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Welcome!
We’re happy to present yet another issue of Scouts Voice (SV). In this edition, we discussvoluntary medicalmale circumcision. Different people practicemalecircumcision for different reasons. When done the traditional way, circumcisionat timesincreases risks of infections, pain, over-bleeding and injury. This is because circumcisers are not well trained to do the job and often use one knife to cut several boys in unclean environment. Also find out how Medical Male Circumcision (MMC) can reducethe spread of HIV by 60%. However, this does not make MMC 100% protective against HIV. It meansthat even if a boy or a man is circumcised, he still has 40% chances of getting infected or infecting his partner.
Medical Circumcision MaleCircumcision & and HIVPrevention : Make it safe
(MaleMedical circumcision reduces the spread of HIV by 60%. Readmore on page 2.)
Boys are born with the foreskin. This covers the head of the penis called the glans. Normally theforeskin can be pulled back when urinating or bathing.But the shape of the penis is made to look different by aminor littleoperation called circumcision.Circumcision is when the foreskin is cut off, exposing the head of the penis. Worldwide, peoplecircumcise because of religion, culture,andhygiene reasons. In Uganda, Bagisu, Sabiny of Kapchorwa,Bakonzo and Bamba circumcise to initiate boys for manhood. Today, most males circumcise to reducethe spread of HIV. Also, many people think circumcised penis looks better. Others do it for socialreasons, such as the wish to look like other men in the family and to protect their sons from the badpractices of witchcraft, kidnap and child sacrifice.
Traditional male circumcision has been practiced purely as rite of passage and a socialization forum for boysinto taking up additional responsibilities and challenges in adulthood in most circumcising communities.However, traditional circumcision methods have continued using unsafe practices such as sharing one knifeor razor blade among all initiates. This poses the risk of passing on HIV infection if one initiate is infected.
Dr Kihumuro Apuuli, Uganda AIDS Commission, says:“Circumcision is best done in hospital to reducerisks of infections, pain, over-bleeding and injury. NO two people should share a circumcision knife,even if they are brothers, to avoid spreading HIV.”Scouts, whatever reason you are circumcising for, do it safely. Medical Male Circumcision is the safestway to avoid risks such as infections, over-bleeding, pain and injury. In April2010,Scouts16 scouts met at Dabani Girls SS and talked aboutmedical male circumcision.Read more stories on page 3
Message from the SFS Technical Advisor’s desk 
Although medical male circumcision has been shown to reduce the risk of HIV infection by a big margin, it must beaccompanied by responsible behavior that protects oneself and others. However, male circumcision, however, DOESNOT PROVIDE COMPLETE PROTECTION FROM HIV Infection. Circumcision should not in any way replaceabstaining from sex or using condoms for those who are sexually active because even a circumcised male can still getinfected with HIV if he is having unprotected sex.
However before you make a decision to be If you aresexually active, even if you are circumcised, you need tofirst go for HIVtest with your partner, befaithful and to always use a condomto protect yourself and partner from HIV/STDs and unwanted
 
