Memory Lane: My Open Letter to Annie Lennox, 2012

Following her appearance at the International AIDS Conference in Vienna, 2010, I wrote the following open letter to Annie Lennox. I'm just re-posting it as an accompaniment to my latest post regarding her latest appearance at the Hope Rising fundraiser concert in Toronto.

Is this about HIV/AIDS prevention and human rights?

Or is this a mere PR project for her?


An Open Letter to Annie LennoxFriday, July 23, 2010

Dear Annie Lennox,

I am Joseph Lewis, and I'm a US Citizen, resident of the City of Stockton in the state of California. I'm writing to you today because I saw you on some footage taken at the International AIDS Conference in Vienna.

I must commend you for your activism against AIDS. I had heard some of your music before (my favorite song by you is Love Song for a Vampire), and I must say I never imagined that you'd be such an activist in this field. You do it so passionately as well. You went to the conference in Vienna with an in-your-face attitude, and I think that’s what it’s going to take to get governments involved.

I was writing because I wanted to express my concern for part of what is being vehemently promoted at the Vienna Conference, and that is the promotion of male circumcision.

As a human rights activist, and as a member of the male sex, and as someone who appreciates not having undergone circumcision as a child, I am concerned as to why any organization has even considered research that centers around the vilification of a perfectly healthy body part, and legitimizing its destruction, especially in healthy, non-consenting individuals.

Would organizations such as the WHO, UNAIDS or UNICEF ever consider "research" on female circumcision? If "studies showed" that female circumcision "could reduce the risk of sexually transmitted HIV/AIDS by 60%", would these organizations ever endorse it and call for mass female circumcision campaigns? Would you, Annie Lennox, ever get behind them? Why or why not?

I hope that I have brought attention to the underlying sexism in this campaign to circumcise a mass population of men. "Research" and "benefits" seem to matter only when it comes to male circumcision; female circumcision would NEVER be endorsed, not even if there were "studies" that said that it reduced HIV risk by 100%. I’m sure of it.

Here are some studies that show a correlation between female circumcision and a lowered HIV transmission rate. I somehow doubt that the WHO or UNAIDS would ever take them seriously though.

Stallings et al. 2009
"Risk of HIV among women who had undergone Female Circumcision is roughly half that of women who had not. Association remained significant after adjusting for region, household, wealth, age, lifetime partners and union status."
Female circumcision and HIV infection in Tanzania:
For better or for worse?
3rd IAS conference on HIV pathogenesis and treatment
International AIDS Society

"Women who have undergone Female Circumcision have a significantly decreased risk of HIV-2 infection when compared to those who had not."
Kanki P, M'Boup S, Marlink R, et al.
"Prevalence & risk determinants of HIV type 2
(HIV-2) and human immunodeficiency virus type 1
(HIV1) in west African female prostitutes
Am. J. Epidemiol. 136 (7): 895-907. PMID 

You might tell me that female circumcision causes all this damage, that women lose the ability to orgasm. "Studies show" that male circumcision "doesn't affect satisfaction", and thus this is why circumcision can be recommended. But did you know, studies ALSO show that women who have been circumcised do not lose their ability to orgasm? In fact, women who have undergone infibulation, which is the worst kind of female genital mutilation in the world, are still able to orgasm.

http://www.ncbi.nlm.nih.gov/pubmed/17970975

http://www.newscientist.com/article/dn2837-female-circumcision-does-not-reduce-sexual-activity.html

Still, others claim that having one’s labia removed actually INCREASES “satisfaction."

http://www.labiaplastysurgeon.com/labiaplasty-clinical-study.html

Please understand that I am in no way trying to justify female circumcision: The point that I'm trying to make to you is that when something is wrong, when something is a human rights violation, it doesn't matter how many studies have been written for it. It doesn't matter if it’s couched in medical terms. It doesn't matter that it is performed in a clean environment by doctors, with clean utensils and pain killers. Genital mutilation is genital mutilation, whether it is performed on women or men.

And my question is HOW can this have happened? How have organizations managed to come to the conclusion that they can endorse male genital mutilation under the pretext of "HIV prevention?" What would be the outcry would that the WHO endorsed female circumcision for the same reason? What would be YOUR reaction, Annie Lennox? My question to you is how could you stand idly by while UNAIDS head Michel Sidibe and Deputy President of South Africa Kgalema Motlanthe celebrate that they were able to coerce men to take up the practice of circumcision? How would you react if you heard women celebrate and say "we are so happy and excited that women are accepting female circumcision."?

