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News24(SouthAfrica)
June28,2010

Circumcisiontollrising
CapeTownThedeathtollintheEasternCape'swintercircumcisionseasonhasrisento39,theprovincialhealth
departmentsaidonMonday.
SpokespersonSizweKupelosaidthelatestdeathshadoccurredintheNtabankuluandEngcoboareasofTranskeiandon
farmsintheChrisHanidistrict,whichincludesQueenstown.
NationalTraditionalAffairsMinisterSiceloShicekasaidattheweekendhewasconsideringregulatinginitiationschools
afterongoingreportsofyouthsdyingatillegalschools.
Hisdepartmentwasalsoseekingharshsentencingforthosefoundtoberunningillegalschools.
TheEasternCapealreadyhasitsowncircumcisionlegislation,butprosecutionsaresometimeshamperedbyalackofco
operationfromcommunitiesandparents.
KupelosaidonMondayhisdepartmentwassendinganofficialtoMthathainabidtopersuademunicipalcouncillorsto
stopissuingdeathnoticesforvictimsoftheseillegalschools.
Thenoticesallowedfamiliestoobtaindeathcertificatesfromthedepartmentofhomeaffairs,hesaid.
"Thesecannotbetreatedasnaturaldeaths.Theseareallpolicecases,andtheremustbeapostmortemoneveryone,"he
said.
"They(thecouncillors)shouldrathernotifythepoliceifanydeathsarereportedtothem."
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CityPress(SouthAfrica)
June27,2010

Cousinssuccumbtosepticwounds
LoyisoSidimbaatlusikisiki
CousinsXolileMdingwaNgobeandWezileNgobediedofbotchedcircumcisionswithin24hoursofeachotheraftertwo
weeksataninitiationschoolinLambasivillage,Lusikisiki.
MdingwaNgobe(26)wasacarpentry,plumbingandbricklayingstudentatIngweFETCollegeinLusikisiki,whileNgobe
(27)wasunemployed.Theirmothersaresisters.
MournersatMdingwaNgobesfuneralinMgungudlovuonSaturdaydescribedhimasquietandpeaceful.
MdingwaNgobesaunthadboughtacolourfulblanketforhisgraduationceremony.Atthe
funeral,theblanketwasplaced
nexttohiscoffin.
DistraughtuncleWelcomeNgobesaidheonlyfoundoutaboutWezilesinitiationfromyoungmeninhisvillage.
MdingwaNgobetoldan
uncleonhisfathersside,butWezilenevertoldanyone,hesaid.Wezilewasburiedathis
maternalhomeinLambasionThursday.
HewasonlytakentotheStElizabethHospitalonJune16
afterhiscousinMdingwaNgobesdeaththatmorning.
Wezilediedthefollowingmorningatthehospital.
Theirwoundsbecame
septic,Welcomesaid.
Theirtraditionalnurses,
despiteseeingthatthemenhadbeenimproperlycircumcisedbyaningcibiknownonlyas
Bhabholomhlehlo,keptthemintheirhutuntilitwastoolatetosavetheirlives.
Theother10initiatesintheirhutwerealladmittedtoSt
ElizabethHospitalwithbotchedcircumcisions.
Welcomewantsgovernmenttodeclarethesituationadisasterandtostepintoassistthe
familiesofdeadinitiates.Weve
hadtotakeoutloansfortheirfunerals,Welcomesaid.

flikr
June27,2010

NewsloganatGayPrideparade
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June16,2010

HRWurgesKurdstobanfemalecircumcision
ARBILHumanRightsWatchonWednesdaycalledonIraqiKurdishauthoritiestooutlawfemalecircumcisioninthefaceof
growingevidenceofuseofthephysicallyandemotionallydamagingpractice.
Ina73pagereportentitled:"TheyTookMeandToldMeNothing':FemaleGenitalMutilationinIraqiKurdistan,"theNew
Yorkbasedwatchdogrecordedtheexperiencesof31girlsandwomeninfourvillagesinnorthernIraq'sautonomous
Kurdishregion.
...
Thewatchdogsaidthatwhiletherewerenoofficialfigures,localresearchindicatedthatfemalecircumcisionwas
widespreadintheregionandhadaffectedasignificantnumberofgirlsandwomen.
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"Femalegenitalmutilationviolateswomen'sandchildren'srights,includingtheirrightstolife,healthandbodilyintegrity,"
saidthewatchdog'sMiddleEastwomen'srightsresearcher,NadyaKhalife.
...
A2007regionaljusticeministrydecreeorderingthearrestandpunishmentofpractitionersappearednevertohavebeen
implemented,andaproposed2008billtooutlawthepracticehadnevergotbeyondapreliminaryvoteofsupportinthe
regionalparliament,thereportsaid.
Inearly2009,theregionalhealthministrydrewupastrategyforeliminatingthepracticebutlaterwithdrewitssupport
withtheresultthatapublicawarenesscampaignwas"inexplicablydelayed",thewatchdogadded.
FemalecircumcisionhastraditionallybeenpractisedinEgypt,SudanYemenandpartsofeastAfrica.Ithasbeenoutlawed
inanumberofcountries,mostrecentlyUganda.

JerusalemPost
June25,2010

Rehovotnewbornsavedafterbotchedcircumcision
ByJUDYSIEGEL
Infanthadlostathirdofhisblood.
KaplanMedicalCenterdoctorssavedthelifeofanewbornbabywhoonWednesdaywasseriouslyinjuredbyamohel
duringhiscircumcisionandlostathirdofhisblood.
Dr.MariusGuy,aseniorurologicalsurgeon,saidthattheeightdayoldbabyfromRehovotwasinseriousconditionwith
hispenisnearlydisconnectedatitsbase,causingmassivebloodloss.
TheHealthMinistrywasgivenfulldetailsbythehospital,butifwasnotclearwhetherthereligiousfamilywasgoingtofile
acomplaintagainstthemohel.TheparentsrefusedtoallowKaplantoreleaseanyinformationthatmightidentify
themselvesortheritualcircumcisor,thehospitalspokesmansaid.
Inallmyyearsasanurologist,Ineverencounteredsuchadeepcutcausingsuchextensivebloodloss,saidGuy.Thebaby
underwentimmediatesurgerytostopthebloodandlatermicrosurgerytoreattachthepenisonThursday.Skinwas
removedfromthegrointoreplacedamagedtissue.Thebabyisunderobservationinthepediatricintensivecareunit,but
hislifeisnotindanger.
Themothersaidsheopenedthebabysdiaperandfoundalotofblood.
Wecalledthemohel,whocameandputpressureonthearea,shesaid.Heaccompaniedustothehospital.
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Thedoctorssaidtheforeskinhadnotbeenremovedinthefailedcircumcision,butthecutwasmadeontheborder
betweenthepenis,thescrotumandtheabdomen.Inaddition,alargearteryatthetopofthepeniswasharmedinaway
thatendangeredhislife.
[Thissuggeststhatthemohelwasutterlyincompetentyettheparentsleavehimfreetostrikeagain.]
Thesurgeonsaddedthatafteracircumcision,parentsmustopenthediaperandmakesurethebabyisnotbleeding.If
thereisbleedingandthebabyisnotquiet,donthesitatetotakehimtoahospitalemergencyroom,theysaid.
Anybleedinginbabiescanputthemquicklyintoshockandevenendangerlife,oneofthesurgeonssaid.

TheTimes(Swaziland)
June24,2010

PMwantsallMPstocircumcise
BySIBONGILESUKATI
LOBAMBAPrimeMinisterSibusisoBarnabasDlaminiyesterdaysaidarollcalltocheckallmaleparliamentariansifthey
werecircumcisedshouldbeconducted.
DlaminipreachedtotheMembersofParliamentabouttheimportanceofgettingcircumcisedandsaidallthelegislators
shouldplaytheirpartinensuringthatthehalvednewinfectionrateforHIV/AIDSisachievedby2015.
Swaziland
HIVRates:

Circumcisedmen

21.8%

Intactmen

19.5%

Source:www.measuredhs.com
ThePMwasrespondingtoamotionwhichwasmovedbyMafutseniMPJosephMadonselawhosaidthePMshouldcome
upwithanactionplanwhichparliamentarianscanuseinthefightagainstHIV/AIDS.
ThePMsaidtherewasalotthattheMPshadtolearnandadvisedthemthatforstarterstheyshouldbefaithfultotheir
respectivepartners.
Ensure
ThePMtoldfemaleMPstoalsoensurethattheirpartnerswerecircumcisedastheyhadaccesstotellwhethertheir
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partnerswerecircumcisedornot.HefurthersaidfemaleMPsshouldensurethateveryboychildinthefamilyincluding
newlybornbabieswerecircumcised.HesaidtheMPshadabigroletoplayinthefightagainstHIV/AIDSandsaidsoonhe
wouldensurewiththehelpoftheNationalEmergencyResponseCouncilonHIV/AIDS(NERCHA)thathewouldbring
forwardtoParliamenttheactionplan.
[ThereisnoevidencewhatsoeverthatcircumcisingbabiesoffersanyprotectionagainstHIVatall.]
ThePMrevealedthattheAmericangovernmenthadgiventhecountryE200million[=USD26,400,000]forthe
circumcisioncampaignandsaidtheyhadindicatedthatshouldmoremoneybeneededtheywerewillingtoprovideit.He
saidMPsshouldalsobeabletoteachtheirconstituentsontheimportanceoftakingantiretrovirals(ARVs)andthe
PreventionofMothertoChildTransmission(PMTCT).
Hesaidthecircumcisioncampaignshouldalsobepreachedinchurches.

TimesLive(SouthAfrica)
June24,2010

EastCapecircumcisiondeathtollat33
YetanotherwouldbeinitiatehasdiedatanillegalcircumcisionschoolintheEasternCape,theprovince'shealth
departmentsaidonThursday.
Thedeathbringsthetollforthiswinter'scircumcisionseasonto33.
DepartmentspokesmanSizweKupelosaidonThursdaymorninghewasonhiswaytothevillageofMoyeninearLibode,
whereayouthhaddiedonlyhoursearlier.
"Whatisupsettingisthatlastweek,wewentthereandthevillagershidtheseboysaway.Nowtheyarecallinguswhenthis
boyisdead,"hesaid.
"It'sveryupsettingandunnecessary,becausewecouldhavesavedthisboy."
...

IOLNews(SouthAfrica)
June24,2010

Nightmaredragsonforcircumcisionvictims
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ThewintercircumcisiondeathtollintheEasternCapehasreached32,theprovincialhealthdepartmentsaidon
Wednesday.
NewsofthedeathscameastraditionalleaderssoughttoextendamoratoriumoncircumcisiontothewholeofPondoland.
DepartmentspokespersonSizweKupelosaidtwowouldbeinitiatesdiedonThursday,oneatMachibivillagenearPortSt
Johns,andtheotherintheLusikisikiarea.
...
AtStBarnabasHospitalinLibode,oneoftherescuedyouthshadbeenurinatingwhenhisgangrenouspenisdroppedoff,
Kupelosaid.
AtNelsonMandelaAcademicHospitalinMthatha,doctorshadperformedmorethanadozenpartialpenisamputations
sincetheweekend,toremovegangrenoustissue.
DoctorsatStElizabeth'sinLusikisikihadperformedtwofullamputationsthisweek.
...
Kupelosaidotherdepartmentsneededtogetinvolved,becauseitwasnotjustahealthissue.

WoodTV
June22,2010

Didcircumciserhavemorevictims?
KentCountydetectivesaysyes
ByMarcThompson
SPARTA,Mich.(WOOD)TheSpartamanwhoposedasadoctorandperformedanadultcircumcisionillegallyinhishome
mayhavemorevictims,oneinvestigatorbelieves.
OnJune9,ThomasHeugelwassentencedtofiveyearsprobationafterpleadingguiltyinApriltoonecountof
unauthorizedpracticeofahealthprofession;afelonythatcouldhavecarriedafouryearprisonsentence.
TheinvestigatorinthatcaseDetectiveEdKolakowski,oftheKentCountySheriff'sDepartmentalwayssuspected
thereweremorevictims,hesaidTuesday.
24HourNews8obtainedacopyofapolicereportfrom1999whereayoungmanaccusedHeugelofcriminalsexual
conduct.
Sheriff'sinvestigatorswantedtoaddthosechargestothismostrecentcase,butthestatuteoflimitationshadrunout.
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Casessuchastheseareimportant,investigatorssaid,becausetheyshowapatternofindecentbehavior.
In1999,Heugelwasasupervisorforaworkdetailprogram.Youngoffenderswouldbeassignedtohiscaretocomplete
jobsinthecommunity,insteadofservingjailtime.
Inapolicereport,oneoftheoffendersaccusedHeugeloftouchinghiminappropriately.HesaysHeugelinvitedhimbackto
hishouseandofferedhimamassage.
Heugelmadecommentsabouthispubichair,grabbedhispenisandsaidhehadagoodcircumcisionthatwasn'tcutback
toofar,themanalleged.Thecasewasclassifiedasfourthdegreecriminalsexualconduct.
"Itappearstherewerenochargesfiledinthatcomplaint,"Kolakowskisaid.
Hecameacrossthe1999reportandwantedtoaddittohiscase,butwastoldbecausetheCSCwasfourthdegreeandnot
first,thestatuteoflimitationshadexpired.
KolakowskiwaslookingforandstillbelievesHeugelhasothervictims.
...
Earlierstory.

AllAfica.com
June22,2010

SouthAfrica:ControversialPlasticClampUsedtoCircumciseMen
KerryCullinan
KwaZuluNatal'shealthdepartmentisusingaplasticdeviceinitsmassmalecircumcisiondrivethatspeedsupthe
procedurebuthassignificantsideeffectsinadultmen.
DoctorswhospokeanonymouslytoHealthe,expressedconcernaboutthedepartment'suseoftheTaraKlamp(TK),a
disposabledevicedesignedtostayonthepenisforaroundsevendaysuntilitfallsoffwiththeforeskin.
AsmalltrialofyoungmeninOrangeFarmfoundthatthosecircumcisedwiththeMalaysiandevelopedTKwerefarmore
likelytoreportbleedingandswellingthanthosecircumcisedwithforceps.
Thetrialinvolved69men,35ofwhomwerecircumcisedwiththeTKand34withforceps,andwaspublishedintheSA
MedicalJournalinMarch2009.
Almost40percentofthosecircumcisedwiththeTKreported"adverseeffects"includinginfection,delayedwoundhealing,
swellingandproblemswithpenisappearancewhileonlythreepercentofthosecircumcisedwithforcepsreportedany
problems.
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ThispromptedleadresearcherDrEmmanualLagardeandcolleaguestoconclude:"Giventhehighrateofadverseeventsin
thisstudyandthelownumberofavailablestudies,westronglycautionagainsttheuseoftheTKforyoungadults,andwe
recommendcarefulevaluationoftheprocedurewhenperformedonchildren."
[Whydochildrengetlessprotectionthanadults?]
TheWorldHealthOrganisation(WHO)hasadvisedcautionwhenusinganydevicestocircumcisemen.
"Currently,WHOdoesnotrecommendanydevicesforcircumcisionamongadultoryoungmen,"accordingtothe
organisation'scircumcisionguidelines.
"WHOencouragesfurtherresearchonpromisingdevicestoassesstheirsafety,effectivenessandacceptability.The
surgicalapproachesusedintherandomizedcontrolledtrials(theforcepsguidedandsleeveresectionmethods)havebeen
showntobesafe,effectiveandacceptable."
Afterasignificantdelayinrespondingtoqueries,duringwhichtimetheprovince'sfirst"circumcisionweekend"washeld,
departmentalspokespersonChrisMaxonsaidthatwhiletheWHO"providesguidancetomembercountries",countries
"mayusetheirdiscretiontoutilisemethodsthatmightnotbeapprovedbytheWHObutarebeneficialtotheir
communities".
"ItisnotthefactthatWHOdoesnotapprovetheTaraclampbutthefactistheydonothaveenoughdataontheuseofthe
deviceatamassscale,whichiswhatKZNwillprovideatalaterstage,"saidMaxon
"TheuseoftheTaraclampinKZNwillbeusedunderstrictprotocolswhichwillincludetrainingandsupervisionbythe
surgeonthathasbeenidentifiedbytheprovince."
However,DrFrancoisVenter,headoftheSAHIVCliniciansSocietysaid:"Goodlocalandpublisheddatasuggeststhatthe
TaraKlampismoredangerousthanWHOrecommendedmethods.WehavepreciousfewHIVpreventioninterventions
availabletous.IdonotunderstandwhyKZNwouldbeusingthisdevice,whenwehavesaferalternatives,especiallywhere
unsafecircumcisionhasbeenroundlycondemnedbythenationalDepartmentofHealth."
Currently,thedeviceisbeingsoldwholesaleforR99andHealthewasunabletoconfirmrumoursthattheMalaysian
companyplannedtoopenamanufacturingplantintheprovince.
TheprovincehasembarkedonamassmalecircumcisiondriveascircumcisedmenhaveafarlowerchanceofgettingHIV
thanuncircumcisedmen.

