Friday, September 30, 2016

UNICEF Seeking Strategist to Scale Up Male Genital Mutilation in Africa


It's almost as if this were lifted right out of George Orwell's 1984.

The United Nations International Children's Emergency Fund, otherwise known as UNICEF, whose role is supposed to be protector of children's rights is promoting the genital mutilation of male children in the so-called name of HIV prevention.

Currently they're looking for a strategist/consultant to formulate plans to mutilate millions in Africa.

The pretext, of course, is HIV prevention.

However, genital mutilation by any other name would still be genital mutilation.

Their recruitment page can be visited right here.

It appears the focus of the strategy is on cost and creating demand for doctor-facilitated male genital mutilation.

Some of the existing programs focus on indoctrinating and pressuring boys at schools.

In some cases, organizations are outright taking school boys without parental consent, as well as circumcising newborns, even though this was not part of the original WHO plan.


It's time we start calling the forced genital mutilation of healthy, non-consenting minors what it is.

Even if "research" showed female circumcision to be "beneficial" to women, forcibly cutting healthy, non-consenting girls would still be a violation of the most basic human rights.

A sad day in the world when an organization whose role is supposed to be protecting the basic human rights of children is actually promoting the very violation of these rights.

Something needs to be done to alert UNICEF donors.

Are they aware of precisely how their donations are being spent?

Related Post:
Politically Correct Research: When Science, Morals and Political Agendas Collide

AFRICA: NGO's Taking Children from School to Circumcise Them Without Parents' Knowledge

MALAWI: USAID-Funded Program Kidnapping Children for Circumcision - Boy Loses Penis

Wednesday, September 28, 2016

PHIMOSIS: Lost Knowledge Missing In American Medicine



Those who have been keeping their eye on circumcision, circumcision advocates and their alibis, will no doubt be aware that the diagnosis of "phimosis" is far too commonly given as a pretext to circumcise an older child. This is the reason most often cited by parents who claim that circumcision on their child "had to be done." Circumcision is also marketed as prophylaxis for "phimosis" by those who advocate or have to gain from performing the procedure.

It must be asked, how is it that after thousands of years of evolution, human males evolved to be born with a problematic sexual organ?

Is it that the human penis is inherently problematic?

Or is it that there is no real problem, and opportunistic physicians have been successful in characterizing perfectly normal, healthy stages in male genital development as "problematic," when they're actually not?


American and European Physicians Don't Learn The Same Thing
America and Europe are different in many ways. One of the biggest differences between both continents is circumcision and anatomically correct male genitals. Whereas circumcision, particularly the routine circumcision of infant males, is a common, culturally ingrained practice in the United States, it is rare or virtually not practiced in Europe, except among Jews and Muslims.

Perhaps due to Judeo-Christian roots, people in both continents share a taboo surrounding nakedness, so they are unaware of each others' practices. People in Europe often believe that circumcision is limited to religious groups, such as Judaism and Islam, and generally believe that their American counterparts hold male circumcision in the same regard; people in America believe anyone who's anyone is circumcised. It often comes to a shocking surprise to people in either country, when they find out the truth; Americans are surprised that the rest of the English-speaking world does not circumcise, and Europeans are horrified to find out that in America, male newborns are often circumcised.

It is no surprise, then, that American and European physicians hold different views when it comes to male genitals and circumcision. What they learn in medical school concerning male genital development is vastly different; while European physicians are taught to regard unaltered male genitals as nature made them as healthy and normal, American physicians are taught to look at the same genitals as aliens from another planet. While in Europe, physicians are taught to look at the foreskin as an intrinsic part of the male organ, akin to labia in female organs, in the United States, the physicians are taught to treat the presence of a foreskin as a superfluous growth and a liability. Indeed, some hospitals will list the presence of a foreskin alongside other medical problems.


This picture was taken at an American hospital. Notice that being uncircumcised
is a "problem," along side hearing loss and poor growth and weight gain.


To Europeans, penises in American textbooks may appear strange, as they are depicted as circumcised, as if this is they the human penis appears in nature. To Americans, pictures of penises may be "Ew, gross!" The foreskin, if mentioned at all in American textbooks, is often described as "that loose piece of flesh at the end of a penis, which is removed in circumcision." Whereas European textbooks present the penis as-is and moves on, American textbooks must describe various reasons why circumcision is performed, and why parents ought to make a "decision." Circumcision prevents cancer, STDs, makes it easier to clean, and, it prevents phimosis. What good parent wouldn't want to prevent all these problems in their children?

