Welcome!

We’re happy to present yet another issue of Scouts Voice (SV). In this edition, we discuss voluntary
medical male circumcision. Different people practice male circumcision for different reasons. When
done the traditional way, circumcision at times increases 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 reduce
the spread of HIV by 60%. However, this does not make MMC 100% protective against HIV. It means
that even if a boy or a man is circumcised, he still has 40% chances of getting infected or infecting his
partner.

Medical CircumcisionMale
Circumcision & and HIV
P r e v e n t i o n : M a k e i t s a f e (Male
Medical circumcision reduces the spread of HIV by 60%. Read
more on page 2.)
Boys are born with the foreskin. This covers the head of the penis called the glans. Normally the
foreskin can be pulled back when urinating or bathing.

But the shape of the penis is made to look different by a minor little operation called circumcision.
Circumcision is when the foreskin is cut off, exposing the head of the penis. Worldwide, people
circumcise because of religion, culture, and hygiene reasons. In Uganda, Bagisu, Sabiny of Kapchorwa,
Bakonzo and Bamba circumcise to initiate boys for manhood. Today, most males circumcise to reduce
the spread of HIV. Also, many people think circumcised penis looks better. Others do it for social
reasons, such as the wish to look like other men in the family and to protect their sons from the bad
practices of witchcraft, kidnap and child sacrifice.

Traditional male circumcision has been practiced purely as rite of passage and a socialization forum for boys
into 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 knife
or 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 reduce
risks 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 safest
way to avoid risks such as infections, over-bleeding, pain and injury. In April 2010, Scouts 16 scouts
met at Dabani Girls SS and talked about medical 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 be
accompanied by responsible behavior that protects oneself and others. However, male circumcision, however, DOES
NOT PROVIDE COMPLETE PROTECTION FROM HIV Infection. Circumcision should not in any way replace
abstaining from sex or using condoms for those who are sexually active because even a circumcised male can still get
infected with HIV if he is having unprotected sex. However before you make a decision to be If you are
sexually active, even if you are circumcised, you need to first go for HIV test with your partner, be
faithful and to always use a condom to protect yourself and partner from HIV/STDs and unwanted
pregnancy for protection until when you are ready to have children. Condoms have proved to be a very
effective barrier available against HIV and other sexually transmitted infections if they are used properly each and
every time.

It is important to remember that circumcision does not confer any special rights, privileges or power to boys and men
nor does it remove them from the obligation of ensuring that HIV infection is reduced in their communities by
protecting themselves and their partners for those in relationships. Use of power or violence to demonstrate their male
status is completely unacceptable as gender violence has been shown to lead to increased HIV infection among
women.

Page 2
Making a circumcision decision
Try not to worry if you decide to get circumcised. It only takes a short time. The doctor cleans around
the foreskin before injecting around your penis so you do not feel pain.

The foreskin is removed using a surgical blade. The wound is then stichedstitched for quick healing. A
small 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 long
enough 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 private place without your
pants, for about half an hour everyday to allow fresh air for fast healing. The best time for circumcision
is 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 the
health worker will take them out usually after a week. This only takes a few minutes and does not really
hurt.

When is MMC necessary?

Dr Olive Sentumbwe, from the World Health Organisation, says besides the need for HIV prevention,
Medical Male Circumcision is also recommended 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 original
location without force).
• Frenulum Breve (the foreskin cannot be smoothed down the shaft because the little cord (the
frenulum) 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 in
female sex partners.

How we felt after losing our foreskins

Mandyosi Abdu, 12, P7 from Greens PS was 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 be
circumcised.
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, Dabani
Girls 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 the circumcision •circumcision • Irritation of the
glans
• Increased risk of meatitismastitis (inflammation of the opening of the penis) • Risk of injury to the
penis

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 to
get HIV. How? HIV enters the body through the cells under the foreskin. The inner part of the foreskin can take up
HIV 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 to
the 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 can
break and make it easy for the HIV to enter the bloodstream. In addition, the space between the foreskin and the head
of the penis (glans) may be conducive to the survival of germs. By removing the foreskin, you are therefore removing
a part of the penis that is most open to allowing HIV to enter the body. This results in REDUCING the chances of HIV
entering the body of a male person.

