Circumcised men in uniform

Soldiers are not known for cowardice. Their sworn job puts them first in the firing line of the fiercest and final danger in human life—death. But there are unseen enemies that are persuading the men in uniform to shed the helmets of their jealously guarded organs. To them, circumcision is no retreat or surrender, but an act of courage and love. Malawi Defense Force peer educator MIKE LANGA LULANGA writes.

It is about a year since Malawi Defense Force (MDF) soldier Mphatso Mkanda, 26, was circumcised, and he couldn’t be happier.

Just last year, confesses the soldier who originates from Traditional Authority Mkanda in Mchinji, he was afraid of undergoing voluntary medical male circumcision (VMMC), particularly because of the spectre of pain during and after the procedure.

“Quite frankly, I was scared,” he says. “Anyway, I went for it because I was more scared of HIV and sexually-transmitted infections [STIs],” said Mkanda.

Mkanda, a private soldier at Kamuzu Barracks in Lilongwe, is now an ambassador for VMMC. Apart from being one of the peer educators at the military headquarters, he belongs to the unit’s Theatre for Development (TFD)—a group that promotes healthier and more responsible lifestyles among the men in uniform.

Commonly known as Mpho among his colleagues, Mkanda has been encouraging male soldiers to cut back chances of contracting HIV and Aids and other STIs by undergoing VMMC.

Studies conducted in Kenya, Uganda and South Africa in 2007 back up the notion that complete removal of the foreskin can reduce chances of HIV infections by 60 percent. Locally, the Ministry of Health—which adopted the procedure last year after recommendations from the World Health Organisation (WHO) and evidence-based studies in some districts—insists that circumcision should be accompanied by consistent and flawless use of condoms to achieve the desired defence.

For the soldier, circumcision, like any other operation to combat the spread of HIV in the country where one in every 10 people is living with the virus which causes Aids, gives him satisfaction.

He says: “I feel good and it makes me feel great to be part of this project and to be making a positive difference.”

Of course, he confesses experiencing some pain after the circumcision. However, he strongly believes it was worth it.

It took only a week for the wound to dry and six weeks to heal. Ever since, he has not looked back.

Everywhere he goes, Mkanda is armed with benefits of circumcision and he is conquering some hearts which would be at higher risk without the timely awareness.

From his words, the benefits of circumcisions include drastically reduced exposure to HIV and other STIs, less risk of cervical cancer to your female partner and penile cancer in men and improved hygiene of private parts.

Mkanda is convinced that it is good for a soldier to be circumcised, saying: “During training and other operations, some of them can go a week without a bath.

“Being circumcised helps to prevent bad smell coming out of their manhood. If a man does not clean himself very well, dead cells inside the foreskin accumulate and form madeya [husk-like stuff) which produces a bad smell. This can be prevented with circumcision.”

By reducing infections, circumcision also helps create a health army to safeguard the people and wealth of their country.

At family level, Mkanda lauds VMMC as necessary for children because most of them tend to have urinal infections and problems closing or rolling down their foreskins.

Like Ministry of Health spokesperson Henry Chimbali, he warns that those who undergo circumcision must continue insisting on condoms every time they have sex—for taking the stop-gap procedure as a licence for wanton and unprotected sex can land one in danger.

Circumcision does not provide 100 percent security, he argues.

“Circumcision reduces risks of infections by getting rid of cells that attract HIV, but there is still a 40 percent chance that circumcised men can get the virus,” he explains.

He reckons STIs are so diverse and widespread that circumcision is a must for men who care about their health and loved ones, saying: “It is good for a women’s health too as it reduces their risk to cervical cancer by removing the human pappiloma virus that is often carried in the foreskin.”

As one way of HIV prevention, MDF is providing male circumcision services to soldiers, their spouses and relatives as well as surrounding communities. The VMMC campaign falls under the Behaviour Change and Communications (BCC) programme within the army’s HIV and Aids Department.

Currently, all five MDF camp hospitals are providing VMMC and these are Mafco, Moyale, Cobbe, Chilumba and Kamuzu Barracks.

With support from USA Department of Defence through Project Concern International (PCI) and Jhapigo, MDF has constructed special wings for VMMC and has trained military personnel involved in service provision.

Since 2009, MDF has been implementing the Defence HIV and Aids Prevention Programme in partnership with PCI Global.

MDF, through its 12 military units, provides an array of services, including HIV testing and counseling, antiretroviral therapy, prevention of mother-to-child transmission and prevention.

On the other hand, the behavioural change communications group brings together the theatre for development, peer educators, youth groups, community home-based care (CHBC) givers, chaplains, women platoons and support groups comprising people living with HIV.

According to WHO, medical male circumcision refers to complete removal of the foreskin of the male organ. It is normally done shortly after birth, during childhood or during adulthood.

It is estimated that 30 percent of the world’s male population is circumcised. This accounts for approximately 670 million males.

Evidence shows that the inner skin of the foreskin is more likely to absorb HIV than any other skin, as it is more prone to small tears during sex.

Within the foreskin there are cells called Langerhans and other receptor cells that attract the HIV virus.

Men who are not circumcised are also more likely to get other STIs such as genital ulcers, especially Cancroid and Balanitis, that increase the risk of HIV infection.

But Chimbali, addressing the media recently, warned that the thrust on circumcision does not mean government has forsaken the traditional ABC comprising abstinence, being faithful and condom use.