Extract from the executive summary of the progress report on key initiatives in health, as presented by KZN Health MEC, Dr Sibongiseni Dhlomo at the KwaZulu Natal Provincial Legislature, July 29 2010

Male Medical Circumcision

In response to the call by His Majesty to revive the culture of circumcision in the Province, the Department developed an operational plan for the roll out of this programme in KwaZulu-Natal. To ensure buy in from the communities, the Honorable Premier convened a consultative meeting was with Amakhosi in January 2010 and this meeting was followed by local consultative meetings with other stakeholders through the flagship programme. The programme was launched by His Majesty on the 10th of April 2010 in Nongoma and this launch was followed by the implementation in the whole Province. The implementation is through the day to day circumcisions in the facilities and also through seasonal camps where mass circumcisions are performed.

Based on the data from the clinical trials, models have estimated that routine MMC across sub-Saharan Africa could prevent up to six million new HIV infections and three million deaths in the next two decades. The call by His Majesty provides an opportunity for the Province to implement the programme as part of the comprehensive risk reduction package to make a dent in the epidemic in this Province.

The target group for adult circumcision is the age group 15-49 years. Of these 4,321,830 males in the province, approximately 54% are males of ages 15-49, translating to 2,333,788 males that would need to be circumcised (catch up phase). This number excludes Jewish, Muslims and other ethnic groups that practice circumcision in the province. It would be expected that this number will be low in KZN province as these groups are in a minority. Therefore these figures are negligible for the purposes of this document. These figures have therefore been broken down into yearly targets for the next five years. A programme around neonatal circumcisions is still being discussed.

Honourable Speaker, All our District hospitals are designated to provide MMC as part of comprehensive package for HIV/AIDS management. In this regard additional resources have been allocated to support the added MMC function. By the end of June, a total of 5571 male medical circumcisions have been completed. Of this total, 2 223 circumcisions were performed at health facilities, 2548 at camps specially set up for this and 800 or more were performed using TARA KLAMP method.

This device enables circumcisions to be performed safely and easily with the following benefits:

• It is a safe and effective method
• There is no active bleeding during surgery or in the post circumcision period
• It is a disposable device ; and
• Reduces the risk of infection

Honourable Speaker as we speak, for the whole of this week we have a team of health practitioners from Malaysia led by the inventor of TARA KLAMP Dr. A. Singh conducting training to our local doctors and male nurses on the correct use of the devise. We would be able to provide the house with comparative experience in use of both methods in the next sitting. I must add that we have appointed a Manager at Head office to manage MMC together with Traditional Medicine. Additional budget has been allocated to facilities to appoint additional sessional doctors to assist with MMC. The Department has also brought in Urologists into the programme to provide clinical oversight and training.

MMC has been integrated into the mainstream HIV budget as part of the comprehensive plan to manage HIV and AIDS.

Source: www.kznhealth.gov.za

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