Christianity Today

Karambuka is a leader at the Loco Health Center in Nairobi, where voluntary circumcisions take place nearly every weekday. On average, 20 procedures are performed each day. But that number frequently surges much higher for the 15-minute surgery.

The steady stream of patients is partly due to Christian organizations now referring their members to Loco and similar clinics for circumcision. Referrals are coming from Roman Catholics, Anglicans, Presbyterians, independent Pentecostals, and Zinduka Afrika, an organization linked with a megachurch in Nairobi. Some 500 young men from the Presbyterian Church of East Africa signed up for circumcisions late this fall.

One way to convince men to agree to the procedure, said Green, is to point out that Jesus as a Jew was circumcised. Also, health officers inform uncircumcised men that their spouses would now have a lower risk for cervical cancer.

Scaling Up

Several years ago, three randomized clinical trials in Africa revealed for the first time that male circumcision reduced female to male infections by about 60 percent. In one study in South Africa in 2006, the results were so startling that researchers halted the trial and immediately offered circumcision to the so-called control group.

In 2007, the World Health Organization and the UNAIDS agency issued official recommendations, saying, "The efficacy of male circumcision in reducing female to male HIV transmission has now been proved beyond reasonable doubt." According to UN projections, if 20 million men aged 15-49 are circumcised by 2015 in 14 target nations, there would be 3.4 million fewer HIV infections by 2025.

After these findings, dozens of health agencies added male circumcision to the arsenal of treatment and prevention, including condoms, antiretroviral drugs, voluntary testing, and support for faith-based prevention programs focused on sexual abstinence and marital fidelity.

In January 2008, Kenya officially published policy guidelines on male circumcision. A phased rollout of the national program began in November 2008. The goals were to increase the proportion of 15- to 49-year-old Kenyan males who are circumcised from 84 percent to 94 percent by 2013. Four U.S.-based organizations signed on: the U.S. President's Emergency Plan for AIDS Relief; the U.S. Agency for International Development; the independent Family Health International, a North Carolina nonprofit originally involved in contraceptive research; and the Gates Foundation.

Male circumcision is offered as part of a package rather than just a surgical procedure. This minimum package includes HIV counseling and testing, treatment for other sexually transmitted diseases, provision of condoms, and counseling on risk reduction and safer sex.

From the faith sector, the Catholic Medical Mission Board has been one of the largest service providers in Kenya. In addition to providing sterile, safe, medical surgeries for adolescent males, the initiative incorporates HIV/AIDS and life skills education for parents and siblings, counseling and testing, and ongoing mentorship for young men.

Karambuka told CT that most Kenyan evangelicals are willing to work with Catholics, government agencies, and other groups from overseas to cope with the large number of families devastated by HIV/AIDS.

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