pregnancy for protectionuntil when you are ready to have children.
Condoms have proved to be a veryeffective barrier available against HIV and other sexually transmitted infections if they are used properly each andevery time.It is important to remember that circumcision does not confer any special rights, privileges or power to boys and mennor does it remove them from the obligation of ensuring that HIV infection is reduced in their communities byprotecting themselves and their partners for those in relationships. Use of power or violence to demonstrate their malestatus is completely unacceptable as gender violence has been shown to lead to increased HIV infection amongwomen.
Page 2Making a circumcision decision
 Try not to worry if you decide to get circumcised. It only takes a short time. The doctor cleans aroundthe foreskin before injecting around your penis so you do not feel pain. The foreskin is removed using a surgical blade. The wound is thenstichedstitchedfor quick healing. Asmall bandage will be wrapped around the wound to protect it from germs and dirt. The nurse will check to make sure you can urinate properly. There may be a bit of blood. Stay longenough to be sure all bleeding has stopped and the doctor will deal with it if it has not.For the first few days,. yYou will not go to school or play rough games with your friends. It is best to just read or watch TV, listen to radio or play video games. While at home, sit in a privateplacewithout yourpants, for about half an hour everyday to allow fresh air for fast healing. The best time for circumcisionis during the school holidays to allow enough time to heal. You may see the small stitches that are used to hold the cut together. These will go away. If not thehealth worker will take them out usually after a week. This only takes a few minutes and does not reallyhurt.
When is MMC necessary?
Dr Olive Sentumbwe, from the World Health Organisation, saysbesides the need for HIV prevention,Medical Male Circumcision isalsorecommended if any of the following conditions apply:•Phimosis (the foreskin is too tight and cannot slide back).•Paraphimosis (the foreskin gets trapped in the coronal groove and cannot return to its originallocation without force).•Frenulum Breve (the foreskin cannot be smoothed down the shaft because the little cord (thefrenulum) underneath the glan is too tight.•Balanoposthitis (inflammation of the glans and foreskin).•Your foreskin balloons out while urinating.•Your foreskin and glans develop splits or tears during sex or repeatedly become infected or very sore.•You suffer from itching of the foreskin that is often a sign of herpes infection.•You have difficulty keeping smegma under control.•Protection against penile cancer, urinary tract infections, STDs and a reduced risk of cervical cancer infemale sex partners.
How we felt after losing our foreskins
Mandyosi Abdu, 12, P7 from Greens PSwas circumcised because of religion. He says:
“Expect a bit of teasing when your friends first see your ‘new’ penis. Just smile at their jokes. It is better for you to becircumcised.By Athieno Victoria, 14, s1, S1, Dabani Girls SS and Aujo Martha, 12, P6, Dabani Girls PS.
 
Maloba Ali, 16, P7, Greens PS, says: 
“I am a Moslem but I was circumcised in the hospital. The doctor used a clean blade. He cleaned the wound and put gauze. He told me to clean it regularly to avoid infections. I followed the advice and the wound healed very fast."By Namujehe Phoebe, 14, S1, DabaniGirls SS & Silver Anthony, 14, S1, Masaba College
Ibrahim Abduliziza, says: 
"Your glans rubs against your underwear all the time as you walk or run. It does not hurt, it just tickles. You get used to it. In the end you forget about it."
Inkuzisa Ibrahim, says:
 
"Circumcision turns what was an inside part into an outside part of your body.What was moist is now dry."By Egessa Francis, 13, S1, Masaba College
Circumcision risk
Like any surgical procedure, there are risks associated with circumcision. However, these risks are low.Problems associated with circumcision include:• Pain • Risk of bleeding and infection at the site of thecircumcision •circumcision •Irritation of theglans• Increased risk of meatitismastitis(inflammation of the opening of the penis) • Risk of injury to thepenis
Circumcision and HIV: What every scout needs to know
Harasini Caroline Rosini, S2, Busia Girls SS, asked: How does circumcision reduce the spread HIV?
"
Recent studies in Uganda, South Africa and Kenya show that males who are circumcised are about 60% less likely toget HIV. How? HIV enters the body through the cells under the foreskin.The inner part of the foreskin can take upHIV virus more easily than other parts of the penis. It has a very high concentration of the cells that HIV targets for entry into the body.As the foreskin rolls off the tip of the penis during sex, the cells inside the foreskin are exposed tothe virus.The inner part of the foreskin also has greater chances of tearing during sex, thus providing a gateway of entry for harmful germs, including HIV.HIV enters the male’s body by connecting onto these cells. The inside layer of foreskin is soft like the inside of an eyelid, nose or mouth. During sex, this wet soft membrane of the foreskin canbreak and make it easy for the HIV to enter the bloodstream.In addition, the space between the foreskin and the headof the penis (glans) may be conducive to the survival of germs
.
By removing the foreskin, you are therefore removinga part of the penis that is most open to allowing HIV to enter the body. This results in REDUCING the chances of HIVentering the body of a male person.
In circumcision the foreskin is removed allowing the skin of the tip of penis to dry up and becometougher. Circumcision reduces the number of the special cells. This makes it difficult for HIV to enterthe body.
Taking care of a penis after circumcision
It takes between 7 to 10 days for a penis to heal after circumcision. Keep the area as clean as possible.Good hygiene prevents infections and swelling. Gently clean with a piece of clean cloth and warmwater.Contact a health worker right away if you notice:•persistent bleeding•increasing redness on the swelling•worsening discharge or pus
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