Hello Dr Dick, my friends need a ...

Repairs done here

A rather funny conversation ensued in my taxi cab ride to work yesterday on an interesting, but also sensitive subject.

I had just read about André van der Merwe, a South-African urologist who had headed a team of surgeons in performing the first successful penis transplant in the world in December 2014.

Whilst attempts have been made before to transplant the penis, in this case, the recipient of this wonderful gift of surgery and apparent return to manhood now can urinate, can have an erection, can experience an orgasm and can even ejaculate. I guess it is time to make babies. [BBC News]

One point to note is that South Africans have pioneered various firsts in surgery that have become commonplace as in the case of Christiaan Barnard who performed the world’s first heart transplant in 1967 and Patrick Soon-Shiong who performed the world's first full pancreas transplant in 1987.

Fixing the system

Now, Dr van der Merwe or for simplicity sake ‘Dr. Dick’ was addressing an absolute necessity in South Africa where the Xhosa boys were involved in a rite of passage, Ulwaluko which involves genital circumcision and the initiation into manhood. These circumcision rites have claimed 853 lives in the last 20 years, however, for those who survive the ordeal, they may have had a botched circumcision.

These circumcision activities done in non-sterile bush environments following traditions that one might be persuaded to suggest be abandoned are in terms, dangerous, when not performed by qualified medical personnel.

This is where Dr Dick is now in high demand for his expertise in repairing the damage caused by these crude circumcision abattoirs and I could imagine that eventually when more people are trained up to perform this procedure, other men who are not particularly gifted in the endowment area might seek generous augmentation.

Change has come

By terms, this is a difficult procedure and probably hard to master, but when this becomes commonplace, you wonder how freely men would avail themselves of this opportunity and gift when presented with the choices of length, girth, curvature, and dare I say, colour matching.

At the same time, I guess this gives the concept of organ donor a completely new meaning. The race to endow and perform has begun with new aspects of penis envy becoming the staple of tabloid fodder. The kiss-and-tell of ex-partners spilling the beans of how from the acorns they once knew oaks have suddenly sprung.

Just as Viagra has banished non-performance to the posthumous state, Dr Dick has brought to life the fact that just because you were cut badly or were born with something less wieldy, you have to live with it.

In terms of commendations, Dr Dick can have any Nobel Prize of his choosing, for Medicine and Physiology for obvious reasons, for Chemistry in that it might make a great difference, for Physics just because the earth moved, for Literature if anyone writes about their exploits and for Economics if the recipient considers becoming an International gigolo.

Pick your dick and watch it click.

Thought Picnic: FGM - On my use of "Clitoral Disgust"

Courtesy of UNIVERSAL Health: Female Genital Mutilation in Africa

Why the title?

Soon after publishing my blog about FGM in Nigeria, I entered into discussion about the title I had given the blog with the view that I review the construct and possibly the wording.

FGM in Nigeria: Raze the Abattoirs of Clitoral Disgust

I am sure most of us know what Female Genital Mutilation is, it is also called Female Circumcision and it is evident what the practice entails; the mutilation of female sexual organs.

In coming up with the title, I could have used one of seven easily mentionable names of the object but I chose an adjective which contextually was already attributive and followed that with the noun form rather than the verb form of Disgust to create an adjectival phrase.

This in my view captured the fact that butchering exercise redolent of abattoirs was in traditional disgust of the object that was only mentioned in my blog within the types of FGM that WHO indicated.

Between abattoir and surgery

The use of the word abattoirs cannot be faulted if one views the implements used in this exercise which are by no means surgical by any stretch of the imagination and primitive in the extreme. The victims of FGM do not have the luxury of anaesthesia when then these caveman procedures are done apart from physical restraint and it is unlikely that the practitioners are trained to handle emergencies if they do occur.

If we can move beyond the title which at worst should be forgiven for taking artistic licence and read the story, it is of a girl, Joy Youmgbo who went to visit her grandmother for Christmas, she was mutilated, suffered great agony for days and died a horrific painful death that medical records cited as a result of post-circumcision haemorrhage.

