{"id":91361,"date":"2017-04-17T10:47:38","date_gmt":"2017-04-17T08:47:38","guid":{"rendered":"http:\/\/www.myza.co.za\/making-circumcision-safer-for-young-men-with-bleeding-disorders-the-conversation\/"},"modified":"2017-04-17T10:47:38","modified_gmt":"2017-04-17T08:47:38","slug":"making-circumcision-safer-for-young-men-with-bleeding-disorders-the-conversation","status":"publish","type":"post","link":"https:\/\/www.myza.co.za\/press\/making-circumcision-safer-for-young-men-with-bleeding-disorders-the-conversation\/","title":{"rendered":"Making circumcision safer for young men with bleeding disorders | The Conversation"},"content":{"rendered":"

Making circumcision safer for young men with bleeding disorders<\/a>: <\/p>\n

Haemophilia impairs the body's ability to make blood clots causing excessive bleeding.<\/span> Shutterstock<\/span><\/span><\/figcaption><\/figure>\n

Circumcision is the oldest and most frequent surgical procedure in the world. In some cultures, it marks a clear break from childhood to adulthood. But, reports of young men dying during traditional initiation rites due to spontaneous bleeding are devastating. The Conversation Africa\u2019s Health and Medicine Editor Joy Wanja Muraya asked Dr Peter Kibet Shikuku for his views on a safe circumcision programme in Kenya for boys with haemophilia \u2013 a bleeding disorder.<\/em><\/p>\n

How prevalent is haemophilia in Kenya?<\/strong><\/p>\n

Most patients with haemophilia are born with it, congenital, while others acquire it.<\/p>\n

Patients must see a specialist, a haematologist, before any surgery to control their bleeding. While circumcision is not a major operation, it can lead to death because the bleeding is slow, consistent, continuous and prolonged.<\/p>\n

The prevalence of haemophilia is the same in all communities and remains at 1 per 10,000 in any population. As a country we have only reached awareness of the disease at 14% of those affected.<\/p>\n

Superstitions are driven by lack of awareness in the communities forcing some parents to hide or lock away their children from the general public due to associations of the condition with bad omen.<\/p>\n

During circumcision by traditional healers, the injured young men and those slow to heal are abandoned in the forest to die. Circumcision, they say, is not for weaklings.<\/p>\n

How different is circumcision for haemophiliacs?<\/strong> <\/p>\n

Circumcision carries different meanings in Africa and globally. In most communities in Kenya, it\u2019s a rite of passage practiced by most communities on boys and\/or girls.<\/p>\n

It involves either the removal of certain teeth, tattooing parts of the body, piercing of earlobes, removal of the foreskin or a combination of practices.<\/p>\n

During these rites blood is lost, with a few complications occurring. But, some young men die due to lack of adequate testing for haemophilia – a genetic disorder that impairs the body\u2019s ability to make blood clots.<\/p>\n

This is complicated by lack of information within the circumcising communities on the bleeding disorder. The uninitiated are often stigmatised, ridiculed and bullied by their peers.<\/p>\n

Because of this, some young men do not disclose that they\u2019re haemophiliac and undergo circumcision without the precautionary measures, leading to complications, and even death. <\/p>\n

Blood clot elements that manage haemophilia during circumcision are not readily available and are expensive. The missing factor protein is injected into the affected person\u2019s vein enabling the body to continue the clotting and hence stop the bleeding.<\/p>\n

First case study<\/h2>\n

A 23 year old man in high school was under peer pressure to get circumcised. They threatened to forcibly circumcise him themselves. He knew he had haemophilia and needed the factor concentrate.<\/p>\n

He travelled from one health facility to another to accumulate enough of the concentrate . But, it wasn\u2019t enough and he was circumcised with these expired products in one of the health facilities. <\/p>\n

He developed antibodies to factor eight on the fifth day after the operation and ended up with a by passing agent to overcome the antibodies till he healed. It\u2019s not even possible to establish the reason behind antibody development in this patient.<\/p>\n