Kaisernetwork.org (Washington, DC)
3 September 2008
Science & Medicine
More Training, Improved Tools Needed for African Health Workers Performing Male Circumcisions, Study Finds
[Sep 03, 2008]
African health workers performing male circumcision in an effort to curb the spread of HIV need better tools and more training to avoid high rates of complications, according to a World Health Organization study published Monday in the WHO Bulletin, Reuters Health reports. The authors conducted the study among 1,007 participants, 298 of whom were physically examined by the authors. The researchers also intervened when they observed complications. According to the study, complications such as bleeding, infection, excessive pain and erectile dysfunction occurred in as many as 35% of males circumcised in Kenya's Bungoma district by traditional practitioners, with an estimated 6% of patients experiencing lifelong problems.
Although male circumcision is practiced universally in Bungoma, the study said many clinicians in Bungoma were not trained formally and lacked clean and sharp instruments. The study also found that the rate of complications in public clinics was 18%. The study's findings have "raised questions" about how quickly male circumcision should be included as part of HIV prevention strategies supported by WHO and UNAIDS, according to Reuters Health. The study authors said extensive training and resources are needed to "build the capacity of health facilities in sub-Saharan Africa" before male circumcision can be included in prevention strategies. They added that the high rate of complications "should also serve as an alarm to ministries of health and the international health community that focus cannot only be on areas where circumcision prevalence is low." The authors concluded that health workers should be provided with training in sterilization techniques, surgical procedures, pain management, post-operative care and counseling about wound care before male circumcision is implemented on a wide scale (MacInnis, Reuters Health, 9/1).
The study is available online.
Link to this story.
Global Challenges
Zimbabwe Government Lifts Ban on Aid Groups; Organizations Still Face Difficulties Providing Assistance
[Sep 03, 2008]
Zimbabwe on Friday lifted an almost three-month ban on the work of aid groups in the country, which the government had imposed because it said some of the groups had supported the opposition to President Robert Mugabe, the New York Times reports (Dugger, New York Times, 8/30). However, some nongovernmental organizations attempting to provide HIV/AIDS-related assistance to people living with the disease in the country said that despite the removal of the ban, many of their would-be clients continue to go without aid.
VOA News reports that Zimbabwe's government imposed a ban on all NGOs in early June but backtracked in stages on restrictions in providing services to those living with HIV/AIDS. However, NGOs say the government's official communications on the removal of the ban did not arrive in a timely manner. In addition, the National Association of Non Governmental Organizations says the ban threatened the lives of HIV-positive people because their access to antiretroviral drugs and other forms of care was interrupted (Gombakomba, VOA News, 9/1).
According to the Standard/AllAfrica.com, although NANGO welcomed Friday's announcement, it said the removal of the ban could fail to bring about changes because of "selective application" and because there are no "tangible commitments by government to remove the bureaucratic, security, financial and other restrictions to effective humanitarian operations." NANGO spokesperson Fambai Ngirande also said there is need for "further clarification from the government" because the lift "characteristically excludes organizations operating in areas such as transitional justice, human rights, governance and democracy. It also does not recognize the inseparability of civil society's social, economic, cultural, political and civic responsibilities." Ngirande said the government needs to reform legislation that hampers the operations of NGOs (Sifile, Standard/AllAfrica.com, 8/30).
The Times reports that more than one million orphans, schoolchildren, elderly and other impoverished Zimbabweans were deprived of food and other basic assistance because of the ban and that NGOs will continue to face difficulties in providing assistance to those in need (New York Times, 8/30).
United Nations Secretary-General Ban Ki-moon said the lift is a "positive development (which) will help ensure that neutral and impartial humanitarian assistance is provided to the people of Zimbabwe" (Standard/AllAfrica.com, 8/30).
Link to this story.
U.S. Residents Increasingly Adopting HIV-Positive Children From Abroad, AP/Google.com Reports
[Sep 03, 2008]
U.S. residents increasingly are adopting HIV-positive children from abroad, according to figures from the U.S.-based Adoption Advocates International, the AP/Google.com reports. Figures from the organization indicate a "clear and steady rise" in such adoptions -- the majority of which are from Ethiopia -- from two in 2005, four in 2006, 13 in 2007 to 38 either completed or pending this year, according to the AP/Google.com. Numbers from the U.S. Embassy in Ethiopia confirm this trend, the AP/Google.com reports; however, its figures are slightly different because it counts adoptions according to fiscal year, reporting that U.S. residents this year have adopted 25 HIV-positive children from Ethiopia, up from seven the year before.
According to the AP/Google.com, although most HIV-positive children are being adopted from Ethiopia because it is a well-established adoption "hub," countries including China, Ghana, Haiti and Russia also have seen increases. The numbers remain small -- fewer than five HIV-positive children in each country this year, according to U.S. adoption agencies that work with HIV-positive children -- but the figures could be higher because many nations do not ask if a child being adopted is living with HIV/AIDS.
Ethiopian adoptions to the U.S. peaked at 1,255 in 2007, and the adoption of HIV-positive children is growing in step, according to U.S. government figures, the AP/Google.com reports. U.S. adoptions in Ethiopia have risen steadily from 135 in 2003 to 289 in 2004, and from 440 in 2005 to 731 in 2006. In addition, none of the children adopted through AAI in Ethiopia since 2005 has died, and the oldest is now 13.
Margaret Fleming, founder of Chances by Choice, said that her group has overseen adoptions from Haiti, Guatemala and Russia and that it has helped bring about 52 international HIV-positive adoptions since 2002 from various agencies and countries.
HHS Secretary Mike Leavitt said HIV-positive adoptees pose no public health threat in the U.S. In addition, Congress is set to repeal legislation that requires HIV-positive people to obtain waivers to enter the U.S. For adopted children living with HIV/AIDS, the waiver requirement can increase the nine- to 12-month adoption process by about two weeks.
Leavitt said, "The American people are compassionate people," adding, "I applaud their compassion and I'm delighted to know they're doing so" (Powell, AP/Google.com, 9/1).
Link to this story.
Philippine Health Department Issues Administrative Order To Address HIV/TB Coinfection
[Sep 03, 2008]
Philippine Health Secretary Francisco Duque recently signed an administrative order aimed at increasing efforts to combat HIV/tuberculosis coinfection, Asia Pulse/Individual.com reports.
The order focuses on policies and guidelines for a collaborative approach aimed at decreasing the TB burden among HIV-positive people and decreasing HIV prevalence among people with TB. According to the Philippine Department of Health, HIV/TB coinfection has hindered efforts to control the two diseases because TB is common among people living with HIV and one of the primary causes of AIDS-related deaths. In addition, TB significantly affects the quality of life of HIV-positive people, the department said.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
Read comments. Write your own.
