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How mobile clinic has facilitated male circumcision

WHEN you look at a mountain from a distance, you are excited to reach the peak and see how big and beautiful it looks. When you think of climbing the mountain to the peak you are filled with excitement.

You can’t wait to get to the top. However, when you start climbing, you can’t see the peak anymore. Why? Because you are already at it. You can’t tell how far you have gone, so you start guessing.

Am I halfway through? Is there a long way to go until I get to enjoy the magnificent view from the top?

All these happened to a team of journalists, who recently trekked several kilometres to meet a beneficiary of medical services provided through a mobile clinic unit.

We are talking about Mgaza Village, which is located in Kasanga Ward, Morogoro Urban District. The village is situated at the hills of Morogoro, about 25km from Morogoro Town.

It needs a courageous heart to plan for the journey to reach the people there. The location creates barriers for villagers to easily access health services.

The introduction of a mobile clinic unit in Morogoro Region is a great relief to all residents, including those living in rural areas. Mr Joseph Anthony (21), a brick maker from Mgaza Village is among the beneficiaries of mobile clinic unit services in the region.

The mobile clinic unit worth 660m/-(about $300,000) provides various services such as HIV/Aids test, male circumcision, TB test, blood pressure test and family planning services.

It also provides services to victims of gender-based violence (GBV), sexual transmitted diseases test and other services.

The mobile clinic is part of the various health interventions done by Jhpiego through its two HIV/Aids projects namely, SAUTI and AIDS Free with support from USAID through PEPFAR. Mr Anthony recounts his story that he was lucky to receive the good news about the mobile clinic unit, which has changed his life.

“Last week after we finished work, my boss, Samadu Abdul, told me about a nongovernmental organisation, whose staff members were administering free circumcision for males aged 20 years and above.

I was convinced to go for the service because it is something I was always planning to do,” he said.

He said, his boss had convinced him and his younger brother and connected them to a voluntary community advocacy (VCA), officer, who later took them to the mobile clinic unit for free circumcision service.

“It all happened on July 20, this year. My younger brother and I were taken to the mobile clinic unit, where we were warmly received by professional health service providers. We were later circumcised and allowed to return home.

I now feel happy to have been circumcised,” he explained. He added: “We were first counselled and later tested for HIV/Aids. After all this, we proceeded to a surgery room, which is well designed in the vehicle.

Everything went well.” What delayed him Mr Anthony said he had delayed to undergo circumcision because his parents had no money to pay for the service.

He said before the introduction of the free service, whoever wanted to be circumcised in private hospitals was supposed to pay between 35,000/-and 40,000/-.

“My parents were incapable of raising such money. Both my parents and my girlfriend were happy when I returned home and told them that I was already circumcised,” said the brick maker.

Before hearing about the mobile clinic unit, Mr Anthony had a plan to visit a health centre for the service. However, he kept on postponing it because he was less informed of it and hardly had he any money for it.

The brick maker said he could hardly rise up to 240,000/-per month from his business as a single mud brick was sold between 140/-and 150/-.

Importance of male circumcision Male circumcision helps prevents urinary tract infections, penile cancer in adult men and reduce the risk of sexually transmitted diseases.

“We were informed of the importance of male circumcision that it even reduces the risk of contracting HIV/Aids, but we were also told clearly that it did not protect us from getting HIV/Aids by 100 per cent,” explained Mr Anthon.

According to World Health Organisation (WHO), there is compelling evidence that male circumcision reduces the risk of heterosexually acquired HIV/Aids infection in men by about 60 per cent.

Three randomised controlled trials have shown that male circumcision provided by well-trained health professionals in properly equipped settings is safe.

WHO/UNAIDS recommendations emphasise that male circumcision should be considered an efficacious intervention for HIV/Aids prevention in countries and regions with heterosexual epidemics, high HIV/Aids and low male circumcision prevalence.

Male circumcision provides only partial protection and, therefore, should be only one element of a comprehensive HIV/Aids prevention package, which includes the provision of HIV/Aids testing and counselling services, treatment for sexually transmitted infections, the promotion of safer sex practices, the provision of male and female condoms and the promotion of their correct and consistent use.

Challenges Mr Anthony said he used to take a bath at the end after brick making so that friends shouldn’t know that he wasn’t circumcised.

“I felt ashamed of my foreskin, so I tried my best to hide behind trees or wait to the end for my turn to take a bath when everybody had finished,” he said.

Father speaks out His father, Mr Anthon Abili (59), expressed his gratitude to Jhpiego and the programme at large for providing the service to his two sons. “God has blessed me with nine children, eight of who are boys and one girl.

For a long time, I wanted my sons to be circumcised, but I did not have money for it. I am thankful to the project,” he said.

Government commends the project Speaking during the launch of the mobile clinic unit at Sabasaba grounds in Morogoro, the Regional Commissioner (RC), Dr Steven Kebwe, said there were many men especially in rural areas, who were yet to be circumcised due to various reasons. He asked them to effectively utilise the mobile clinic unit and be circumcised for it had many health advantages.

More than 800,000 people have so far been circumcised in Morogoro Region under the AIDSFree Project from 2009 to 2019, according to Dr Silverius Kesanta, the project’s technical adviser for voluntary medical male circumcision (VMMC) and early infant male circumcision (EIMC).

The AIDSFree programme was initially introduced to scale up voluntary medical male circumcision in Iringa, Njombe and Tabora regions.

In October 2017, in collaboration with USAID and the National AIDS Control Programme, AIDSFree expanded its support to Morogoro and Singida regions.

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Author: FLORENCE MUGARULA recently in Morogoro

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