A social and behaviour change communication campaign aimed at encouraging at least 80 percent Swazi adult males to circumcise within a one year period seems to have been misinterpreted by some of those it targeted.
A study by two university lecturers; one from the Department of Anthropology at the University of the Witwatersrand and the other from the Department of Theology and Religious Studies at the University of Swaziland, reveals concerns of how the slogan used in the campaign led people to behave in a way that could have put them at risk of contracting HIV/AIDS.
The campaign’s main aim was HIV prevention, seeing that Swaziland has one of the virus’ highest prevalence rates globally.
The slogan for the campaign was ‘Soka Uncobe’ – which should translate to ‘circumcise and conquer’.
It turns out that this slogan led people into believing that once they had been circumcised, they had conquered HIV/AIDS as well as their sexual partners and, therefore, could sleep around without using protection.
The campaign conducted awareness and advocacy with royalty, traditional leaders, unions, businesses, religious groups, schools, and government to create awareness of and understanding of MC, using interpersonal communications, mass media, especially radio, and educational print materials.
The project was a collaboration between the ministry of health (MOH), Swaziland National AIDS Programme (SNAP), National Emergency Response Council for HIV/AIDS (NERCHA), Population Services international (PSI) and Pulse.
The study by the two lecturers is titled ‘Christians’ Cut: Ecumenical Perspective on Male Circumcision amid Swaziland’s HIV Epidemic’ and it focused on Christian members of the kingdom’s three main church organisations, namely the League of African Churches in Swaziland (LACS), the Council of Swaziland Churches (CSC) and the Swaziland Conference of Churches (SCC).
Part of the study’s focus was on how the Christian religion (given that a majority, about 90% of Swazis are Christian) influences acceptance, rejection or understanding of male medical circumcision (MMC).
A number of those interviewed for the study pointed out to that people participated in circumcision because of the material incentives that were being handed out and the branding of the MMC campaign such as the free literature and gifts distributed at circumcision clinics and NGOs.
They said such gifts and literature “seductively clouded peoples’ own critical examination of the procedure and its effects on gender identities and sexual relations”.
States the study: “One Zionist LACS member noted, ‘some young men are drawn by pull factors such as T-shirts, juice bottles, tracksuits which are distributed as incentives to every male that visits the clinics to circumcise. These material pull factors are branded with the circumcising NGO or clinic, and more widely under the banner Soka Uncobe, which several people across churches saw as unappealing or dangerously inciting male sexual proclivities and broad licences to no longer use contraception.”
Quoting another study on socio-cultural aspects of MMC by Khumalo (2014, page 135), the study notes that there are those who argue that some men misinterpreted the Soka Uncobe slogan to mean once circumcised they had conquered HIV and AIDS or perceived themselves to be sexual conquerors of their partners.
This view, according to the study, was echoed across several church members and was strikingly highlighted by one woman from an SCC church who narrated the following: “I have a younger brother who is 18 and he is circumcised.
Ever since he performed this surgical procedure he has been sleeping around with many girls of his age. His friend partly attributes this behaviour to the manner in which circumcision is promoted in the schools.”
The woman informed the study that her brother’s friend told her that MMC promoters who visited their school would use a metaphor of a bush knife in their illustrations to explain that circumcision also strengthens your manhood.
“There is the misconception that the ‘bush knife’ (penis) is sharpened by circumcision, and young men develop insatiable sexual appetite. Such language can be destructive because it dupes young men to think that they are justifiable to sleep around because their ‘bush knives’ are now sharpened,” further states the study.
It further found that the language used by the promoters and the advertisements as well as slogans for circumcision were also persuasive and indirectly manipulative.
“For example, ‘lisoka lisoka ngekusoka’, which implies that you are not a real man unless you are circumcised; and ‘soka uncobe’ which depicts a circumcised man as a conqueror. Some adverts would even state that once you circumcise you become ‘lichawe’- a hero,” study points out. It goes on to add: “For both women and men we spoke to, the branding of the MMC campaign was problematic. It potentially shored up male sexual supremacy and forms of violent masculinity, pointing to the otherwise ambiguous facets of general patriarchy, which in Swaziland endures as part of everyday life and “Swazi Culture.”
It’s a pity – NERCHA
The National Emergency Response Council says it is a misfortune that the Soka Uncobe campaign may have not emphasised the use of a condom even after a person had circumcised.
NERCHA Head of Communication Mandla Luphondvo said it was scientifically established that circumcision needs to be used with other HIV prevention approaches, such as.
“It is a sad pity that this message did not seem to have come out clearly from the slogan – Soka Uncobe,” Luphondvo said.
He nonetheless defended the campaign, saying even though there was no problem in critiquing a campaign, it was however more important to look at why campaigns are there in the first place.
He said campaigns were there to inherently push for a particular urgent action that needs to be taken by individuals or society as a whole.