TimesLive(SouthAfrica)
June21,2010

Pondolandcircumcisiondeathtollrises
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TwentyeightinitiateshavediedincircumcisionschoolsinthePondolandareasinceJune5,theEasternCapehealth
departmentsays.
"We'velostsixmoreboysineNgcobo,Libode,QumbuandTsoloovertheweekend,"departmentspokesmanSizweKupelo
toldSapa.
TwodiedwhentheirinitiationschoolineNgcobocaughtfireonFriday,whilethefourdiedinbotchedcircumcisions.
Thedepartmentsuspendedthewintercircumcisionseasonfollowingameetingwithchiefs,traditionalhealers,surgeons
andresidentsinthePondolandarea.
"Inotherareasinitiationshavebeenrunningsmoothlywithoutincidents.Thereasonforthiscrisishereisthatboyswho
werecircumcisedlastyeararenowrunningtheseinitiationschools."
Intheregiontherewere77legalinitiationschools,but"flybynight"oneswereresponsibleforthedeaths.
SincethebeginningofJune,14boyshavehadtheirgenitalsmutilatedandhundredswererecoveringinhospitals.
Hospitalsinthearea,Kupelosaid,wereunderpressuretodealwiththesharpriseinbotchedcircumcisions.

Oh,suspendthemaltogether!

news24(SouthAfrica)
June18,2010

22die,circumcisionssuspended
EastLondonTraditionalcircumcisionsweresuspendedinthePondolandareaonFridayafterthedeathtollfollowing
botchedcircumcisionsroseto22,theEasternCapehealthdepartmentsaid.
ThedecisiontosuspendthecircumcisionsforthisseasonwastakenatameetingbetweenhealthMECPhumuloMasuale,
traditionalhealers,surgeonsandcommunitymembersintheLusikisikiarea.
"Thosewhoattendedthemeetingwereinagreement...thiswillallowustointerveneandtodealwiththoseboyswhoare
alreadyinthemountain,"saiddepartmentspokespersonSizweKupelo.
Teamscomprisingdoctors,policeofficers,traditionalhealersandsurgeonswouldbedispatchedtovariouspoststoassess
theboys.
Hospitalsintheareawereunderpressuretodealwiththesharpriseinbotchedcircumcisions.Thiscontributedtothe
decisiontoputaholdontheprocedure.
Circumcisioncourts
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...
Kupelosaidthedepartmentwasseekingmeetingswiththepolice,justicedepartmentandtheNationalProsecuting
Authoritytodiscussthepossibilityofsettingupspecialcircumcisioncourts

Bernama
June9,2010

72PerCentOfAids/HIVSufferersInMalaysiaAreMuslimsAIDSCouncil
KUALATERENGGANU,June9(Bernama)Morethan70percentofthe87,710HIV/AIDSsufferersinthecountryare
Muslims,MalaysianAIDSCouncilvicepresidentDatukZamanKhansaidonWednesday.
[60.4%ofthepopulationofMalaysiaisMuslim,theremainderBuddhist,Christian,Hindu,andChinesereligions.Virtuallyall
Muslimmenarecircumcised,virtuallynoneoftheothersare.]
Therefore,hesaid,thecelebrationforthisyear'sWorldAIDSDaywouldemphasiseeffortstoenhancetheparticipationof
andawarenessonAIDSamongMuslims.
HesaidwhatwasmoreworryingareportbytheUnitedNationsGeneralAssemblySpecialSession(UNGASS)onAIDS
whichstatedthatnineMalaysianswereinfectedwiththediseaseeveryday.
Alsoofconcernwasthespreadofthediseaseamongwomen,from9.5percentin2000to20percentlastyear,hesaid
whenspeakingatafunctiontocommemorateWorldAIDSDayhereTuesdaynight.
Hesaidthatin2000themaincauseofwomenbeinginfectedwithHIV/AIDSwasdrugaddiction,butlately,ithadbeen
attributedtoheterosexualsex(30percent).
Thishappenedbecauseoflackofconcernandcooperationfromthesocietytoprotectwomenfromthedisease,headded.
...

BBCNews
June18,2010

Circumcisionskill20boysinSouthAfrica
TwentySouthAfricanboyshavediedfollowingbotchedcircumcisionsintheEasternCapeProvince.
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"Thedeathsoccurredoverthepast12days,withnineofthemoccurringoverthepast24hours,"saidaprovincialhealth
spokesperson.
Some60boyshavebeenrescuedfrom11initiationschoolswhichhavesincebeenclosed.
CircumcisionisseenasariteofpassageintomanhoodinsomeSouthAfricancommunities.
ThepracticeiscommonamongtheXhosaandNdebelecommunities.
However,ZuluKingGoodwillZwelithiniwantsitreintroducedamongtheZulupeoplebecauseofreportsthatmedical
circumcisioncanreducethechancesofgettingHIV.
TherescuedboyshavebeentakentotheNelsonMandelaAcademicHospitalinMthatha.
"All60ofthemhavesepticwoundsandaredehydrated,"saidEasternCapehealthspokespersonSizweKupelo,reports
Sapanewsagency.
"Fouroftheboysevenneedtheirgenitalsremovedcompletely,asitcouldresultindeathifit'snot.Wearejustwaitingfor
consentfromtheirparentstoperformtheprocedures."
...

TheStranger(Seattle)
June16,2010

FemaleGenitalMutilationatCornellUniversity
PostedbyDanSavage
WhilethewholeworldwasdebatingtheAmericanAcademyofPediatrics'positionon"femalegenitalcutting"theAAP
wasagainstitbeforetheywereforit,andnow,afteranoutcry,they'reagainstitagainAliceDregerandEllenFederhave
beenraisingthealarmabout"medicalresearch"currentlybeingconductedatCornellUniversity.Apediatricurologistat
CornellDixPoppashasbeenoperatingonlittlegirlswithwhathejudgestobeoversizedclitorises,cuttingawayimportant
clitoraltissues,andthenstitchingtheglanstowhatremainsoftheshaft.Poppasclaimsthat,unlikepastclitoralreduction
procedures,hisprocedureis"nervesparing."...
Tothestudy
[Thearticlehasprovokedwidespreadoutrage,someofitbasedonthemisapprehensionthattheinsturmentPoppasusedto
measureclitoralsensitivity(a"biothesiometer")wasasexualvibrator("massager").Allcomparisonswithmalecircumcision
havebeenpredictiblypoohpoohed,thoughbothoperationsaretomakethechild'sgenitalsconformtoparentalexpectations
ofwhatis"normal"fortheirsex.Sincethesechildrenhad"ambiguousgenitalia"somemightgrowuptoidentifyasmaleand
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considerwhatwasdonetobeunwantedpenilereductionsurgery,verymuchakintocircumcision.]

RecipeforanHIVtsunami

TheObserver(Swaziland)
June17,2010

CircumcisedcanstilldonatebloodSNBTS
ByCalsileMasilela
THESwazilandNationalBloodTransfusionService(SNBTS),theonlyserviceundertheministryofhealthresponsiblefor
thesupplyofbloodandbloodproducts,sayscircumcisedindividualsareamongthetargetgroupstomakepotentialblood
donorsintheeraofHIVandAIDS.
Thisgroupislistedamongthesafetargetsforpeoplewhocanbeconsideredtodonatebloodforuseinhospital
transfusion.
Weconsideranyonewhohastakenthedecisiontocircumciseasapersonwhohastakenastandtoliveahealthylifestyle.
Livingahealthylifestyleisoneoftheselectioncriteriaforpeoplewhomaybeconsideredforblooddonation,saysthe
HeadofClinicalLaboratoriesandBloodTransfusion,Dr.HoseaSukati.
[Thisismadness.Thereisampleevidencethatsomemenchoosetobecircumcisedsothattheycangiveupusingcondoms.]
Hesaid,Apartfromthedecisiontocircumcise,weknowthattheseindividualsalreadyknowtheirHIVstatus,therefore,
theyareconsideredtobeamongthesafegroupforblooddonation.
Swaziland
HIVRates:

Circumcisedmen

21.8%

Intactmen

19.5%

Source:www.measuredhs.com
He,however,indicatedthattheymaybecompelledtodeferapotentialblooddonorforacertainperiodonlyiftheyhave
performedtheircircumcisionoutsideofacreditedhealthinstitution.
TheSNBTSDonorRecruiterKhayaMavusoencouragedcircumcisedblooddonorstocontinuetosharetheirgiftoflife.He
statedthattheywerecurrentlyvisitinginschoolyouthtorequestforblooddonations.
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...
Asabloodbank,wedonotprovideHIVtestingtothepublic.
[Butdotheytestdonations?Accordingtothisstudy,manydevelopingcountriesdon't.]
...
HefurtherexplainedthatWorldBloodDonorDayalsoprovidedanopportunitytocelebratethosewhohavevoluntarily
donatedtheirblood.
...

TimesLive(SouthAfrica)
June17,2010

ECcircumcision:13deadin12days
TwomoreinitiateshavediedintheEasternCape,bringingto13thenumberofcircumcisionrelateddeathsinthepast12
days,theprovincialhealthdepartmentsays.
A16yearoldyouthfromNxukhwebevillageinLibodediedonWednesdaynight,spokesmanSizweKupelotoldSapa.
OfficialsfromthedepartmentwereraidingillegalinitiationschoolsinthePortStJohnsareaonWednesdaywhenthey
learntofanotherdeathofaninitiatethathappenedonSundaynight.
TheteenagerfromPortStJohns'KwaQubuswayovillagediedonhiswaytohospitalafterhisfatherarrangedforhimto
gettreatment.
"Hisisasadcasebecausehewentforinitiationwithouthisparents'permissionandbecausehisfatherwasnotcircumcised,
he[thefather]wasnotallowedintotheinitiationschool.
"Hehadtodependonreportsfromtraditionalnursesabouthisson'shealthanditwastoolatewhentheytoldhimofhis
condition,"saidKupelo.
Theteenagerdiedonhiswaytohospital.Apostmortemtodeterminetheactualcauseofhisdeathwasexpectedsoon.
Meanwhile,HealthMECPhumuloMasualewasonThursdayvisitingtheNelsonMandelaAcademicHospitalinMthatha
whereanumberofboyswerefacingpenileamputation.
HewouldalsovisitillegalinitiationschoolsinMthatha,LibodeandLusikisiki,beforemeetingtraditionalleadersinthe
areasoverthedeaths.
SevenunderagedinitiateswererescuedfromanillegalinitiationschoolrunbyMtshiyelwaMtshayinaNdoda,a55year
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oldunregisteredtraditionalsurgeonwhohadbeenarrestedseveraltimesfortheoffence.
"Hewasrecentlygivenathreeyearsuspendedsentencebuthecontinueddoingthesamething.Inthepastfiveyearsclose
to20initiatesdiedinhisschoolsand15hadtheirpenisesamputated."
NdodahasapendingcaseofoperatinganillegalinitiationschoolwhichwillbeheardonJuly22.
Kupelosaidthedepartmentwasalsoseekingmeetingswiththepolice,justicedepartmentandtheNationalProsecuting
AuthoritytodiscusstheprosecutionofthosecontraveningtheTraditionalCircumcisionAct,whichregulatesthecustomin
theprovince.
"Themajorproblemisthatparentsarereluctanttoprosecuteillegaltraditionalsurgeonswhosometimesforcetheir
childrenintocircumcisionataveryyoungage.
"Weidentifytheperpetrators,butifparentsarenotwillingtoopencasesagainstthem,theyarefreedandcontinue
illegallycircumcisingandkillingtheseboys,"Kupelosaid.
Lastyearalone,91initiatesdiedandhundredswerehospitalisedintheprovince.

Dispatch(SouthAfrica)
June17,2010

35wouldbeinitiatesrescuedinTranskei
EASTERNCapeHealthDepartmentofficialsrescued35teenagersfromillegalcircumcisionschoolsintheTranskeiinthe
earlyhoursofyesterdaymorning.
...
HealthDepartmentspokespersonSizweKupelosaid...designatedmedicalofficersaccompaniedbypoliceinvadedthe
areayesterday,searchingforillegalinitiationschools.
Hesaidtheydecidedtovisittheareaafterreceivingatipoffaboutillegalinitiationschoolsinthearea.
Werescued35boysinLibodeandtookthemtohospitalfortreatment,hesaid
Duringtheoperation,whichstartedat3am,fourillegalinitiationschoolswerecloseddown.
Wehaveanumberofinitiateswhoarereceivingtreatmentinourhospitals;therearefouratStElizabethHospital,fourat
BambisanaHospital,bothinLusikisiki;fiveatMthathaGeneralHospital,allinacriticalcondition,hesaid.
Kupelosaidanother16initiateswereinaveryseriouscondition,12weretakentoStBarnabasHospitalinNgqeleniand
fourtoNelsonMandelaAcademicHospitalinMthatha.
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...
NkosiJongusaphoBokleniofNgqelenisaidtheboysweredyingbecausetherewasnoproperrunningoftheriteinthe
area.
Theseyoungboysletunauthorisedindividualswhoarealsonotfamiliarwiththeritetocircumcisethem,hesaid.
Boklenisaidlackofdisciplineamongtheyoungboyswasalsoamajorproblem.
Sinceinitiationisnotpartofourculture,theseboysdonotlistentous,theysaytheycannotlistentoboys,hesaid.
Boklenisaidtheyhadrunoutofideasonhowtodealwiththecontinuousdeathsinthearea.
Thisproblemisgettingworseeachyear,hesaid.
...

IOL(SouthAfrica)
June16,2010

Nursestraumatisedbycircumcisioncases
AnotheryouthhasdiedatacircumcisionschoolinMthatha,bringingtoninethenumberofinitiationrelateddeathsinthe
past10days,theEasternCapeHealthDepartmentsaidonTuesday.
"Itisatraumaticexperiencetoseeayoungboylosinghisgenitalsinoneday.Ournursesarefindingithardtodealwith,"
saidspokespersonSizweKupelo.ThelatestdeathwasonMonday.
...
Hesaidthatwhilethecauseofdeathwasstillunknown,theteenagerhadbeeninaninitiationschool.
Thehealthdepartmentwas"extremelyconcerned"aboutthedeathsandthehighnumberofcasualtiesinvolved.
OnTuesday,Kupelosaid32youthsbetweentheagesof10and16hadbeenadmittedatStBarnabashospitalinLibode
andthatfourinitiationschoolshadbeencloseddownbythedepartment.
"Thehospitalcannotadmitmoreoftheseboysbecausethere'snospaceinitswards,"hesaid.

