HIV Loosens Tribe's Resistance to Circumcision

The program initially would focus here in western Kenya's Luoland. Existing clinics and youth centers could begin offering services as soon as early next year, and mobile teams would use vans to visit churches, markets and beaches where fishermen work, offering free circumcisions with sterile surgical kits they would bring along.

Kawango Agot, a circumcision researcher and herself a Luo, said the effort is likely to be popular. In a survey she and Bailey conducted, 60 percent of Luo men said they would like to be circumcised because they believed it was cleaner and healthier. The percentage was highest among those younger than 25. She called the cultural concerns overblown.

"Sincerely, I just don't care," Agot said. "What I care about is people are dying."

Fear and Education

Luos long have faced discrimination for not circumcising their sons. Members of other Kenyan tribes sometimes refused to vote for Luo politicians on the grounds that they had not become adults. Luos who traveled far from their homeland were mocked with a variety of cruel nicknames, such as "Kehe," which translates literally as "uncircumcised" but to Kenyan ears means "boy."

Meshack Riaga Ogalo, the 73-year-old leader of the Council of Luo Tribal Elders, said the true source of high rates of HIV in the tribe, which is one of Kenya's largest with a population of about 4.5 million, is not the lack of circumcision but the abandonment of traditional culture, especially by fishing communities.

"Nowadays, because of Christianity and all kinds of civilization, you introduce something like love affairs. The world is now horrible," said Ogalo, who favors a walking stick and black cowboy hat. "We don't want foreigners to interfere with our culture. It is absolutely wrong."

Lake Victoria's fishermen, following the winds, often kept girlfriends at several different beaches. The men generally were among the few in villages with steady supplies of cash, arriving home each day with $10 or $20 -- sometimes much more -- in areas where many earn less than $1 a day.

"With the fishermen, you can't trust them," said Mary Achieng Bunde, 41, a former fish trader and an AIDS activist whose husband died of the disease.

Of the women who trade in fish, she said, sexual favors were expected and generally granted. "Most of them, they are ready to do because maybe your husband has died, your children have school fees. . . . What can you do?"

She said attitudes are changing on the beaches because of fear and aggressive education programs. More fishermen are living in family houses, with their wives and children, rather than in communal dorms. The carousing has quieted as the toll of AIDS has grown.

Yet she suspected that circumcision would require a degree of change beyond what most fishermen would accept. "It will not be easy for them, because it is not our culture," she said.

Abandoning Tradition

Less than a mile away, down on the soggy, grass-covered beach where Bunde once bought fish, a new generation of fishermen has taken over. Erick Onyango Otieno, 21, called circumcision "a good idea" and said younger fishermen did not want to make the mistakes of the previous generation.