By KIUNDU WAWERU
A white tent stands out like a sore thumb at a corner of a sprawling quarry in Njiru, Kayole, Nairobi. Some of the workers at the quarry, well built young men from years of stone cutting mill about the tent excitedly.
But today, these young men seem not to exhibit the raw energy they employ in order to earn a daily bread. They walk slowly and carefully and they beam and ululate every time one of their colleagues comes out from inside the tent, beaming sheepishly.
Inside the tent, a life-changing event for the young men is ongoing. Next in line is Alfred Odhiambo, 29. Inside the tent are two men and a woman all wearing protective clothing and surgical masks. One of the men strikes a conversation with Odhiambo as he asks him to remove his clothes. With a determined look, Odhiambo complies and lies naked on a surgical table.
He clenches his teeth and tightly closes the eyes as the surgeon applies the local anaesthesia. Soon, the assortment of surgical equipment turns bloody. In some cultures, at this particular moment, young men inside and outside the tent would be singing traditional circumcision songs. In contrast, loud Rhumba music plays from a Toyota double cab packed just outside the tent.
Presently, Odhiambo opens his eyes and smiles. He can feel something being done to him and he says, “It is not painful.”
“I told you so,” says the surgeon, his voice muffled by the surgical mask.
Godfrey Wasonga, a clinician and public health officer, has for the last two years been circumcising men under the Voluntary Medical Male Circumcision (VMMC) programme. In his time, hundreds of adults, most whose culture does not allow the practice, have passed through his expert hands.
In only two days here at Njiru, Wasonga and his team have circumcised 55 men. Odhiambo seems to be the last, bringing the number to 56. But this team from Nyanza Reproductive Health Society (NHRS) are determined to have as many men get the cut as possible. One of the team members occasionally calls through a megaphone yonder to the men crashing stones at the far end of the quarry.
“Leo ni siku ya mwisho hapa, njoo ujionee! (Today is our last day here, come see what we are offering),” he calls like someone selling wares.
But this service, launched in 2008 by the Government is free. In 2007, following evidence based studies, the World Health Organisation recommended male circumcision as one of the three major HIV prevention measures. The others include prevention of mother to child transmission and treatment.
The programme was first rolled out in Nyanza and Western Kenya, Teso, Rift Valley, Kericho Nandi and Turkana.
Dr Athanasius Ochieng, VMMC Coordinator, Kenya National Aids and STI Control Programme (NASCOP), says that in these regions, the male circumcision was highly successful, putting Kenya ahead of other East and Southern Africa countries including Uganda and South Africa.
And now, the program is in Nairobi and stakeholders have come up with innovative ways of making sure the programme is successful.
This includes taking the service to the people. One of the community mobilisers hailed for initiating the project is Lutgard Alouch of NHRS, who says that in the initial days, they would wait in clinics for people to come for circumcision. The numbers were low.
The main benefit of VMMC is to reduce HIV infection among males. Thus, males going through the process are given a comprehensive package including a HIV and sexually transmitted infections test, family planning are made to understand the dangers of risky behaviour as circumcision is not a100 per cent when it comes to HIV infection prevention.
What if someone is HIV positive already?
Wasonga says; “We use the World Health Organisation criteria whereby if he is in the first stage, we circumcise, but for full blown, we do not as the client will be too weak.”
We also meet Sylvester Otieno who despite having been circumcised a day before, is at the site. Sylvester is so excited to have undergone the cut and says that he feels so clean as to wear his Muslim Kanzu on a Tuesday.
