What I know about the Orange Farm study is from this letter to the editor by a South African man. It is not a sound bite--you have to read and understand it. But you'll see why I think Orange Farm is the same old foreskin propaganda and pseudoscience.
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It saddened me to read another article calling for the careless mass amputations of the human foreskin without venturing into the overall history and practice of circumcision itself within medicine.
Circumcision has a long, dark and highly controversial history since its inception in the late 1800's. Initially it was proposed as THE cure for masturbation. And since then circumcision proponents have recommended it to cure just about every disease imaginable, from syphilis to cancer to lunacy. In fact, it has been demonstrated that whatever the disease of national attention is, the circumcision advocates will claim it can be cured by this operation. But, no matter how many foreskins are disposed of the claims never prove true. What does however happen is that circumcision becomes entrenched as a cultural practice or custom which is carried over from father to hapless infant or child, ultimately leading to "norming" of this unnatural state within the context of the traditions and customs of the family/society. The justifications are then purposefully altered to ensure ongoing relevance in the face of changing circumstances.
Circumcision is a practice that is not routinely recommended by any medical association in the world. A person recently commented that he "increasingly sees circumcision as a practice driven by the revenge of the already circumcised." I cannot agree with him more. Having been directly affected by this damaging procedure, and choosing not to opt for retreat into a state of denial, I have been motivated into researching the claims and justifications that are repeatedly made, only to discover that the apparent facts are mostly blatant lies. In this process I have uncovered a tragic story and learned about the harm and abuse that this practice consistently causes, particularly when perpetrated against children and infants. When grown males are coerced into circumcision, having given full and informed consent, it is one thing, but when the practice is carried over to mutilating/permanently modifying the genitals of the young for no good reason, it is quite another. And, based on historical trends, that is where this practice will be heading, unless clear medical facts and honest reporting ensue ensuring that the public are better informed.
It is almost as if circumcision has a life of its own. It keeps being reinvented, determined to somehow find a justification for itself, but in over 100 years (within medicine), it has failed at every turn. And now, it is HIV/AIDS' turn.
If it were true that the foreskin were a vector of disease, then where are the HIV epidemics in the non-circumcising nations such as Scandinavia and the rest of Europe? Why are our Zulus (intact) and not dying faster than our Xhosas (circumcised)? Why does America, the only developed nation that has yet to abandon circumcision in entirety, have the highest HIV rate of the first world? And, from the onset of the HIV epidemic, 80-90% of the Americans were already circumcised! Circumcision did not help to protect them. Such selective reporting by the media of historical fact is misleading.
It is obvious that some glaring inaccuracies can be seen when factual information is examined behind the smokescreen of apparent research masquerading as truth. Medicine has a long history of change. As recently as the 1960's female circumcision was touted in scientific journals as being a valuable and worthwhile procedure. I have spoken to women who paid the price of the "scientific" studies.
As a circumcised man I do not consider myself to be any less at risk for acquiring the HIV virus. Fortunately, I have the resources and education to look carefully into this subject and not be sold by the dangerous marketing campaign that carries the underlying promise of protection from HIV if circumcised. But many men in our country do not have the luxury of an education, and such articles strike fear in people, inducing rash and desperate actions.
The foreskin is a valuable part of the human anatomy, and is highly functional during intercourse, improving comfort, glide and proprioception for males and females. It has other important physiological functions that make it indispensable to a male. The unusual [African] practice of dry sex is much more likely to contribute to HIV spread, but remains a practice seldom addressed by our media.
Circumcisions in infants are often carried out without consent or anaesthesia minutes after birth. Babies are strapped down to circumstraint boards. Cold instruments are then used to tear the naturally adhering foreskin from the glans, thereby amputating thousands of nerves that should have plugged into pleasure centres in the developing brain. A cruel welcome to the world by anyone's standards, especially to a developing nervous system. Not that many men even remember this event consciously, but the subconscious remembers it well, and there it lies and festers. Much research has emerged showing the negative effects of trauma on developing minds. As more men are standing up against this practice, more research is sure to follow. But studies such as Orange Farm will have precipitated much damage by then.
All that the much quoted Orange Farm paper shows, is that over a mere 19 month period out of a total of 69 men, who were coerced into circumcision by payment, 18 of the intervention group and 51 of the control group acquired HIV. This means circumcised men STILL get HIV at an alarming rate. Moreover, the results are misleadingly advertised, and there are other irregularities not mentioned. It takes at least 3 months from the time of infection of HIV for HIV seroconversion to take place. It also takes between 6 weeks and 3 months for an average surgical wound to heal thus making the penis usable. The researchers did not allow for this fact and many more men in the intervention group may have been HIV positive and not yet seroconverted at the time of testing. Did the researchers stop the study early for claimed "humanitarian reasons" because they feared that once the circumcised men healed and become as sexually active as before, their rates of infection would also start to catch up with the intact group?
There has also been no follow-up to this day. For a study that is being used to justify mass circumcisions on a national basis this is unheard of. Why has there been no follow-up of the men involved? Where are they now and what is their HIV status? And other questions remain unanswered; like what information were they given before circumcision? And, why were the participants paid money to be circumcised? They were already in a desperately impoverished situation and this represents a clear abuse of medical authority requiring further investigation. Were they truly informed or just bought?
Moreover, how can a study conducted over only 19 months be used to institute national health policies? It is imperative to note before the Orange Farm study there was one major systematic review known as the Cochrane Review conducted by the highly respected Cochrane Association. This thorough review of almost all previous circumcision-related research stated that there is no conclusive evidence to show a benefit in being circumcised with regard to acquiring HIV. In an application of any new study, protocols are put forward along with a review of previous publications about the subject. This information is handed to the ethics committee. The peer reviewers check to see if the homework has been done and that the prospective researchers looked at pertinent papers. When Auvert and his team of researchers put forward proposals to the ethics committee for the Orange Farm study the Cochrane Review's conclusion was "conveniently" omitted, and in fact all mention of the Cochrane review was suspiciously edited out. For this reason alone the integrity of the researchers is called into question, coupled with the fact that some of the researchers have been interested in circumcision-related research previously, expressing a bias towards proving that circumcision is beneficial rather than genuinely looking for a way to combat HIV. The Lancet (medical journal) rejected Orange Farm. It was first published in an online journal.
As you can see when you dig deeper a whole new picture emerges. When people are fearful any suggestion seems like a good one. And when it comes from clever men in white coats with foreign accents, it is often believed without question. The men getting circumcised now as a result of this study are at an age where they are about to have their own children. Now they will circumcise their young using HIV (partial) protection as a justification. Babies and children experience circumcision without such rationales. They experience it as a physical truth without words to conceal the reality. They experience it as a genital mutilation. This is a massive violation of the human right to bodily integrity. Girl or boy - the spirit of a child is the same. We have a responsibility to protect that spirit from harm. For the good of us all.
Dean Ferris
NOCIRC-SA -
www.nocirc-sa.co.za -
nocirc-sa@afridata.net
National Organisation of Circumcision Information Resource Centres - South
Africa, supported by
NORM-SA -
www.norm-sa.co.za - National Organisation of Restoring Men - South
Africa, and
ICGI -
www.icgi.org - The International Coalition of Genital Integrity