The slogan for the conference in Vienna is "Rights here, right now." One of the speakers that I saw footage of was one Claudia from the country of Chile. Human rights, she said, is the freedom to choose. It means choices. Choices to live how you want, have sex with whomever you want to, use injected drugs, etc. The WHO's endorsement of circumcision is already being used to promote the circumcision of healthy, non-consenting children who are not even having sex yet, and therefore at zero risk for any sexually transmitted disease. What about THEIR human rights? If an adult man wants to get circumcised, that is his body, and therefore his prerogative. But why should children be forcefully circumcised if they're not even at risk, where they would benefit more from mother-to-child prevention?

I recently saw this video on the website for the Bill and Melinda Gates foundation, and I was heartbroken.

http://www.gatesfoundation.org/hivaids/Pages/reducing-hiv-risk-through-circumcision.aspx

Here is this young man. He is impressionable, and he is afraid. He is old and smart enough to make his own choices. And yet he succumbs to the pressure of his father. Where is “choice?” Where are "human rights" here? That boy did not want to undergo circumcision. He did it out of fear, and out of wanting to appease his father. WHY is circumcision being endorsed when all it takes is education? Why must men be coerced to take up circumcision if they are smart and capable enough to learn to change their behavior? The people of Kwazulu Natal. Did they really need to be convinced to take up circumcision?

Have you read this, Annie?

From PlusNews.org:

Jairus*, 41, a family man, knew the procedure would reduce his chances of contracting HIV, but said his wife would be suspicious.

"My wife believes I am faithful - if I go for the cut, she will just think I have been dogging [cheating] on her," he said. "I don't want to create that mistrust."

"We Luos do not circumcise ... it is like betraying my culture, and even my friends we grew up with will look at me badly," said John Ngesa, 37.

Older married have been were particularly reluctant to be circumcised, partly because they see themselves at low risk of contracting HIV, even though it has been spreading fastest among married and cohabiting couples.
"I am married, so where do I get HIV, yet I am a faithful man? I trust my wife," Dan Musa, 43, told IRIN/PlusNews. "When you are faithful you are safe."

http://www.plusnews.org/Report.aspx?ReportId=89496

Annie, promoting circumcision is going to hurt in more ways than one. It will create a new stigma; having a foreskin makes you HIV positive. To add to that, if a circumcised man is found to be HIV positive, what will people say? That he must have been doing drugs since his circumcision was supposed to protect him? And what will they say of the uncircumcised HIV positive man? That he should have been circumcised to begin with? In other reports, doctors actually suggested that HIV positive uncircumcised men be circumcised "to avoid the stigma." So isn't this just creating more stigma, not to mention it's a waste of money to circumcise an HIV positive man (assuming studies were true)?

http://www.circumcisionandhiv.com/2009/07/africa-more-evidence-women-at-greater-risk-of-hiv-from-circumcised-men.html

Usually, medical studies tend to study how to preserve the human body, not vilify it and justify its destruction. For example, the study of cancer is a tedious one, and usually researchers are trying to find ways to avoid the loss of organs, such as the testicles, the prostate, and/or the mammary glands. Circumcision "studies" are unique. They're the only ones of their kind that seek to preserve a procedure, and not the human body.

Do you know if there has been any research for alternatives for HIV/STD prevention WITHOUT having to circumcise? Is the WHO or NIH doing anything to eventually move past circumcision? Is there research looking for ways in which men don't have to consider circumcision anymore, and is the WHO considering it?

Let's get real here. Circumcision, for all intents and purposes, is the mutilation of a person's healthy genitals. The WHO and others are promoting male genital mutilation and HIV/AIDS "prevention" is the pretext. It should strike you as odd, Annie, that these "researchers" are fixated on trying to legitimize a particular surgical procedure, male circumcision of all things. Recommending female circumcision would NEVER fly, no matter how much “research” the WHO or UNAIDS presented.

Annie, there are many problems with the "studies" people are trying to use to promote circumcision, the biggest one being that their "conclusions" conflict with a few realities.

In America, for example, 80% of men are already circumcised from birth. The rates of infant circumcision are dropping, but at large, the population remains circumcised. These rates are at their highest in the East Coast, where cities such as Philadelphia and Washington DC rival HIV hotspots in South Africa. In the 1980s, when the AIDS epidemic first hit, the rate of circumcised men in America was at 90%. One needs to question how something that never worked here in our own country is suddenly going to start working wonders in Africa.