Face up!

We would not have heard of this criminality – and I say criminality because no such operations as cutting the flesh in tender areas, no matter the traditional expertise should ever be conducted outside hospitals, in this day and age – if the other sister had not run away from home in the fear that the same fate might befall her.

Now, this topic is controversial and there are those for and against FGM, in my view, if the practise cannot be stopped, then the theatre of that practice must change.

If FGM must occur then it should only be in hospitals under strict medical supervision all the parties involved having undergone essential counselling and therapy before the decision to cut is made.

In the end, I stand by the title I chose, it in my view conveys the complete context of the blog that follows and the sooner we called a spade, a spade, we can start digging.

Thank you.

Reference

UNIVERSAL Health: Female Genital Mutilation in Africa

FGM in Nigeria: Raze the Abattoirs of Clitoral Disgust

Note: On my decision to retain the blog title see opinion.

This discreditable practice

This is 2012 and I find myself writing about acts in parts of the world that belong in a museum of antiquity long before mediaeval times as types of torture that defeminise women in a manifestly atrocious cultural or traditional rite.

Female Genital Mutilation [1] (FGM) despite the international activism against it is still rife and it does take lives without consequences for the perpetrators who do it still with impunity in their quest to hold on to their Neanderthal customs.

In this case, the news [2] in Nigeria is of a 17-year old girl who fled her family home and has been declared missing having witnessed the painful and agonising death over days of her younger sister who was grievously mutilated on January the 15^th 2012.

Embracing shabby traditions

This reprehensibly irresponsible act was coordinated by her grandmother who corralled the family into participating in this rite of torture and enduring grievous bodily harm and what is almost unbelievable about this is the parties involved cannot be so matured in age to be oblivious of modern thinking.

The girls lived in Lagos, a sprawling metropolis and had returned to their homestead for the Christmas holidays in Ijaw-land, which happens to be the place from which our current highly educated, PhD holding President hails. Though from research, this practice is not restricted to that area, it is quite pervasive and it cuts a swathe through the whole south of West-Africa and parts of Chad arcing up through Sudan and Egypt to the north and through Ethiopia and Somalia to the east and horn of Africa where the prevalence [3] is up to 95% like a plague.

Types of FGM

The WHO identifies four types of Female Genital Mutilation [1] which intensify in the incredibly macabre for each more intrusive act that could involve cauterisation; it is almost unreadable for the horror of the exercise.

Type I: removal of the clitoral hood, the skin around the clitoris, with or without partial or complete removal of the clitoris;

Type II: removal of the clitoris with partial or complete removal of the labia minora;

Type III: removal of all or part of the labia minora and labia majora, and the stitching of a seal across the vagina, leaving a small opening for the passage of urine and menstrual blood (infibulation);

Type IV: other miscellaneous acts, including cauterization of the clitoris, cutting of the vagina (gishiri cutting), and introducing corrosive substances into the vagina to tighten it.

Abattoirs of clitoral disgust

These are at best radical surgery, if tradition or custom and in some cases conflated with religion so dictates that this practice is essential, important and of the highest priority, they must be conducted under strict medical conditions probably under general anaesthetic and these village abattoirs of clitoral disgust must be razed.

The barbarity of this exercise is in the fact that seeming knowledgeable people aware of hygienic needs for surgical practice engage in the use of crude implements and unschooled hands hoping to be vindicated by long held traditions and the evidence of those who barely survived the ordeal.

It might be difficult to criminalise FGM in the many societies that practise it but all the charlatans who engage in the mutilation of genitalia outside of accredited modern medical facilities most be prosecuted to the fullest extent of the law and made a public example of.

Much as one will prefer that this practice be totally outlawed and completely stopped, if that is not possible, then this event must only occur in a hospital under professional supervision after extensive counselling of all parties involved.

This was murder

However, back to the case in Nigeria, the news story says the victim “suffered severe excruciating pains for days after the mutilation of her genital before her death.”

