Neil Pollock, flashing the tools of his trade
In a recent article on the Jewish Independent, Neil Pollock expresses his intentions to fly to Haiti, with the goal of proselytizing doctors there, training them to perform circumcisions, hoping those doctors will train other doctors in the region, and that thus, that circumcision will flourish under the guise of HIV prevention. A very lovely thought, if you're a stark Jewish advocate of infant circumcision, or if you're a doctor whose main source of income happens to be infant circumcision (Neil Pollock happens to be BOTH), but is this endeavor feasible? Practical? Realistic? Based on sound evidence? Honest?
Are Neil Pollock's intentions based on a genuine concern for public health? Or is this nothing more than a PR project to redeem infant circumcision by making it relevant to medicine? After all, it looks real good for your business to go to other countries training doctors in infant circumcision under the guise of medicine, if you happen to be a doctor who makes a living entirely from infant circumcision. Not to mention the fact that Pollock also happens to be a Jewish mohel, is affiliated with other mohels, not to mention other Jewish physicians that promote infant circumcision as medicine, where ritual infant circumcision is seen as divine commandment.
Male infant circumcision has been increasingly under fire from human rights groups, not to mention the recent herpes scandals in New York, and the latest developments in Europe zeroing in on infant circumcision.
So is this about HIV prevention?
Or about the continuous fight for Jews and gentile circumcision doctors to redeem the dying practice of infant genital mutilation?
It is difficult to get a man to understand something, when his salary depends on his not understanding it. ~Upton Sinclair
I'm going to go through the Jewish Independent article on this blog post and post my insights about it bit by bit.
The headline is already dubious, as it starts with a definite claim:
Vancouver doctor will train physicians in Haiti in circumcision
If one reads the article to the end, one realizes whether or not Pollock flies to Haiti depends on whether or not he can collect funding for his project. So the headline would be more accurate if it read something more like "Vancouver circumcision doctor asking for funds to train physicians in Haiti".
Begins the article:
"Dr. Neil Pollock specializes in circumcision, from newborn to adult, and adult vasectomy."
This is the first time I've heard of Pollock "specializing" in anything other than newborn circumcision and adult vasectomy. To my knowledge, he is first and foremost a mohel, who doubles as a circumciser of gentile newborns on the side. I guess he's trying to make more money now?
"As a leading expert in circumcision, he has traveled around the world to train physicians and, this summer, he will head to Port-au-Prince, Haiti, to teach a team of doctors in medical newborn and infant circumcision."
Not if he doesn't raise enough funds, he won't...
Now let's look at that first sentence; "...he has traveled around the world..." I know he went on a circumcision tour in Rwanda once, but I haven't heard of him going anywhere else... A rather modest exaggeration if I do say so myself...
“'After carrying out 50,000 infant circumcisions and traveling recently to Turkey, China and Africa to exchange ideas, I have evolved my technique to make it applicable to infants, children, teenagers and adults,' Pollock told the Independent in a recent interview."
The story changes a bit here. So he HAS traveled "around the world." He has traveled to Turkey, China and Africa "to exchange ideas," but that's slightly different than "to train physicians." Rather wishy-washy here.
But here we read that Pollock has "evolved his technique." He attempts to sound so matter-of-fact and so sure of himself, and most people reading this would be forgiven if they believed that Pollock came up with something totally new, unique and original that only he could do. Not mentioned here is his so-called "technique," which, if people cared to investigate, is nothing more than a glorification of the Mogen clamp technique, which is in and of itself, a circumcision method that dates back hundreds of years.
I'm sitting here asking myself... Pollock isn't actually using a Mogen clamp to circumcise children, teenagers and adults, is he?
“I have developed a technique to do circumcision in this older age group under local anesthetic without using sutures and using, instead, a cyanocrylate skin glue that closes the wound. Being able to do the procedure under local anesthetic and with skin glue instead of a general anesthetic in hospital provides for a much simpler, easier, quicker, safer and improved cosmetic outcome for patients.”
Here, Pollock is trying to sound "new" and "innovative." Let's not forget that circumcision is a few thousand years old.
Not addressed here are the questions of, why are children and teenagers being circumcised? Were these circumcisions medically necessary? Or were these healthy minors being forcibly circumcised at the whim of their parents?
Without medical or clinical indication, how is it doctors like Pollock are performing surgery on healthy, non-consenting minors, let alone be giving parents any kind of "choice?"
Maybe what he does is "much simpler, easier, quicker, safer," etc., but isn't reaping profit from performing surgery on healthy, non-consenting individuals the epitome of medical fraud?
Let's ask a different question; would female circumcision ever be justified if someone came up with a "simple, easy and safe" way to perform it?
