Israeli Doctors Providing Male Circumcision in Swaziland in Effort To Prevent Spread of HIV
Teams of Israeli surgeons have begun providing male circumcision in Swaziland in an effort to prevent the spread of HIV, the Washington Post reports. Health officials in Swaziland, which has fewer than 100 doctors and the world's highest HIV prevalence, say that over the next five years, they hope to offer the procedure to 200,000 sexually active men at a rate of roughly 200 daily -- 20 times faster than the current pace. According to the Post, six Israeli doctors are scheduled to work for two weeks in Swaziland this year under a program organized by the Jerusalem AIDS Project and underwritten by the U.S.-based Jewish organization Hadassah and other donors.
The Israeli doctors primarily are expected to train Swazi doctors on how to perform circumcision among adult men. However, many Swazi doctors already know how to perform the surgery. According to some Swazi doctors, what they primarily need from the Israeli doctors are "extra hands to help get enough done to impact the epidemic," the Post reports. The demand for circumcision -- especially surgeries that are no cost or subsidized -- appears to "far outstrip supply in Swaziland," according to the Post. The health system "routinely runs low" on basic medical supplies -- such as sutures, gloves, dressings and surgical tools -- the Post reports. In addition, there is a "major constraint" on surgeons and doctors, Dudu Simelane -- executive director of the Family Life Association of Swaziland, a nongovernmental group hosting the Israeli doctors -- said.
Some Swazi surgeons have shown that they can each perform 10 circumcision procedures -- which take about 25 minutes -- daily during the country's occasional series of "Circumcision Saturday" events, the Post reports. According to medical experts, it would take four doctors at each of five separate facilities to perform 1,000 circumcisions weekly if Swazi doctors can maintain that speed every weekday (Timberg, Washington Post, 10/21). Some of the Israeli experts have said that providing counseling to men and their sexual partners is required to prevent them from developing a "false sense of security and engaging in high-risk behaviors that could undermine the partial protection provided by male circumcision," according to the Jerusalem Post (Siegel-Itzkovich, Jerusalem Post, 10/18). The Israeli doctors "developed expertise in rapidly conducting large numbers of adult male circumcisions" in the late 1980s, when a large number of uncircumcised Jewish emigrated from former Soviet countries and Ethiopia and requested the procedure, the Financial Times reports. "Until then, we had just a few cases each year for medical reasons," Eitan Gross -- medical director of Operation AB, which was formed by volunteers from the Hadassah Medical Organisation and the Jerusalem Aids Project to lend their expertise to Africa -- said. he added, "It had been very unusual to circumcise adults" (Jack, Financial Times, 10/20).