Friday, October 26, 2007

The kindest cut of all helps Swazi men fight off AIDS

Oct 22, 2007 04:30 AM
Craig Timberg
Washington Post

MBABANE, Swaziland–The young men in a cramped waiting room in Swaziland's capital twitched with nerves. Feet tapped. Fingers drummed. The occasional brave joke was delivered with a smirk.

Beyond a wooden door a few metres away, two Israeli doctors donned blue hospital scrubs adorned with faded Hebrew script. Stepping into a modest room where only a dangling sheet separated the operating tables, they prepared to perform the world's oldest surgery for free.

So began Day 10 of an uncommon experiment in international assistance. Teams of Israeli surgeons have begun circumcising Swazi men, using an ancient ritual to curb the modern malady of AIDS.

Studies have shown circumcised men are at least 60 per cent less likely to contract HIV. Less clear is how meagre public health systems already overwhelmed by AIDS cases can offer the procedure widely enough to slow the epidemic.

"For us, the major constraint is surgeons, doctors," said Dudu Simelane, executive director of the Family Life Association of Swaziland, a nongovernmental group hosting the Israelis.

Medical experts in Swaziland, with fewer than 100 doctors and the world's highest rate of HIV infection, say that for five years they would like to offer the procedure to all 200,000 of this tiny southern nation's sexually active men, at a rate of roughly 200 a day – 20 times faster than the current pace in this country of 1.1 million.

No country has tried anything like it – save Israel, whose doctors circumcised 80,000 men after the 1989 fall of the Berlin Wall brought a flood of new immigrants, mostly adults who grew up in Soviet Bloc states that banned Jewish rituals.

Scientists warn the foreskin has cells very receptive to AIDS but removing it lets the penis head grow thicker and more resistant to sexual infections. The World Health Organization says making circumcision widely available, inexpensive and safe could prevent 5.7 million HIV infections in the next 20 years.

The men awaiting circumcision said they wanted the easier hygiene and HIV protection it offers.