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Data from around the world suggests that men are less likely than women to seek and use health services and tend to be sicker when they finally seek medical help. In South Africa, about a third of new HIV infections in 2019 were among men, while more than half of HIV deaths were among men.

It’s a long-standing question that many health experts grapple with: How do you get more men to seek health services? One solution currently being tried in the Western Cape is a male-only clinic.

The Metro Men’s Health Center at Karl Bremer Hospital in Cape Town was officially opened in November last year as part of “Movember”.

It is high time that men put their health first, says Dr Saadiq Kariem, chief of operations in the Western Cape health department.

“This problem of men reluctant to get tested or see a doctor must end.

As men, we must put our health first. Men should use the center, not only for screening for chronic diseases like HIV and tuberculosis, but also for activities like screening for prostate cancer, ”says Kariem.

For men by men

“The facility, the first of its kind in the Cape Metro, aims to empower boys and men to lead healthy lives and will be a one-stop-shop for wellness and chronic disease screenings, preventive interventions. of HIV, treatment of sexually transmitted diseases and offering medical male circumcision, ”says Dr Abdul Sungay, who heads the center.

Sungay says most men prefer one-stop health care, and men often prefer to disclose their issues to a male health professional, with the idea that “men understand men.”

“It creates a safe and comfortable space where the client can share their health concerns. In 2016/2017, the management team of [the] Western Cape Health Northern and Tygerberg Substructure

saw an opportunity to support men’s health services, when Karl Bremer Hospital made unused infrastructure available for [use]Sungay says.

The space used for the center was previously used as a cold chain warehouse, but has now been transformed into a men’s wellness center, with rooms for counseling, screening, surgery and follow-up.

VMMC Booster

One of the services offered at the new center is voluntary medical male circumcision (VMMC).

VMMC is reducing the risk of someone contracting HIV, and some experts believe the country’s VMMC program has helped reduce new HIV infections in recent years.

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VMMC’s deployment in the Western Cape has lagged behind other provinces. It was launched at 14 facilities and the Goodwood Correctional Center in the Northern and Tygerberg substructure in June 2011.

The goal was to prevent and reduce new HIV and sexually transmitted infections (STIs) by 50% between 2011 and 2015.

“Medical male circumcision services were limited because they were not available on a daily basis in our health facilities. This has been identified as a limiting factor why men do not have access to these services in our region, which has ultimately led to misuse of men’s health services as a whole. When we reviewed the program in 2015, accessing men’s health services was still a challenge. It was clear that although men wanted to take responsibility for their health, these services were not readily available to them, ”says Sungay.

Sungay says they employ seven staff at the facility and see an average of 10 to 15 patients per day. He adds that they can perform at least 10 VMMC procedures per day.

According to the latest estimates from the Thembisa model, the main mathematical model of HIV in South Africa, around 40.9% of men aged 15 to 49 have been circumcised in the Western Cape. Of the country’s nine provinces, only the North Cape at 37% has a worse record.

Six of the nine provinces circumcised more than half of the men and boys in this age group.

Other services

In addition to VMMC, other services offered at the center include:

• wellness screening and counseling – to identify and reduce any risk of chronic disease (hypertension, diabetes, etc.);

• Screening for prostate cancer to promote early diagnosis and treatment;

• HIV / TB and STI testing to promote early diagnosis and treatment;

• Promotion of health education and awareness of men’s health issues;

• Distribution of condoms; and

• Vasectomies.

Vasectomies, Sungay says, are not yet operational but will hopefully be available soon.

While the new center targets men more broadly, Cape Town has had the Health4Men clinic for more than a decade, which specifically targets men who have sex with men. In 2018, Spotlight reported on funding cuts that threatened Health4Men’s operations.

Responding to a question about whether the services offered at the new center include services for gay and bisexual men, Sungay says it is a stigma-free clinic open to all men who need health services. .

“We do not discriminate [against] people [based on] gender, sexuality, race or culture. We try to offer services tailored to the needs of our clients, which include members of the LGBTQ + community. “

“The word is circulating”

“Since opening this site a little over two months ago, we have seen an increasing number of people come for HIV testing and prostate exams. We do our best to advise our clients on the benefits of circumcision and several clients have returned for this. A lot of our clients over the past month have been referred by a friend, so the password, ”he says.

Due to the pandemic, Sungay says customers are reluctant to visit health care facilities.

“However, we are spacing out our appointments so that we can adhere to all Covid-19 protocols and precautions. We encourage all men in the metro to make an appointment, especially if they have concerns about themselves, their body or their health. Appointment systems help us ensure minimal wait times and anticipate the type of service needed, ”says Sungay.

Reception of the men’s health center

The men’s sector coordinator at the SA National AIDS Council, Mbulelo Dyasi, says chronic diseases such as tuberculosis and HIV are prevalent in many households, often because men refuse to be screened or tested.

Welcoming the opening of the Men’s Health Center as a long overdue initiative, Dyasi says it will go a long way in encouraging men to take their health seriously and change their behavior and attitude towards taking charge of their health. .

“We fully support this type of initiative and in fact, since 2008 when we launched the Brothers For Life campaign, we have been advocating this type of service. The men in our communities have long called for clinics that focus specifically on them, ”he says.

“First of all, remember that it is quite embarrassing for men to admit that they have sexual problems. They didn’t talk about their sexual problems, even to their own friends. And, for example, there are some very sensitive issues like erectile dysfunction and penis size that most men face that need a health manager who will treat them with sensitivity and understanding. they deserve, ”says Dyasi.

“Traditionally, our fathers discouraged us from going to the clinic. A clinic is often seen as a place [for] women. And as such, most men claim to be strong and that they can take it even if it is painful. So they end up using traditional medicine or even healing themselves instead of going to the clinics. Long queues also discourage men. They see it as a waste of time because they want to go and fight for their families. Now facilities like this will play a critical role, ”he says.

Dyasi says they always encourage open dialogue in families that can help fight “superhero syndrome”.

“It starts in our own families where wives and children can start saying ‘daddy / honey you don’t look well, let’s go see a doctor.’ The importance of having regular check-ups in families is also something we stress all the time. It must be a family culture that after a certain period of time we all pass checks as a whole family, ”says Dyasi.

Garron Gsell, managing director and founder of the Men’s Foundation of South Africa, says that with data showing that men on average have a shorter life expectancy than women and die more often than women from preventable causes, there is a need to create more such centers across the country.

“This men’s center can be used as a good example that can help deploy more centers,” says Gsell.

* This article was produced by Projector – health journalism in the public interest

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