News24.com
June14,2010
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Leadersmeetovercircumcisiondeaths
MthathaEasternCapehealthMECPhumuloMasualewillmeettraditionalleadersintheMthathaareathisweekover
circumcisionrelateddeaths,aspokespersonsaidonMonday.
Sevenyouthshavediedofbotchedcircumcisioninthepastninedays,saiddepartmentalspokespersonSizweKupelo.
ThefirstwasayouthfromMandelaParkVillage,inMthatha,whodiedlastSaturday.
TheseconddiedonThursdayatGodiniVillagenearLibode.ThreeothersdiedatKwaCele,MarhamzeniandMkhambathi
villages,outsideLusikisiki,onSaturday,whiletwomorefromLusikisikidiedonSunday.
"Oneofthetwoinitiateswhodiedyesterday(Sunday)wasallegedlydumpedbyabakkieathishome.Thebakkiethen
spedoff,"saidKupelo.
Hesaidthatwhilethecauseofdeathwasstillunknown,theteenagerhadbeeninaninitiationschool.
Thehealthdepartmentwas"extremelyconcerned"aboutthedeathsandthehighnumberofcasualtiesinvolved,with24
initiatesinhospital,someofthemsinceMarch.
91diedlastyear
"ItcoststhedepartmentoverR1000adaytotreataninitiate.Itiscostingusmillionsofrands,"saidKupelo.
Thedepartmentworkeddayandnightandoverweekends,respondingtocomplaintsaboutyoungboysbeingcircumcised.
"Thedepartmentisnottryingtocoordinatetheancienttradition,butinsteadofwaitingforinitiatestodie,wegot
involvedtosavetheboys'livesandsavethedepartmentalotofmoney."
"Wewillcontinuetohelp,butcallontraditionalleadersandothercustodiansofthecustomtodomore,"hesaid.
Meanwhile,anunregisteredtraditionalsurgeon,MtshiyelwaMtshayinaNdoda,55,appearedintheLibodeMagistrate's
Courtforillegallycircumcisingboysinthearea.
Hehasillegallycircumcisedmorethan300boys,chargingthemR200oralivechicken.HiscasewaspostponeduntilJuly
22.
Lastyearalone,91initiatesdiedandhundredswerehospitalisedintheprovince.

Howmanydeathswillittaketillweknowthattoomanypeoplehavedied?

DispatchNow24/7(SouthAfrica)
June14,2010

Initiatediesascircumcisionseasonopens
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AnteenageinitiatehasdiedatacircumcisionschoolinMdantsaneovertheweekend,astheseasonforyoungboys
passagetoXhosamanhoodstartedoffwithschoolsclosinglastweek,writesBonganiFuzile.
CaptainLeonFortunesaidpolicewerecalledtoaninitiationschoolinNU15onSaturdayafteritwasreportedthatan
initiatewasgettingsick.
Onarrivalathishut,hewasalreadydead.Thereportisthathebecamesickandstartedvomiting,saidFortune.
Policeareinvestigatingcircumstancesaroundhisdeath.
...

JerusalemPost
June13,2010

TraditionalIsraelibritmilatechniqueupsinfectionrisk
ByJUDYSIEGELITZKOVICH
J'lemdoctorssayemployingdifferentmethodtostanchbleedingcouldreducecomplications.
ThelongtimepracticebyIsraeliritualcircumcisers(mohelim)ofusinggauzeforaslongas26hourstostoppenilebleeding
isresponsibleforthesignificantlyhigherrateofurinarytractinfections(UTIs)withinafewweeksoftheJewishritual.
AccordingtopediatriciansandinfectiousdiseasesexpertsatJerusalemsShaareZedekHospital,byadoptingadifferent,
yetsimplemedicaltechniqueforstanchingthebleeding,manyUTIscanbeprevented.
...
StudiesconductedabroadhaveshowedthatUTIswereinfrequentwhenaphysicianperformedthecircumcision,even
outsideahospitalorclinic,comparedtotherateamongIsraelimalescircumcisedbyamohel.Thedifference,theauthors
suggested,wasinthemethodusedtostopthebleeding....(calledhemostasisinmedicaljargon),anaspectofbritmilathat
isnotdictatedbyJewishlaw....TheuniquephenomenonofthehighrateofUTIinmaleinfantsinIsraelseemstobe
relatedtothetraditionaltechniqueofhemostasis.Itistimetoimprovethepracticeoftraditionalcircumcision.
Afterbeingaskedtocomment,theHealthMinistrytoldTheJerusalemPostitwouldseriouslyconsiderthe
recommendationsinthejournalarticlesanddecidewhethertoasktheReligiousServicesMinistrytodirectmohalimto
changetheirhemostasistechniques.
TheShaareZedekteamstudiedthemedicalrecordsof449newbornsuptotheageoffourweekswhowerebroughtwith
fevertothehospitalspediatricemergencyroombetween1997and2006.AllunderwenturineculturesforUTIs,andthe
290withapositiveculturehadculturestakenoftheircerebrospinalfluid.Theirparentswereaskediftheinfantshad
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recentlyundergonecircumcisionand,ifso,whetherithadbeenperformedbyanonphysicianmohel.
Aftereightdaysoflife,24.7%ofcircumcisedboyswhohadfeverwerefoundtohaveUTIs,comparedto8.4%ofgirlsofthe
sameage.Meningitiswasfoundtobeveryrare.
Mohalimhavealreadychangedsomeoftheirmethodsoutofhealthconsiderations.Forexample,theyabandoneddirect
suckingbymouthofthebleedingorgan[exceptinNewYork]toavoidgivingorgettinghepatitisBorC,orHIVinfections,
andinsteadsuckthroughanhourglassshapedglasstubeinwhichcottonwoolisinsertedtopreventtransmissionof
pathogensineitherdirection.

TimesLive(SouthAfrica)
June12,2010

Destituteteencircumcisedboys
ByZINEGEORGE
Aboyhasconfessedtocircumcisingatleast35youngstersafterquittingschooltoperformtheritualinexchangeforcash.
Theteenadmittedtohavingusedanunsterilised,homemadescalpeltocircumciseyoungstersforaslittleasR25[$US
28.25].
Policearrestedthe15yearold,wholiveswithhisunemployedmotheratMchonkcoVillagenearMthatha,lastweek.
Healthofficialswereshockedtolearnthathehadstartedperformingcircumcisionsattheageof10withoutanytraining.
About91initiatesdiedintheEasternCapelastyearafterbotchedcircumcisions.
Aspokesmanfortheprovincialdepartmentofhealth,SizweKupelo,saiditwascostingoverR1000adaytotreateach
initiate.
Theteen,whomaynotbenamedbecauseheisaminor,hasbeensummonedbyelderstoappearbeforeatraditional
councilatNgqeleni.Hefacesafineofonecowforillegallyperformingtheritual.
Tearingup,theboytoldtheSundayTimes:"IdiditbecauseIknowIcandoit.Iusedtopractiseonotherboysatschool
whiledoinggrade1.It'ssimple.Whenoneofmyfriendsaskedmetodoitin2005,Ididit."
Theboy,whowasinitiatedhimselfin2008,saidtherehadbeenno"casualties"fromhisoperations.
Hestartedsoyoungbecause:"Idon'thaveafather.Mymotherisunemployed.Iamthebreadwinnerathome.That'swhyI
droppedoutofschoolingrade2.Ihadtofindawaytomakealiving.
"Iwashmytoolswithwater,andthat'sit.IfIhavetodealwithmoreboyslater,Ijustwipeit."
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His28yearoldmothersaid:"Iamawoman,andhavenothingtodowithinitiation.Iwasnotawarethatmysonwasa
surgeon.WhenIaskedaboutthecashhebroughthomefromtimetotime,hesaidhewashelpingotherinitiates."
Mthathahospitalcomplex'schiefmedicalsuperintendent,DrMbuyiseloMadiba,condemnedtheteen"surgeon"and
blamedthelocalcommunityandtraditionalleaders.
"Atraditionalnursemustbeknowntothecommunityandthechief.Howcantheyallowaboywhoshouldbeatschoolto
dothis?Initiationisnotaboutcuttingtissueorforeskin.It'smovingfrombeingaboytobeingaman,andhelpingayoung
manthroughthistransition.Heshouldhavebeenarrestedlongago."
PolicesaidtheteenfacedachargeofcontraveningtheCircumcisionAct.

HubPages
June12,2010

SouthAfricaAndThe2010WorldCup:InTheEyeOfTheStorm65
Byixwa
...Insomeofitsbreakingnews,theDailyNewshasreportedthat"Morethan800menhavebeencircumcisedinKwaZulu
NataltohelpcombatHIVinfections.Sofar800menhavebeencircumcisedaTtheendofApril.Thepremiersaidthatthe
provincialgovernmenthadsetatargetofcircumcising47,055newbornboyand186,703malesduring2010/11.Strong
evidencefromclinicaltrialsinOrangeFarminGauteng,KenyaandUgandahaddemonstratedthatcircumcisedmaleshad
closeto60percentlesschanceofacquiringHIVduring[unprotected]sexualintercoursethanuncircumcisedmen.In
Eshowe,accordingtopremierMkhize,hisdepartmentandtheUnitedStatesGovernment'sPresidentialEmergencyPlan
forAidsReliefwouldholdthefirstmalecircumcisioncamp,formenbetweentheagesof14and25years....[Howmany
newbornshaveunprotectedsex?]

WZZM
June10,2010

Spartamanwhoperformedillegalcircumcisionwantsanapology
GrandRapids,MI(WZZM)ASpartamansentencedtoprobationforperformingacircumcisionwithoutamedicallicense
saystheKentCountysheriffoweshimanapology.
"Thewaytheinvestigationwasconductedwasinappropriate,"says56yearoldThomasHeugel.
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ThomasHeugeladmitsheperformedacircumcisionona21yearoldhomelessmanwithadeformity.
"Hebeggedme,'Please,pleasehelpme',"saysHeugel."IdecidedthatwastheonlythingthatwasgoingtocureitsoIdid."
Heugel,whosaysheistrainedparamedic,saysthepatientiscompletelysatisfiedwiththeresults.
...
Heugelpledguiltytoonecountofpracticingmedicinewithoutalicense.KentCountyCircuitCourtJudgeGeorgeButh
sentencedhimto5yearsprobation.
[Apparentlyhiscrimewaspretendingtobeadoctor.Anyonemaycircumciseanyone.]
"Thecourtisnotplacingyouonanyadditionaljailtime,"thejudgetoldHeugel."Youhavereceivedsufficientpunishment
becauseofthedisgraceyouhavesuffered."
DuringtheinvestigationtherewerereportsHeugelmaybeoperatingacircumcisionclinicinhishome.Thathemaybe
assaultingminors.
Nosupportingevidencefromthedetectiveonthecasewaseverpresentedincourt.
...
Becausehepledguiltytothesinglechargetherewasnotrialandprosecutorsneverhadanopportunitytopresentany
evidenceagainstHeugel.
...
Earlierstory

TimesLive(SouthAfrica)
June9,2010

Threehospitalisedwithgangrenouspenises
ThreeTranskeiboyshavebeenadmittedtoMthatha'sNelsonMandelaAcademicHospitalwithgangrenouspenises
followingillegalcircumcisions,saystheEasternCapehealthdepartment.
Thehealthdepartment'sspokesmanSizweKupelosaidtheboys,fromtheNgqeleniarea,wouldreceivespecialistcareina
bidtoavoidamputation.
TheywerepartofagroupofsixoriginallytakentoLibode'sStBarnabasHospital.
Kupelosaida20yearoldmanwasarrestedintheLibodeareaonWednesdaymorningafterhecircumcisedsixother
underageyouths.
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HealthdepartmentofficialswereonWednesdayafternoonpreparingtorescueeightyouthsfromanillegalcircumcision
schoolintheNgqeleniareafollowinginformationthattheywereill.
Kupelosaidithademergedthata14yearoldarrestedlastweekforperformingillegalcircumcisionsonhisagemates,was
responsibleforpreviousbotchedoperationsthathadalreadyresultedinninepenisamputations.
Theyouth,whohadbeenreleasedfromcustody,wasbeingdealtwithunderthenewlyimplementedChildCareAct.
HeisscheduledtoappearbeforeatraditionalcouncilonThursday.

GulfDailyNews
June9,2010

Circumcisiongirl'sfatherwinscustody
ByRASHAALQAHTANI
AFATHERatthecentreofarowaboutthecircumcisionofhisfiveyearolddaughterwasyesterdayawardedcustodyof
thechild.
Thegirl'sBahrainimother,28,waspreviouslyarrestedafterasixdayhuntwhenshewentintohidingwiththeyoungster,
toavoidhavingtohandherbacktotheEmiratifollowingacustodyvisit.
Shewasreleasedthefollowingdayandfiledanofficialcomplaintagainstherexhusband,accusinghimofperforming
illegalcircumcisiononthechild.
ShariaCourtjudgesyesterdayrefusedmother'srequesttoimposeatravelbantokeepthegirlinBahrain,duringaclosed
doorsessionbutawardedthefathercustody.
Thefather'slawyersearlieradmittedthatthegirlhadbeencircumcised,butsaiditwasatraditionpractisedintheUAEand
wasdonelegallybydoctors.
...
Thecouplemarriedin2004andtheirdaughterwasbornthefollowingyear.
TheydivorcedayearlaterandthefatherreturnedtotheUAEwiththechild.
However,themotherthenfoughtforlegalcustodyofherdaughterinBahrain'scourts,whichgrantedherfullcustodyin
2006.
Butthechild'sfatheralsofiledacaseintheUAE,whereacourtawardedhimfullcustodyin2008,althoughthemother
laterwonvisitationrights.
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ThemothernowplanstocontinuehercustodybattleattheIslamicShariacourt.
...

TimeLive(SouthAfrica)
June4,2010

14yroldarrestedforillegalcircumcision
A14yearoldboywasarrestedintheNgqeleniareaofTranskeiafterperformingillegalcircumcisionsonsixyouths,says
theEasternCapehealthdepartment.
Hewouldbechargedundertheprovince'scircumcisionlaws,spokesmanSizweKupelosaid.
Thesixboyswerethesameageashewas.
"Thisboy,accordingtopolice,hasbeenwantedforsimilaroffencesforthelastthreeyears,meaninghestartedthisthing
atten[yearsofage]"Kupelosaid.
"Thisreallycallsforcommunitymembers,traditionalists,torelookatthisthing,becauseit'snolongeracustomaryritual,
it'ssomethingelse:boysjustdoingastheywish."
Hesaidthearrestcameasthewintercircumcisionseasongotunderwayintheprovince.
ElevenillegallycircumcisedboyshadbeenadmittedtoLibode'sStBarnabasHospitaloverthepasttwodays.
Severalofthemhadhadtohavebotchedcircumcisionsredone.
HealthdepartmentofficialswerelateonFridayontheirwaytoBhukwinivillagenearLibodetorescueagroupofboysatan
illegalcircumcisionschoolwhowerereportedlysick,Kupelosaid.
Everyyearscoresofyouthsintheprovincearehospitalised,andanumber[90in2009]die,afterbotchedcircumcisions.
Theprovince'scircumcisionlawprovidesthatonlyboysolderthan17maybecircumcised,andthenonlyatrecognised
schools.

