VMMC…man ‘takes bull by the horns’
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JUMA Ramadhan (23) a resident of Tulya ward in Iramba District believes that getting circumcised was the smartest decision he has made to protect himself from HIV infections and keeping himself clean.

Mr Ramadhani who was circumcised during the ongoing voluntary medical male circumcision (VMMC) in Singida Region narrates that he was convinced by a Clinical Officer he met on his way from the farm. “I met a Clinical Officer on my way from the farm, he told me about the procedure and I decided to come here for this crucial exercise,” he said.

He said at the age of 23, it was difficult for him to approach a girlfriend due to his situation. He said some his friends were making him a ‘laughingstock’ because he was not circumcised. To him, the matter was beyond health related advantages. He said being uncircumcised was a big challenge to daily social life in the area. “Some of my friends who knew I was not circumcised were making jokes at me, to be honest, I was not happy with my situation,” he said. Mr Ramadhan said he delayed to undergo circumcision due to his community taboo and culture, which do not give priority to the matter.

“I have always considered doing this but the environment I live in did not allow me to, I am glad this campaign has finally reached this side,” said Mr Ramadhan. He added that the services were not available in most of rural areas and that it was difficult for them to get such kind of services in their environments. “I am very thankful to whoever came up with this idea, at my age of 23, I have been able to undergo circumcision,” he said.

The young man who wears a smiling face said from the minute the clinical officer removed the unwanted skin from his body, he felt free from the chains he had lived with for 23 years. “As we talk right here, I feel happy, I am a freeman,” he said. VMMC services for HIV prevention are offered free of charge in Singida region with the support from the U.S.

President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) under the AIDSFree Project. The Program Manager for VMMC-Jhpiego, Dr Felix Mkina said the response has been good in all areas where the project has been introduced. He said in Singida, the project is taking place in two districts: Singida rural and Iramba districts. “We have a total of 12 centres, we collect data from each centre every day, so far the response is encouraging, a big number of men have been circumcised in the ongoing campaign” he said.

Singida has been picked for the project among many regions due to the fact that in recent years there have been an increase number of people from different parts of the country mostly being pastoralists who move with livestock. He added that AIDS prevalence is another reason behind picking Singida for the project. Other regions where voluntary male circumcision has taken place include Njombe, Tabora, Morogoro and Iringa. He said the target is to offer service to at least 17,018 males in Iramba district and 16,311 males in Singida rural district respectively.

According to various studies, male circumcision protects a man by 60 percent from HIV infections. Also the men who are not circumcised are also in 60 percent risk of being infected by HIV/AIDS. During the ongoing campaigns in Singida Region men from 10 to 29 years are encouraged to participate, and women were also urged to encourage the males in their family to attend. However, all men regardless their ages are attended except children below 10 years old. For Mr Ramadhan the VMMC is a blessing to his village and the region at large.

He said there have been many people who are not ready to appear for the service. According to him, the use of Volunteer Community Advocates (VCAs) has helped many men to appear for the service at various centres in their areas. “It has difficult for some people in our areas to appear for this service. Personally I have been convinced by the Clinical Officer,” he said.

Ms Emmy Mkwawa, a coordinator for Volunteer Community Advocates (VCAs) said they apply various methods to reach people and educate them on the importance of male circumcision. She said VCAs have been going door to door to educate ‘wananchi’ on the important of male circumcision. She said the number of men who voluntarily visit centres for circumcision has increased. “We have been engaging VCAs in this exercise, the good thing with this method is that most VCAs come from the project area, therefore it is easier for them to understand clients, in some areas they even use vernacular languages to explain points to them,” she said.

According to Ms Mkwawa, it has been easier for clients to approach VCAs in case of any challenge and thus they feel more comfortable and secured when they deal with VCAs instead of other officials from far. “We have managed to get as old as 60 years clients in some areas, these people have been hiding, but they feel free to communicate with VCAs for the service,” she said.

One of the assistant medical officers who are fully engaged in the project, Ms Fortune Itael said the turnout has been fairly good. She said at her centre ‘Tulya dispensary’ she attends at least between 10 and 15 men a day. She added that at the beginning the number was bigger and that the centre was attending at least 30 men a day. “The services are offered free of charge, before, I have been told that it was 5,000/- for children and 10,000 for men, this project helps many people in the area to get free service,” she said.

The VMMC mobilizers encouraged the men to take advantage of the free comprehensive package of HIV prevention services at a nearby health clinic. The VMMC program has been offered with the support of Jhpiego and funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID

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