Day in the life of a Kenyan circumcision doctor

Editor's note: Africa has the world's largest number of HIV infections and AIDS cases. Across the continent the disease is being battled with public education and antiretroviral drugs. A new additional strategy is male circumcision. Several tests show that circumcised men have substantially reduced risks of contracting HIV. In response, several campaigns have been launched to circumcise men.

GlobalPost has investigated this public health effort in eastern and southern Africa. The series starts in Kenya in the fishing villages by Lake Victoria and includes a video of a circumcision. Also, health writer Mercedes Sayagues gives her controversial opinion on the issue and a South African doctor describes the circumcision campaign in several southern Arican countries.

NAIROBI, Kenya — Kenya is at the forefront of countries using male circumcision as a
way to fight the spread of HIV/AIDS. Last November the government launched a male circumcision campaign in Nyanza province, in western Kenya on the shores of Lake Victoria.

The target is men from the Luo tribe which, unlike many other Kenyan tribes, traditionally does not circumcise and among whom HIV rates are double the national average as a result.

Since the launch of the campaign 40,000 men have been circumcised and in October the government launched a renewed drive aiming to circumcise 30,000 men in just seven weeks.

Wickliffe Omondi, a 34-year old doctor who lives in Mamboleo, close to Kisumu in Nyanza province, is one of those leading this new fight against HIV/AIDS. During a visit to Nairobi he told GlobalPost about his work:

“I get up at six in the morning. By then the sun is not even up. I normally take a heavy meal in the morning of ugali [maize porridge] and meat and vegetables. It’s important because I work the whole day and at times even forgo my lunch.

“I leave my home by 7 a.m. I used to drive myself to work but six months ago I had a road accident so my vehicle just stays in the compound where I live. Since then I have been taking a matatu [minibus taxi] to Kisumu.

“It takes just 15 minutes because Kisumu is not like Nairobi with a lot of traffic jams and heavy traffic.

“When I arrive at the UNIM Clinic at the Lumumba Health Centre — the same place where they did the study that showed how circumcision can help prevent the spread of HIV — I check the patient files to see who will be coming today, but if there is nothing in the tray I walk straight to the office to check my emails. Then I prepare for work: I go through all the theaters [operating rooms] making sure all the supplies are there and in good condition.

“At times the patients come as early as 7 a.m. The clinic operates from eight in the morning but if they come early, we start early.

“When the client arrives he is registered and given a consent form before he sees the counselor. If there are more than five clients they have group counseling. They are taken through the risks and the benefits of circumcision, and how the procedure is done, and how to take care of the wound at home.

“For example, how to keep the wound clean, to remove the dressing on day three, avoid alcohol for some time and also to abstain from sex for six weeks.

“Most of our clients are coming for male circumcision for the purpose of preventing HIV infection so we also sell the idea of testing for HIV. If the client accepts, he is tested — just a quick prick — it takes around 15 minutes and he gets his result.

“The clients are as young as eight years I have had one or two as old as 85, but the majority are teenagers up to around 45.

“We screen the clients to ensure they are fit and healthy and ready for an operation, then he comes into theater [operating room] where I explain what will happen and he climbs onto the surgical couch.

“When they are here in the theater I’d say around 90 percent are anxious. They have never had any experience with such things so most are scared. We reassure them as best we can. I tell them the injection will remove the pain, but even so they are scared, for the site of the injection is in the penis.

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