Panel on Safe Male Circumcision

For the most part, Peace Corps volunteers understand that we will rarely see the impact of our hard work.  I do feel appreciated by some people in my community, but they usually say, “You are so important” or “You are doing so much.”  They rarely single out specific interventions or projects as particularly noteworthy.  Peace Corps Botswana has mechanisms to recognize volunteer work.  We can submit success stories to the monthly newsletter.  We get positive feedback from our program managers.  And recently PC has started “Realities from the Field” panels.  PC staff invites volunteers working on specific interventions to come give a presentation to our governmental and non-governmental partners in Gaborone.

On November 20^th, the “Realities from the Field” panel was on safe male circumcision (SMC).  I presented on my work, along with four other volunteers.  The idea behind these panels is to give feedback to policymakers.  We tell them what is going on at the ground level, our successes and challenges in the safe male circumcision campaign.  We presented to a group of over 20 people with representatives from the Center for Disease Control, President’s Plan for Emergency AIDS Relief, Department of Defense, Botswana Ministry of Health, Population Services International, JHPIEGO and ACHAP (organizations working on SMC in Botswana).  It was definitely a room of heavy hitters.  We told them how men and women were receiving SMC in our villages, myths and questions we encountered, etc.  They can then shift their programs as needed.

The panels are great for Peace Corps volunteers because they are an appreciation of our work that we rarely experience otherwise.  I worked with Bright Mosimegi, a nurse at Shoshong Clinic, to develop a Setswana SMC/pap smear informational pamphlet for our April Month of Youth Against HIV/AIDS event. We designed it in Setswana because all of the pamphlets on SMC from the Ministry of Health were in English.  Some people speak English in Shoshong, but plenty do not.  Since we wanted everyone to be able to understand the message, they needed to be in Setswana.  The Ministry and its related partners in the SMC are starting to translate their materials into Setswana, but that is still a problem.

At the panel, I presented on my pamphlet and related health talks at the clinic.  I roughly translated the pamphlet, explaining to everyone the headings and information contained therein.  Many people asked me questions.  Then at the end, one man said that he was so happy to see this pamphlet.  He said that the Setswana was simple, which one rarely sees in pamphlets designed by public health specialists.  He was happy that the pamphlet was accessible, urging the groups there to involve people on the ground to make more pamphlets like this one.  And then everyone clapped.  It was such a great moment.

Before the panel, I sent the pamphlets out in an email to all volunteers in Botswana.  At this point, I think that about 5 other volunteers are using it.  Knowing that I have created something that is making health information accessible to people is a great feeling.

In the last post, I wrote about becoming comfortable in my role as a Peace Corps volunteer.  I learned early on that there is no reason to reinvent the wheel.  Using already existing programs and materials is the way to go.  It is really nice knowing that a product of mine will help volunteers and other service providers in Botswana better explain the importance of safe male circumcision and pap smears.

Left hand side is SMC; right is pap smear info

General translation of the pamphlets:

PAP PAMPHLET

What is pap smear (direct translation: testing for cervical cancer)?

•  It is done every year
• Checks the cervix

What does pap smear test for?

• Non-sexually transmitted infections like yeast and bacterial infections
• Sexually transmitted infections like gonorrhea, syphilis and others
• Sexually transmitted infections that can be treated, but that without treatment can give you pelvic inflammatory disease and cervical cancer
• Sexually transmitted diseases that cannot be cured like genital herpes

Consequences of not testing:

• Many of these diseases show no symptoms, so you can have them and not know it
•  If you do not seek treatment, some can become cancer
•  Cervical cancer can lead to fertility and even death

SMC PAMPHLET

What is SMC (direct translation: cutting the foreskin of the penis safely)?

• SMC is the surgical removal of the foreskin of the penis by health professionals in a health facility

SMC reduces the chances of the following:

•  Contracting sexually transmitted infections like syphilis
• Contracting HIV by 60 percent
• Getting penile cancer
•  Getting urinary tract infections
• Transmitting HPV to female partners

Why does SMC work?

•  The foreskin is easy to tear during sex
• The foreskin holds CD4 cells, which HIV targets
• It is difficult to clean foreskin, resulting in diseases if not cleaned properly

Other things you should know:

• SMC does not prevent HIV
•  Men must wait 6 weeks before having sex after doing SMC