Abstract #232  -  Training Medical Circumcisers in Safe and Swift Adult Male Circumcisions for HIV Prevention in Swaziland: Results of a Pioneer Operation Abraham Pilot
Authors:   Presenting Author:   Dr Inon Schenker - Jerusalem AIDS Project
Additional Authors:  Dr Francis Serour, Dr Zvi Shkolnik, Dr Zvi Gimon, Dr Jamal Garaj,
Aim: Translating male circumcision (MC) science and policy into practice requires a comprehensive capacity building and training approach. Responding to requests from Swaziland, we have developed and implemented a technology transfer and training model which could scale up dramatically MC services by local providers in Africa. These are reported.
Method / Issue: The removal of the foreskin is a simple operation under local anesthesia, which could be performed at community-level clinics even in adults. The large intake of men expected with the promotion of MC for STI/HIV prevention requires rapid training of medical providers in large scale circumcisions. In Israel, with more than 100,000 adult MCs completed safely and swiftly in the past decade, an experience gained by expert Operation Abraham surgeons was shared with Swazi counterparts through collaboration with FLAS.
Results / Comments: Three medical delegations from Israel travelled to Swaziland for 14 days each (October 08-February 09) volunteering as on-site, hands-on trainers of local doctors; as health community educators and as policy advisors. At the end of the pilot: 12 doctors were trained in performing swift and safe adult MC with increased intake leveling at 10 clients a day per doctor. 230 MC were performed, with scaled up capacity of nursing and administrative staff. Policy informed and larger health community better educated on MC benefits.
Discussion: It is possible to deploy international surgeons to assist in scaling up MC services in Africa. Training needs are for both trainees and trainers. Our supporting the development of the standardized manual (UNAIDS/WHO) in this field allowed maintaining high quality. With an easy to follow model and organizational support Operation Abraham know-how was well received and adopted. Replication to other settings in Swaziland and to other countries in Africa is achievable.
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