Of course, when comparing world data, it's not entirely clear that circumcision prevents much. Not a single medical organization recommends male circumcision based on any of the claimed "benefits." Circumcised males are still susceptible to cancer and any STD one can name. The latest canard used to justify male infant circumcision is that it prevents HIV transmission. No, scratch that; it's supposed to "reduce the transmission of HIV transmission by 60%," a claim that doesn't really mean much of anything, as even if it were true, even those who promote circumcision as HIV prevention must stress that circumcised males and their partners must continue to wear condoms. (In other words, male circumcision fails.)

The one valid concern is phimosis, an actual physical condition that is exclusive to males with anatomically correct genitalia.

But what precisely *is* phimosis?

Who gets it?

What causes it?

How common is it in actuality?

When and if it is necessary, what treatment options are available?

When is a situation not "phimosis" but a normal stage in development?

I'm writing this blog post to answer these questions and more.

Here, readers will learn what all physicians should be learning in medical school, but is often omitted in American medical curricula. The sources used for this blog post are cited for reference.

The Facts

What is phimosis?
The word "phimosis" originates from the Greek word phimos (φῑμός) which means "muzzle". "Phimosis" is a vague term used to describe any situation where, in intact males, the foreskin cannot be retracted to reveal the glans, or the head of the penis. The term may also refer to clitoral phimosis in women, whereby the clitoral hood cannot be retracted, limiting exposure of the glans clitoridis.

What are the normal stages of development?

At Birth 
Typically, when a baby boy is born, the prepuce is long with a narrow tip.(1)(2) Retraction is not possible in the majority of infants because the narrow tip will not pass over the glans penis. Moreover, it is normal for the inner mucosal surface of the prepuce to be fused with the underlying mucosal surface of the glans, or head of the penis,(1)(2)(4)(5) by means of a membrane called synechia, also known as the balano-preputial membrane or balano-preputial lamina,(1) further preventing retraction. This attachment forms early in fetal development and provides a protective cocoon for the delicate developing glans.(6) It is normal for the foreskin to be non-retractable in infancy and early childhood.(6)


Retraction of the Foreskin In normal development, the foreskin usually separates from the glans and becomes retractable with age.(4) As the infant matures into a boy and the boy into a man, the tip of the prepuce becomes wider, and the shaft of the penis grows, making the tip of the prepuce appear shorter. The membrane that bonds the inner surface of the prepuce with the glans penis spontaneously disintegrates and releases the prepuce to separate from the glans. The prepuce spontaneously becomes retractable.


In order for retraction to occur, the foreskin must have separated from the glans and the opening of the foreskin must have widened to allow it to slip back over the glans. Throughout childhood and adolescence, there is a release of hormones. As hormone levels rise, the fiber-dense tissue of the prepuce is replaced with a more elastic tissue. A boy will begin to explore his genitals as he grows, and as time passes, the elastic tissue will allow the opening of the foreskin to widen. This can happen at any age but it is not common in young boys.

The amount of time it takes for a boy's foreskin to become fully retractable varies from boy to boy; this process can take many years for some boys, and yet minutes for others. In some boys, the foreskin may not be retractable until after puberty.(7)(8)(9) This is an entirely normal stage of development and should not be diagnosed as any kind of "problem." 

When Does Retraction Happen? 
According to the experience of doctors and researchers in cultures where circumcision is uncommon, retraction happens at varying ages, and a non-retractable foreskin rarely requires treatment. Observations from doctors in Denmark, and Japan and other countries indicate that spontaneous loosening usually occurs with increasing maturity.(7)(8)(9)(10)(11)(12)

Non-retractability is considered normal for males up to and including adolescence. The process whereby the foreskin and glans gradually separate may not be complete until the age of 17.(4) A Danish survey (2005) reported that average age of first foreskin retraction is 10.4 years.(13) Marques et al (2005) reported that 99% of boys can retract their foreskins by age 14.(12)(14)(15)(16) One may expect 50% of 10-year-old boys; 90% of 16-year-old boys; and 98-99% of 18 year-old males to have a fully retractable foreskin. Treatment is seldom necessary.

A 1999 study by Cold and Taylor shows that at 6 to 7 years, approximately 60% of the boys had natural adhesions. At 10-11 years, close to 50% of the boys still had adhesions. At 14-15, approximately only 10% of the boys had adhesions. As they approach the age of 17, only a very small percentage of boys will have adhesions. That means that, left uncircumcised, most boys will be able to retract their foreskin before they are 17 years old. 