Reuters
June4,2010

Circumcisionmaypreventsexrelatedpenisinjuries
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NEWYORK(ReutersHealth)Anewstudyfindsthatcircumcisedmenappearlesslikelytosustaincuts,abrasionsand
otherminorinjuriestothepenisduringsexwhichmayhelpexplainwhycircumcisionlowerstheriskofHIVtransmission
fromheterosexualsex.
Forthenewstudy,researchersuseddatafromanHIVclinicaltrialinAfrica,wherenearly2,800menbetweentheagesof
18and24wererandomlyassignedtoundergocircumcisionorremainuncircumcised.In2005and2006,thattrialandtwo
othersinUganda,SouthAfricaandKenyashowedthatcircumcisioncanreduceaman'sriskofHIVinfectionthrough
heterosexualsexbyupto60percent.[Theyneverfailtomentionthatfactoid,dothey?]
Inthecurrentstudy,theresearchersfoundthat,overtwoyears,circumcisedmenwere39percentlesslikelythantheir
uncircumcisedcounterpartstoreportanytypeofpenileinjuriesduringsex.
ThisraisesthepossibilitythatlowerinjuryriskisonereasonthatcircumcisionlowerstheoddsofHIVtransmission,
accordingtotheresearchers,ledbyDr.SupriyaD.MehtaoftheUniversityofIllinoisatChicago.[Italsoraisesthepossibility
thatcircumcisionmakesmenlesslikelytoreport(other)penileinjury...]
ExactlywhycircumcisionmayprotectagainstHIVduringsexisunknown,MehtaandcolleaguesreportintheJournalof
Urology.Thereareafewtheories:Oneisthat,byreducingtheamountofmucosaltissueexposedduringsex,circumcision
limitsthevirus'accesstothebodycellsittargets.Anothertheoryisthatthethickenedskinthatformsaroundthe
circumcisionscarhelpsblockHIVfromgainingentry.
Butthereisalsoapossibleroleformildpenileinjuriescuts,scratchesandtearsintheskinthatcouldserveasaportalof
entryforHIV.Insomepaststudies,uncircumcisedmenhavereportedhigherratesofsuchinjuriesthancircumcisedmen.
Attheoutsetofthecurrenttrial,64percentofthemensaidtheyhadsustainedsomeformofpenileinjuryduringsexinthe
pastsixmonthsmostoftengeneralsoreness,scratches,cutsorabrasions.Seventeenpercentsaidtheyhadbleeding.
[Thosefiguresareremarkablyhighdidtheycontrolfordrysex?]
Sixmonthsintothetrial,thatratewasonthedecline.Byyeartwo,31percentofcircumcisedmensaidthey'dhadasex
relatedpenileinjuryinthepastsixmonths.
Menintheuncircumcisedgroupalsoreportedareductionininjuries,thoughitwaslesssignificantwith42percentsaying
they'dsustainedapenileinjuryinthepastsixmonths.Thatdecline,accordingtoMehta'steam,islikelyduetothegeneral
improvementsbothstudygroupsshowedintheirsexualhealthpracticesincludinggreatercondomuseandfewersex
partners.
[Andthedifferencebetweenthosetwofiguresis11percent.Thereductionattributabletojustgoinginthestudythe
Hawthorneeffectisthreetimesthereductionattributabletocircumcision.]
Menwhosaidtheyhadhadmultiplesexpartnersinthepastmonthweremorelikelytoreportsexrelatedpenileinjuries
thanthosewhohadbeenmonogamous.Ontheotherhand,condomuseandthehabitofwashingthepeniswithinanhour
ofhavingsexwerebothlinkedtodecreasedrisksofpenilesorenessandotherinjuries.
Furtherstudies,Mehta'steamwrites,shouldlookattherolepenileinjuriesmayplayinthetransmissionofHIVorother
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sexuallytransmitteddiseases.
[Orperhapstheyshouldlookharderforconfoundingfactorsandanexplanationfortheextraordinarilyhighrateofpenile
injuriesinthissample.]
SOURCE:here%2810%29029885/abstractJournalofUrology,onlineMay17,2010.
Thestudyis

JUrol.2010May16.
CircumcisionandReducedRiskofSelfReportedPenileCoitalInjuries:Results
FromaRandomizedControlledTrialinKisumu,Kenya.
MehtaSD,KriegerJN,AgotK,MosesS,NdinyaAcholaJO,ParkerC,BaileyRC.
Abstract
PURPOSE:Injuriestothepenisduringintercourserepresentahypothesized
mechanismbywhichuncircumcisedmenareatincreasedriskforHIV.Thereareno
published,systematicallycollecteddataregardingmildpenilecoitaltraumatoour
knowledge.Weidentifiedrisksofselfreportedpenilecoitalinjuriesinmen18to24
yearsoldinarandomizedtrialofcircumcisiontopreventHIVinKisumu,Kenya.
MATERIALSANDMETHODS:Eachparticipantunderwentstandardizedinterview,
medicalhistoryandphysicalexaminationatbaseline,and6,12,18and24months
afterenrollment.Selfreportedpenilecoitalinjurieswereassessedateachvisit,and
weredefinedaspenisfeelssoreduringsex,penisgetsscratches,cutsorabrasions
duringsex,andskinofthepenisbleedsaftersex.Generalizedestimatingequation
analysisestimatedoddsratiosforpenilecoitalinjuries.
RESULTS:FromFebruary2002toSeptember2005,2,784participantswere
randomized.Atbaseline1,775(64.4%)menreportedanycoitalinjuryincluding1,313
(47.6%)soreness,1,328(48.2%)scratches,abrasionsorcutsand461(16.7%)
bleeding.Onmultivariableanalysiscoitalinjuryriskwaslowerforcircumcisedthan
foruncircumcisedmenwithsoreness(OR0.71,95%CI0.640.80),
scratches/abrasions/cuts(OR0.52,95%CI0.460.59),bleeding(OR0.62,95%CI
0.510.75)andanycoitalinjury(OR0.61,95%CI0.540.68).Othersignificantrisks
includedincreasingage,multiplerecentsexpartners,HSV2seropositivityand
genitalulcers(p<0.05).Condomuse,cleaningthepenissoonafterintercourseand
beingmarried/cohabitingwereprotective(p<0.05,each).
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CONCLUSIONS:Selfreportedpenilecoitalinjurieswerecommoninthesehealthy
youngmen.Circumcisedmenwereatlowerriskforcoitalinjuries.Verifyingpenile
coitalinjuries,themechanismofacquisitionandtheassociationwithHIVriskis
needed.

KMPHNews
June3,2010

DeliberatingBeginsin7yearoldBoyTattooedCase
by:CarynKochergen
Ajuryhasbegundeliberatingthefateoftwomenaccusedoftattooinga7yearoldboy.
BothsidesofthecasemadeclosingargumentsWednesday.
Theboytestifiedthathisfather,EnriqueGonzalezheldhimdown,whilecodefendantTravisGormanputabulldogtattoo
onhiship.
Thedefensesaidtheboyhadbeencoachedandwasnotareliablewitness.
"JohnDoehasneverchangedfromwhathestatedfromtheverybeginningofthiscase,fromdayone.Thathisfatherheld
himdownandhewasforciblygiventhetattoobyTravisGorman,"saidprosecutingattorney,WilliamLacy
ThedefensesaysthejuryhastofindGonzalezandGormannotguiltyiftheyarenotwillingtoconvictaparentforpiercing
theirkids'earorgettingthemcircumcised.[Indeed,becauseatattooislessofamodificationthancircumcision]
Ifthetwoareconvictedofaggravatedmayhem,theyfacelifeinprison.
Earlierstory

ZimDaily
May29,2010

PoliticsdisturbingCircumcisionprograminZimbabwe
ZIMBABWEHARAREDonorsareshunningtofundthenationalcircumcisionprogramwiththegovernmentsuspending
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thenationalrolloutoftheprogramtoAugustwhenithopesthingswouldhavechangedpolitically,aseniorofficial
involvedinthecircumcisionpilotprogramhasrevealed.
Weweresupposedtohaverolledouttheprogramnationallysomefewweeksagoaftersuccessfulfirstpilotproject,but
wehadtopostponeitbecauseoffinancialconstrains.
InitiallythedonorshadpromisedtofundtheprogrambuttheyhavesincesaidtheGlobalPoliticalAgreementshouldfirst
beimplementedbeforetheyreleasetheirfundsandweareverymuchworriedbythisdevelopment,saidthesourcewho
declinedtobenamed.
OfficialsintheMinistryofHealthandHIV&AIDSresearcherssaid6000maleshavebeencircumcisedinthepilotproject
whichwascarriedoutinsixmonths.
SpecialistUrologistandUZcollegeofHealthEducationInstituteofContinuingHealthEducationDirectorMrChristopher
SamkangesaidcircumcisionhasprovedtobeapplicableinZimbabwe.
Wehavecarriedoutapracticalmodelthathasprovedthatmalecircumcisionhastheimpactthatweareaimingto,that
toreduceHIVprevalencefromdoubledigitstosingledigit,andforus[t]oachievethatwemustcircumcise80%ofthe
malepopulationinthecountry.[NB.TheyhavenotactuallystudiedtheeffectofcircumcisiononHIVtransmissionifany
themselves.]
Wecarriedoutafeasibilitystudythatshowedusthatthecircumcisionoperationscanbedoneandwesetupfivecenters
inthecountrywhichwehaveusedasamodeltohowbestitcanbedoneanditisinthesefivecentersinthepilotphase
thathaveproducedthe6000malesthathavesofarbeencircumcised.[6000in6monthsin5centresis1.2menperworking
hourpercentrethestaffweren'texactlyrunofftheirfeet.]
Wehavenowlearntonhowbestwecandonetheoperationsandnowrollingoutanationalcircumcisionprograme,said
MrSamkange.
ThecountrysHIVprevalenceiscurrentlyat13.7%andHIV&AIDSspecialistssaycircumcisioninsocietieswhichpractice
vaginalsexreducestheprevalencetoasingledigit.
Zimbabwe20056
HIVRates:

Circumcisedmen 20%
Intactmen

19%

Source:Gisselquisttable7.4

LATimes
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May29,2010

Femalegenitalcutting:notevena'nick'
TheAmericanAcademyofPediatriciansbacksawayfromanillconceivedmovetorelaxitsrulesonthepractice.
Latelastmonth,330villagesinSenegalheldaceremonytoannouncethattheywouldendthepracticeoffemalegenital
cutting.ThatbroughtthenumberofSenegalesecommunitiestoabandonthepracticeto4,229,andwhenthenumber
reaches5,000,completeeradicationwillbeachieved.Similarpronunciationsandcelebrationsareoccurringinother
countriesinGambiaandSomalia,andinMauritania,whereonTuesday78villagesparticipated.
Thegrowingmovementtoendtheancientpracticeofslicingoffpartorallofagirl'sclitorisand/orlabiahistoricallydone
toprepareherforadulthoodandmarriageistheresultofyearsofworkbylocalandinternationalactivists.Particularly
noteworthyhasbeenthesuccessofthenonprofitTostan,whichmeans"breakthrough"inWolof.Theorganizationspends
almostthreeyearsteachingvillagersabouthealthandhumanrights.Thus,whenacommunityoptstoendgenitalcutting,
itisgenerallybecauseofarecognitionthatcuttingnotonlyendangersgirls'physicalwellbeingbutrunscountertothe
universalrighttostewardshipofone'sbody.Andthatunderstandingleadstootherchanges:Asvillagerslearnaboutthe
healtheffectsofchildbearing,girlsarelesslikelytobemarriedoffaschildrenandmorelikelytogotoschool.Andas
womenbecomebettereducated,theyaremorelikelytoparticipateintheeconomyandopenbusinesses.
Intothisdelicateinternationaleffort,theAmericanAcademyofPediatriciansblunderedwithallthefinesseofawater
buffalo,suggestinglastmonththatthebanongenitalcuttingintheUnitedStatesberelaxedsothatphysicianscould
accommodateimmigrantparentsand"nick"theclitorisofyounggirls.Asymbolicprocedureperformedstateside,the
academymaintained,mightspareagirlabrutalexperienceoutsidethecountry.
Theoutcryagainstsuchamisguidedproposalwasimmediate.Thatdoctorswantedtosavegirlsfromgreaterharmwas
commendable,butthispolicywaspotentiallydisastrous.First,when"minor"cuttinghasbeenembracedinAfrica,ithas
oftenprovidedacoverformoreseverecutting.Second,thepurposeofgenitalcuttingistodiminishordestroyfemale
sexualdesire;itisthefirststeptowardagirl'ssubjugationtofamilyhonor,toafather'sauthorityandahusband'smastery.
Evenasymbolicnickisaviolationofagirl'shumanrights.Andlastly,finedistinctionsabout"nicking"couldeasilyhave
beenlostintranslation;thenewmessagetotheMiddleEastandAfricawouldhavebeenthatAmericandoctorswillcut
girls.
Thursday,theacademyretractedtheproposalandreaffirmeditsoppositiontoallformsoffemalegenitalcutting.We
commenditforheedingthepleasofactivistsinthefieldandwomenwhohavesurvivedbeingcut.Pediatricianshavean
importantroletoplayaswell,butitistoexplaintoparentswhycuttingisforbiddenheredetailingthehealthproblemsit
createsforgirlsandemphasizingthelegalconsequencesparentsfacebyhavingitdonetotheirdaughters.

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SydneyMorningHerald
May28,2010

Doctorsdon'tsupport'ritualnicking'
ThecollegeforAustralia'sobstetriciansandgynaecologistssaysitdoesnotsupportthe"ritualnicking"ofyoungMuslim
girlsandanyonesuspectedofperformingsuchgenitalmutilationshouldbereportedtoauthorities.
DrTedWeaver,presidentoftheRoyalAustralianandNewZealandCollegeofObstetriciansandGynaecologists
(RANZCOG),saidmediareportssuggestingthecollegewouldreviewitspolicyweretheresultofamisquote.
Hesaidtheissuewaslikelytobediscussedatameetingnextmonth,triggeredbyrecentannouncementsmadebythe
AmericanAcademyofPediatrics,butapolicyshiftwasnotontheagenda.
"Thecollegedoesnotsupportdoesnotsupportfemalegenitalmutilation,fullstop,"DrWeavertoldAAPonFriday.
"Thisritualnicking,asithasbeencalled,hasbeenputforwardasawayofsatisfyingculturalsensitivitieswithoutmakinga
lotofdifferencetoawoman'sgenitaliabutwedonotsupportthateither."
TheUSpaediatricsbodyreleasedanewpolicylastmonth,andretracteditthisweek,whichraisedtheideaofdoctors
beingabletoprickornickagirl'sclitoralskininordertosatisfyculturalrequirementsinsomeMuslimcommunities.
Theprocedurenotdissimilartoanearpiercingwasproposedasasaferalternativetoceremonialcuttingdonewithout
medicalsupervisionandwhichcouldresultinbroaderdamageand,potentially,alossofsexualsensitivity.
"That'sadecisionfortheAmericans.Ourviewatthemomentisthatweareopposedtoit,"DrWeaversaid.
HesaidhewasnotawareofanydoctorsinAustraliathatwereperformingritualnicking,thoughanyonewhowas
suspectedofdoingsoshouldbereportedtoauthorities.
"Childprotectionlegislationisaboutstoppingthesesortsofthingshappening...allofthestateshavelegislatedinthisway
soitisillegalinAustralia,"DrWeaversaid.
"Atthisstage,thecollegehasnointentionofchangingitspositiononfemalegenitalmutilation."
RANZCOGsecretaryGinoPecoraroisreportedinNewsLtdnewspapersassayingthepractisewouldbediscussedatnext
month'sWomen'sHealthCommitteemeeting.

