Infant male circumcision has lifelong health benefits that outweigh immediate risks, parents should be counselled so they can decide what is best for their child
Circumcision is becoming increasingly popular due to the evidence accumulating that it has a very strong protective effect against all sex transmitted diseases including AIDS.
A report from Africa says:
"As hospital wards overflow, avoiding HIV has become a consuming concern for Swazis. Since the South African report appeared saying that circumcised men are 60 percent less likely to contract HIV, the shift in Swazi attitudes toward circumcision -- once widely viewed as unmanly -- has been dramatic and swift….Hospitals that once rarely performed circumcisions have recently been doing 10 to 15 a week, with two-month waiting lists.
A physician with a radio show has called on his listeners to have the surgery, which removes the foreskin and along with it the cells most vulnerable to HIV. A lawmaker has advocated the procedure in a speech to parliament and demanded that the government increase capacity and subsidies for it…..
The South African study was the first to experimentally test the effectiveness of circumcision in preventing HIV, but dozens of studies have shown that infection rates are far higher in regions with low circumcision rates.
As discussed in chapter on AIDS, I had advocated the inclusion of circumcision as part of the AIDS control programme way back in 1997 when I authored, "Islamic Model for Control of AIDS", and later organised a three-day National Seminar on AIDS in collaboration with NACO, Ministry of Health, Govt. of India.
At that time, my suggestion was laughed off. Now even the WHO has recognised it as an important part in the strategy to combat AIDS. With the advance of Sexual Revolution it can be expected that newer infections will continue to haunt humans; and circumcision will play an important role in increasing life expectancy.
The Scientific fraternity is usually not sympathetic towards religion. There have been attempts in the past to disregard the beneficial effects of circumcision. But the greater numbers of medical experts have argued in favour than those against it. In the US, circumcision enjoyed great popularity in the last century. But after 1999, when the American Academy of Paediatrics issued a policy statement saying the potential medical benefits of neonatal circumcision weren't strong enough to recommend it as a routine procedure, the popularity declined. The group shifted its stance however again recently saying newer studies indicate the health benefits of circumcision do outweigh the risks and that parents should be told of its protective effects.
Ronald Gray, a physician and professor in the Johns Hopkins Bloomberg School of Public Health, makes the case in favour of neonatal circumcision. Here are a few excerpts from his article," Yes: The Benefits Are Many, While the Risks Are Few":
"The health benefits of newborn male circumcision outweigh the risks, and the procedure should be accessible to all families who want it. So said a task force convened by the American Academy of Paediatrics to review the latest scientific evidence on circumcision and update the group's policy stance…Here are the facts, based on published, peer-reviewed and independently monitored studies
"The risk of complications from newborn circumcision in U.S. hospitals is estimated to be about 0.2%. The most common complication is bleeding, which can be readily controlled. Infection and penile injuries are very rare…..
The benefits of circumcision that accrue during childhood include a marked reduction in urinary-tract infections, which affect one in 100 uncircumcised boys, mainly during the first two years of life, and inflammation or infection under the foreskin, which affects around 17 in 100 uncircumcised boys before the age of 8. Circumcision reduces the risk of these problems by around 60%. In adulthood, circumcision has been shown to reduce the risk of HIV infection in men by 50% to 60%, and is now recommended by the World Health Organization as an HIV prevention strategy…….
Circumcision also lowers the risk of acquiring herpes infection and genital ulcers in men. It reduces infection with human papilloma viruses, or HPV, in both men and their female partners. HPV is one of the most common sexually transmitted infections in the U.S., causing cervical, penile and anal cancers and genital warts. Female partners of circumcised men have lower rates of vaginal infections and genital ulcers……
Circumcision doesn't impair sexual potency or pleasure, according to randomized controlled trials. These studies are considered the most credible because they compare men who are circumcised at random versus men who aren't, and the men who are circumcised during the trial can assess whether their pleasure or potency is affected by the procedure.
In short, infant male circumcision has lifelong health benefits that outweigh the immediate risks, and parents should be counselled so they can decide what is best for their child."
Another report says:
"A 2009 Cochrane meta-analysis of studies done on sexually active heterosexual men in Africa found that circumcision reduced their acquisition of HIV by 38–66% over a period of 24 months. The WHO recommends considering circumcision as part of a comprehensive HIV program in areas with high endemic rates of HIV, such as sub-Saharan Africa, where studies have concluded it is cost-effective against HIV Circumcision reduces the incidence of HSV-2 infections by 28%,and is associated with reduced oncogenic HPV prevalence and a reduced risk of both UTIs and penile cancer, but routine circumcision is not justified for the prevention of those conditions.
Studies of its potential protective effects against other sexually transmitted infections have been inconclusive. A 2010 review of literature worldwide found circumcisions performed by medical providers to have a median complication rate of 1.5% for newborns and 6% for older children, with few instances of severe complications/ Bleeding, infection and the removal of either too much or too little foreskin are the most common complications cited. Circumcision does not appear to have a negative impact on sexual function…….
There are plausible explanations based on human biology for how circumcision can decrease the likelihood of female-to-male HIV transmission. The superficial skin layers of the penis contain Langerhans cells, which are targeted by HIV; removing the foreskin reduces the number of these cells. When an uncircumcised penis is erect during intercourse, any small tears on the inner surface of the foreskin come into direct contact with the vaginal walls, providing a pathway for transmission. When an uncircumcised penis is flaccid, the pocket between the inside of the foreskin and the head of the penis provides an environment conducive to pathogen survival; circumcision eliminates this pocket. Some experimental evidence has been provided to support these theories…..
The WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) state that male circumcision is an efficacious intervention for HIV prevention, but should be carried out by well-trained medical professionals and under conditions of informed (parents' consent for their infant boys).
The WHO has judged circumcision to be a cost-effective public health intervention against the spread of HIV in Africa, although not necessarily more cost-effective than condoms.
The Centres for Disease Control and Prevention (CDC) has calculated that newborn circumcision is cost-effective against HIV in the US. The joint WHO/UNAIDS recommendation also notes that circumcision only provides partial protection from HIV and should not replace known methods of HIV prevention." (Wikipedia article)
Circumcision is not only effective in controlling AIDS and other sex transmitted diseases; it also has been shown a protective effect against Cancers of Penis as well as Cancer of Cervix in females. The chances of Cancer of Penis in circumcised males are almost non-existent and the chances of Cancer of cervix in females having male spouses are alsao extremely low. In addition, of course, it prevents Phimosis and Paraphinosis in young boys.
Finally coming to the religious angle, it cannot be without significance that the practice of circumcision was started by Abraham (Ibrahim in Arabic, PBUH), the revered Prophet of Jews, Christians as well as Muslims; and there must have been more to it than a sheer coincidence that this was done at a time when Sodom and Gomorrah had become the hotbed of homosexuality and were subsequently destroyed by God.
[Dr Javed Jamil is India based thinker and writer with over a dozen books including his latest, "Quranic Paradigms of Sciences & Society" (First Vol: Health), "Muslims Most Civilised, Yet Not Enough" and "Muslim Vision of Secular India: Destination & Road-map". Other works include "The Devil of Economic Fundamentalism", "The Essence of the Divine Verses", "The Killer Sex", "Islam means Peace" and "Rediscovering the Universe". He can be contacted at doctorforu123@yahoo.com or 91-8130340339. ]
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