Foreskin Retraction as Observed in Children in Other Countries 
Jakob Øster, a Danish physician who conducted school examinations, reported his findings on the examination of school-boys in Denmark, where circumcision is rare.(7) Øster (1968) found that the incidence of fusion of the foreskin with the glans penis steadily declines with increasing age and foreskin retractability increases with age.(7)

Kayaba et al. (1996) also investigated the development of foreskin retraction in boys from age 0 to age 15.5, and they also reported increasing retractability with increasing age. Kayaba et al. reported that about only 42% of boys aged 8-10 have fully retractile foreskin, but the percentage increases to 62.9% in boys aged 11-15.(8) Imamura (1997) reported that 77% of boys aged 11-15 had retractile foreskin.

Thorvaldsen and Meyhoff (2005) conducted a survey of 4000 young men in Denmark. They report that the mean age of first foreskin retraction is 10.4 years in Denmark.(13) Non-retractile foreskin is the more common condition until about 10-11 years of age.

Current medical literature indicates that the foreskin is non-retractable in the majority of males until they begin to approach puberty. Until a boy begins to reach sexual maturity, non-retractability of the foreskin is a normal part of growing up.

When is "phimosis" a problem?
Given the empirical facts stated above, it is already mistaken to assume that just because the foreskin cannot be retracted to reveal the head of the penis, a male has some sort of pathological condition. As evidenced by the facts given above, the great majority of male children who have anatomically correct genitals will have foreskins that cannot be retracted, and it is a mistake to assume that all children undergo this transitory "illness" where they can't retract their foreskins, akin to the mumps, measles or chicken pox. Girls do not begin to menstruate until the onset of puberty, and they are not considered to be suffering any sort of medical condition until then.

Non-retractability of the foreskin may pose a problem if it continues well past puberty. Typically the foreskin has dilated to allow retraction as a result of the release of hormones. In a small percentage of males, the production of these hormones is insufficient, and the foreskin fails to dilate, resulting in a condition known as "preputial stenosis," or, a narrow foreskin. This condition may make hygiene and sexual intercourse difficult, if not impossible, but not always. In older men that have bad hygiene habits and who smoke regularly, having a non-retractile foreskin can increase the chances of developing penile cancer.

There is another reason why the foreskin may not be retractable in a male, and that is because he has suffered an infection with balanitis xerotica obliterans, or BXO for short. In this case, the tip of the foreskin is scarred and indurated, and has the histological features of a pathological infection. The foreskin of a male who has suffered an infection with BXO will have developed a fibrotic ring, which makes retraction difficult or impossible. It is this pathologically induced non-retractability which can be correctly termed "phimosis." To differentiate normal stages of development, and even the physiological state of a foreskin which has failed to dilate as a result of lack of hormones, from pathologically-caused non-retractability, doctors have invented the term "true phimosis." It is non-retractability caused by pathological infection with BXO that can be considered an actual problem.

Can phimosis be cured?
It is estimated that 2% of males go their entire lives without their foreskins ever becoming retractable. How this condition can be treated will depend on what the actual problem is. The physiological condition where a foreskin has failed to dilate as the result of a lack of hormones, otherwise known as "preputial stenosis," tends to respond to steroid cream therapy, coupled with stretching exercises and/or stretching devices.

Non-retractability as a result of a BXO infection, however is different, as this is caused by a resulting fibrotic ring at the end of the foreskin, which is scarification that may or may not respond to steroid cream treatment or stretching exercises. It is non-retractability caused by BXO infection that can be genuinely considered a problem which may call for corrective surgery.

It should be noted that non-retractability of the foreskin as a result of BXO infection occurs in less than 1% of males. Additionally, it should be noted that even when a case of "true phimosis" may require surgical correction, it does not always entail a complete removal of the prepuce. There are procedures that can correct phimosis which can preserve the foreskin and its functions. Surgical methods range from the complete removal of the foreskin (circumcision) to more minor operations to relieve foreskin tightness, such as a "dorsal slit" (AKA "superincision") a "ventral slit" (AKA "subterincision") and "preputioplasty."

If treatment should be necessary, it should not be done until after puberty and the male can weigh the therapeutic options and give informed consent.(9)

How should a genuine case of phimosis be diagnosed?

In order to correctly determine that there is a real problem occurring in a male, a learned doctor will begin by ruling a few things out.

If, for example, a child hasn't reached puberty yet, and because non-retractability is common for this age group, the doctor should consider that the child may be experiencing normal stages of development.

If, for example, a child hasn't reached puberty yet, but he was able retract his foreskin previously, it may be probable that the child may have experienced an infection with BXO.

