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I World

Aiding Africa

Circumcision fights AIDS pandemic.

Dina Kraft
Jewish Telegraphic Agency

"It's fitting that our project is named
after Abraham," he said. "It symbolizes a
measure of unity to give the message to
other people that we can work together."
Officials from the World Health
Organization traveled to Jerusalem in
2006 to gather information on Israel's
expertise in the field.
"The circumstances in which adult male
circumcision are done in some institu-
tions in Israel are generally of a high
standard with few complications',' said Dr.
Tim Hargreave, a leading British urologi-
cal surgeon and technical advisor to the
WHO, explaining the organization's inter-
est in Israel's experience.
Drawing in part on Israeli methodol-
ogy, Hargreave helped author the WHO
manual on male circumcision that along
with a teaching course, is now being
used as part of government male cir-
cumcision programs in several countries
in Africa.

Tel Aviv

I

n a clinic in the hills of Swaziland's
capital, Israeli doctors have been
training their counterparts in male
circumcision, hoping expertise in the
ancient technique will help in the battle
against the modern scourge of AIDS.
The United Nations announced last year
that the procedure could reduce the rate of
HIV transmission by up to 60 percent. It
was in Israel, with its experience perform-
ing adult male circumcision on a wide
scale, that the international medical com-
munity found an unlikely partner in the
global fight against AIDS.
"Israeli medicine and public health are
positioned as a real asset in African coun-
tries:' said Dr. Inon Schenker, a director of
Operation Abraham, the consortium that
sent the doctors to Swaziland and plans
to send more training teams to Africa.
"They recognize the expertise and experi-
ence gained in Israel over the past decade,
where close to 100,000 male circumcisions
have been conducted."
Israel's accidental expertise in conduct-
ing large-scale numbers of male circumci-
sions came with the mass wave of immi-
gration from the former Soviet Union,
which brought with it a dramatic rise in
men requesting the procedure.
To meet the demand, Israeli hospitals
set up special circumcision clinics in five
hospitals throughout the country. In turn,
Israeli doctors gained unique experience
in performing a high number of proce-
dures efficiently.

Useful Paradigm
It's a model organizations such as the World
Health Organization and the United Nations
would like to see replicated in Africa as a
tool for combating the spread of HIV.
Answering the call has been Operation
Abraham, a team of Israeli doctors and
AIDS educators — Jews, Muslims and
Christians — who this year made three
training trips to Swaziland in what is con-
sidered a pilot program that they hope is
just the start of their work.
The organization has had requests to
do a similar training program in Uganda,
Lesotho, Namibia, Kenya and South Africa.
Their work is sponsored by the
Jerusalem AIDS project and the Hadassah

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November 20 • 2008

Learning Curve

Operation Abraham surgeon Dr. Moshe Westreich trains a local surgeon in Swaziland
in adult male circumcision methods while the patient reads a leaflet on preventing
HIV/AIDS.

Medical Center, and they hope to recruit
surgeons from abroad.

where the average life expectancy has
plummeted to just 31 years old.
"People came of their own free will': he
Surprise Benefit
said. "There was no publicity to draw them
Dr. Eitan Gross, a pediatric surgeon at the
in out of fears that we'd be overwhelmed
Hadassah hospital in Ein Kerem who was
by a massive number of clients. When we
in Swaziland and is the medical director of spoke to the men who came, many of them
Operation Abraham, said he was surprised in their 20s and 30s, they told us about
initially to hear that
living amid the epi-
"It's fitting that our
surgery could play a
demic and what it's
role in preventing the
like to see so many
project is named after
spread of AIDS.
people die."
Research has
Abraham. It symbolizes Israeli
shown that male
circumcision reduces
Initiative
a measure of unity to
the chance of HIV
Although nearly 30
infection. Experts say
of the world's
give the message to other percent
the scientific evidence
men are circumcised,
has shown that spe-
practice is quite
people that we can work the
cific cells on the penis
rare in many south-
foreskin appear to be together."
ern African countries
targeted by the virus.
where AIDS has
It also has been found
become a pandemic.
that an unremoved
- Dr. Jamal Garah, Israeli Arab pediatrician
Dr. Jamal Garah,
foreskin can trap the
an Israeli Arab pedi-
virus on the skin,
atrician, was among
making infection more likely.
the Israeli doctors in Swaziland. He has
Gross said he was moved by his time in
experience in performing male circumci-
Swaziland, which has one of the highest
sions, usually on babies or young children
rates of HIV infection in the world and
in Israel's Muslim community.

Dr. Kiron Koshy was one of the doctors

working in Swaziland trained by the
Israeli team. He now conducts as many
as 15 male circumcisions a week at the
Catholic mission hospital where he works
near the Mozambique border — more
than twice the rate he was performing
previously.
"I have now learned the technique and
I can work faster:' Koshy told JTA in a
phone interview from Swaziland. "There
are a lot of people coming in for the oper-
ation, and I think the numbers are only
going to increase."
Meanwhile in San Francisco, Don
Abramson, a former chairman of American
Jewish World Service who has been advo-
cating for the project, said he hopes it will
help galvanize Diaspora Jewry to fight one
of the world's biggest problems.
One of his ideas is to encourage Jews
around the world to donate money to
Operation Abraham whenever they attend
a bris.
"My message to Jewish families is that a
bris affirms the Divine covenant relation-
ship with the child, but also demonstrates
that their friends and family who care
about the child celebrate that the child is
healthy enough to have a bris," Abramson
said. "A contribution to Project Abraham
demonstrates a desire for others to be
alive and healthy as well and could be a
life-saving act." ❑