In circumcision the foreskin is removed allowing the skin of the tip of penis to dry up and become
tougher. Circumcision reduces the number of the special cells. This makes it difficult for HIV to enter
the 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 warm
water.

Contact a health worker right away if you notice:

• persistent bleeding
• increasing redness on the swelling
• worsening discharge or pus
• fever
• not urinating normally within 12 hours after circumcision

Abstain from sex for at least six weeks after circumcision to ensure the wound heals completely.

One last point from Peace Balikudembe

Dear Scouts, there is still no cure for HIV. Circumcised or not, keep your zip up to protect yourself.
Being circumcised does not mean you should now have unprotected sex with every girl or woman. You
can still be infected with HIV or infect your partner. Circumcision works best with other prevention
methods such as abstinence, faithfulness and if you are sexually active, always use condoms correctly
and consistently.

Page3
Scouts share stories on
circumcision
While in Busia the SV Journalists visited Greens PS, Parents Pride PS and Busia Girls PS where fellow
scouts shared with them stories on circumcision. Read on

A sign of adulthood
Celestine Oyula, S3, Busia Girls SS, She says: “I am from western Kenya where circumcision is
compulsory. A circumcised person is highly respected and considered an adult even if he is young.” By
Namajja Phiona Diana, 14, S2, Dabani Girls SS and Wabwire Rehema, 12, P6, Dabani Girls PS

Painful
Katisi Aidah, 14, P5, Parent’s Pride PS, says: “A friend was circumcised in the traditional way. It was
very painful. A circumciser cut him badly with a dirty old knife and the wound took long to heal.” By
Apio Dorothy, 13, S2, Dabani Girls SS and Nafula Sarah, 11, P6, Dabani Girls PS

Trained health workers better

Nyasuna Budester, 14, S2, Busia Girls SS, says: “Circumcision is good if done in a proper way. It should
be done by a trained health worker in a clean environment. That is what I wish for my brothers and
friends.” Story by Wandera Benard, 13, S1, Masaba College and Nasirumbi Venisha, 14, S1, Dabani
Girls SS

Re-educate people
Nandera Doreen, 17, S3, Busia SS, agrees: “I think we need to tell everybody that our cultures can be
made safe. Anything risky, painful or which threatens life should be abolished.” By Wandera Fred, 14,
S1, Masaba College and Priscilla, 11, P6, Dabani Girls PS

A family defender
Atedat Christine, 16, S2, Busia Girls, says: “In our family, all males are circumcised for health reasons.
But I hear in other cultures the pain is meant to introduce bravery into a boy as a family defender.” By
Nasirumbi Venisha, 14, S1, Dabani Girls SS and Wandera Bernard, 13, S1, Masaba College

It is OK medically
Ndagire Babrah, 17, Brown Sea Scouts Club, Busia, says: “Male circumcision is OK. But we are in
modern times and we have to do it medically whether it is for religious, cultural or any other reason.”
By Nankwanga Josephine, St John’s SS, Busia and Asumpta Bridget Hope, Dabani Girls SS

Will not disappear

Orobo Ronald, 13, P7, Greens PS, adds: “My friends say among the Bagisu when a boy is not
circumcised, he is like a sheep among the goats. He cannot be respected.” By Namujehe Phoebe, 14,
S1, Dabani Girls SS

Curious
Muwebwa Brain, 15, P7, Green PS, says: “The first time I heard about circumcision I became curious. I
asked my friends from Mbale who told me that during circumcision boys are told to leave childish
behaviour and adopt adult behaviour. Boys are allowed to have sex with any girl or woman.” Story by
Nasinyama Hellen, 14, Dabani Girls SS and Were Innocent, 14, Busia SS