If, for example, an adult male who has already gone through puberty still has a non-retractile foreskin, the doctor needs to determine if this is a physiological problem caused by a lack of hormones (preputial stenosis), or if it is a pathological problem as a result of infection with BXO (AKA "true phimosis").

Because non-retractibility of the foreskin can be both a normal stage of development, and a pathological problem, it can be very easy for doctors to make an inadvertent, or even deliberate misdiagnosis. Particularly in countries like the United States, where circumcision is a perceived norm, and doctors may not be educated in the differences between normal stages of development and phimosis as a pathological condition, it can be very easy for doctors to say that a child is suffering a condition that may require surgical correction, where in fact, there is actually none. 

For a correct diagnosis, a doctor who is knowledgeable about the difference between normal stages of development and non-retractability caused by BXO infection will correctly have the male analyzed for signs of lesions of BXO. Then, and only then, can a doctor properly make the diagnosis that a male child is suffering a medical problem, and that the child may need surgery to correct the problem.

Because non-retractability in adult males is rare, and "true phimosis" (pathologically induced non-retractability) even more rare, there is a high probability that a diagnosis for "phimosis" is actually false, especially in children, where non-retractability of the foreskin is a part of normal development.

Iatrogenically Induced Problems
Problems with the retraction of the foreskin may either be the result of a lack of hormones, the result of an infection with BXO, or, they could be iatrogenically induced. (E.g. actually caused by the doctor himself.)

It has been widely recognized by the medical profession for most of the 20th century that normal male infants have foreskins which are incompletely separated from the epithelium of the glans.(17) The foreskin cannot be retracted without tearing the fusion and adhesions which are commonly present between the inner foreskin and the glans penis in normal stages of development.

In English-language medicine, there is an absence of proper knowledge of the foreskin and its development in the medical curriculum. According to McGregor et al (2005), physicians often have difficulties distinguishing between this normal, natural state of the penis in neonates and pre-pubecent boys and pathological phimosis caused by BXO.(17)(18) Spilsbury et al (2003) suggest that doctors may be likely to confuse the aforementioned conditions with pathological phimosis.(19)

Unaware of the harmless nature of the normal, natural state of the penis in neonates, and the presence of adhesions in infants and pre-pubecent boys, and unaware that this can be damaging, doctors have been known to forcibly attempt to retract the foreskin in healthy, developing children, just to see if it retracts, tearing natural adhesions and/or ripping the foreskin in the process. Furthermore, they have been known to erroneously instruct parents that a child's foreskin needs to be retracted in order to "clean under it," arguing that they will develop infections otherwise.(20)

Premature, forcible retraction of the foreskin is an extremely painful, serious, and potentially permanent injury(17). It can damage the glans and mucous inner tissue of the foreskin. Forcibly retracting a child could result in iatrogenically induced phimosis, where the raw, open wounds of ripped adhesions could heal and fuse together, or where a forcibly dilated foreskin could develop scarification, resulting in a fibrotic ring similar to the one caused by BXO infection. Additionally, this can result in a complication known as "paraphimosis," where the narrow foreskin strangles the penis trapped behind an enlarged glans, thereby necessitating surgical intervention.

It must be noted here that these problems rarely present themselves in countries where circumcision is rare or not practiced. There is simply no epidemic of foreskin problems in countries where male children aren't circumcised. These problems tend to suspiciously present themselves in countries where circumcision is common, and diagnosed by doctors who happen to specialize in child circumcision. Children may have been circumcised to correct "problems" that either never existed, or whom were given their problems by ignorant doctors to begin with.


 It is harmful and misleading to tell parents that a child's foreskin must be forcibly retracted. In children whose foreskins are still adhered to the glans, or where the foreskin has not dilated to allow the glans, this can be a harrowing experience. Forcibly retracting a child's foreskin "to clean under it" is the equivalent of cleaning out a girl's vagina with a pipe cleaner. Surely, a doctor who would instruct parents to clean out their child's vagina would be dismissed as a lunatic. Medical associations advise not to forcibly retract the foreskin of an infant, as this interferes with normal penile development, and may result in scarring or injury.(21)(22).