It is very likely that after the mutilation she suffered severe bleeding and the perpetrators waited too long before they took her to hospital, by which time little could be done to save her life and that medical reports indicated she died of a “Post Circumcision haemorrhage.”

She basically bled to death.

Now, one can understand the sadness that accompanies the loss of a child, a grandchild, a sister and being back at the homestead, a close relation. It would appear that death did not remove the blinkers of absurd traditions from the perpetrators that they were ready to butcher the elder sister.

One cannot put it beyond these evil people that they were afraid that their heinous acts will be exposed that they could have schemed to sacrifice two young girls on the altar of tradition in order to cover their criminal enterprise – that calls for an intervention, it is an emergency that calls for justice to be expedited so that Joy Youmgbo would not have died in vain.

Arrest, indict, prosecute

The medical evidence is there, she died of a Post-Circumcision haemorrhage, it is now for the police to go after the grandmother and all her accomplices and pursue at the minimum a charge of manslaughter against all these people.

We have to come to a point in our society where no human being stands the risk of being sacrificed with impunity and with no consequence on the altar of custom, tradition, practice, creed or any belief system and civil society is able to protect the absoluteness of the right to life and happiness without anyone being subjected to the unpalatable for the preservation of the censurably odious.

If anything, the untimely and avoidable death of Joy Youmgbo must lead to greater agitation to stop the practice of FGM in Nigeria, one death is already one too many. I can only hope that Patricia Youmgbo finds succour for her pain of loss and protection from what those demons did to her sister.

STOP FGM NOW!

Sources

[1] Female Genital Mutilation (FGM), Wikipedia

[2] Girl, 17 flees home over forced circumcision | Premium Times Nigeria

[3] Prevalence of female genital mutilation by country, Wkipedia

Thought Picnic: Where circumcision beats choosing lipstick colours

Where expression is unsafe

I have observed over time that the Nigerian chat and comment space is fraught with imponderables and probably worse.

In fact, the safest place to offer an opinion is probably my blog and the comment advisory that probably creates a high entry level to those who have opinions that are best left unspoken and unwritten.

Twitter is also a good place to offer views, the compelling need to be concise and precise whilst offering a view is a great challenge for many even if they have to use applications that break the Twitter default of 140 characters for succinct expression.

Facebook however brings you in contact with another different crowd, the people that I have chosen to befriend appear to be quite reasonable having learnt well the purpose of comprehension exercises we took in English classes.

The problem is usually with those other friends of friends who you end up engaging with when you express a view on a friend’s status.

The gulf between reading and comprehension

Strangely, much as many of them can read, very few understand what they are reading, much less have comprehension and fewer still can be objective or proffer any logical analysis on the status under review.

Sadly, in the process of trying to contribute, clarify and raise the standard of discourse you get drawn into some exchanges that leave you utterly flustered if not flabbergasted and outraged. Much as one’s English reserve kicks in, the need for a public putdown becomes necessary one of which ended with the praise of a contributor’s talent with hands rather than with his brains.

The beauty of many procedures

In the last week, one instance was with the news story about a young and upcoming female artiste who felt that a butt augmentation procedure would improve her career; she ended up in a hotel in America where the injection of industrial silicone cost her life.

The exchanges went well until someone suggested male circumcision was cosmetic surgery for the purposes of looking good as a manicure, the application of make-up and the shaving of beards. At which point we enquired as to how that line of thought was plausible and as the person went off on a diatribe and a tangent with the licentious use of inclusive plural pronouns we were stumped.

Now, to refer the origin of circumcision to Abrahamic traditions of religious covenant keeping or its recent presumed usefulness in the prevention of the transmission of HIV especially in Africa became an insurmountable task of the attempt to share knowledge – there was nothing else to say.

Attitudes to homosexuality lead to jail

Then there was the case which included the presumed attempt to force a 17-year old Nigerian resident into marriage which on examination of the issues and the reported detail linked punishments, exorcisms and lifestyle to the desperate actions of a mother to convert her seemingly gay son back to heterosexuality.

Under the presumed notion that sending her son back to Nigeria from the UK would separate him Western influences and restore his supposed heterosexuality in an environment hostile to homosexual expression she risked jail.