In other countries, the "protection" remains to be seen as well. AIDS is a rising problem in Israel, where the majority of the male population is already circumcised. On Wednesday, July 7th, two weeks ago, Malaysian AIDS Council vice-president Datuk Zaman Khan announced that than 70% of the 87,710 HIV/AIDS sufferers in the country are Muslims (in other words CIRCUMCISED). The Muslim, circumcised population accounts for 70% of the incidence of HIV, but only 60% of the population, which would mean that the circumcised population is getting HIV at a much higher rate than the non-circumcised population.

There are also studies that contradict the trials the WHO is using.

Two recent studies examining African circumcision rates and HIV prevalence found that circumcision status was not significantly associated with HIV. Garenne examined data from 13 sub-Saharan countries found no association, and Connolly C, et al. found that circumcision made no difference in HIV rates in South Africa. Talbott Jr. concluded that, once commercial sex-worker patterns are factored in, male circumcision is not significantly associated with lower HIV.

Michel Garenne. African Journal of AIDS Research 2008, 7(1): 1–8.Connolly C, et al..Male circumcision and its relationship to HIV infection in South Africa: Results of a national survey in 2002. S Afr Med J 2008;98:789–94.
Talbott JR. Size Matters: The number of prostitutes and the global HIV/AIDS pandemic. PloS One. 2007;2(6): e543.

The promotion of circumcision is hurting the African community in different ways. As you may or may not know, circumcision is an important rite of passage for men in certain tribes in South Africa. In case you haven't already been informed, there have already been 47 dead casualties to circumcision rituals this year. Many more have lost their penises to gangrene. Endorsing circumcision is giving tribal groups where circumcision is important the go-ahead for their dangerous rituals. It is considered unmanly to run to the hospital, so many men stay behind fear of being ostracized, being forced to run the risk of death or of losing their genitals.

A recent issue of the WHO Bulletin noted that African ritual circumcisions have a 35% complication rate, while clinical circumcisions have an 18% complication rate. A neonatal circumcision complication rate of 20.2% was found in Nigeria. As you may know, Annie, funds for the fight against AIDS are scarce. Dealing with these complications is going to divert resources away from other more-needed programs, such as mother-to-child transmission reduction, and treatment of people who are already infected.

Bailey RC, Egesah O, Rosenberg S. Male circumcision for HIV prevention: a prospective study of complications in clinical and traditional settings in Bungoma, Kenya. Bull WHO. 2008;86(9): 669-677.
Okeke LI, Asinobi AA, Ikuerowo OS. Epidemiology of complications of male circumcision in Ibadan, Nigeria. BMC Urology. 2006;6:21.
“Male circumcision to prevent Aids is pushing other healthcare programmes, including other HIV and Aids interventions to the back-burner..." 

http://www.nation.co.ke/oped/Opinion/-/440808/818352/-/5ojrlt/-/

And, as if things weren't already bad enough, there are some opportunistic charlatans taking advantage of the WHO's stance to sell their wares. The Treatment Action Campaign (TAC) has issued out a warning on the so-called "TaraKlamp" because of its high rate of adverse effects.

"Adverse events from use of the TK were far higher: 37% compared to 3.4% for the forceps-guided method. This was a statistically significant result (p=0.004). Men circumcised using the TK also reported worse pain than men circumcised using the forceps-guided method. Furthermore, the device clearly causes consternation: 97 men refused to participate in the trial, 94 of them giving the reason that they did not wish to use the TK.

The TK trial was stopped early due to the unacceptably high rate of adverse events. The researchers concluded, "Given the high rates of adverse events in this study and the low number of available studies, we strongly caution against the use of the TK for young adults, and we recommend careful evaluation of the procedure when performed on children." 

http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71619?oid=185517&sn=Marketingweb+detail

And the people of KwaZulu Natal are being told to withdraw the use of the TaraKlamp, and they are  REFUSING to do so.

"We don’t have any evidence that suggest that the Tara KLamp method is more unsafe that the forceps method," said Chris Maxon, spokesperson for KwaZulu-Natal health MEC Sibongiseni Dhlomo. 

http://www.news24.com/SouthAfrica/News/KZN-defends-circumcision-clamp-20100709

THE Southern African distributors of the Tara KLamp circumcision device have rejected a call for it to be put on hold until safety concerns had been addressed.

http://www.dispatch.co.za/article.aspx?id=416512

"Where are you? A catastrophe is taking place in your backyard and you're ignoring it."

http://www.google.com/hostednews/afp/article/ALeqM5gtj1R_Je24e4eVSGOCDro84oVboA

These are your words, Annie Lennox. Please don’t let charlatans abuse the AIDS/HIV cause to sell their wares.