Camille et al (2002), in their guidance for parents, state that "[t]he foreskin should never be forcibly retracted, as this can cause pain and bleeding and may result in scarring and trouble with natural retraction."(23)


Simpson & Barraclough (1998) state that "[n]o attempt should be made to retract a foreskin in a child unless significant separation of the subpreputial adhesions has occurred. Failure to observe this basic rule may result in tearing with subsequent fibrosis and consequent [iatrogenically induced] phimosis. ..."(24)

The American Academy of Pediatrics cautions parents not to retract their son's foreskin, but suggest that once he reaches puberty, he should retract and gently wash with soap and water.(25) The Royal Australasian College of Physician as well as the Canadian Paediatric Society emphasize that the infant foreskin should be left alone and requires no special care.(26)

Summary
The facts, which are well-documented in medical literature, speak for themselves.

A foreskin that is adhered to the glans and/or will not retract is a normal stage of development in all healthy male children in infancy. The belief that a foreskin that is "tight" and will not retract is a problem in male infants implies that all human male children are born with some kind of birth defect, congenital deformity or genetic anomaly akin to a 6th finger or a cleft.

In the great majority of males, the foreskin separates from the glans and becomes retractable as they approach puberty, without the aid of medical or surgical intervention.

A foreskin that will not retract in older males is rare, and may or may not be a pathological problem. In order to determine the cause of a non-retractile foreskin, a knowledgeable doctor who understands anatomically correct male genitals, the normal stages of development of healthy males, and true pathological problems of male genitalia, must run the correct analyses in order to detect the presence or absence of pathological lesions; then, and only then, can the doctor determine whether the problem can be remedied with conventional medicine or by means of surgical correction.

Even when a genuine case of phimosis that necessitates surgical intervention presents itself, circumcision, or the full excision of the foreskin is not always called for; there are surgical interventions which will correct phimosis while preserving the foreskin and its functions.

Intervention to hasten the retraction of the foreskin in otherwise healthy, prepubescent males may actually cause iatrogenically induced problems. The forced retraction of the foreskin may itself cause non-retractability. Forcibly dilating the foreskin causes scar tissue to form, which may result in a fibrotic ring at the end of the foreskin. Breaking the natural adhesions which occur between the glans and the foreskin during normal stages of development may cause new adhesions to form between the glans and the foreskin, becoming fused as the raw wounds of the broken adhesions heal together. Forcibly pulling back naturally narrow foreskin over the glans in otherwise healthy children may result in paraphimosis, where the narrow foreskin catches behind the glans, preventing the foreskin from returning to its neutral position covering the glans, ironically necessitating the need for surgical intervention.

Conclusion
It is a shame that there is a gap in medical knowledge between the United States and other English-speaking countries. The information presented here is well-documented knowledge that all doctors need to know. This is the information that a doctor needs to be giving to parents of a male child. Anything other than this is misinformation or an outright lie.

American medical curricula is either omitting information, teaching outdated information, if not outright teaching misinformation. Efforts need to be made to bring English-language curriculum on the foreskin, the natural stages of development and genital pathology up to date. Doctors need to educate themselves and stop dispensing erroneous and dangerous advice to parents. They need to learn to differentiate between the normal stages of development in human males, and actual pathological phimosis.

Doctors who diagnose "phimosis" in a perfectly healthy child are either uneducated when it comes to the foreskin and natural stages of development, or may in fact be committing medical fraud, deliberately inventing a misdiagnosis in order to justify surgery in a healthy, non-consenting minor, and/or collecting medicaid funds intended for actually medically necessary surgery.

Until American medicine undergoes this long-needed overhaul, long-term visitors to the United States ought to be warned that doctors in America are often inadvertently, or quite deliberately misinformed about anatomically correct male genital anatomy, and that taking their child to an American-trained doctor could be hazardous to their child's health.

References:
1. Gairdner D. The fate of the foreskin: a study of circumcision. Br Med J 1949;2:1433-7.

2. Spence J. On Circumcision. Lancet 1964;2:902.

3. Deibert GA. The separation of the prepuce in the human penis. Anat Rec 1933;57:387-399.

4.  Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child 1968;43:200-3.

5. Catzel P. The normal foreskin in the young child. (letter) S Afr Mediense Tysskrif [South Afr Med J] 1982 (13 November 1982) 62:751.

6. Wright J.E. (February 1994). "Further to 'the further fate of the foreskin'". The Medical Journal of Australia 160 (3): 134–5. PMID 8295581. http://www.cirp.org/library/normal/wright2/

7. Øster J. Further fate of the foreskin: Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child (published by the British Medical Association), April 1968. p. 200-202.

8. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. Journal of Urology, 1996 Nov, V156 N5:1813-1815.

