Y-1-xtulepinoy Report

 

Reynaldo O. Joson, MD

January 17, 2003

 

2002 was Y-1-xtulepinoy.

 

Xtulepinoy is an advocacy against routine circumcision in the Philippines.

 

The advocacy officially started in April 25, 2002 after the business meeting of the Department of Surgery of Ospital ng Maynila Medical Center (OMMC).  In that particular meeting, after extensive and comprehensive presentation of the pros and cons of routine circumcision by Dr. Hazel Turingan and Dr. Janix de Guzman, the following policies were adopted by the Department of Surgery of OMMC:

1.        The Department will NOT include Operation Tule in its Operasyon Pinoy (in-house surgical mission).

2.        The Department will NOT conduct "circumcision" missions within or outside the hospital.

3.        The Department will discourage routine circumcision. It will perform circumcision only when indicated such as recurrent urinary tract infection with phimosis (abnormally small opening of the foreskin).

4.        If circumcision is performed, the procedure should preserve the frenulum. The procedure can be a dorsal slit or at most trimming part of the foreskin but with preservation of the frenulum.

5.        The Department will conduct public health education on the myths and facts of circumcision as part of its social responsibility program.

The discussion on circumcision was actually triggered by a request from the Metro Manila Chapter of the Philippine Society of General Surgeons (PSGS) to conduct Operation Tule in OMMC.  The request was politely turned down with the following reasons (quoted from the official reply letter):

 

  1. We have a year-long schedule of surgical missions known as Operasyon Pinoy in our hospital.  We want to make effective and efficient use of our limited resources.
  2. We do NOT include Operasyon Tule in our Operasyon Pinoy Project because it does NOT fall within the concept of the social responsibility program of our Department and there is an emerging global clamor against routine circumcision.  We do NOT want our Department to be accused of propagating the myths on circumcision.  We are presently conducting an in-depth study on the issue.

 

In 2002, advocacy efforts and initiatives were mainly along the line of promoting public as well as physicians’ awareness that routine circumcision is not necessary.

 

Publications in dailies:

 

  1. May 23, 2002, Philippine Daily Inquirer – Circumstitions – by Dr. Mike Tan (Pinoy Kasi)
  2. May, 2002, Manila Bulletin – Is circumcision in males necessary? Dr. R. Joson
  3. June 14, 2002, Philippine Daily Inquirer – Case of rite of passage to manhood – by Dr. Raffy Castillo (Medical Files)
  4. June, 2002, Abante – Dr. Margie Holmes
  5. June, 2002, Abante – Dr. Roberto Zaide
  6. October, 2002, Family Reader – The Unkindest Cut – by Ms. Nina Gamboa
  7. November, 2002, Medical Tribune – Surgeon group campaigns against routine circumcision – by Mr. Eric Santos
  8. December, 2002, Health Today – Surgeons campaign against routine circumcision – by Mr. Eric Santos

 

Hand-outs (Is circumcision in males necessary?) given to members of City of Manila Council, May, 2002.

 

Official stand of groups of physicians sought for.

 

  1. The Department of Family and Community Medicine and the Department of Pediatrics of OMMC have a stand against routine circumcision.
  2. The Philippine College of Surgeons and the Philippine Urological Association have a stand through the opinions of three pediatric urologists in the country – routine circumcision should not be advocated.

 

Talks

August 30, 2002, Postgraduate Course of the Department of Family and Community Medicine of OMMC – Tule or Not Tule? Dr. R. Joson

 

Letters to school physicians

November, 2002, letters were sent to 11 school physicians in Metro Manila inquiring whether circumcision is a requirement for enrollment in their schools.   Only 1 responded.

 

Hand-outs to parents and school teachers who are patients of Dr. R. Joson

 

Radio Program

                  Dr. Marissa Lim of Zamboanga City

 

Website, established in June, 2002, http://xtulepinoy.tripod.com

 

Email broadcasting

                  Egroups (edhedephi@yahoogroups.com; upcm74@yahoogroups.com;

etc.)

 

 

 

Informal assessment of outcome of 2002 advocacy efforts and initiatives:

 

1.        At least the 3 pediatric urologists gave their opinions in support of the advocacy.

2.        At least some lay people now realized that circumcision is not a must afterall.

 

                                     

 

Plans for 2003: More advocacy efforts and initiatives to start January, 2003

 

Targets:

Less Operation Tule, if not zero

Less routine circumcision, if not zero

Less neonatal circumcision, if not zero