lakeshore areas. Jando, as it is called, is a traditional initiation ceremony where boys are circumcised in preparation for puberty.
However, health experts have warned that traditional circumcision is, in many occasions, not complete as parts of the foreskin remain. There are also reports of using one blade to carry out circumcision on a number of males.
But some people have defended the traditional practice. Sheikh Dinala Chabulika from the Islamic Information Bureau in Blantyre is particularly worried with how messages about circumcision are being put across.
“I have been listening to several messages on radios and other media from those that champion circumcision. They are deliberately confusing people by portraying that traditional circumcision [jando] is incomplete while that from the hospital is,” says Chabulika.
He pointed out that jando circumcision is complete just like that from the hospital and appealed to those that are advocating hospital circumcision not to confuse people.
“I went through traditional circumcision and there is nothing wrong. The only problem with it is purely healthy. I have no problem with people going to hospitals to be circumcised, but to portray traditional circumcision as being incomplete is wrong,” he points out.
Former Television Malawi (TVM) director general Rodrick Mulonya believes that for the VMMC to succeed, there is need to incorporate traditional circumcision.
Mulonya adds that traditional circumcision has been practised for over 500 years in Africa by the angalibas (traditionalists who conduct circumcision at the jandoand counsel initiates on proper conduct) in their initiation summer camps known as tsimba as part of informal education. The circumcision, according to him, is practised for mainly two reasons: hygiene and for graduation into manhood.
To that effect, angaliba look at circumcision as a process of the construction of the patriotism thinking of humankind towards the society apart from the medical reason given here.
Angaliba Foundation, a Machinga-based NGO, is helping the community in these areas to understand medical circumcision.
“There is a strong belief that the medical circumcision is there to counteract the traditional one. That is the reason may communities that have been doing it for long sometimes feel suspicious about any new development,” says Mulonya, chairperson for the foundation’s board of trustees.
He adds that he knows how people in Mangochi, Machinga, Zomba, Mulanje, Balaka, Salima and Nkhotakota feel about the matter.
“What is important is to make an understanding between traditional and medical circumcision personnel to bridge the mistrust that is there. Already, there are people who are wondering whether some organisations that are encouraging family planning can carry out circumcision. They suspect that these organisations are only hiding behind circumcision but in actual fact, they are carrying out family planning.
“It is, firstly, important to create awareness on the cultural rights of Malawian citizenry on issues such as jando, litiwo, nsondo, chiputu, lupanda, chidototo and traditional dances like chikongo, likwata, mbwiza, beni, chindimba, lisini, masewe and many others. Make them understand that much as they have the right to those cultural practices, they have to understand and accept other ways of doing things, like medical circumcision,” stresses Mulonya.
According to him, the idea is not to do away with traditional circumcision, but blend it with the medical one so that there is a win-win situation. In the end, the future of the country regarding HIV and Aids transmission will be promising.
The organisation has already carried out activities in the form of awareness to drum up support for voluntary medical circumcision. Last year, the campaign took place in Balaka but this year, it will be in Nkhotakota, according to Mulonya.
“We have also replanted trees in several areas where they were cut to construct tsimbas. In addition to that, we tell the community to be strategic on when to have initiation ceremonies so that they do not clash with school calendars,” said Mulonya.
Ministry of Health spokesperson Adrian Chikumbe said the ministry is aware of angaliba’s existence and its activities.
“We want to continue working with them, particularly on mobilisation. We want to continue working as partners,” said Chikumbe.
He, however, admits that not all traditional circumcisions are incomplete, but that there is need to be checking first to see how they were carried out.