9. Warren JP: NORM UK and the Medical Case against Circumcision. In: Sexual Mutilations: A Human Tragedy; Proceedings of the 4th Intl Symposium on Sexual Mutilations , Denniston GC and Milos MF, Eds. New York, Plenum, 1997) (ISBN 0-306-45589-7)

10. Celsus. De medicina, vol 3. Harvard University Press, Cambridge, p 422

11. Celsus. De medicina, 6.18.2. In: Spencer WG (ed and trans) (1938) Celsus. De medicina, vol 2. Harvard University Press, Cambridge, p 269

12. Hodges FM. Phimosis in antiquity. World J Urol 1999;17(3):133-6.

13. Thorvaldsen MA, Meyhoff H.. Patologisk eller fysiologisk fimose?. Ugeskr Læger. 2005;167(16):1852-62.

14. Marques TC, Sampaio FJ, Favorito LA (2005). "Treatment of phimosis with topical steroids and foreskin anatomy". Int Braz J Urol 31 (4): 370–4; discussion 374. doi:10.1590/S1677-55382005000400012. PMID 16137407. http://www.brazjurol.com.br/july_august_2005/Marques_ing_370_374.htm.

15. Denniston; Hill (October 2010). "Gairdner was wrong". Can Fam Physician 56 (10): 986–987. PMID 20944034. PMC 2954072. http://www.cfp.ca/content/56/10/986.2.long. Retrieved 2014-04-05.

16. Huntley JS, Bourne MC, Munro FD, Wilson-Storey D (September 2003). "Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons". J R Soc Med 96 (9): 449–451. doi:10.1258/jrsm.96.9.449. PMID 12949201. PMC 539600. http://www.jrsm.org/cgi/pmidlookup?view=long&pmid=12949201.

17. McGregor TB, Pike JG, Leonard MP (April 2005). "Phimosis—a diagnostic dilemma?". Can J Urol 12 (2): 2598–602. PMID 15877942.

18. Metcalfe PD, Elyas R. Foreskin management. Survey of Canadian pediatric urologists. Can Fam Physician 2010;56:e290-5.

19. Spilsbury K, Semmens JB, Wisniewski ZS, Holman CD (February 2003). "Circumcision for phimosis and other medical indications in Western Australian boys". Med. J. Aust. 178 (4): 155–8. PMID 12580740. http://www.mja.com.au/public/issues/178_04_170203/spi10278_fm.html.

20. Osborn LM, Metcalf TJ, Mariani EM. Hygienic care in uncircumcised infants. Pediatrics 1981;67:365-7.

21. "Care of the Uncircumcised Penis". Guide for parents. American Academy of Pediatrics. September 2007. http://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Care-for-an-Uncircumcised-Penis.aspx.

22. "Caring for an uncircumcised penis". Information for parents. Canadian Paediatric Society. July 2012. http://www.caringforkids.cps.ca/handouts/circumcision.

23. Camille CJ, Kuo RL, Wiener JS. Caring for the uncircumcised penis: What parents (and you) need to know. Contemp Pediatr 2002;11:61.

24. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3.

25. American Academy of Pediatrics: Care of the uncircumcised penis, 2007

26. Royal Australasian College of Physicians. (2010) Circumcision of Infant Males.


Related Posts:
Phony Phimosis: How American Doctors Get Away With Medical Fraud

What Your Dr. Doesn't Know Could Hurt Your Child

Phimosis and Circumcision in Japan

INTACTIVISTS: Why We Concern Ourselves

Sunday, September 4, 2016

FACEBOOK: KENTUCKY - Botched Circumcision Gives Newborn Severe UTI


The latest tragedy that has come up in my Facebook news feed is that of a child whose circumcision has resulted in a serious UTI that is spreading throughout the child's body.

The child's aunt asking for prayers on Facebook (Names have been blotted out for privacy):

Yes, nevermind what the child is struggling through.
Pray for the mom and kids. Pay no attention to the kid.

These are common on Facebook.

Mothers and fathers are warned that circumcision has risks, they ignore us because, you know, we're not doctors, and who are we to tell them how to raise their kids right?

Then tragedy strikes, and no one wants to be told "We told you so."

They ask for prayers for something that could have been totally avoided.

Not to mention it says right there in the New Testament that circumcision is forbidden for gentiles.

What's interesting is that "reduced risk of UTIs" is given as an alibi for performing elective, non-medical circumcision on newborns.

Most UTIs can be remedied with anti-biotics, in boys as in girls.

Somehow I think this UTI will take a little bit more than that to fix.

Note that this UTI was iatrogenically induced.

When are parents, when are doctors going to learn?

The risks of male infant circumcision include infection, partial or full ablation, hemorrhage and even death.

