Jhpiego's Blog

In Zambia, Leading by Example

June 30, 2010 at 11:27 am Leave a comment

By Hanna Tesfasyone

Near the market in the Zambian township of Bwacha, dancers in native dress draw a crowd as African music fills the air. With their audience in place, actors from the Youth Cultural Promotion Association offer their take on a deadly serious subject—the threat of HIV and ways to avoid getting the disease. It’s a heartwarming and humorous bit of role playing that prompts conversation and a few attitude changes about male circumcision.

After each performance, audience members are asked to take part in a focus group discussion. A man from the crowd explains what he’s learned: “Male circumcision is not a guarantee to an infection-free life.”

Members of the drama group concur, adding that medical circumcision can reduce the risk of getting HIV by 60% and urging all to continue other prevention measures such as condom use and faithfulness to one partner.

The Youth Cultural Promotion Association, with funding from the Centers for Disease Control and Prevention (CDC) and support from Jhpiego, has staged theater performances in six compounds in the Kabwe District in central Zambia. It’s all part of an effort to educate communities on medical circumcision and explain the benefits of the procedure in protecting men and their families from infection, especially in combination with other prevention measures.

Since 2003, Jhpiego has helped Zambia address the country’s HIV/AIDS epidemic. With support from CDC, Jhpiego has worked in close partnership with the Zambian Ministry of Health to support and strengthen their  national HIV/AIDS program. Using a multi-faceted approach, programs included antiretroviral therapy, counseling and testing for HIV and tuberculosis, community outreach and male circumcision. Through its work, Jhpiego has conducted male circumcision clinical skills training courses and supportive supervision visits to service centers in Zambia.

In Zambia, male circumcision has been a rite of passage to manhood performed as part of a cultural tradition, primarily in secluded areas and among the Lunda, Luvale and other circumcising tribes of Kabompo District in north west Zambia. Jhpiego has been working with traditional leaders to explain the benefits of medical circumcision in a health care setting in an effort to prevent complications such as infection, injuries and death. A team of male medical specialists, who were trained by Jhpiego, recently provided free circumcisions to families in the Kabompo District and performed 150 procedures within five days. Patients also received follow-up care to ensure proper healing.

“This new approach was made possible,” said Dr. Evans Chinkoyo, Jhpiego’s Technical Advisor in Zambia, “because we sought agreement from traditional leaders and showed cultural respect for cultural values and customs, which is very important if we want this service to be well-received and long lasting.”

For Raymond, a 26-year-old member of the youth troupe, his decision to be circumcised was challenged by his family. As members of the Lambya tribe, his family opposed circumcision because of its association with another tribe.

< But that didn’t stop Raymond. Through his participation in the performance group, he learned about the benefits of the medical procedure—not only the protection from HIV but also genital hygiene—and decided he should practice what he preached.

“I believe in leadership and not telling people lies,” he says. “I am proud to tell people that I went for the procedure. I was the first one in my performance group to do it and I have shown them that it is a simple procedure with great benefits . . . .

“Even my younger brother and two of my nephews listened to my advice and got the procedure.”

Raymond’s decision may have been his own, but the community outreach program is proving to be an effective means of educating people about HIV prevention strategies in Kabwe District. Within four months, the drama troupe had performed before more than 4,500 people in the Bwacha Township.

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