Die Sauerei, die in Afrika läuft

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    • Die Sauerei, die in Afrika läuft

      Sorry, aber anders kann ich das nicht nennen.

      "Dank" Bill Gates und anderen Sponsoren. Jungen werden gepresst, über den Tisch gezogen:

      For VMMC clinics, achieving targets is essential to the continued funding of their respective IPs. A 49-year-old, male mobilization supervisor offered, “…targets… are about funding, and [if] you don’t reach your target, you don’t get funding”

      Presented below, these areas of concern relate to ...potentially misleading or questionable mobilization practices (including possibly undue inducements), problematic uses of social pressure, and circumcision of children under age ten. By undue inducements, we mean benefits (monetary or non-monetary) that are used to motivate prospective participants (in this case adolescents or young adults) to join a study—benefits that may be inappropriate because of their potential to distort a participant’s understanding of the study.[34] A final issue that we link to the pursuit of targets is the reduced quality of clinical care.

      Wie bitte? Ist ein Junge ab zehn Jahren "einsichts- und urteilsfähig"?

      There are times when they are having exams, or when exams are approaching, or when there is athletics or ball [soccer]; when those are taking place, we don’t get people coming… we end up having zero clients cut [circumcised]. And you know, when there are zero clients cut, all the pressure comes to the mobilization supervisor because the surgeons will be saying, ‘We are ready to cut, where are the clients?’ So the buck stops on me as the mobilizer; so it is not a very easy task.

      This memo made clear that the IP was aware that “some teams are circumcising over and above the safe maximum number of clients per team” and that this limit is 25 clients per day. During one observation session on a high season day at a Level 4 facility, we counted over 100 boys waiting to be circumcised at a clinic with four surgical beds.

      Referred to as “moonlighting” by our interviewees, VMMC staff may sometimes work extra hours, late into the evening, and/or over weekends or holidays when they would not normally be expected to work (for which they receive extra compensation) in order to handle large client loads, meet current targets, or make up for previous months when a lack of clients meant targets were missed. One 33-year-old, female counselor explained, “Yeah, you are put into pressure and you have to get the targets. We always know we have to get our targets, come what may. So we do moonlight to get those targets”

      Then the other factor is the high numbers given as targets annually. So if you look at the number of clients you should do, you get fatigued along the line because remember you stand all day. So if you do 20 clients or 25 clients in a day, every day, say from Monday to Friday, it is a hell of a tiresome job…. So most of those AEs [are] attributed to fatigue, because if you look at the timings of most of the AEs, it is usually late in the evening, after lunch, afternoon; so it has always been attributed to high volume in terms of target, and then fatigue, then people not following the protocol. You find somebody, because he wants to finish faster, they want to split [meaning the surgeon and the assistant each operate on their own] instead of [following] MC protocol [and working together]…. It reaches a point where you have to split where everyone is doing [operating alone] because the number is high….

      Another thing is the peer mobilizers, yeah, someone wants to meet his or her targets and that is the time that they engage in what I called the uncouth methods, whereby the end justifies the means; whichever means that can make those clients come out. So you end up having the clients coming, but they are not coming for the VMMC the way we want it. They have been pushed; they have been coerced…yeah. This one is happening because of these targets. So that is the downside of the targets.

      For us we are calling it ‘broking [brokering] system’. So after the exercise, you tell him to go… and convince a friend and bring a friend… [….] For me I am using my own system being that we are not even allowed to give children money. But for me, because I have a target, and if I get my target, I am expecting 10800 KES [108 USD]. So I do divide this 10800 KES; maybe if he brings me two boys, I can give him up to 50 KES. I can even give out 100 KES [1 USD]. The moment I give that money, 50 bob, to that boy, he is going to bring me more four boys. So the more he bring boys for instance if they are four, I give 100–150 KES. At the end of the day, I will hit my target

      There is no skin like foreskin
    • During a promotional skit in which mobilizers played the roles of a husband, wife, and brother all discussing VMMC, the message to the audience was one of strong female preference for circumcised men. The wife told her husband, “Go and cut your firimbi [whistle] … go and remove that sleeve of a sweater. That whistle is not going inside me…don’t blow the whistle inside me. I have refused…. I am not giving you [sex].” Later, when the husband’s brother arrived, he explained that his wife is refusing to have sex. In response, his brother said, “I was passing here to tell you to go for circumcision. Look at me, I have gone, and I am fine. I am now a clean person.”
      wi-der-lich..... *Brech*

      There is no skin like foreskin
    • So hat man sich das immer vorgestellt:

      Later that same day, the mobilizer asked a large group of older students,“How many of you wish to get the HIV virus? If you don’t want to get the HIV virus, the only option is to remove the foreskin.”
      Und dann glauben sie, geschützt zu sein und auf ein Kondom verzichten zu können.

      There is no skin like foreskin