ReutersLife!
May27,2010

Dutchdoctors'groupcallsforcircumcisionban
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AMSTERDAMTheRoyalDutchMedicalAssociationonThursdaysuggestedapossiblebanonelectivecircumcisionsfor
youngboys,sayingtheyweremedicallyunnecessaryandviolatedchildren'srights.
The161yearoldorganization,whichrepresentsmorethan46,000doctorsandstudents,calledtheprocedure"aviolation
oftheintegrityofthebody."
Thegroup,knownbyitsDutchinitialsKNMG,proposedadialoguebetweendoctorsandreligiousgroupsontheissue.
MostnontherapeuticcircumcisionsintheNetherlandsareperformedonreligiousgrounds.InthecapitalofAmsterdam,
parentsseekingcircumcisionsforelectivereasonsareoftenreferredtoasmallclinicinaheavilyMuslimneighborhood.
"KNMGseesgoodreasonsforalegalbanonnontherapeuticcircumcisions,butfearsthatthiswillleadtotheoperation
goingunderground,"itsaidinastatement.
InacolumnontheKNMG'swebsite,chairmanArieNieuwenhuijzenKrusemansaidsome80percentofthegroup's
membersagreedcircumcisionshouldbediscouraged.
Accordingtoa2007WorldHealthOrganizationreport,some30percentofmenworldwidearecircumcised.
(ReportingbyBenBerkowitz,editingbyPaulCasciato)
KNMGhomepage(Dutch)(Englishtranslation)
Conclusion
Thereisnoconvincingevidencethatcircumcisionisusefulornecessaryintermsof
preventionorhygiene.Partlyinthelightofthecomplicationswhichcanariseduringor
aftercircumcision,circumcisionisnotjustifiableexceptonmedical/therapeuticgrounds.
Insofarastherearemedicalbenefits,suchasapossiblyreducedriskofHIVinfection,itis
reasonabletoputoffcircumcisionuntiltheageatwhichsuchariskisrelevantandthe
boyhimselfcandecideabouttheintervention,orcanoptforanyavailablealternatives.
Contrarytowhatisoftenthought,circumcisionentailstheriskofmedicaland
psychologicalcomplications.Themostcommoncomplicationsarebleeding,infections,
meatusstenosis(narrowingoftheurethra)andpanicattacks.Partialorcompletepenis
amputationsasaresultofcomplicationsfollowingcircumcisionshavealsobeenreported,
ashavepsychologicalproblemsasaresultofthecircumcision.
Nontherapeuticcircumcisionofmaleminorsiscontrarytotherulethatminorsmayonly
beexposedtomedicaltreatmentsifillnessorabnormalitiesarepresent,orifitcanbe
convincinglydemonstratedthatthemedicalinterventionisintheinterestofthechild,as
inthecaseofvaccinations.
Nontherapeuticcircumcisionofmaleminorsconflictswiththechild'srighttoautonomy
andphysicalintegrity.
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TheKNMGcallson(referring)doctorstoexplicitlyinformparents/carerswhoare
consideringnontherapeuticcircumcisionformaleminorsoftheriskofcomplicationsand
thelackofconvincingmedicalbenefits.Thefactthatthisisamedicallynonessential
interventionwitharealriskofcomplicationsmakesthequalityofthisadviceparticularly
important.Thedoctormustthenrecordtheinformedconsentinthemedicalfile.
TheKNMGrespectsthedeepreligious,symbolicandculturalfeelingsthatsurroundthe
practiceofnontherapeuticcircumcision.TheKNMGcallsforadialoguebetweendoctors'
organisations,expertsandthereligiousgroupsconcernedinordertoputtheissueofnon
therapeuticcircumcisionofmaleminorsontheagendaandultimatelyrestrictitasmuch
aspossible.
Therearegoodreasonsforalegalprohibitionofnontherapeuticcircumcisionofmale
minors,asexistsforfemalegenitalmutilation.However,theKNMGfearsthatalegal
prohibitionwouldresultintheinterventionbeingperformedbynonmedicallyqualified
individualsincircumstancesinwhichthequalityoftheinterventioncouldnotbe
sufficientlyguaranteed.Thiscouldleadtomoreseriouscomplicationsthaniscurrently
thecase.
ThisviewpointbytheKNMGisjointlyendorsedbythefollowingscientificassociations:
TheNetherlandsSocietyofGeneralPractitioners
TheNetherlandsSocietyofYouthHealthcarePhysicians
TheNetherlandsAssociationofPaediatricSurgeons
TheNetherlandsAssociationofPlasticSurgeons
TheNetherlandsAssociationforPaediatricMedicine
TheNetherlandsUrologyAssociation
TheNetherlandsSurgeonsAssociation
ToapdfofthefullpolicyinEnglish
ToapdfofthemediareleaseinEnglish
ReactionsintheBritishMedicalJournal

AAP
May27,2010

AmericanAcademyofPediatricsWithdrawsPolicyStatementonFemaleGenitalCutting
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CHICAGO:TheAmericanAcademyofPediatrics(AAP)hasretiredits2010policystatementonfemalegenitalcutting
(FGC).TheAAPBoardofDirectorshasapprovedthefollowingasAAPpolicyonFGC:
"TheAAPreaffirmsitsstrongoppositiontoFGCandcounselsitsmembersnottoperformsuchprocedures.Astypically
practiced,FGCcanbelifethreatening.Littlegirlswhoescapedeatharestillvulnerabletosterility,infection,and
psychologicaltrauma.
"TheAAPdoesnotendorsethepracticeofofferinga'clitoralnick.'Thisminimalpinprickisforbiddenunderfederallawand
theAAPdoesnotrecommendittoitsmembers.
"TheAAPissteadfastinitsgoalofprotectingallyounggirlsfromtheharmsofFGC."
AAPPresidentJudithS.Palfrey,MD,FAAP,said,"Ourintentionisnottoendorseanyformoffemalegenitalcuttingor
mutilation.WeretractedthepolicybecauseitisimportantthattheworldhealthcommunityunderstandstheAAPistotally
opposedtoallformsoffemalegenitalcutting,bothhereintheU.S.andanywhereelseintheworld.
"TheAAP'sgoalistoprotectthehealthandwellbeingofallchildren,"Dr.Palfreysaid."Onegoodthingtoemergeisthat
thisdiscussionhasshoneabrightlightonthisissueandraisedtheworld'sawarenessaboutthisharmtoyoungwomen."
TheAmericanAcademyofPediatricsisanorganizationof60,000primarycarepediatricians,pediatricmedical
subspecialistsandpediatricsurgicalspecialistsdedicatedtothehealth,safetyandwellbeingofinfants,children,
adolescentsandyoungadults.

TheAAP'smediarelease
AAP
June1,2010
Academyclarifiespositiondenouncingallformsoffemalegenitalcutting
ByAlisonSulaskiWyckoffAssociateEditor,Pediatrics
Reaffirmingitsstrongoppositiontofemalegenitalcutting(FGC),theAAPBoardofDirectors
retiredarecentpolicystatementonFGCandreplaceditwithanotherstatementclearly
denouncingthepractice.
Theoriginalversion,RitualGenitalCuttingofFemaleMinors,fromtheAAPCommitteeon
Bioethics,waspublishedinMayPediatricsandfeaturedinAAPNews
(http://aapnews.aappublications.org/cgi/content/full/31/5/31).Updatedfroma1998version,the
statementdetailedthehealthrisksofFGC,providedhistoricalperspectiveandurgedmembers
tocounselfamiliesnottohavesuchproceduresperformed.
However,confusionensuedwhenafewsentencesweremistakenlyinterpretedasendorsinga
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milderversionofFGCforsomeimmigrantgirlswhocouldbereturnedtotheirhomecountries
formoresevereformsofthepractice.

Herearethefewsentencesthatwere"mistakenlyinterpreted":
MostformsofFGCaredecidedlyharmful,andpediatriciansshoulddecline
toperformthem,evenintheabsenceofanylegalconstraints.However,
theritualnicksuggestedbysomepediatriciansisnotphysicallyharmful
andismuchlessextensivethanroutinenewbornmalegenitalcutting.
Thereisreasontobelievethatofferingsuchacompromisemaybuildtrust
betweenhospitalsandimmigrantcommunities,savesomegirlsfrom
undergoingdisfiguringandlifethreateningproceduresintheirnative
countries,andplayaroleintheeventualeradicationofFGC.Itmightbe
moreeffectiveiffederalandstatelawsenabledpediatricianstoreachout
tofamiliesbyofferingaritualnickasapossiblecompromisetoavoid
greaterharm
Therewasalsothedeletionofthispassagefromthe1999policy:
TheAmericanAcademyofPediatricians...
4.Recommendsthatitsmembersdeclinetoperformanymedically
unnecessaryprocedurethataltersthegenitaliaoffemaleinfants,girls,and
adolescents.
Thecontroversyignitedwidediscussionviatelephonecalls,lettersandblogpostsfromallover
themap.
OnMay27,afterhearingfrommembersandothers,theAAPBoardofDirectorsandleaders
respondedbyretiringthestatementandreplacingitwiththefollowing:
TheAmericanAcademyofPediatrics(AAP)reaffirmsitsstrongoppositiontofemalegenital
cutting(FGC)andcounselsitsmembersnottoperformsuchprocedures.Astypicallypracticed,
FGCcanbelifethreatening.Littlegirlswhoescapedeatharestillvulnerabletosterility,
infectionandpsychologicaltrauma.
TheAAPdoesnotendorsethepracticeofofferinga"clitoralnick."Thisminimalpinprickis
forbiddenunderfederallawandtheAAPdoesnotrecommendittoitsmembers.
TheAAPissteadfastinitsgoalofprotectingallyounggirlsfromtheharmsofFGC.
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AAPPresidentJudithS.Palfrey,M.D.,FAAP,emphasizedthattheAcademy'sgoalistoprotect
thehealthandwellbeingofallchildren.
"TheMay2010statementairedsomeimportantcontroversiesinthefieldabouthowtoend
thesepracticesworldwide,"saidDr.Palfrey."Unfortunately,thediscussionaboutthe
controversial'ritualnick'ledtoconfusionandmisinterpretationofourpolicy."
ShesaidtheAcademypublishedtheclarificationtoreaffirmthattheAcademyis"opposedtoall
formsoffemalegenitalcuttingincludingtheritualnick,"whetheritisintheU.S.orelsewherein
theworld.
ThepracticeofFGCiswidespread,with4to5milliongirlsbeingsubjectedeachyearto
dangerousprocedures,accordingtoDr.Palfrey.Shesaidthediscussionhasincreasedworldwide
awarenessaboutthisissue.
Earlierstory

May26,2010

Doctorsallowedtoforciblyoperateonwomanwithphobiaofhospitals
Courtrules55yearoldwomanwithlearningdifficultiescanbecoercivelysedatedinordertohavelifesavingcancer
surgery
Ahighcourtjudgetodaygavedoctorspermissiontoforciblysedateawomanwhohasaphobiaofhospitalsatherhome,
sothatshecanbetakenforcancersurgeryagainstherwill.
ThehighlyunusualjudgementbySirNicholasWall,headofthecourt'sfamilydivision,saidthatifthe55yearoldwoman,
whohasasignificantlearningdifficulty,continuedtorefusetreatment,thenanambulancecrewcouldbesenttoherhome
togiveheramildsedative"mixedwithasoftdrinksuchasRibena".Ifthisprovedimpossible,aconsultantanaesthetist
shouldbeonhandsothewomancouldbeforciblyinjectedwithafasteractingdrug,ketamine.
Thedecisionwaspraisedbythelearningdisabilitycharity,Mencap,whichsaidithadneverpreviouslyheardofasimilar
case.DavidCongdon,headofcampaigns,praisedthejudgeformaking"averydifficultdecision".
Sittinginthecourtofprotection,thejudgesaidthatthewoman,identifiedintherulingonlyasPS,lackedsufficient
capacitytomakedecisionsaboutherownhealth.ThecasewasbroughtbyanunnamedNHSfoundationtrust,whose
doctorsbelievePSwilldieifshedoesnothaveanoperationtoremoveherovariesandfallopiantubes.
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EvidencepresentedtoWallsaidPSwasdiagnosedlastyearwithuterinecancer,whichwasslowgrowingbutwould,
withoutsurgery,ultimatelyspreadandkillher.
AttemptstolookmorecloselyatthetumourusinganMRIscanprovedimpossibleasPShasbothaphobiaofhospitalsand
needlesandisalsoclaustrophobic,meaningshecannotliestillforascan.Aftersherefusedtoattendhospitalseveral
times,"theclinicalteamtreatingherhasreluctantlycometotheconclusionthatspecialarrangementswillneedtobeput
inplacebothtoensurethatshehastheoperationandthatsheremainsinhospitalforherpostoperativerecovery",the
judgmentsaid.While"everyeffort"wouldbemadetoavoidforciblysedatingPS,thiswasseenasanecessarybackup
plan,thejudgesaid.Aftertheoperation,shewillremaindruggedtomakesureshedoesnotflee....
(totherestifthislinkfails,contactus)
[Thecaretakeninreachingthisdecisionandthelifesavingnatureoftheoperationputitintosharpcontrastwithforcible
unnecessarygenitaloperationsonchildren.]

NewYorkTimes
May26,2010

DoctorsReverseStandonCircumcision
ByPAMBELLUCK
TheAmericanAcademyofPediatricshasreverseditsdecisionlastmonthregardingthepracticeoffemalecircumcisionby
immigrantsfromsomeAfrican,MiddleEasternandAsiancultures.Theacademyhadsuggestedinapolicystatementthat
doctorsbegivenpermissiontoperformaceremonialpinprickornickongirlsifitwouldkeeptheirfamiliesfromsending
themoverseasforthefullcircumcision.AlthoughthenickonagirlsclitorisisillegalintheUnitedStates,theacademys
bioethicspanelhadnoteditispracticedinsomecountries.Thepolicystatementignitedastormofcriticismfrom
opponentsoffemalegenitalcutting.Dr.JudithS.Palfrey,presidentoftheacademy,said:Weresayingdontdoit.Do
everythingthatyoucantosupportthatfamilyinthistoughtime,butdontbepulledintotheprocedure.
Earlierstory

newsreporter(Russia)
May26,2010

InTatarstan,thefiveyearchilddiedaftercircumcision
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TheinvestigatingauthoritiesofTatarstanstartedcheckingintothedeathoffiveyearoldboyafteracircumcision
performedbyavisitingphysicianatthehouse.ItisreportedbythepressofficeoftheInvestigationDepartmentUPCRF
RepublicofTatarstan.
ItwasreportedthatachildwholivedinthevillageYudininsideKazan,diedtheeveningofMay22inanambulanceonthe
waytohospital.Accordingtothestaffoftheambulance,theboyfaintedaftertheremovaloftheforeskinofthepenis
circumcised.Theprocedurewasperformedonthehousesurgeon,clinicnumber19oftheKirovdistrictofKazan.
AccordingtotheUPC,aftersurgerythechildhadconvulsionsanddieddespiteresuscitationperformedarrivedoncall
physicians.Thepreliminarycauseofdeathboywasanallergicreactiontopainmedication.
AsimilarcasewasreportedinTatarstaninJuly2008.AfterthetraditionalMuslimritualattheChildrensRepublican
Hospital,diedfouryearsoldboyfromthevillageofNewSalmanAlkeevskogoregionofTatarstan.Thecauseofdeathof
thechildhasanallergicreactiontomedicationforanesthesia.

May23,2010

25boysrescuedafterillegalcircumcision
TwentyfiveEasternCapeinitiateshavebeenrescuedandtakentohospitalaftertheywereillegallycircumcised,the
provincialhealthdepartmentsaid.
"Theywerecircumcisedyesterday[Saturday]andonpreliminaryexamination,itwasclearthattheyneededtoseea
doctor,"saidspokesmanSizweKupelo.
Theboys,agedbetween12and15,weretakenfromNkangaVillageinLibodetoStBarnabasHospitalonSunday
afternoon.
Thetraditionalsurgeonwhoillegallycircumcisedtheboys,NdondaMtshayina,hadbeenarrestedseveraltimesforthe
offence.
HewasfirstgivenasuspendedsentenceofthreeyearsbyanEasternCapecourtbutcontinuedwiththeillegal
circumcisions.
"Hespentthewholeof2008injailafterasecondsentencewasimposedonhim.Hewasbannedfrompractisingbuthestill
continues,"saidKupelo.
Hesaidtheboys'parentswouldhavetotakethemattertothepoliceforhimtobearrested.
"Sometimestheseillegalsurgeonsgetawaywithmurderbecauseparentstendtostopattendingcourtproceedingsonce
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theirchildrenarehealed.
"Thisisreallyaconcernforusbecausewespendalotofgovernmentfundsontheseboyswhenallthiscanbeavoided."
KupelosaidthedepartmentspentaboutR1000adayforeachboyinhospital,moneyhesaidshouldbeusedforother
matters.
ThedepartmentwouldsoonsendadelegationtothekingofWesternPondolandtodiscussMtshayina.
"Heisaproblem,"saidKupelo.

