Over the course of the past 5 years, advanced medical research through experimental trials has proven that male circumcision can reduce a man’s risk of becoming infected with HIV during heterosexual intercourse by up to 60 percent. This has lead to the World Health Organization and UNAIDS to recommend circumcision as a new form of HIV prevention. This week, PPI-SA’s Senior Life Skills Coordinator, Ntobeko Ngcamu, shares a very powerful story about his circumcision experience at McCord Hospital, who through PEPFAR, USAID and the South African Government, are offering free “same day” circumcision surgery for South African males.
For the past few years, the message was out. Everyone was talking about HIV & circumcision– clinics, schools and the radio (specifically Gagasi FM) was spreading the word about the opportunity for a free circumcision procedure at McCord Hospital in Durban. For the past 6 months, I was trying to find the strength to go through with the procedure. The thing that scared me the most was that you needed to complete an HIV testing and counselling session beforehand. Luckily, I had have been through this experience before with Zoe-Life, a PPI-SA partner, and their counsellors. My nervousness about going for testing comes from the fact that I live in the township of Umlazi, which has some of the highest rates of HIV infection, and that there is a “3-month window period” with current forms of HIV tests, meaning that if I were to contract HIV within the 3 month period of going for testing, it is likely that a positive result would not be displayed. In my opinion, this is also the thoughts and feelings of other South African males, preventing them from going to get circumcised.
As a part of my job as a Senior Life Skills Coordinator at PPI-SA, I was spreading the word about circumcision to our staff, coaches, participants and partner school personnel, while also discussing the topic with friends and family. I wanted to be able to educate people about the advantages of circumcision and be able to answer any questions they might have.
On November 7, 2011, I go to McCord Hospital and am instructed to sit in the Administrative Area with the 40 person limit in the waiting room.
I get there early because if I’m number 41, I won’t be able to go for surgery that day. I end up being number 40.
We fill in our personal biographical details. At this point, no one is talking to each other – it’s very quiet – you could hear a pin drop. We wait 45 minutes to an hour with no one speaking to one another, fearful of what is about to happen with our upcoming individual HIV counselling and testing session.
I then move to the reception area, waiting to go to the counselling session for an HIV test. Patients will go upstairs to proceed with the surgery (if negative), or out of the counselling room (if positive). If positive, the patient will then take a test to measure their “CD4 count” and come back in 7 days for the explanation of the results.
Next, I move to the “Theatre” waiting area. Orientation – We get a brief orientation explaining the advantages of circumcision and how to properly take care of yourself after the circumcision. I then went into the surgery, which lasted only 15-20 minutes after receiving the anaesthetic from the Doctor.
Once you’re done with circumcision, you get “review dates” to see that everything is going as planned after the procedure.
Review Date 1 – November 9th – I meet with the Doctor to make sure that the healing process is going as planned and the bandage is removed. All people that received the surgery that day are back together and individually consult with the surgeon. A person in the waiting room next to me shares the following:
“I can’t wait until I leave here and recover from surgery because now I’ll be able to go have sex with a woman that I love and she’ll be less likely to leave me and sleep with other men, because sex will feel better for her if I don’t wear a condom.”
Review Date 2 – November 14th – I meet with the Doctor individually again to makes sure everything is still going smoothly with the healing process. Overall, the process takes 6 weeks and I have two more visits scheduled with the doctor. A different patient shares the following:
“I can’t wait until I recover from surgery. Since the festive (holiday) season is approaching, I think I’ll be able to sleep with at least 10 different women over the next 2 months. Since I’ll be circumcised, I’m less worried about contracting HIV so I’m excited to have unprotected sex with as many women as I can, and more women will likely have sex with me now that I’m circumcised.”
There is significant room for improvement in what McCord Hospital, PEPFAR, USAID and the South African Government are trying to achieve with their mass circumcision initiative. People are not getting circumcised for the right reasons. In reality, based on people’s attitudes and perceptions from the government program, it is quite possible that the actual number of HIV infections could be higher than if nothing were done.
People need more information and it needs to be delivered in a proper manner. I suggest that during the waiting times in the Admin and Waiting Rooms, there can be educational workshops increasing the knowledge and awareness of the benefits of circumcision. There is no use delivering this message in an unprofessional way, 5-minutes before going in to the circumcision surgery, since our minds at the point are only thinking about what is about to take place with the surgeon’s scissors… A facilitator should educate the patients in a professional way, and then a group discussion could be had where everyone can have the opportunity to discuss their thoughts and feelings in a supportive environment. I think there would be a very positive impact on the patients if this happened.
Thanks for sharing your story with us, Ntobeko. We understand that this was a difficult story for you to share with the public, and doing so speaks volumes about your leadership. We hope that your story informs and inspires readers and all PPI stakeholders, encouraging them to make positive, responsible decisions for their own personal health!