“Secondly, campaigns involve having a conversation with society, persuading people to take an unusual interest in supporting a move that would not normally happen. Thirdly, campaigns seek to lower barriers against action and increase incentives to take action. Soka Uncobe sought to identify and address barriers to the uptake of circumcision services,” said Luphondvo.
Since a campaign is a conversation, he said, prospects of misinterpretation cannot be ruled out, instead there is need to look at the bigger challenge and the accruing benefit for every campaign so as to give a fair assessment.
“Soka Uncobe, Accelerated Saturation Initiative, was meant to scale up levels of circumcision, with good reason. One of the drivers of HIV in Swaziland is low circumcision levels. Circumcision reduces – but doesn’t eliminate – the chances of contracting HIV, by at least 60 percent. Given that the country has adopted combination prevention approach to HIV, no one intervention is a magic bullet,” explained Luphondvo.
He said overall the initiative was never a bad programme and that additionally, it attempted to achieve high national male circumcision coverage within a short period.
He listed the numerous benefits of the initiative to be as follows:
1. It got Swazi society to talk openly about sexuality issues and transmission of HIV. The national strategy on HIV and AIDS speaks of taking HIV and AIDS out of seclusion, and the campaign contributed towards doing just that.
2. There were several cases of women who actively participated in the campaign by encouraging their partners to circumcise. In some instances, they physically accompanied their partners, and further provided support during the six week healing period.
3. There has been full integration of male circumcision into a majority of public hospitals, health centres, clinics and non-governmental organisation-supported sites and mobile facilities. This means the service is readily available as one of the standard services in health facilities.
“Additionally, the idea of “conquering” in the message “Soka Uncobe” does not speak to the sexual act but is to be understood in the context of the campaign – specifically what it sought to do – reduce the chances of HIV infection. And “lichawe” (hero) in the context of the campaign refers to somebody who has taken action to protect himself and those around him. Once it is taken out of that context, there is no telling what else we could make out of the same messages,” Luphondvo said
Soka Uncobe - which translates to "circumcise and conquer" - is a social and behaviour change communication (SBCC) campaign in Swaziland designed to achieve 80% coverage of voluntary medical male circumcision in the adult male population within a one year period. The overall approach is based upon understanding existing perceptions, identifying motivators, and eliminating barriers. The campaign conducted awareness and advocacy with royalty, traditional leaders, unions, businesses, religious groups, schools, and government to create awareness of and understanding of MC, using interpersonal communications, mass media, especially radio, and educational print materials. The project was a collaboration between the ministry of health (MOH), Swaziland National AIDS Programme (SNAP), National Emergency Response Council for HIV/AIDS (NERCHA), Population Services international (PSI), and Pulse.
The overall approach of Soka Uncobe was based on understanding existing perceptions, identifying motivators, and eliminating barriers relating to male circumcision and HIV in Swaziland. Within the programme, the communications team worked to build awareness about male circumcision (MC) and improve access to services throughout the country.
Soka Uncobe implemented three focused initiatives, as guided by a communications consultation in April 2011 and documented in their SBCC Field Guide.
n The first was a partnership with the Public Sector HIV/AIDS Coordinating Committee (PSHACC) to develop and implement action plans on MC for each ministry within the Government of the Kingdom of Swaziland (GKOS). Ministries implemented their work plans with support from Soka Uncobe.
n The second initiative was the Back To School campaign, a partnership with the ministry of education (MOE) to focus on school aged boys for circumcision. In mid-August 2011, schools in Swaziland went for a Term Two break. With guidance from the MOE, Soka Uncobe launched a sensitisation, advocacy, and messaging workshop series for all four regions. Workshops in each region started with the 1) Regional Education Officers, followed with 2) Head Teachers and the chairpersons of school committees (parent representatives) and completed with the training of the 3) Career Guidance teachers. The guidance teachers, with the help of head teachers, led the messaging with the students and were responsible for the registration of male students for circumcision for the Soka Uncobe school campaign in July and August. During the campaign, mass media produced targeted information, education and communications (IEC) materials highlighting the clinics supporting the campaign. These were distributed prior and during the period of the school break. Radio spots highlighted teachers and students who were engaged with Soka Uncobe, mothers voicing protection for their sons, and leadership encouragement. A press conference between the MOH and MOE was held to further motivate the community to engage in male circumcision services during this campaign.
The third initiative was the regional waves, which followed the endorsement of male circumcision by His Majesty King Mswati III on July 15, 2011. Following the Soka Uncobe launch by King Mswati III, a follow up meeting was held with the Regional Administrators for the four regions. The regional administrators directed the Soka Uncobe team to connect with the chiefs directly. Soka Uncobe put together Advocacy Response Teams, consisting of a nurse, counsellor, interpersonal communications agent and promoter, and a driver to meet with chiefs and their chiefdoms in structured community engagements.
Source: C-Hubonline website and K4health website