"This method, he said, is unique. 'I’m unaware of this approach being used anywhere in [Canada] except in my clinics. The older age group is currently requesting circumcision for reasons like reduction in disease transmission, preference of their partners and improved hygiene.'"
What about the younger age group? Are they requesting it? Or is he performing circumcision on them against their express wishes?
"In 2008, Dr. David Patrick was the head of the B.C. Centre for Disease Control. Pollock said he was asked by his colleague “to teach my surgical techniques for circumcision in Rwanda, where they were using scissors and stitches, without anesthetic, and their surgeons desperately required training in an alternative quick, safe and painless infant circumcision technique that would be accepted by their population. In coordination with their surgeons, I planned with my team a five-day surgical training mission that year and flew to Rwanda. I have been in contact with these surgeons by email since my trip and they have informed me that they are using my technique effectively and safely throughout the country now."
Here, Pollock toots his own horn; he tries to make his "work" indispensable. Towards the end of my post, we will look at another circumcision technique which basically makes Pollock and his "new and improved techniques" obsolete.
“'The impact of our humanitarian effort became known in the international medical community, which led to Dr. Jeffrey Klausner, professor at [the University of California, Los Angeles] Medical School, contacting me recently and asking me to essentially replicate the work I did in Rwanda, but this time in Port-au-Prince, Haiti, where they are being overwhelmed by the number of patients requiring treatment for AIDS and would receive huge benefit from introducing a preventative strategy to reduce AIDS transmission, such as infant circumcision, which will reduce the risk of their circumcised infants later contracting AIDS when they hit sexual age, by over 60 percent.'"
This sounds rather fictitious to me!
I'd be interested to know who this Jeffrey Klausner is, what his religious affiliations are, and whether or not he had any affiliations with Pollock prior to his so-called "humanitarian effort." Methinks Klausner is nothing more than another circumcision enthusiast, trying to look for venues to take advantage of to push circumcision, particularly infant circumcision.
Who IS Klausner? And does he also just "happen" to have ties with Edgar Schoen?
I have a hard time believing that Pollock was such a prominent figure in the international medical community a man in UCLA just "happened" to take notice. Klausner might not happen to have any affiliations with Arleen Leibowitz, who is working to try and restore Medicaid coverage in states that no longer pay for infant circumcision, does he?
A quick Google search reveals that Klausner has published with circumcision "researcher" Daniel Halperin, another circumcision advocate in Africa who wants to make circumcision as HIV prevention his legacy. (Halperin also happens to be Jewish and is quoted saying he wants to make his mohel grandfather proud.) He has also published with Australian circumcision enthusiast Brian Morris, whose reputation we all know about. Klausner has been "researching" was to increase circumcision in India and elsewhere. Is it really any wonder that Pollock and his "work" caught his eye?
No, this was no coincidence; all of these so-called circumcision/HIV "experts" know each other and sniff each others rear ends. I don't believe for a second that Klausner contacted Pollock "out of the blue," asking for his "assistance." They're probably on each other's contact lists and sat around on Skype or Facetime brainstorming the whole thing. They must look at every country with HIV prevalence and sit around thinking "How can we make circumcision part of the picture?"
For the record, there is simply no evidence whatsoever that infant circumcision has any effect on HIV transmission. Additionally, there is no scientifically demonstrable causal link between male circumcision and reduced HIV transmission. Unproven and disproven theories abound, but it cannot be demonstrably shown that circumcision reduces HIV transmission at all, let alone by the fabled 60%.
Interesting fact; according to American circumcision pundit Edgar Schoen (good friends with Pollock), 80% of US males are already circumcised from birth. And yet, according to the CIA Factbook, we have a higher HIV prevalence rate than 53 countries where circumcision is rare (below 20%) or not practice. The United States has a higher HIV prevalence than MEXICO.
"'Its impact and effectiveness has been referenced metaphorically to be like a vaccine.' Circumcision, he added, 'works to reduce AIDS by removing the portal of entry of the virus, which is the foreskin.'"
Referenced by WHOM?
And here, we have Pollock spewing an unproven, if not disproven theory as matter-of-fact. It simply cannot be demonstrated under a microscope that the foreskin facilitates HIV transmission, nor that removing it reduces it. Actually, the Langerhans cells, which have been indicted as "the main port of entry" for HIV have been shown to actually effectively destroy the HIV virus. Pollock is hoping to ride the HIV gravy train to redeem infant circumcision, to which he has religious convictions, and to promote his business.
