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Kimeru circumcision

March 10, 2013

Glans exposure with no foreskin removal

In the early 1980s I spent nearly four years in Chogoria Mission Hospital (click here), near Meru, on the eastern slopes of Mount Kenya. The local Kimeru were close relations of the largest Kenyan tribe, the Kikuyu. As general duty medical officer I treated a lot of men, and saw a lot of penises. The older ones had all been circumcised in a rather unusual way.

I’ve not come across a description, although this website mentions that the neighbouring Chuka did it the same way, without describing how. Here is what I remember seeing, and being told, 30 years ago. I hope no-one was pulling my leg.

Appearance

The Kimeru circumcised penis had an exposed glans as normal, but also a flap of loose skin on the ventral surface, the “beard”. Men being men, a large “beard” was something to be proud of!

The procedure

The operation was done at puberty. The surgeon pulled the dorsal foreskin forward, and made a longitudinal incision through both layers, creating a buttonhole which he pulled over the glans penis, leaving it exposed. No skin was removed.

It doesn’t sound much fun, but I guess it was a good deal less painful and less mutilating than the usual procedure. I wonder what the effect was on HIV transmission.

Related posts here, here, here and here.

Jim Thornton

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5 Comments leave one →
  1. March 10, 2013 12:09 pm

    Very interesting Jim, thank you. HIV prevalence by tribe from MeasureDHS shows that prevalence among males and females is roughly equal, which is something unusual in Kenya, the Somali, with much lower prevalence being the only other example. The Embu are the only tribe in Kenya where HIV prevalence is substantially higher among men than women. But I’m not sure if that has anything to do with type of circumcision!

    • March 10, 2013 12:26 pm

      I guess in theory, the Kimeru method might reduce female to male transmission by thickening and keratinising the skin of the exposed glans. But since it does not remove the, allegedly easily infected, inner layer of the foreskin, it should have no effect. A natural experiment?

      • March 10, 2013 12:49 pm

        Do you mean a controlled trial? My problem with circumcision and HIV is that there is an assumption that almost all HIV is transmitted sexually; if that assumption is unfounded, circumcision is probably a waste of time. It’s also surprising that, if circumcision were so instrumental in reducing HIV transmission, it only seems to be associated with lower HIV prevalence in some countries and is associated with higher prevalence in other countries. I understood that the protection from ‘thickening and keratinising the skin’ is speculative insofar as there is no convincing explanation of why circumcision should give any protection, where it does appear to give protection. After all, we know it’s not a question of hygiene and that male genital douching may well be a risk factor, rather than a prevention strategy.

    • June 22, 2016 9:14 am

      What can we do to prevent this pandemic amongst embu men

  2. March 11, 2013 12:48 am

    They do something similar in one region of the Western Solomon Islands. I saw one example. I’m guessing it was done just before puberty, because the foreskin was evident only as a pea-sized lump under the glans. Presumably, not being put under tension by the growing glans, it had stayed at childhood size.

    There is no limit to human ingenuity – at least so far as things to do to the genitals of the non-consenting is concerned.

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