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Constant Karma: Advocating circumcision in Papua
JPCircumcision is not that popular in Papua, with predominantly Christian locals usually avoiding the practice because they associate it with Islam
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span class="inline inline-left">JPCircumcision is not that popular in Papua, with predominantly Christian locals usually avoiding the practice because they associate it with Islam.
In the last three years, however, circumcision has emerged for public discussion.
It was Constant Karma, serving his second term as executive chair of the AIDS Control Commission of Papua (KPAD), who initiated the conversation.
Karma took the risk of facing off against Protestant institutions, particularly the Synod of Evangelical Christian Church (GKI) in Papua, which was opposed to circumcision.
“I was virtually hitting a wall, but that was the risk I had to brave to prevent human immunodeficiency virus [HIV] from spreading,’’ he said.
Since 2008, Karma has been popularizing circumcision as a means of HIV prevention in Papua. In order to convince the Christian community – in which the practice was quite new – he worked with two theologians from the GKI IS Kijne College of Theology, Rev. Sostenes Sumihe and Rev. Mawene.
“With both experts’ explanations that circumcision was not opposed to Christian teachings and [getting circumcised] wasn’t a sin, many other church ministers came to understand and have given their support,’’ he said.
In order to disseminate the benefits of circumcision further, Karma and his team wrote HIV-AIDS and Circumcision According to the Bible, published by KPAD in 2009 and distributed in and outside of Papua.
Circumcision is just one additional approach to the control of HIV/AIDS in Papua, along with campaigns for the use of condoms for people at risk of HIV and against extramarital or promiscuous sex. It was Karma’s background in the study of viral expansion that made him extremely anxious about the spread of the virus.
“This virus is very rapidly transmitted so that we have to do all we can to reduce its spread. It’s impossible to reduce its distribution to zero but we should strive to slow it down, which requires every kind of attempt, including circumcision,” the deputy governor of Papua between 2000 and 2005 said.
Regarding circumcision in the Bible, in 2008 Karma examined the scriptures and discovered 96 verses in the Old and New Testament mentioning the tradition.
“That whole year I was reading the Bible during my spare time from Friday through Sunday,” he said.
According to Karma, circumcision already existed in Papua before Christianity arrived, and has even traditionally occurred in Sorong to date.
But circumcision was mostly lost with the advent of Christianity in Papua. “Circumcision used to be carried out in communal houses, which before the missionary arrival were places of idolatry, so they were destroyed and the practice thus ended,” said Karma.
Based on a recommendation by the World Health Organization (WHO), circumcision can reduce HIV virus transmission by 60 percent. Karma’s endeavor to popularize the practice has been fruitful, with more Papuan parents having their children circumcised. In 2010, the Family Planning Coordinating Agency organized a mass circumcision in Jayapura, with 350 children, including 76 local Papuans, participating.
Besides the WHO recommendation, Karma’s pursuit was inspired after observing the fact that countries with high circumcision rates had lower rates of HIV infection. “Middle Eastern and European countries, the Philippines, [they] listed small numbers of HIV cases; in Indonesia, regions with this tradition like Java had a low HIV incidence, Toraja with its Christian majority like Papua had less HIV cases because all its male residents were circumcised, which made me even more eager to campaign for it.”
There are five reasons for the reduction in the spread of HIV with circumcision. First, the inner part of the foreskin is vulnerable to infection, thus allowing the virus to nest and enter the bloodstream within 72 hours. Second, without circumcision, there is more of a chance of a breaking of the skin as a result of sexual intercourse. Third, when the foreskin is absent the virus can’t penetrate the skin of the penis. Fourth, without the foreskin the virus has no way of nesting, and fifth, after sex less semen remains that could harbor the virus.
Karma’s perseverance in promoting circumcision earned him the Ksatria Bakti Husada Arutala 2011 award for his community motivation and empowerment, granted him in November by the health minister.
Karma said Papua will lose its younger generation unless the spread of HIV/AIDS is prevented and controlled, and he called on all agencies in Papua, the government and private individuals and companies to join in the effort to stop the disease.
“The spread of the virus is very fast so we all should work extra hard and seriously or else we may regret later if Papua faces the same situation as the Congo did, which I witnessed in 2001 when the virus plagued families including those of the clergy, and deaths due to HIV/AIDS were recorded daily,’’ he said.
Circumcision and condoms only constitute a means to reduce the rate of HIV infection, which can only be halted by individual awareness.
“Never have extramarital sex, never change sex partners, use condoms when there’s HIV risk and young men should be circumcised for better health,” he stressed.