SydneyMorningHerald
May22,2010

SupportforfemalecircumcisionstirscontroversyinUS
SIMONMANN
WASHINGTON:ThereviewbyaprestigiousUSmedicalacademyofitspolicyonfemalegenitalcuttinghastriggereda
stormofprotestfromlobbyists,women'sgroupsandfeministbloggers.
TheAcademyofAmericanPaediatricshasbeenaccusedofsanctioningchildabuseandofbehavingunethically.Amongits
criticsaremanyUSmedicalpractitioners.
''Haveyouallgonenuts?''onepaediatricandemandedoftheacademy'sbioethicscommitteeinawebsiteexchange.
''Justalittlefemalecircumcision?There'snoreasontodothisprocedureandtocondoneanyformofitisnotacceptable.''
IntactAmerica,anonprofitgroupthatcampaignsagainstallformsofcircumcisionmaleandfemaleaccusedthe
academyofdeliberatelysofteningitsstancetoavoidadoublestandardbecauseittoleratesmalecircumcision.
''Thisisgenderequityrunamok,''claimedthegroup'sfounder,GeorganneChapin.
Theoffencewasnotcausedbythecommittee'sfinalrecommendations,whichendorsedtheacademy'sprevious
oppositiontofemalegenitalcutting,lastreviewedin2007.
Rather,theoutragewasinvokedbythecommitteeadmittinginitsreportthequandaryofsomepaediatricianswhoargue
thatofferingaformof''ritualisticgenitalnick''mighthelpdissuadefamiliesfromtakingtheirdaughtersoverseaswhere
theywouldbemorelikelytoundergolifeendangeringsurgeryandmutilation.
Thebioethicscommitteenotedthesensitivitiessurroundingtheissueandexplicitlysaiditwasnotadvocatingsurgeryin
theUS.FemalegenitalcuttinghasbeenoutlawedintheUSsince1996andisillegalinmanyWesterncountries,including
Australia.
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Coincidentally,twomembersofCongresslastmonthintroducedabillwhichwouldmakeitillegalforanyonetotakegirls
outoftheUSforthepurposeofgenitalcutting.
Thecommitteestressedtheneedfordoctorstocounselparentsonthedangersoffemalecutting,especiallyinthecaseof
moreextremesurgeryinwhichtheentireclitorisandsome,orall,ofthelabiaminoraareremoved.
However,itraisedtheprospectoftokenisticsurgery.
''Thereisreasontobelievethatofferingsuchacompromise[ofa'nick']maybuildtrustbetweenhospitalsandimmigrant
communities,savesomegirlsfromundergoingdisfiguringandlifethreateningproceduresintheirnativecountries,and
playaroleintheeventualeradicationof[femalecutting],''wrotethecommittee,whichincludesthreewomenethicists.
Thechairmanofthecommittee,DrDougDiekema,aSeattlepaediatricianandbioethicist,toldtheHeraldmost
paediatriciansintheUSwouldneverhavefacedthedilemmarecountedbythecommittee.
ButinareaswithlargenumbersofeastAfricansinSeattleandMinnesota,forexampleitwasclearthatjustsayingno
wasofteninadequate.
''Wehadfamiliesexplicitlytell[paediatricians]thatifwedidnothingtheywouldtaketheirkidsbacktoAfricawherethey
wouldnothavecontroloverhowharmfulaprocedurewasdone,''DrDiekemasaid.''Whattheyneededwassomething
thatsatisfiedwhattheybelievedwerethedemandsoftheirreligion.''
Thecommittee'sconceptofanickwasfarlesintrusivethaninfantmalecircumcision.
''[It]wouldremovenotissue,wouldnottouchanysignificantorganbut,rather[it]wouldbeasmallnickoftheclitoralhood
whichistheequivalentofthemaleforeskinnothingthatwouldscar,nothingthatwoulddodamage,''DrDiekemasaid.
Hesaidtheethicalrationaleforsuchasuggestionwas''harmminimisation''.
''MyfeelingisthatthiscertainlywouldnotincreaseinanywaymoreharmfulproceduresItcouldonlydecreasethem.I
don'tthinkyou'regoingtohavefamilieswhocurrentlydonothingsuddenlywantingtheprocedure.Theonlythingyou
wouldseeisaflowoffamilieswhowouldotherwisegetamoredangerous[procedure]movingtowardsonethatdoesn't
harmtheirgirl.''
HesaidsomeWesternphysiciansworkinginAfricabelievedaritualistic''nick''hadbeenusedtosatisfyparentswantingthe
procedurefortheirdaughters.Hesaidtheacademymeanttospeak''toallpaediatricians,includingthoseincountries
wherethishadn'tbeenprecludedbyalaw''.

TheBritishMedicalJournal(fulltextrequiressubscription)
May13,2010

UKcollegescriticise"compromise"inUSguidanceonfemalegenitalmutilation
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ZosiaKmietowicz
TwoUKRoyalCollegeshaveraisedconcernsaboutguidanceissuedbyAmericanpaediatriciansonfemalegenital
mutilationinwhichtheysuggestthatdoctorscouldofferfamilies"aritualnickasapossiblecompromisetoavoidgreater
harm."
TheRoyalCollegeofObstetriciansandGynaecologistsandtheRoyalCollegeofPaediatricsandChildHealthsayina
statementthat,"Tosuggestthataqualifiedmedicalpractitionerisinvolvedinthispracticeasacompromisedoesnot
makeitlessbrutalandhasthedangerofgivinglegitimacytoFGM[femalegenitalmutilation].Twowrongsdonotmakea
right.Themainobjectiveforallcivilisedsocietieshastobethecompleteeradicationofanunacceptablepractice."
...
"FemalegenitalmutilationisinitselfaritualpracticeandtosuggestthatanotherritualnickreplacestheFGMdoesnot
changethesimplefactthatprepubescentgirlsinsomesocietiesareexpectedtogothroughaviolentandpainful
procedurewhichwillscarthemfortherestoftheirlives.Forcliniciansinanycountry,theactofengaginginanyritual
femalegenitalcutting,nomatterhowtoken,willmakethemcomplicitincontinuingthepracticeofFGM."

May16,2010

Teensheldforillegalcircumcisions
JohannesburgTwoteenageboyswerearrestedaftertheyallegedlyillegallycircumcisedfiveothersatLibode,Eastern
CapedepartmentofhealthsaidonSunday.
SpokespersonSizweKupelosaidthetwo,bothaged15,werearrestedatDalagubavillageonSaturdaybyajointteam
fromthedepartmentandpolice.
"Theycircumcisedfiveboysundertheageof17andtwootherscircumcisedoneanother.Thesevenweretakentohospital
inastablecondition."
Kupelosaidthedepartmentwasconcernedabouttheillegalcircumcisionbecauselastyearover90boysdiedduetoillegal
circumcision.
...

OpenCongress
April26,2010
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BillintroducedtoprotectgirlsfromtravelforFGC
HR5137IH
111thCONGRESS
2dSession
H.R.5137
Toamendtitle18,UnitedStatesCode,toprovidepenaltiesfortransportingminorsinforeigncommerceforthepurposes
offemalegenitalmutilation.
INTHEHOUSEOFREPRESENTATIVES
April26,2010
Mr.CROWLEY(forhimselfandMrs.BONOMACK)introducedthefollowingbill;whichwasreferredtotheCommitteeon
theJudiciary
ABILL
Toamendtitle18,UnitedStatesCode,toprovidepenaltiesfortransportingminorsinforeigncommerceforthepurposes
offemalegenitalmutilation.
BeitenactedbytheSenateandHouseofRepresentativesoftheUnitedStatesofAmericainCongressassembled,
SECTION1.SHORTTITLE.
ThisActmaybecitedastheGirlsProtectionActof2010.
SEC.2.TRANSPORTFORFEMALEGENITALMUTILATION.
Section116oftitle18,UnitedStatesCode,isamendedbyaddingattheendthefollowing:
(d)Whoever,beingaUnitedStatescitizenoralienadmittedforpermanentresidenceintheUnitedStates,knowingly
transportsapersoninforeigncommerceforthepurposeofconductwithregardtothatpersonthatwouldbeaviolationof
subsection(a)iftheconductoccurredwithintheUnitedStates,orattemptstodoso,shallbefinedunderthistitleor
imprisonednotmorethan5years,orboth..

LATimes
May1,2010

AliceMillerdiesat87;psychoanalystexploredeffectsofchildabuse
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ByElaineWoo
AliceMiller,aSwisstrainedpsychoanalystwhowonawideAmericanaudiencewithprovocativebooksaboutthe
pervasivenessofchildabuseanditslegacyofphysicalandemotionalsuffering,hasdied.Shewas87.
...
Millerwasconcernedaboutaspectrumofbehaviorsrangingfromsexualandphysicalabusewhich,byherdefinition,
includedspankingandcircumcisiontoneglect,humiliationandotherformsofemotionalcruelty....
(totherestifthislinkfails,contactus)

PeninsulaDailyNews(WASHINGTON)
May13,2010

Manwhousedbrandingirononkidsfoundnotguiltyofoneassaultcount;mistrialonothercount
PORTANGELESThejurydecidingthefateofaSequimmanaccusedofassaultingtwoofhischildrenbyburninginitials
intotheirskinwithahotbrandingironfoundhimnotguiltyofseconddegreeassaultthisafternoon.
Thejuryisdeadlockedonalesserchargeoffourthdegreeassault.SuperiorCourtJudgeBrookeTaylordeclaredamistrial
onthatcount.
Earlierreport:
ByPaulGottlieb
PORTANGELESAClallamCountyjurywillbegindecidingat9a.m.todayifMarkJ.SeamandsofSequimshouldbe
convictedofassaultforbrandinghistwoteenagesonslikecattleas"afamilything."
TestimonyandclosingargumentsconcludedlateTuesdayinthetwodaySuperiorCourttrial.
ItcouldendwithSeamands,39,beingsentencedforupto12to14monthsforbranding"SK"for"SeamandsKids"on
thechestofhisthen13yearoldsonandthearmofhisthen15yearoldson.
HebrandedthemonNov.25,2008,aftertheyaskedhimtodoit,thefatherandbothboystestified.
'Askedtobebranded'
"Iaskedtobebranded,"theyoungerson,now15,testifiedTuesday.
Hewantedtobebranded,hesaid,"becauseIwasgoingtobepartofthisfamilymywholelife."
Onthesameday,afriendbranded"SK"onthearmofthefatherwiththesameredhotbrandingiron,accordingtothe
father'stestimony.
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Thefatheralsobrandedhisthen18yearolddaughter.
Inclosingarguments,LawyerLorenOakleyofthecountyPublicDefender'sOffice,whoisrepresentingSeamands,didnot
disputethatSeamandsbrandedhischildren.
Oakleycomparedthebrandingtocircumcision.
Hesaidtherewasnoevidenceofcriminalintentandclaimedtheboyswerenot"disfigured."
"Thisisacaseaboutdifferentstrokesfordifferentfolks,"Oakleysaid.
Presentingastarklydifferentview,DeputyProsecutingAttorneyJohnTrobergsaiddespitethesons'willingnesstobe
branded,Seamands"didn'tdohisjobasaparent"andactedirresponsiblybyputtingthemunderriskofinfectionand
scarringthem.
"Inthisstate,wedonotletminorchildrenbebrandedlikelivestock,"Trobergsaid.
Seamands,whointestimonycalledbranding"afamilything"andthebrand"afamilybrand,"ischargedwithtwocountsof
seconddegreeassaultdomesticviolence....
(totherestifthislinkfails,contactus)

May6,2010

GroupBacksRitual'Nick'asFemaleCircumcisionOption
ByPAMBELLUCK
InacontroversialchangetoalongstandingpolicyconcerningthepracticeoffemalecircumcisioninsomeAfricanandAsian
cultures,theAmericanAcademyofPediatricsissuggestingthatAmericandoctorsbegivenpermissiontoperforma
ceremonialpinprickornickongirlsfromtheseculturesifitwouldkeeptheirfamiliesfromsendingthemoverseasforthe
fullcircumcision.Related
Theacademyscommitteeonbioethics,inapolicystatementlastweek,saidsomepediatricianshadsuggestedthat
currentfederallaw,whichmakescriminalanynonmedicalprocedureperformedonthegenitalsofagirlintheUnited
States,hashadtheunintendedconsequenceofdrivingsomefamiliestotaketheirdaughterstoothercountriestoundergo
mutilation.
Itmightbemoreeffectiveiffederalandstatelawsenabledpediatricianstoreachouttofamiliesbyofferingaritualnickas
apossiblecompromisetoavoidgreaterharm,thegroupsaid.
Butsomeopponentsoffemalegenitalmutilation,orF.G.M.,denouncedthestatement.
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Iamsuretheacademyhadonlygoodintentions,butwhattheirrecommendationhasdoneisonlycreateconfusionabout
whetherF.G.M.isacceptableinanyform,anditisthewrongstepforwardonhowbesttoprotectyoungwomenandgirls,
saidRepresentativeJosephCrowley,DemocratofNewYork,whorecentlyintroducedabilltotoughenfederallawby
makingitacrimetotakeagirloverseastobecircumcised.F.G.M.servesnomedicalpurpose,anditisrightfullybannedin
theU.S.
GeorganneChapin,executivedirectorofanadvocacygroupcalledIntactAmerica,saidshewasastonishedthatagroupof
intelligentpeopledidnotseetheutterslipperyslopethatweputphysiciansonwiththenewpolicystatement.How
muchbloodwillparentsbesatisfiedwith?...
(totherestifthislinkfails,contactus)
AversionofthisarticleappearedinprintonMay7,2010,onpageA16oftheNewYorkedition.

,2010

FGM:ThePharaonicritethat'sahardhabittobreak
NorhanElhakeem
AswanInanationwhereUNICEFestimates96percentofallmarriedwomenhaveundergonesomeformoffemale
genitalmutilation(FGM),Aswan'sofficialdeclarationagainstthepracticeearlierthisweek,markedbyFirstLadySuzanne
Mubarak'stwodayvisittothesoutherngovernorate,wasonethathashumanrightsandwomen'srightsgroupscheering
andgearingupformoreaction.
ButwhilevariousunitswithintheEgyptiangovernmentwhoseHealthandPopulationMinistrybannedallformsoffemale
genitalcuttingin2007andnumerousnongovernmentalorganizationsandcivilandhumanrightsgroupshavealltakena
clearstandagainstthecontinuedpracticeofFGMacrossthecountryandareworkingtowardeliminatingit,ontheground
andespeciallyinvillages,Aswan'sdeclarationmeansverylittle.
"Allthesepeople,theycansayanddowhatevertheywant,"saysNabawiyaAbdelHamid."Theseareourtraditions,and
they'reimpossibletochange."...
(totherestifthislinkfails,contactus)

NewVision(Kampala)
May4,2010
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Waragainstfemalecircumcisionhitssnag
ByCatherineBekunda
EFFORTStoendfemalegenitalmutilationhavehitasnagaftertheGovernmentfailedtoprovidesh400mfor
compensatingthepractitioners.
Themoneyismeantforstartupcapitalforover400promotersofthepractice,saidlabourstateministerEmmanuel
Otaala.
Theministryisproposingtocompensatethemwithsh1meachforthelostincomeasaresultofeliminatingthepractice,
Otaalaexplained.
Thesepeoplearealsolookingforsurvival.SincethefemalegenitalmutilationActwaspassed,theyhavebeenoutof
business.
...

AlHdhod
May5,2010

AfricanstatespushforUNbanonfemalecircumcision
DAKARLawmakersfrom27AfricancountriesgatheredinDakaronMondayforatwodayconferencetopushforaUN
banonfemalegenitalmutilationasabreachofhumanrights.
InternationalactivistsjoinedenvoysfromtheUnitedNationsandAfricanUnioninSenegalto"promotetheadoptionofa
resolutionthatexplicitlybansfemalegenitalmutilationasapracticethatiscontrarytohumanrights."
Thecuttingorremovalofyounggirls'andwomen'sclitorisand/orlabiaaffectssome120to140millionwomenin28
countries,mostlyinAfricaandtheMiddleEast,accordingtotheWorldHealthOrganisation.
Oftencarriedoutfordeepseatedreligiousorculturalreasons,itcanleadtoinfection,urinarytractproblems,mental
trauma,sterilityorcomplicationsduringchildbirth,andinsomecasesfatalhaemorrhaging.InAfrica,around91million
girlsagednineandunderhaveundergonethepractice,withthreemillionoperatedoneachyear,theUNpopulationfund's
envoyRoseGkubatoldtheconference.
"NowisthetimetomoveforwardswithaspecificresolutionattheUnitedNationsthatcangiveanewboost,anewhope
toactivists,governmentsandlawmakers,"ItalianSenatedeputyleaderandcampaignerEmmaBoninosaid.
"Thereisnomiraclesolution,"shetoldtheconference."Onlyacomplexstrategythatneedstobeimplemented."
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TheAfricanUnion'senvoyYetundaTeribastressedthattheWesthadaroletoplayincombatinggenitalmutilations.
"Migrantshaveexportedthepractice,"shesaid."AlthoughmostofthevictimsareinAfrica,theproblemisgrowingin
Europeamongmigrantandrefugeecommunities."
ButSenegal'sparliamentspeakerMamadouSecksaidthekeytofightinggenitalmutilationwas"educationand
persuasion,toconvincebutnotcoerce."
Senegalisoneof19AfricancountriesthathavebannedthepracticeanditsFamiliesMinisterNdeyeKhadyDiopsaida
nationwidecampaignbetween2000and2005managedtoreducethenumberofmutilationsbyover70percent.Dakaris
preparingtolaunchasecondcampaignthathopestoeradicatethepracticecompletelyby2015,shesaid.

