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Of dreams and nightmares: implementing medical male circumcision in eSwatini (Swaziland)

Published online by Cambridge University Press:  11 March 2020

Nolwazi Mkhwanazi
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Abstract

This article uses the accelerated saturation initiative (ASI) Soka Uncobe, which took place in the kingdom of eSwatini in 2011 and 2012, to comment on HIV humanitarian health interventions in Africa. Soka Uncobe, the first ASI on voluntary medical male circumcision, aimed to circumcise 80 per cent of all HIV-negative men aged fifteen to forty-nine years over a twelve-month period. Using written and verbal accounts, I draw attention to the dreams and hopes behind the design of the initiative. I also highlight the dynamics of the implementation of Soka Uncobe, and, in doing so, I chart the path to its ultimate failure by showing the reluctance of the implementation partners (based mainly in the global North) to take seriously what have now become well-known critiques of why humanitarian interventions fail. Ultimately, I suggest that, despite having the potential to produce some critical results, Soka Uncobe was no different from previous transnational humanitarian health interventions. Thus, an exposé of why it failed is pivotal to this article about the dreams that underpinned the first ever ASI related to medical male circumcision.

Résumé

Résumé

Cet article utilise l'initiative de saturation accélérée (ASI, de l'anglais Accelerated Saturation Initiative) intitulée Soka Uncobe, mise en œuvre dans le royaume d'eSwatini en 2011 et 2012, pour commenter les interventions humanitaires de santé relatives au VIH en Afrique. Soka Uncobe, la première ASI de circoncision masculine médicale volontaire, visait à circoncire 80 pour cent de la population masculine séronégative âgée de quinze à quarante-neuf ans sur une période de douze mois. S'appuyant sur des récits écrits et oraux, l'auteur attire l'attention sur les rêves et les espoirs derrière la conception de l'initiative. Il souligne également Ies dynamiques de la mise en œuvre de Soka Uncobe et, ce faisant, suit l'itinéraire de son échec en montrant la réticence des partenaires de mise en œuvre (essentiellement basés dans les pays du Nord) à prendre au sérieux ce que sont désormais devenues des critiques bien connues des raisons de l’échec des interventions humanitaires. Enfin, l'auteur suggère que Soka Uncobe, bien qu'ayant le potentiel de produire des résultats critiques, n'avait rien de différent des interventions humanitaires transnationales de santé précédentes. Ainsi, un exposé des raisons de son échec est un élément central de cet article concernant les rêves qui sous-tendaient la toute première ASI relative à la circoncision masculine médicale.

Type
Generative fictions
Information
Africa , Volume 90 , Special Issue 1: Beyond realism: Africa's medical dreams , January 2020 , pp. 132 - 147
Copyright
Copyright © International African Institute 2020

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References

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