programme as compared to the published standards such as those obtained in randomised control trials or the model” of 1.8% described by Lissouba et. Al (ibid) using “Roll-out the conventional FG technique. It is possible to say provisionally at this stage, even given the limitations of the adverse event follow-up only being limited to 5 days, that the reported adverse event rate of the TCD approach being used in KZN (1.5%), is many orders of magnitude lower than the alarmingly high rate of 37% reported by Legarde et al in their and feared by the TAC and Media. It is very similar, and possibly even lower than the adverse event rate achieved in the major RCTs undertaken in Africa (2.7%). undoubtedly there have been some adverse events in the KZN MMC programme, as would be anticipated in a mass circumcision of this scale, describing the outcomes as would appear to be excessive and not based on the evidence from the “mutilating” Province. However, given the limitations of the Retrospective analysis, it is hoped that information from the Concurrent cohort where there has been closer independent scrutiny and an intended six week follow up of the results, a more accurate picture of the adverse events rate for KZN MMC programme may be possible. In summary, at this provisional stage Adverse events and comparison with the clinical outcomes in the KZN MMC programme have focussed on the immediate and intermediate term. There has been no attempt to document the late surgical complications of the procedures after one month either using the TCD or FG approaches; Given the available records, the severity of the complications of the different procedures, TCD or FG, in terms of additional medical treatment, referral for specialist treatment and the duration of treatment seem comparable; The records thus far provide no insight into the educational or cultural activities associated with the MMC to assess the extent to this might contribute to future gender sensitivity and sexual practices; From a formative assessment perspective there do not seem to be grounds to believe that the KZN MMC programme is grossly unsafe. Although there is undoubtedly
programme as compared to the published standards such as those obtained in randomised control trials or the “Roll-out model” of 1.8% described by Lissouba et. Al (ibid) using the conventional FG technique. It is possible to say provisionally at this stage, even given the limitations of the adverse event follow-up only being limited to 5 days, that the reported adverse event rate of the TCD approach being used in KZN (1.5%), is many orders of magnitude lower than the alarmingly high rate of 37% reported by Legarde et al in their and feared by the TAC and Media. It is very similar, and possibly even lower than the adverse event rate achieved in the major RCTs undertaken in Africa (2.7%). undoubtedly there have been some adverse events in the KZN MMC programme, as would be anticipated in a mass circumcision of this scale, describing the outcomes as “mutilating” would appear to be excessive and not based on the evidence from the Province. However, given the limitations of the Retrospective analysis, it is hoped that information from the Concurrent cohort where there has been closer independent scrutiny and an intended six week follow up of the results, a more accurate picture of the adverse events rate for KZN MMC programme may be possible. In summary, at this provisional stage Adverse events and comparison with the clinical outcomes in the KZN MMC programme have focussed on the immediate and intermediate term. There has been no attempt to document the late surgical complications of the procedures after one month either using the TCD or FG approaches; Given the available records, the severity of the complications of the different procedures, TCD or FG, in terms of additional medical treatment, referral for specialist treatment and the duration of treatment seem comparable; The records thus far provide no insight into the educational or cultural activities associated with the MMC to assess the extent to this might contribute to future gender sensitivity and sexual practices; From a formative assessment perspective there do not seem to be grounds to believe that the KZN MMC programme is grossly unsafe. Although there is undoubtedly