Protection from witchcraft

Akinyi Lynnet, 18, S4, from Busia Girls SS, says: “I am a Samia. In our culture we don’t practice
circumcision. But my brother was circumcised in a traditional way to protect him from the witch doctors
kidnapping him. It is believed that if a child is circumcised, he is not clean enough for sacrifice to gods.”
By Priscilla, Dabani Girls SS and Wandera Fred, Masaba College

FGC: Not healthy for the girls

Female genital mutilation/cutting (FGM/C), involves cutting away all or parts of a girl’s
clitoris, labia minora and labia majora. In Uganda, it’s practiced by Sabiiny of Kapchorwa
and Pokot tribes in Amudat, Bukwo and Nakapiripiriti.

FGM has no health benefits for girls and women. In fact, girls and women who are cut face
serious lifelong health risks such as severe bleeding and problems urinating, and later,
potential childbirth complications and newborn deaths.

Inono Narada, 13, P7, Greens PS, says: “There is a female friend whose clitoris was badly
cut. After two months the wounds had not healed. She was taken to the hospital but it was
too late. Serious wounds developed in her vagina and she died.” Story by Athieno Victoria,
14, s1, S1, Dabani Girls SS and Aujat Martha, 12, P6, Dabani Girls PS

If you are a girl and you are being forced or you know of a girl who is being forced to be
cut, talk to a responsible educated person in your community or report the matter to the
police.

Pg 4
Scouting for solutions
What is circumcision and when did it start? Namajja Phiona Diana, Dabani Girls SS
Circumcision is the surgical removal of the foreskin, the tissue covering the head of the penis. It is an
ancient practice that has its origin in religious rites. Today, many parents have their sons circumcised
for religious or health other reasons.

When is it right circumcision to be done? Icumar Esther Ruth, P7, Greens PS

Circumcision is usually performed on the first or second day after birth. (Among the Jewish population,
circumcision is performed on the eighth day.) The procedure becomes more complicated and riskier in
older babies, children, and men. But doctors recommend age five as appropriate because the foreskin
would have retracted. Circumcision can be done at any age provided it is done by trained health
personnel.

How is circumcision done and when should a circumcised male have sex? Adeke Aminah, P7, Greens PS
During a circumcision, the foreskin is pull from the head of the penis (glans), and the excess foreskin is
clipped off. If done in the newborn period, the procedure takes about five to ten minutes. Adult
circumcision may take more time. The circumcision generally heals in five to seven days.

Is circumcision necessary? Anyango Nancy, S1, Busia Girls SS

The use of circumcision for medical or health reasons is an issue that continues to be debated. But
procedure may be recommended in older boys and men to treat phimosis (the inability to retract the
foreskin) or to treat any other infection of the penis and to prevent HIV infection.

POEM
AIDS cases among adolescents between the ages of 13 and 19 grew by 88% in 1992 and 1993.

WHAT DO YOU FEEL?

AIDS. What do you

feel when this word
is said to you? Do you
shiver? Do you shudder?
Or do you listen?

If you shiver, you

are shuddering. If
you shudder, you are
shivering. But if you listen, you are
understanding.

When you listen, you

understand more about
AIDS. Not only AIDS,
but HIV, the virus that
causes AIDS.

You understand the

pain and fear and remarks
that the people who have
it go through.
If you listen,
you can understand.

AIDS is more than just a word.

It doesn’t rhyme, or sound a
certain way.
It doesn’t give itself
to a meaning.
AIDS cannot be summed up
into one definition.
But one can try:
Sadness, tears, depression.
Moments, relationships, love.
 Beauty, ugliness, emptiness.
No, AIDS is more than just
words.

Listen and understand.

Aujo Claire Mary and Nabwire Suzan