circumcision a weapon against aids

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Circumcision: A Weapon Against AIDS

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Circumcision helps prevent AIDS. To bring this message – and offer the procedure – to South African men, an innovative training course has been launched for local medical teams. Rambam Health Care Campus (RHCC) operating room nurse Yasser Barakat recently lead one such course, as part of an international delegation to Durban, South Africa

In Africa, circumcised males present 60% less HIV than the un- circumcised. For this reason, health organizations, including the World Health Organization, are backing programs that offer high-volume and -quality medical circumcision for adult men. Rambam operating room nurse Yasser Barakat recently spent two weeks in South Africa as part of a team that trained local medical personnel, and performed more than 160 operations.

The delegation was organized by the Jerusalem-based Operation Abraham Collaborative (OAC), a group of international experts who advise U.N. public and private sector organizations on performing numerous safe, efficient circumcisions. Comprised of five doctors and 12 nurses, the OAC team worked in St. Mary’s Hospital, near Durban.

Barakat’s job involved some psychology, religion, and public relations, and a lot of medicine. “My job was to teach local teams to counsel prospective clients, as well as women and parents, on circumcision,” says Barakat, who has worked at Rambam 13 years, and has guided nursing teams in different units. Fluent in English, Yasser holds a BA in nursing and an MA in social work.

“I spoke to the hospital’s staff and nursing students about the benefits of circumcision in countering HIV,” says Barakat, who also described the role of circumcision in Islam, as South Africa has a large population of Muslim Indians.

Barakat explains that Langerhans cells, concentrated in the inner foreskin, help HIV enter the body. As the foreskin is moist, it is conducive to incubating organisms that cause most ulcerative Sexually Transmitted Illnesses (STIs). These ulcerations also allow HIV to easily enter the body.

When the foreskin is removed, the area dries, becoming less friendly to Langerhans cells, and lessening the spread of HIV. In addition to HIV, uncircumcised men easily contract fungal infections of the urethra and the foreskin, which can lead to cancer. Cirumcision, therefore, prevents penile cancers.

Beyond the cold medical facts, circumcision is, for patients, a “loaded” procedure, fraught with anxiety about pain, performance and potency. Surprisingly, the local men responded to advertisements placed by St Mary’s Hospital, and were overwhelmingly receptive to the procedure.

“Most of the Zulu men who came for examination had related problems, and wanted to prevent HIV and other illnesses,” says Barakat. “On one day alone, we performed 37 operations, on young men between the ages of 15 and 20. They would come in buses.”

While hospital conditions were hardly up to Rambam standards, Barakat was impressed with the staff, who he says, learned quickly.

“It was amazing to work with these people in their own facility,” says Barakat. “We met many South Africans, black and white, visited villages, and saw how people live. The delegation gave me a great sense of doing and being.”