In some cases, such as these, circumcision may cause the very problems it is said to prevent.

Because circumcision is elective, non-medical surgery, any number of complications above zero is unconscionable.

Were these parents warned of the risks?

Is the AAP keeping tracks of these incidents?

Because we sure are.

It really is too bad that children have to suffer needlessly like this.

This tragedy could have been avoided had the parents simply refused this for their child, had doctors simply left the child alone.

Reaping profit from non-medical surgery on non-consenting individuals constitutes medical fraud. In minors, clear abuse.

Without medical or clinical indication, doctors have no business performing surgery on healthy, non-consenting minors, let alone giving parents any kind of "choice."

They day is coming when doctors who perform this needless surgery on healthy newborns will be held responsible.

Related Posts:
FACEBOOK: Circumcision Sends Another Child to NICU - This Time in LA 

GEORGIA: Circumcision Sends a Baby to the NICU

CIRCUMCISION DEATH: This Time in Italy

INTACTIVISTS: Why We Concern Ourselves

MALE INFANT CIRCUMCISION: Another Baby Boy Dies

CIRCUMCISION: Another Baby Dies

CIRCUMCISION DEATH: Yet Another One (I Hate Writing These)

Another Circumcision Death Comes to Light

 CIRCUMCISION DEATH: Yes, Another One - This Time in Israel

 FACEBOOK: Two Botches and a Death

CIRCUMCISION DEATH: Child Dies After Doctor Convinces Ontario Couple to Circumcise

ONTARIO CIRCUMCISION DEATH: The Plot Thickens

Joseph4GI: The Circumcision Blame Game
Phony Phimosis: How American Doctors Get Away With Medical Fraud 

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Friday, September 2, 2016

MALAWI: Christian Health Organization Pushing Male Circumcision


A recent report tells of a Christian health organization in Malawi, doing what they can to upscale male circumcision in the area.

A few things jump out at me.

A Christian Organization? Promoting and Facilitating Circumcision?
First, the fact that this is, at least on the surface, supposed to be a Christian health organization, one apparently run by a Catholic Church.

This is strange, as the New Testament expressly forbids circumcision for gentiles in the New Testament (see Galatians 5), and yet here is this "Christian" organization run by a Catholic Church facilitating precisely that.

Will the Catholic Church also run abortion clinics?

They might as well.

Is the Message Being Lost?
Secondly, this whole program seems to be run under the current alibi for promoting circumcision; preventing HIV transmission.

And yet, the free circumcision program is alluring to men, boys and their parents for other reasons.

Asked about their reasons for participating in the program, they give the following responses, according to the report above:

"At the hospital, trained staff do the circumcision. Besides, they use safe tools and this is important for the boys' health," said a father.

"In Balaka, this is the season of initiation camps when young boys are taken to be circumcised as a rite of passage into adulthood. However, this year is tough. Most of us did not send our children because we cannot afford to pay for them due to the ongoig food crisis in the district," said another father.

"Medical circumcision is safer for the kids than getting what they go through in initiation camps, locally known as ndagala, here thy face the risk of HIV infection as the elders use unsterilised equipment. That aside, the boys are subjected to harsh conditions and some boys die due to inadequate care given after circumcision," laments a mother.

"It is pleasing that parents are realizing the need to get their kids circumcised at a health facility and not initiation camps," said a coordinator for the Christian organization.

It sounds like most people are interested in having the boys circumcised at medical facilities, so as to avoid having them be circumcised in the bush as African tribal traditions call for.

This is a real concern, as every year, scores of boys and men lose their penises to gangrene, and scores of others die in the process, or take their own lives at the prospect of living without their male organs.

(Complications are also a concern when it comes to female circumcision. Somehow, I doubt that suggesting girls and women be circumcised by doctors in the hospital setting would be a welcome solution to the problem.)

So it sounds like these boys and men were already going to be circumcised as a matter of religious or cultural course.

In which case, the Christian health organization isn't "promoting" or "upscaling" circumcision per se; they're merely re-routing circumcisions that were going to take place anyway and taking credit for it, raising new questions altogether. (Is there any real upscaling going on? Are there actually any new men and parents of boys being won over to circumcision? Or is this merely a publicity piece exploiting already existing circumcision adherents? In other parts of the country, circumcision campaigns have failed, where circumcision simply isn't part of the culture. Do a search on Soka Uncobe in Swaziland. A good article can be seen here. [Last Accessed 9/3/2016])

Boys and men are now being circumcised in medical facilities, and I suppose in contrast to the initiation schools in the bush where they risk loss of their organs or death, this could be a good thing, but if they're more concerned at getting circumcised to meet a cultural/tribal requirement, do they even care about the so-called "benefits" of circumcision?