That was because her son had sought the advice of a gay charity and taken out a protection order against his parents; within 6 days of receiving the order, he was carted off to Nigeria and the parents felt they had escaped the ambit of the Forced Marriages Act that their son had sought the protection of.

The law and sentiment disagree

Now, there are many strands to this situation; those for strict and overarching parental rights over their wards who must be fully obedient and acquiescent to every diktat of their parents because good intentions and possible bad judgement are always in the best interest of the child – one can sympathise.

There is also the fact that the basic letter of the law had been broken; a direct order from the court to produce the child in the UK was ignored and the mother having held the court in contempt was sent to jail for 8 months.

The cross-border influences between Nigeria and the UK on the matter of a Nigerian child who was wise after the possible protections the law provides against his parents’ untrammelled control in the UK as opposed to in Nigeria can excite strong emotions.

The labour of hands and heads

There might be many wrongs but the facts are what they are; a young gay Nigerian resident in the UK against his Nigerian parents caught between Western protections and Nigerian indifference to the rights of minors when pitched against their guardians but could there ever be a balanced view of these stack realities – hardly.

By the time we broke off, each side had been insulted as one who laboured with calloused hands and the other with ideas.

How hard it is to resist the need to help with comprehension first and then the appreciation of basic logic when our schools school too many in rote learning and regurgitation rather than the ability to research and convey ideas in coherent and engaging ways – the refuge of a blog can suddenly offer the best security from the absurd as one admires the beauty of circumcision with confusion of colours for lipstick.

Always have your condoms at the ready

HIV as weapon

The case of the German singer Nadja Benaissa being prosecuted [1] for grievous bodily harm and attempted bodily harm in having unprotected sex with partners whilst knowing she was HIV positive makes interesting and controversial reading.

There are various camps pitched between considering her acts criminal to properly apportioning responsibility in relation to sexual liaisons between infected and uninfected partners.

For the case of the man who allegedly became infected through having sex with her, I am beginning to wonder if the onus of proof should not be extended to ascertain the particular strains of the virus because it does not appear to be conclusively proven that she infected him, rather the assumption has been made of her culpability without addressing the possible promiscuity of the partner.

Abdication of personal responsibility

My greater concern about these prosecutions comes from that of responsibility, each partner in a sexual liaison should be in charge of securing their personal protection when indulging in a sexual act.

I find it reprehensible that people would abdicate that responsibility and then seek to blame others for their personal irresponsibility when things go wrong.

In the passion of the moment or conversely in the moment of passion, if people can assume without verification that a partner is not infected with the virus and then engage in unsafe sex, the consequences are dire and the results can be life changing; it might be a consideration for a female to wear a femidom but surely anyone who likes wick-dipping should for all intents and purposes have condoms in their pockets.

Now, for a more clinical approach the partners can be as pragmatic as to obtain saliva test swabs from the local chemists and make a crude determination of status before copulation, but how many do have the presence of mind to do that?

The assumed invincibility of being active

There is a stigma attached to having the HIV virus and not everyone has reached the point where honesty about status is as forthcoming as the Karma Sutra positions they might persuade each other to take.

In another article I read earlier this week [2] with the graphic detail of homosexual sex, what was interesting was the inclination for the penetrative partner to assume that they are at lower risk of infection than the partner who receives the penetration.

The other matter of condom aversion with heterosexuals and homosexuals alike does not seem to be addressed too, this following on from the hubris of being the active partner and thence the almost invincible partner.

Another issue about sexually transmitted diseases is that the more common infections like chlamydia, gonorrhea, herpes and syphilis makes the HIV negative partner more susceptible to infection but that chronology of events would normally not be forensically proven by the time the vindictiveness of prosecution and persecution takes hold.

Preventative measures of dispute

In another set of circumstances there is the matter of circumcision being preventative [3] of infection along with the recently announced microbicide gel [4] which is purported to prevent the transmission of the virus to women.