Forward
April30,2010

ForwardcondemnsAAP'spolicyonFGC
FORWARDCondemnstheAmericanAcademyofPediatrics'amendedpolicyonFemaleGenitalMutilation(FGM),which
suggestsconductingritualnickofgenitalsas"compromise".
On26April2010theAmericanAcademyofPediatrics(AAP)releasedarevised"PolicyStatementRitualGenitalCutting
ofFemaleMinors"whichsignificantlyweakenstheircommitmenttohealthandwellbeingofinfantsandchildren.TheAAP
isendangeringrightsofyounggirlsatriskofFGMbysuggestingtheperformanceofTypeIV*FGMas'apossible
compromisetoavoidgreaterharm'.FGM,inallitsforms,isaviolationofhumanrightsandposesimmediateandlong
termhealthconsequencestogirlsandwomen.
FORWARDisdeeplyconcernedatthisweakeningofpolicyonFGMandiscallingontheAAPtoreverttoitscaveatfree
1998policystatementthat'opposesallformsoffemalegenitalmutilation'.
"AllformsofFGMareaclearbreachofagirl'shumanrightsandthispracticeshouldnotbeperpetuatedbyhealth
professionals,whosedutyistocareandprotectthegirl.FGMcarriedoutbymedicalprofessionalsgivesalegitimateand
acceptablefacetoapracticewhichdamageswomen'sandgirls'reproductive,sexualandpsychologicalhealth.Performing
FGMinsterileconditionsdoesnotalleviatethelongtermeffectsofFGMandinternationalbodiessuchastheWorld
HealthOrganisationhaveconsistentlyopposedsuchamove,"statesFORWARD'sExecutiveDirector,NaanaOtoo
Oyortey.
TheAAPhasdowngradeditsrecommendationto'opposeallformsofFemaleGenitalMutilation',asstatedinthe1998
recommendations,to'opposeallformsofFemaleGenitalCutting(FGC)thatposeriskofphysicalorpsychologicalharm'.It
hasqualifiedtherecommendationthat'itsmembersactivelyseektodissuadefamiliesfromcarryingoutFGM',bynow
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applyingitonlyto'harmfulformsofFGC'.Mostseriously,ithasalsoerasedaltogetherthe1998recommendationthat'its
membersdeclinetoperformanymedicallyunnecessaryprocedurethataltersthegenitaliaoffemaleinfants,girls,and
adolescents'.
Ineffect,thenewAAPpolicypromoteschangesinUSfederalandstatelawsthatwould'enablepediatricianstoreachout
tofamiliesbyofferingaritualnick'forexample'prickingorincisingtheclitoralskintosatisfyculturalrequirements'.
FORWARDisanAfricanDiasporawomen'scampaignandsupportcharity.Itsworkrespondstotheneedtosafeguard
dignityandadvancethesexualandreproductivehealthandhumanrightsofAfricanwomenandgirls.Itworkswith
individuals,communitiesandorganizationstotransformharmfulpracticesandimprovethequalityoflifeofvulnerable
girlsandwomen.
FORWARDenvisionsaworldwherewomenandgirlsliveindignity,arehealthyandhavechoicesandequalopportunities
tofulfiltheirpotential.
*TheWorldHealthOrganisationidentifiesthefollowingfourtypesofFGM:a..TypeI:Excisionoftheprepuce,withor
withoutexcisionofpartortheentireclitoris(clitoridectomy).b..TypeII:Partialortotalremovaloftheclitorisandthelabia
minora,withorwithoutexcisionofthelabiamajora(excision).c..TypeIII:Narrowingofthevaginalorificewithcreationof
acoveringsealbycuttingandappositioningthelabiaminoraand/orthelabiamajora,withorwithoutexcisionofthe
clitoris(infibulations).d..TypeIV:Allotherharmfulprocedurestothefemalegenitaliafornomedicalpurposes,for
example:pricking,piercing,incising,scrapingandcauterisation

Ifhewasperfect,whycutpartoff?

People
April28,2010

WorldExclusive:MeetSandraBullock'sBabyBoy!
..."He'sjustperfect,Ican'tevendescribehimanyotherway,"BullockrevealsexclusivelyinthenewissueofPEOPLE,
announcingthatsheistheproudmotherofLouisBardoBullock,a3montholdboy,borninNewOrleans."It'slikehe's
alwaysbeenapartofourlives."
HollywoodLife
April28,2010

Sandra'sShockingFavoriteMomentWithNewBabyLouisYou'llNeverBelieveWhatItIs!
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Asstrangeitmaysound,herfavoriteexpeirence[sic]wasbabyLouisBardoBullockssecretbris,aJewishcircumcision
ceremony.
ThoughSandraBullockandherfamilyhadtobesupersecretiveabouttheadoptionofbabyLouisBardoBullock,theydid
managetoshareonespecialexperiencetogetheraprivatecircumcision!Youhaveneverseenadultsmorepanicked
aboutwhatwasabouttohappentotheirson,butthecelebrationandtheamountoflovewefeltandtheprideinthelittle
manwhomweloveso,somuchbecamethegreatestmomentIhaveeverhadinmylife,shetellsPeople.Wowwe
neverthoughtwedgetallmistyeyedoveracircumcision,butSandrajustmakesitsoundsobeautiful.[Theyshouldhave
askedLouis.]
Ofcourse,thereisonecuriousthingSandrasaysabouthersonsprocedure.Itwasntjustastandarddoctorperformed
circumcisionitwasafullonJewishbris!
Afriendofourshelpedarrangeforabrisatthehouse,becausewecouldntgo[toahospitalfortheprocedure]Sandra
tellsPeople.Themohel[apersontrainedinthepractice]cametous.
ItissurprisingthatSandraoptedtohaveabris,consideringneithershenorhersoontobeexhusbandJesseJamesare
Jewish...
[Ifonlyoneparentneedstoconsent,andanadoptedchildhas,ineffect,fourparents,hischanceofremainingintactfallsto
onein16eveniftheyalltosscoins.]

Bravi!

TheLocal
April29,2010

Doctorsrefusetoperformcircumcisions
DoctorsinwesternSwedenarerefusingtocarryoutthecircumcisionofboys,despiteclearancebyelectedofficialstocarry
outtheprocedurefornonmedicalreasons.
TheVstraGtalandregionisobligedtoprocurehealthcareforatleast300operationseachyearamongJewishand
Muslimfamilies,accordingtotheGteborgsPosten(GP)localdaily.
"Nowwehavetogooutandfindsomeonewhoiswillingtoperformtheoperations.Thedoctors'sectorcouncil
(Sektorsrdet)havesaidnototheseprocedures.Werespectthedoctors'position,"saidLarsGranMoberg,headofthe
region'shealthcarecommitteetoGP.[Iftheyrespectthedoctors'position,theywon'tlookforanyoneelsetodoit.]
PaediatricsurgeonJohnWestfeltcanseenopossibilityfordoctorswithinthepublichealthcaresystemtoperformthe
operations.
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"Wehavedeprioritisedseveralothermeasurestohelpsickchildren,suchassurgeryontightforeskinsformedicalreasons.
Andobviouslywecannotcarryouttheseoperationswithoutsacrificingsomethingelse."

AAPnowletsitsdoctorsperformfemalegenitalcuttingeventhoughthatisillegal

PEDIATRICS(doi:10.1542/peds.20100187)
April26,2010

PolicyStatementRitualGenitalCuttingofFemaleMinors
FROMTHEAMERICANACADEMYOFPEDIATRICS
COMMITTEEONBIOETHICS
Thetraditionalcustomofritualcuttingandalterationofthegenitaliaoffemaleinfants,children,andadolescents,referred
toasfemalegenitalmutilationorfemalegenitalcutting(FGC)[orfemalecircumcision.DoestheAAPwantthatexpression
notjustdisused,butforgotten?],persistsprimarilyinAfricaandamongcertaincommunitiesintheMiddleEastandAsia.
ImmigrantsintheUnitedStatesfromareasinwhichFGCiscommonmayhavedaughterswhohaveundergonearitual
genitalprocedureormayrequestthatsuchaprocedurebeperformedbyaphysician.TheAmericanAcademyofPediatrics
believesthatpediatriciansandpediatricsurgicalspecialistsshouldbeawarethatthispracticehaslifethreateninghealth
risksforchildrenandwomen.[HowlongbeforetheAmericanAcademyofPediatricsacknowledgesthatpediatriciansand
pediatricsurgicalspecialistsshouldbeawarethatcircumcisionhaslifethreateninghealthrisksforchildrenandmen?]The
AmericanAcademyofPediatricsopposesalltypesoffemalegenitalcuttingthatposerisksofphysicalorpsychological
harm,counselsitsmembersnottoperformsuchprocedures,recommendsthatitsmembersactivelyseektodissuade
familiesfromcarryingoutharmfulformsofFGC,andurgesitsmemberstoprovidepatientsandtheirparentswith
compassionateeducationabouttheharmsofFGCwhileremainingsensitivetotheculturalandreligiousreasonsthat
motivateparentstoseekthisprocedurefortheirdaughters.[Toreadtheserecommendations,youwouldn'tknowthateven
"nonharmfulforms"ofFGCareillegal.]
RECOMMENDATIONS

1999RECOMMENDATIONS

TheAmericanAcademyofPediatrics:

TheAmericanAcademyofPediatrics:

1.OpposesallformsofFGCthatposerisksofphysicalor 1.Opposesallformsoffemalegenitalmutilation(FGM).
psychologicalharm.
2.Encouragesitsmemberstobecomeinformedabout
FGCanditscomplicationsandtobeabletorecognize
physicalsignsofFGC.
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3Recommendsthatitsmembersactivelyseekto
dissuadefamiliesfromcarryingoutharmfulformsof
FGC.
4.Recommendsthatitsmembersprovidepatientsand
theirparentswithcompassionateeducationaboutthe
physicalharmsandpsychologicalrisksofFGCwhile
remainingsensitivetotheculturalandreligiousreasons
thatmotivateparentstoseekthisprocedurefortheir
daughters.

2.Recommendsthatitsmembersactivelyseekto
dissuadefamiliesfromcarryingoutFGM.
3.Recommendsthatitsmembersprovidepatientsand
theirparentswithcompassionateeducationaboutthe
physicalharmsandpsychologicalrisksofFGM.

4.Recommendsthatitsmembersdeclinetoperform
anymedicallyunnecessaryprocedurethataltersthe
genitaliaoffemaleinfants,girls,andadolescents.
[Theoldrecommendation4isgonecompletelydoctorsarenolongerevenrecommendedtodeclinetoperformallFGC,only
"theharmfulforms".Thehumanrighttogenitalautonomyiscompletelylackingwhomaydecidewhethergenitalcuttingis
physicallyorpsychologicallyharmfulbutthegirlherself?Isn'ttheveryfactofbeinghelddownandhavingpartofyourgenitals
cutoffpsychologically(ifnotphysically)harmful?
HereistheAAP'sarticleannouncingthepolicy,withnomentionofa'ritualnick'orthatthe1998recommendationNo4had
beendeleted.

NEWSANDFEATURES
Cultureshock
AAPopposesritualgenitalcuttingoffemaleminors,recommendscultural
sensitivity
AlysonSulaskiWyckoffAssociateEditor
Almost15yearsago,aU.S.hospitalservingalargeimmigrantpopulationcaredfor
patientswhosehomecountryinAfricapracticedfemalegenitalcutting(FGC).
WhenthephysiciansandnursesinobstetricalpracticeaskedthepregnantSomalian
womenabouttogivebirthwhethertheywouldliketheirnewbornscircumcisedif
theywereboys,thewomenanswered,"yes,andthegirls,too."
Thisstartledthehospitalworkersbutraisedawarenessofthecomplexitiesof
dealingwithimmigrantsaccustomedtosuchpractices.SomeSomalianmothers
suggestedthehospitalallowdoctorstoperformasymbolicor"ritualnick"
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proceduretosavethedaughtersfrombeingsentbacktotheirhomecountries
wheretheywouldbeforcedtoendureamuchmoresevereanddangerous
procedure.Thedoctorswhosupportedthesuggestionknewitalsocouldprevent
thefamiliesfromhiringalocaltraditionalpractitionertocarryouttherequest.
However,apublicoutcryatthattimeagainstanyformofFGC,aswellasnew
federallegislationbanningit,causedthehospitaltodroptheidea.
WhileseeminglyfarremovedfromtheconcernsofmostU.S.physicians,the
customdoesimpactpediatricpracticehere.InareasoftheUnitedStateswhere
immigrantfamilieshaverelocatedfromcountrieswhereFGCiscustomary
SomaliaaswellasSudan,EthiopiaandEritrea,amongotherssomeparents
continuetoaskpediatricspecialiststoperformtheprocedures.
MorepediatriciansalsoareencounteringpatientswhohaveundergoneFGC.
RitualGenitalCuttingofFemaleMinors(Pediatrics2010;125:10881093)statesthat
theAcademyopposesalltypesofFGCthatposerisksofphysicalorpsychological
harm.
TheupdatedpolicystatementremindsAAPmembersofthelifethreateninghealth
risksforfemaleswhoaresubjectedtoFGC,counselsthemnottoperformsuch
proceduresandrecommendstheytrytosensitivelypersuadefamiliesofthe
potentiallylifethreateningcomplicationsinvolved.
Thetoneoftheupdatedstatementismoreculturallysensitiveanddialogue
focused,accordingtoauthorDenaS.Davis,J.D.,Ph.D.,aformermemberofthe
AAPCommitteeonBioethics.Languagethatiscondemningorcondescending
doesnthelpphysicians"startaconversation,"Dr.Davissaid.
Forexample,themoreneutralterm"femalegenitalcutting"isusedinsteadof
"femalegenitalmutilation"(titleofthe1998statement)inpartbecauseitmayhelp
doctorsandhealtheducatorsbroachthesubjectwithfamilieswhodontviewthe
procedureasmutilation.
Infact,thestatementsayspediatriciansshouldremainsensitivetothecomplex
culturalandreligiousreasonsthatmotivateparentstoseekFGCfortheirdaughters.
Parentsoftenareunawareoftheharmfulconsequences.
FGCpersiststodaymainlyinAfrica,theMiddleEastandsomeAsiancommunities,
withabout4.5millionproceduresperformedeachyearongirls4to10yearsold.
Sometimesitsdoneoninfantsorpostponedforfemalesuntiljustbeforemarriage.
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Typically,alocalvillagepractitioner,laypersonormidwifeperformsFGCfor
paymentwithoutanesthesiaandbyusingavarietyofcrudeinstruments.In
developedcountries,physiciansmightbeenlistedtodotheprocedureundersterile
conditionswithanesthesia.
ThepolicystatementincludesillustrationsoffourmaintypesofFGC;type3,
infibulation,ismostsevereandinvolvessewingtogetherthelabiasothevaginal
openingisaboutthesizeofapencil.
AmongtheconsequencesofFGCarehemorrhage,shocksecondarytobloodlossor
pain,localinfectionandfailuretoheal,septicemia,tetanus,traumatoadjacent
structuresandurinaryretention.Infibulationisassociatedwithlongterm
gynecologicorurinarytrackproblems,infertilityandpainfulintercourse;apelvic
examorvaginalchildbirthpresentssignificantchallenges.
FGChasbeendocumentedinpeopleofmanyreligions,includingChristians,
MuslimsandJews.AmongthosewhopracticeFGC,thereisaperceptionthatitis
obligatoryoratleastencouragedbythereligioustradition,whichmaynotbethe
case.Thestatementavoidscriticizingthosewhobelievetheritualisimportantfor
religiousreasons.
Intheircounseling,pediatriciansshouldexplainfemalegenitalanatomyand
function,andbepreparedtodiscusswhymalegenitalalterationispracticed
routinelyinthiscountrybutfemalegenitalalterationiscondemnedandisillegalif
thefemaleisyoungerthan18.
Protectionofthephysicalandmentalhealthofgirlsshouldbetheoverriding
concernofthehealthcarecommunity,thestatementsays.
PublishedonJune1,2010,doi:aapnews.201006012*2010AmericanAcademyof
Pediatrics(requiressubscription)
MoreanalysisontheAAPFGCpage.]