Will they be interested in HIV prevention through condoms?

Or will it send the wrong message that being circumcised is a "win-win" because they get circumcised "safely," they meet their cultural requirement, AND they're "protected" from HIV transmission?"

It just seems like a juncture where the message of HIV prevention could easily be lost.

That circumcision might "reduce the risk" of HIV transmission, but males and their partners should still wear condoms is sketchy enough.

If men and their families are more concerned about being circumcised safely to fulfill their cultural requirement, the importance of HIV prevention and wearing condoms may not even register.

Conclusion
Is this about HIV prevention or culture facilitation/preservation?

This initiative is being paid for by PEPFAR for the supposed purpose of HIV prevention, but is this message lost on those who see this as nothing more than an opportunity to get a free alternative to the mutilations that go on at initiation schools?

What will be the take away message?

"Get circumcised AND were protected from HIV! (So who cares about condoms?)"

Fact: 80% of US males are also circumcised at birth.

Fact: In the 1980s, when the epidemic hit, that number was 90%.

Fact: According to the CIA World Factbook, the US has a higher HIV prevalence than 53 countries where circumcision is rare or not practiced.

Fact: According to USAID, HIV prevalence was found to be higher among *circumcised* men in 10 out of 18 African countries.

Fact: Even if the latest research is correct (and it has many questionable flaws, namely the lack of a scientifically demonstrable causal link, failure to correlate with world data, unconfirmable results, etc...), circumcision would still be ineffective at preventing HIV, so ineffective that circumcised males and their partners must still be urged to wear condoms.

Fact: Circumcision is forbidden to Gentiles under the New Testament.

It must be asked why so much money is being pumped into such a questionable procedure for which more effective, less invasive alternatives are already available.

How is something that never worked for the US going to suddenly start working miracles in Africa?

If circumcised men and their partners must still be urged to wear condoms, what is the point of promoting circumcision?

What's the point of spending millions of dollars promoting a surgery, when that money can be better spent?

Like food and water? (See what one of the parents above had to say.)

Is no one going to question the ethics of promoting what is essentially genital mutilation in a hospital setting?

Is no one concerned that this is a green light for tribal circumcisions which result in injury and death?

Is no one going to talk about all the mishaps that happen even in the medical setting?

The fact that male circumcision promotion is a stumbling block to activists trying to stop female circumcision?

The fact that this promotion is resulting in the forced circumcision of non-consenting minors?

Even against parental wishes?

The coercion of boys and men to get circumcised?

What is this about?

Is this truly about HIV prevention?

 Or is this about legitimizing, preserving a controversial procedure that is dwindling back home?

(Back home meaning the home country of those pumping money and effort in spreading circumcision in Africa and elsewhere under the guise of public health? PEPFAR? JHPIEGO? Bill and Melinda Gates? The Clinton Foundation? CDC? What do these organizations that are so eager to circumcise millions of males in Africa have in common? They all come from America, where male infant circumcision used to be a common procedure for the majority of newborn makes, and where these numbers are falling and doctors are struggling to convince parents to circumcise their children. So is this about medicine? Or culture preservation? Subplantation? Look at the fine print; these companies' organizations' ultimate goal is to implement infant circumcision in Africa as it exists back home. Never mind this hasn't helped to prevent STDs. What is this really about? Why does the world watch in silence as the US imposes male genital mutilation on Africa under the guise of disease prevention?)

Related Posts:
Where Circumcision Doesn't Prevent HIV

Where Circumcision Doesn't Prevent HIV II
 

MASS CIRCUMCISION CAMPAIGNS: The Emasculation and Harassment of Africa

UNITED STATES: Infant Circumcision Fails as STI Prophylaxis

UGANDA: Myths about circumcision help spread HIV

ZIMBABWE: Circumcised men abandoning condoms

Botswana – There is an upsurge of cases of people who got infected with HIV following circumcision.

Zimbabwe – Circumcised men indulge in risky sexual behaviour

Nyanza – Push for male circumcision in Nyanza fails to reduce infections

JAMA: Lead Article is a "Study" on Bribing Men to Get Circumcised

AFRICA: Creating Circumcision "Volunteers"
 

AFRICA: NGO's Taking Children from School to Circumcise Them Without Parents' Knowledge

MALAWI: USAID-Funded Program Kidnapping Children for Circumcision - Boy Loses Penis