Academic journal article International Journal of Men's Health

"Seizing the Day": Right Time, Right Place, and Right Message for Adolescent Male Reproductive Sexual Health: Lessons from the Meru of Eastern Province Kenya

Academic journal article International Journal of Men's Health

"Seizing the Day": Right Time, Right Place, and Right Message for Adolescent Male Reproductive Sexual Health: Lessons from the Meru of Eastern Province Kenya

Article excerpt

For AIDS prevention programmes, finding the right time and the right place in which to impart the right message is critical. This ethnographic study asks if the traditional seclusion period following male circumcision among the Meru in Kenya may be a "'moment to seize." Interviews were conducted with boys undergoing circumcision, adult Meru men, traditional circumcisers, and hospital staff carrying out circumcision. Traditionally, during the seclusion period following the circumcision, cut boys, already physically "made into men," were taught how to behave, feel, and function as men. Ingrained in Meru culture is not only an expectation of social, psychological, sexual, and behavioural change but teaching/social mechanisms to facilitate change. A pilot health education programme, held during circumcision seclusion, appears to be an acceptable and effective means of modifying risk-taking behaviour, though further rigorous evaluation is required. The Meru imperative for circumcised youth to "learn the ways of men" presents an opportunity to reach young men with health messages.

Keywords: male circumcision, Kenya, adolescence, sex education, HIV/AIDS, timely intervention

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This paper will examine the context of male circumcision among the Meru of Kenya (see Nyaga, 1997) to explore if the traditional moments of education within the male circumcision rite are still important moments for today's youth in zones where adolescent circumcision is still practised, and outline an intervention project aimed at seizing the day to reach adolescent boys with youth-friendly health messages.

The Meru live on the eastern slopes of Mount Kenya in the central part of Kenya, home to the Meru people (Bell, 1955). The area once boasted a profitable cash-crop economy, but failing harvests and changing rhythms in world coffee production have reduced its stability. Many inhabitants of this region remain subsistence farmers. The provincial capital of the area, Meru, has an HIV prevalence of 35%. its environs are famous for the miraa or Khat, a stimulant leaf chewed in Eastern Africa.

The Meru are traditionally a male-dominated, patriarchal society. Disciplining through violence, particularly within family relationships, provided a means of control. Young Meru people struggle for employment, the division of land through the years having reduced its capacity for substantive returns. Many describe a general apathy and cite idleness as a major problem in their lives and a reason why alcohol, miraa, and cannabis (bhangi), which is grown in the forests of Mount Kenya, are so abused. An estimated 3,929,000 of Kenya's total population of 32 million are between 15 and 24 years old. In this group. 15 percent of the females and 9 percent of the males are HIV-positive. More than 1.1 million adults are HIV-positive in Kenya. Life expectancy dropped in 2001 to 49 years from 57 years in 1990, largely due to AIDS.

On ethnographic maps, all societies in the central Kenyan highlands are shown as practicing male circumcision (Bongaarts. Reining, Way, & Conant, 1989: Caldwell, Orubuloye, & Caldwell, 1997: Dodge & Kaviti, 1965: Moses, Bradley, Nagelkerke, Ronald, Ndinya-Achola, & Plummer, 1990). Meru oral history indicates that they have practiced male circumcision at least since arriving in the area in the late 18th century (Greeley, 1977).

Chogoria Hospital, in the South Meru region, is the largest NGO health provider in the area and serves a population of 528.000. Chogoria Hospital was founded in 1922 by Clive Irvine, a zealous Scottish missionary doctor with farsighted ideals for women's education, industry creation, and public and preventative healthcare. In 1926, Irvine offered hospital-based circumcision as an alternative to traditional circumcision of the field and forest. He retained the particular Meru cut. Several traditional techniques of circumcision (gutanwa) have been identified among the Meru people alongside the period of seclusion and male-only supervision and nursing care (Brown, Micheni, Grant, Mwenda, Muthiri, & Grant, 2001). …

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