InternationalCoalitionforGenitalIntegrity
April26,2010

Infantcircumcisioncauses100deathseachyearinUS
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AnewstudypublishedyesterdayinThymos:JournalofBoyhoodStudiesestimatesthatmorethan100babyboysdiefrom
circumcisioncomplicationseachyear,includingfromanesthesiareaction,stroke,hemorrhage,andinfection.Because
infantcircumcisioniselective,allofthesedeathsareavoidable.
TheInternationalCoalitionforGenitalIntegrityapplaudsthat,forthefirsttime,arationalattempthasbeenmadeto
estimatethescaleoftheproblem,andissimultaneouslyappalledbyhowmanybabyboysneedlesslydieeachyearinthe
UnitedStates.
Thestudyconcluded:Theseboysdiedbecausephysicianshavebeeneithercomplicitorduplicitous,andbecauseparents
ignorantlysaidYes,orlackedthecouragetosayNo.Andcalledthedeathsanunrecognizedsacrificeofinnocents.
Thestudyfoundthatapproximately117neonatal(first28daysafterbirth)circumcisionrelateddeathsoccurannuallyin
theUnitedStates,oneoutofevery77maleneonataldeaths.Thestudyalsoidentifiedreasonswhyaccuratedataonthese
deathsarenotavailable,someoftheobstaclestopreventingthesedeaths,andsomesolutionstoovercomethem.
Previousstudiesestimatedthedeathrateaslowastwoperyeartoasmanyas230.Thestudycollecteddatafromhospital
recordsandgovernmentsourcestoattempttoprovideamoreaccuratemagnitudeoftheproblem.
Toputthisinperspective,about44neonatalboysdieeachyearfromsuffocation,and8fromautoaccidents.About115
neonatalboysdieannuallyfromSIDS,nearlythesameasfromcircumcision.
Totheabstract.

TheGuardian
April21,2010

Leavingbabytocrycoulddamagebraindevelopment,parentingguruclaims
Neurobiologistssayhighlevelsofstresshormonecortisolare'toxic'tothedevelopingbrain,accordingtoPenelope
Leach
Leavingadistressedbabytocryonaregularbasiscouldbedamagingtothedevelopingbrain,accordingtoparentingguru
PenelopeLeach,whosenewbookwillbeseenasaheadonconfrontationwiththetoughloveapproachofbabyexperts
suchasGinaFord,whosayparentsshould"train"theirinfantsbyallowingthemtocrythemselvestosleep.
Inthelatestsalvointhebabywars,Leachbringssciencetoheraid,whichshesayshasprogressedremarkablyinrecent
years.Usingsalivaswabtests,scientistshavebeenabletomeasurehighlevelsofthestresshormonecortisolindistraught
babieswhosecrieselicitnoresponsefromparentorcarer.Neurobiologistssay,accordingtoLeach,thathighcortisollevels
are"toxic"tothedevelopingbrain.[e.g.DeBellisetal.]
"Itisnotanopinionbutafactthatit'spotentiallydamagingtoleavebabiestocry.Nowweknowthat,whyriskit?"Leach
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saysinherbook,TheEssentialFirstYearWhatBabiesNeedParentstoKnow....
(totherestifthislinkfails,contactus)
"Wefoundthatinourownchildcareresearch.Wefollowed1,200motherandbabypairsfrombirthtostateschool.We
weresurprisedtofindthatdifferencesinchildcaredonotmakenearlyasmuchdifferenceasweexpectedthemto.What
makesmoredifferenceisthecarer'sresponsiveness."
...
[Circumcisionproducesanincreaseinplasmacortisol:AnandKJ,HickeyPR.Painanditseffectsinthehumanneonateand
fetus.NEnglJMed.1987;317(21):13219.]

HelsinginSanomat(Helsinki)
Aprill15,2010

Legislationoncircumcisionstalled
Motherfinedforhavingsoncircumcised
Proposedlegislationonnonmedicalcircumcisionshasnotprogressedeventhoughabillonthematterhasbeen
underpreparationfornearlyadecade.Therearenoplanstoputforwardaproposalonthematterduringthecurrent
governmentterm,whichrunsoutnextyear.
TheMinistryofSocialAffairsandHealthrecommendedin2003thatcircumcisionsshouldbeallowedasapartof
publichealthcare,butthishasnothappened.
Anestimated200boysarecircumcisedinFinlandeachyearforreligiousreasons.
NoneofFinlandsuniversityhospitalsperformcircumcisionsfornonmedicalreasons,andthewillingnessof
privatedoctorstodotheprocedurehasdeclined.
Asaresult,someparentsaresendingtheirsonsabroadfortheprocedure,orhavetheoperationdoneinFinlandby
someonewhoisnotadoctor.
HelsinkiDistrictCourtonTuesdaysentencedamothertoafineforincitementtoassaultforhavinghersixmonth
oldsoncircumcised.
Inthesummerof2008thewomanhadhiredapersonwhoclaimedtobeasurgeontoperformthecircumcision.No
credentialswereshown,andtheboyhadtobehospitalisedthenextdayforbleeding.
Earlierinthespring,theparentsofanotherboywerefinedinasimilarcase.Thecircumcision,whichledto
complications,wasperformedbyarabbiwhowasbroughtinfromBritain.
InbothcasesthecourtappliedaprecedentsetbytheFinnishSupremeCourtin2008.
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InitsrulingtheSupremeCourtdecidedthatareligiouslymandatedcircumcisionofaMuslimboywasnotillegal,
becauseitwasmadeinapropermedicalfashion.Accordingtothedecision,banningallcircumcisionswouldviolate
theconstitutionalguaranteeofprivacyinfamilylifeandfreedomofreligion.[Dotheseguaranteesapplytoanyother
contestedparentalpractices,suchascorporalpunishmentorchildmarriage?]
However,thedecisiondoesnotanswerthecontroversialquestionsofwhetherornotdoctorsareobligedto
performcircumcisions,orhowtheyshouldbepaidfor.Itishopedthatnewlegislationmightclarifytheseissues.
Ifalawweretocome,itskeycontentwouldbethattheprocedurecouldbedoneonlybydoctors.Individual
doctorswouldbeallowedtorefuse,saysdirectorEijaKoivurantaoftheMinistryofSocialAffairsandHealth.
ReligiouslymandatednonmedicalcircumcisionsaremainlyperformedonJewishandMuslimboys.
InJudaism,aritualcircumcisionmustbeperformedbyamohel,whoistrainedintheprocedureaccordingtoJewish
tradition.InFinlandnearlyallmohelsarealsodoctors,althoughJewishlawdoesnotrequirethemtohaveformal
medicaltraining.
Wefeelthatitisnotnecessarytopassalawaccordingtowhichsomeonewhoperformsacircumcisionshouldbea
doctor,saysDanKantor,aspokesmanfortheHelsinkiJewishCongregation.
FinlandsIslamicCouncilisinfavourofpassingalawoncircumcisions.
Ifafamilycannotaffordaprivatedoctor,itshouldbepossibletoperformtheprocedureinthepublicsector,or
financialassistanceshouldbeprovided.Otherwisecircumcisionsmightbeperformedinconditionsthatarenotsafe
forchildren,saysthecouncilsinformationofficerIsraLehtinen.[Thisargumentcarriesnoweightwhenthechildren
involvedaregirls.]
TheFinnishMedicalAssociationfeelsthatnolawauthorisingcircumcisionsshouldbepassed,andthatpublic
healthcareshouldnotbeobligedtoperformtheprocedures.
ThisviewisechoedbyHarryLindahl,thinksthatnonmedicalcircumcisionsforunderageboysshouldbeillegal.
Ithinkthatitwouldbefinetowaituntilaboyturns18,whenhecandecideforhimself,Lindahlnotes.

PlusNews
April13,2010

MALAWI:Clinicsdispelmalecircumcisionmyths
LILONGWE,13April2010(PlusNews)Malecircumcision(MC),whichcanreduceHIVamongmenbyupto60percent,is
controversialinMalawiandgovernmenthasyettoimplementmassmalecircumcision.Butachainofprivateclinicshas
rolledoutthemeasurewithsomesurprisingresults.
BanjaLaMtsogolo(BLM)FutureFamilyinthelocalChichewalanguageaprivatefamilyplanningorganization,rolled
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outtheprocedureatitsnetworkof30nationalclinicsin2009andistheonlyorganizationofferingitaspartofanHIV
preventionpackage.
TheUNWorldHealthOrganizationrecommendscircumcisionandMalawi'sNationalHIVPreventionStrategy20092013
acknowledgesitsrole,butfallsshortofoutliningaclearpolicy.
BrendanHayes,theheadofBLM,admittedthatMChasbeenahardsell.
"InMalawi,you'vegotverybigdifferencesintheHIVepidemicfromnorthtosouthandthosedifferencesdontcorrelateto
differencesincircumcisionprevalence.Highprevalenceratesareinthesouthernpartofthecountry,whichisalsowhere
wehavethemostcircumcision...butyou'restillonlytalkingaboutoneinthreemen,"hetoldIRIN/PlusNews.
"Thesedifferencesaren'ttotallyinexplicablebutIthinkit'smadepeoplemorecautiousaboutmovingforwardwithmale
circumcision."
Confusionandcontroversy
SouthernMalawihasalargemigrantlabourpopulationandanHIVprevalencerateofabout18percent,accountingfor
almost70percentofthecountry'sHIVinfections,accordingtogovernmentfigures.Circumcisionisculturallyless
prominentinnorthernMalawi,whereprevalenceratesarealsolower.
Malawi
HIVRates:

Circumcisedmen

13.2%

Intactmen

9.5%

Source:www.measuredhs.com
ThemismatchbetweenHIVprevalenceandtraditionalcircumcisionrateshasraiseddoubtsamongsomehighlevelhealth
officials,mostnotablyPrincipalSecretaryforHIVandAIDSwithinthePresidency,DrMaryShawa.[orShaba]
Earlierthisyear,Shawaarguedinlocalnewspapersthatshehadnotyetbeenpresentedwithenoughclinicalevidenceon
MC,anditsefficacywasquestionablegivenhighHIVprevalenceratesamongtraditionallycircumcisingpopulationsinthe
south.
Shawaalsoquestionedtheacceptabilityofthepracticeamongethnicgroupsthatdidnotperformtheprocedure.
...

Meninahurrynottogetcircumcised...

IOLNews
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April12,2010

Lunchbreakcircumcisionisasnip
ByKaninaFoss
Joburgmencannowgetcircumcisedduringtheirlunchbreaks.ThesnipthatsaveslivesisdoneattheZuziMpiloMedical
CentreintheCBD.IttakesjustonehourandcostsR400.
...
TheclinicstartedofferingcircumcisioninmidFebruary.Ithasreceivedcallsfromalloverthecountry,butithas
circumcisedonlyabout12men.[That'sonecircumcisioneveryfivedays.]
Martinsonhopesthatnumberswillincreaseinwinterwhentraditionalinitiationstakeplaceanddemandforcircumcisions
increases.
...
TheR400feebarelycoversbasiccosts,andissubsidisedbytheUSgovernment,whichfundsthecentre.Martinsonsaid
GPschargedaboutR700andurologistsatprivatehospitalsaboutR2000.
Oneofthereasonsthecentre'sservicesmaybeslowtotakeoffisthatthegovernmenthasn'tissuedanymajorcallfor
circumcision.[Orperhapsbecausemenhaveconsidereditandsaid,"Notonyourlife!"]
AccordingtoMartinson,thisisbecausepublichospitalsdon'thavethecapacitytodealwithlargenumbersofpeople
requestingcircumcisions.
...

AfricaOnLine
(April12,2010)

Femalecircumcisionbanned
Kampala,UgandaAUgandanofficialsaysthatparliamenthaspassedabillbanningfemalegenitalmutilation.
UgandasMinisterofEthicsandIntegrityJamesNsabaButurosaidthatthenewlaw,passedwithoutoppositionlateon
Thursday,couldgiveoffendersalifesentence.
Femalegenitalmutilation,alsoknownasfemalecircumcision,ispractisedmostlyinnortheasternUgandaonmorethan3
000girlseachDecember.
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Thepracticeinvolvestheremovalofagirlsclitorisorothergenitalpartsatayoungage.Criticssayitcanleadto
complicationsduringchildbirthandeliminatesanypleasureforwomenduringsex.
FemalecircumcisionisillegalinmorethanadozenAfricancountries,althoughlawsarerarelyenforced.SapaAP

6Minutes(Australia)
April12,2010

CircumcisionbenefitsnotseeninAustralia
[Falslyimplyingtherearebenefits.Howabout"CircumcisiondoublesNSUrisk"?]
byMichaelWoodhead
CircumcisiondoesnotseemtobejustifiedintheAustraliancontextbecauseithasnoprotectiveeffectsagainstSTIsand
doesnotreducesexualdifficulties,amajornewstudyhasfound.
Aquestionnairesurveyofalmost4300mencarriedoutbyresearchersfromLaTrobeUniversityinVictoriaandthe
UniversityofNSWfoundthatcircumcisionwasunrelatedtoSTIriskoverall,butappearedtoincreasetheriskofnon
specificurethritis[actually,tomorethandoubletherisk,withhighsignificance]andreducetheriskofpenilecandidiasis.
RatesofHIVandsyphilisweresolowthatitwasnotpossibletoconcludewhethercircumcisionhasanyprotectiveagainst
theseSTIs,thestudyauthorssayintheAustraliaandNZJournalofPublicHealth(34:160)thismonth.
TheysayfindingsfromapreviousAustraliansurveythatshowedhigherratesofsexualdifficultiesamonguncircumcised
menhadbeenusedinsupportoftheprocedure.However,thenewstudyshowednosuchdifferences.Inparticular,there
werenodifferenceseenbetweencircumcisedanduncircumcisedmenintheover50sagegroup,wherepreviously
uncircumcisedmenhadpreviously[sic]beenshowntohavehigherratesofdifficultymaintaininganerectionandhaving
painduringintercourse.
Atthepopulationlevel,circumcisionappearstohaveminimalprotectiveeffectsonsexualhealthintheAustralian
context,concludesstudyauthorDrJulietRichters.

NOCIRCSA(TheNationalOrganisationofCircumcisionInformationResourceCentresSouthAfrica)
April1,2010(genuine)

SouthAfricanboysgetbetterprotection
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AmendmentstotheSouthAfricanChildren'sRightsActpostedtodaymakeitharderforboystobecircumcisedfor
frivolousreasons.
Thechangesrequireinformedconsentofbothparents,andtheboyifheisoldenough,andthesignatureofthe
circumciser,tobekeptonrecorduntiltheboyis21oldenoughtosueifheisnotsatisfiedwiththeoutcome.
Fromtoday,theChildCareActisrepealedandallsectionsoftheChildren'sActasamendedcomeintooperation.The
proclamationhasbeensignedbytheDeputyPresident.
TheActprovides:
Social,culturalandreligiouspractices
12.(1)Everychildhastherightnottobesubjectedto
social,culturalandreligiouspracticeswhichare
detrimentaltohisorherwellbeing.
(3)Genitalmutilationorthecircumcisionoffemalechildren
isprohibited.
...(8)Circumcisionofmalechildrenundertheageof16is
prohibited,exceptwhen
(a)circumcisionisperformedforreligiouspurposesin
accordancewiththepracticesofthereligionconcernedand
inthemannerprescribed;or
(b)circumcisionisperformedformedicalreasonsonthe
recommendationofamedicalpractitioner.
(9)Circumcisionofmalechildrenolderthan16mayonlybe
performed
(a)ifthechildhasgivenconsenttothecircumcisioninthe
prescribedmanner;
(b)afterpropercounsellingofthechild;and
(c)inthemannerprescribed.
(10)Takingintoconsiderationthechild['sage,maturityand
stageofdevelopment,everymalechildhastherightto
refusecircumcision.
Consentformshavetobekeptuntilthechildis21yearsold.
BacktotheIntactivismindexpage.
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