I have my concerns about the risks involved in conducting these tests in South Africa that sacrificed the health and safety of over 10% of the subjects to arrive at the conclusions and the effectiveness thereof is quite in the lower percentiles of success.

Obviously, the other question about this gel is whether when applied by an infected female partner it prevents the male partner from contracting the disease, they all do not constitute a panacea for risk.

None is so innocent or so wronged

In conclusion, I believe the responsibility must be shared; each person should take the responsibility for their sexual health and wellbeing seriously and personally without succumbing to the delirium of passion.

If a clear decision is made not to engage in unsafe sex as a matter of course and where that does not happen the question of trust is properly verified medically these atrocious persecutions should never happen.

Where one partner can play victim whilst visiting the full force on the law on the other when during the sexual event all common-sense had been thrown out of the window, this becomes unsafe from a justice and fairness perspective and though prosecution might exclude one person from the public sexual pool, I have my doubts that it serves as a deterrent to people from engaging in risky behaviour and it could well prevent people from seeking out the very truth about their status whilst engaging in promiscuously enjoyable behaviour.

In a more dispassionate application of the law, the wronged might well be excluded from the sexual pool by making it public knowledge that they also have become a public sexual risk just as much as the original culprit in the case. The foolishness on the part of the assumed victim should not be excused just as the prosecution for the alleged "crime" is being pursued with questionable vigour.

Sources

[1] 'HIV is no longer an epidemic. But the stigma is' - Health News, Health & Families - The Independent

[2] HIV/AIDS Resource Center for Gay Men: Subconscious Death-Wish of a Gifted, Young Black Man - The Body

[3] Nigerians Talk | What We Are Reading: What’s Good For The Goose…

[4] Microbicide gel: Reduced risk of HIV and herpes infections in women, study shows

FGM banned in Eritrea

Too prevalent for comfort

This is topic I think experts would celebrate better than I could in this write up. I was quite shocked to find out how prevalent it was in Africa, Middle-East and Indonesia, no more so when I also heard that the practices does still thrive in Nigeria.

Learning that Eritrea has banned the practice of Female Genital Mutilation or Circumcision (FGM or FGC) is definitely great news and to be celebrated.

It marks a beginning of what should be a wave of the civilising of customs, traditions and religious practices that cause undue physical harm without any particular health benefit apart from a modicum of social acceptance.

With this law, the practitioners of these acts of mutilation who are usually female too and matriarchs of those communities when caught could face fines and possible imprisonments.

Enforcing the law

However, the issue at hand would be how to break down the ranks after this illegal act has been committed; people can be sworn to silence, risk ostracism within their communities or even suffer worse fates like "honour killing" - basically, one wonders about the enforceability of this law.

Beyond this is the need to health and material support for the victims of this heinous mutilation which at times to other health complications.

Now, we also have the aspect of Male Genital Mutilation known as circumcision which seemingly has a religious progeny has been found to provide health benefits in arresting the spread of HIV/AIDS, this is no way comparable to the mutilation that females suffer as a rite of passage into womanhood.

Conserving the good bits

In all, there is no way that the 4 listed types of mutilation which are just too revolting and despicable to list here but covers excision of critical parts of female sexual organs and in some cases the application of corrosive substances can be justified in the 21^st Century, in fact, it is violent abuse and now considered a violation of human rights by the UN. The other types are no less atrocious in trying to understand what they are trying to achieve.

It is time to ensure that these archaic and barbaric customs are rolled back and consigned to history; we should not condone or countenance anymore the sacrifice of human beings to customs, traditions, culture or religious practices just for the sake of keeping uncivilised practices alive.

We can conserve the positive parts of our heritage whilst losing the negative parts without necessarily losing our identity, acts of separation and differentiation through mutilation have no place in what is now a global village of interacting peoples.

Finally, it is a welcome development that even Muslim scholars have called for an end to this practice, with bans and sanctions; it might require religious leaders sounding the word from the pulpit about how unnecessary these acts are without rubbing up too hard on long held but out-dated customs - the abuse must be stopped forthwith.

References

FGM on the rise in the UK - 2004

Images of FGC - cautionary viewing advised