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Day in the life of a Kenyan circumcision doctor

Wickliffe Omondi says he circumcises around 22 men every day at his clinic in Kenya's Nyanza province.

“It is a minor surgical procedure that takes between 15 and 30 minutes. First we clean the surgical area with an antiseptic then inject a local anesthesia into the base of the penis.

“It takes up to five minutes for the anesthetic to take effect and then we test for any pain sensation by pinching the tip of the penis with tweezers. If there is pain we give it more time; if there is no pain we mark the incision sites, estimate how much skin to remove then
we cut it off.

“Afterwards we arrest the bleeding with sutures and apply a dressing. That is it. Then we admit the client for 30 minutes for observations and after that they can go on their way, returning for review after seven days. Then, if the review is fine, I don’t have to see them again.

“In a few cases clients asked for their foreskin to go home with, because it is part of them, but it is human tissue so we cannot allow it. After cutting it we show them the foreskin and explain we are going to burn it in the incinerator.

“I work until around 4 p.m. by which time I might have circumcised 22 clients and seen another 20 for review from the week before plus some others who are having problems before day seven or after day seven. It’s quite busy and tiring because it involves standing for long, that is why I have to take a heavy breakfast.

“Now I’m just circumcising all the time, and I am the head of circumcision training at the clinic. In fact I train the trainers so I can’t know how many have learned to circumcise because of me. There are so many.

“After 5:30 p.m. I leave for home though we give the clients a hotline number which I have with me — even now — so in case of any problem they call. If it is severe I tend to the client, if he needs reassurance I talk to him.

“Finally I take a matatu back home. When I get home I enjoy being with my family — my wife, my six-year old daughter and four-year old son — I like to watch movies or television programs or I go out with my friends for a beer and a chat.

“I think it was not so difficult to persuade Luo men to abandon the tradition of not circumcising because, as much as it involved cultural issues, we still used to have many clients who sneaked in secretly, who would come for circumcision then go back and keep quiet. But they were coming.

“Now that it has become public, men are coming openly. Some politicians from Nyanza even came in and due to their influence they persuaded most of the community and they are coming in large numbers.

“I was circumcised when I was in college. I made the decision myself for hygienic reasons. It was done by a fellow classmate; in fact we were doing it for each other. It was in 1996 and then it was quite unusual for me to be circumcised as a Luo man.

“I am Luo but I was not born in Nyanza so as a young boy I saw my neighbors and friends going for circumcision so even then I wanted it. But even as an adult I could not tell my parents. In fact I never told them even until they passed away.

“My son is not circumcised — he is scared — but I will allow him to make his own decision when he is older. Being circumcised or not circumcised does not make you Luo or not Luo.”

“There are still some misapprehensions, though not much. Some clients think that after circumcision they have a natural condom so we have to tell them it is around 60 percent effective and they must continue to use the condom even after circumcision. Also, some men find that six weeks is a long time to abstain.

“When I go back to Kisumu I’m really going to be very busy because the government has said it wants to circumcise 30,000. I will be going around and checking on how the doctors and nurses are working and also assisting in the operations. I think we can reach the target. It just depends on the logistics because in some places the terrain is a bit tough and clients have to travel far, but we can beat that target.”

More GlobalPost dispatches on male circumcision in Africa:

A report from a fishing village on Lake Victoria, a video of circumcision, a South African doctor talks about the drive in southern African countries, a health specialist gives her controversial opinion about the male circumcision campaign.

http://www.globalpost.com/dispatch/africa/091124/kenyan-circumcision-doctor