Tuesday, May 02, 2006

Lay still. This is going to hurt you more than it's going to hurt me

I think I'll write this with my legs crossed. Wait. It's too late--The AIDS epidemic in Africa is not laughing matter, actually. Indeed, it is one of the worst medical calamities in history. One does feel a slightly warm feeling however that one way of helping control it may be a very very old religious practice--circumcision.

Several studies have shown that removing the foreskin cuts down on transmission as well as making you Jewish. OK, half right. One study in Brazil last year showed this was true and while the evidence is still underwhelming, physicians in Africa are so desperate they are not waiting for peer reviewed articles to show them the way. For $3, doctors in Zambia will do the surgery. Without the beard and the wine and the food. About 400 men a month are requesting the procedure, far more than the physicians--who are not nearly as fast as your average mohel--can handle. (A mohel--pronounced moy-el--is a rabbi specializing in circumcisions and generally takes less than 2 minutes to do the job. The actual surgery takes seconds and is done before the baby--8 day old boys--know what happened to him.) Swaziland also is beginning to look into the practice. The research seems to show that the procedure dramatically cuts transmission of the HIV virus both to and from the man. The theory is that the cells in the underneath part of the foreskin is very susceptible to the virus as are the inevitable cuts and abrasions.

One published journal article actually shows the opposite, that it makes men more likely to contract the virus, but that study seems to stand alone. Many physicians in Africa are waiting for the World Health Organization to make a decision, which it has yet to do, awaiting more definitive studies. Two such studies are underway in Kenya and Uganda and results are due next month. And things out there are fairly desperate.

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