Here is what Dr. G Singh, inventer of the TaraKlamp had to say about the Orange Farm study:

"All it needs is a simple withdrawal of your manuscript and gracefully accept the reality. I am even not asking for an apology, for I am a very forgiving man..... but there is a limit!"

Annie, there is a danger in telling men that circumcision “reduces the risk of HIV.” It gives men an excuse to forgo the use of condoms. It’s already happening.

"He [my husband] was circumcised and felt he didn't have to wear a condom. When we found we had HIV after testing, he blamed me. He said, 'You brought HIV into this house.' It was because I tested first, when I was pregnant with my second child..."

http://www.irinnews.org/Report.aspx?ReportId=79557

http://www.circumcisionandhiv.com/2008/08/irin-africa-sou.html

According to the Wawer study, women would be 50% more likely to get HIV from a circumcised partner. The study was ended early, because the results weren’t favorable to the researchers, who were looking to find some sort of positive connection between HIV and circumcision.

http://www.circumcisionandhiv.com/2009/07/africa-why-did-they-stop-the-study-to-examine-hiv-infection-among-partners-of-circumcised-men.html

As you may already know, we are living in hard economic times, and governments are looking for ways to cut AIDS funding. You yourself have been involved in taking governments to task. Funds for making “universal access” for AIDS/HIV treatment are scarce. Reports are saying that HIV numbers are coming down, and that this is due to a change in behavior. African youth are choosing to wear condoms. They are having less sex partners and remaining faithful. In light of this, how does it make any sense to be spending a single penny on promoting and carrying out circumcisions? How does it make any sense to giving any consideration to the dubious benefit circumcision is supposed to offer, when we know that it’s condoms and education that does the job?

The millions spent on circumcision could be put to better use. It could go towards mother-to-child prevention treatment. It could go towards the treatment of already infected individuals (Julio Montaner said that treating HIV positive people dramatically decreases HIV transmission). It could go towards condoms and education. On the contrary, the promotion of circumcision discourages the use of condoms which would be more effective than circumcision, putting lives at risk, and endorsing the violation of the basic human rights of minors. Indeed, it is putting men who don't want to get circumcised between a rock and a hard place.

Male circumcision is male genital mutilation. It is a human tragedy that pillars of modern medicine, such as the WHO, UNAIDS and UNICEF ever even considered "studies" that aimed to legitimize it. There are better ways to prevent HIV, and researchers should be looking for them. No organization would so much as even CONSIDER a "study" that a tried to say something good about female circumcision. All the studies in the world would never be enough to justify female genital mutilation, not even if there were studies that said that it would cut down on HIV by 100%. WHY has this happened with male circumcision?

I just wanted to say, thank you for acting as a whip to get countries to donate their money for funds for AIDS treatment and prevention. But I also wanted to say that I hope with all my heart that you don't support this promotion, this “research” of male genital mutilation. It is my hope that you will use your voice to express opposition against this. Genital mutilation is being promoted, and HIV/AIDS is being used as the pretext. I support the AIDS movement right away, and I want to help end it, but I cannot support the effort if it is going to be used as a pretext to endorse genital mutilation.

I beg that you please use your position wisely. I hope that in your fight against AIDS, you have the dignity and integrity to stand up for what's right. You would not stand idly by, would that leaders called for the mass circumcision of girls and women. I ask that you please react in the same way to the promotion of circumcision of men, as you would to the promotion of the circumcision of women.

Annie, I beseech you, please use your powers to call attention this quackery some people call “research.” People should be studying how to stop HIV, not how to preserve genital mutilation practices. Interested “researchers” are abusing the AIDS/HIV movement to pursue their own agenda. It has happened with male circumcision, and it is happening with female circumcision.

"I'm not denigrating charity per se. But we need to have a paradigm shift in our heads. We need to say: this is about human rights."

http://www.google.com/hostednews/afp/article/ALeqM5jlGYvOuHCQRYaYyHAIq8Ckb2AjgQ

It is my hope, Annie Lennox, that you mean these words from the bottom of your heart.

Please forgive my lengthy message.

Thank you for your time.

Joseph Lewis