"Klausner, a professor of medicine in the division of infectious diseases and the program in global health at UCLA, is an advocate in the use of medical male circumcision for the prevention of sexually transmitted diseases and HIV. He volunteers with GHESKIO, an organization run out of the Centre for Global Health at Weill Cornell Medical College in partnership with the Haitian government. Operating primarily in Port-au-Prince, their work is supported by Haiti’s first lady and has a mission to combat HIV and improve conditions of maternal and child health. GHESKIO will host Pollock’s training in Port-au-Prince."
It will be interesting what more information I will find on this Klausner fellow and this GHESKIO. A question that rises in my head is, if Pollock is to be hosted by GHESKIO, why is Pollock asking for funds? Are there not enough funds at Weill Cornell or the Haitian government?
"Raised in Winnipeg, Pollock explained that he decided to become a doctor 'because I had a strong interest in sciences, medicine and surgery from a young age.'"
Really? As someone raised in the Jewish faith, he wasn't interested in brit milah first, and vindicating it through medicalization second? It makes me wonder, what is his area of focus? Urology? Does he treat penile problems? Or is cutting up babies and neutering men all he does for a living?
"Early in his career, he decided to create a special focus on circumcision and vasectomy, and built a highly focused practice and a well-tested – and respected – technique."
"Respected" by whom?
What is this "technique," and did he actually come up with it?
Answer: He is using the Mogen clamp technique, and it is not his own original idea. The Mogen company has been put out of business by million dollar circumcision mishap lawsuits it couldn't afford to pay. The Mogen clamp is notorious for partial or full glans amputations, even in the hands of skilled practitioners.
A common mishap in the Mogen clamp circumcision method
is that part of, or all of the glans gets pulled up into the clamp,
resulting in the partial or full ablation of the glans penis.
Will one week of training provide enough experience to prevent these injuries? And if it isn't, are hospitals in Haiti equipped to deal with these life altering complications?
"'My interest in developing a safe, quick and painless approach to circumcision for the medical community in B.C. arose initially from some of the rabbis approaching me approximately 20 years ago and encouraging me to become a mohel in Vancouver,' Pollock said."
I'm sure it did not arise because he's Jewish and he has a religious conviction to defend circumcision. And I'm sure this has nothing with wanting to cash in on the business of mutilating the genitals of healthy, non-consenting minors.
"The benefits of newborn and infant circumcision are many, but the rates of the procedure vary from region to region, and remain contentious to those opposed to what’s seen as elective (non-consenting) surgeries for babies"
The "benefits" have not convinced a single medical organization in the world to recommend infant circumcision. Circumcision in healthy, non-consenting minors IS elective, non-medical surgery.
"Pollock noted, 'The most important change recently in how the medical community has come to view circumcision is expressed in the … consensus statement from the American Academy of Pediatrics released in late 2012 declaring that ‘the medical benefits of infant circumcision outweigh the risks.’ This is the strongest statement of support ever issued by the American Academy of Pediatrics.'"
Though the AAP tries to make the claim that "the benefits outweigh the risks," it falls short of a recommendation. (Not to mention it was formally rejected by 38 pediatricians, urologists, epidemiologists, and professors, representing 20 medical organizations and 15 universities and hospitals in 17 countries.) But Pollock will not be telling us that.
"'The benefits of circumcision are multiple; they include reduction in the risk of urinary tract infection, which can lead to kidney infection and renal failure (How common is UTI, and furthermore, these complications? When and if they occur, are there non-surgical intervetions?), reduced risk of cancer of the penis (Which is already quite rare at approximately 1 in 100,000 males; according to the American Cancer Society, 1 in 6 US males will be diagnosed with prostate cancer annually. They also do not recommend circumcision as a way to prevent cancer by the way...), cancer of the cervix in partners (...for which there are already effective vaccines), reduced risk of balanitis (which is a [rare] infection of the foreskin), and other foreskin-related problems, like phimosis (Which is already rare, and does not always require surgery for treatment).' As well, circumcised males also experience a 'reduction of multiple sexually transmitted diseases, like HPV, herpes and AIDS transmission. The latter is exponentially more important in places like Haiti and Africa, where a large number of the population has AIDS in comparison to other regions of the world where AIDS is less common.' (According to USAID, HIV was more prevalent among circumcised men in 10 out of 18 countries. Real world data shows that circumcision does not correlate with a lower HIV prevalence rate.) Possible risks include 'bleeding and infection,' he added, 'but, in experienced hands (Like his, right?), risks are extremely low.'
After all is said and done, no medical organization recommends infant circumcision. All of them, including the AAP, say that the "benefits" are simply not great enough.
"Rwanda and Haiti share a history of national trauma, which has led in both countries to poor health outcomes. In 1994, at least 800,000 Rwandans were massacred by their countrymen in a genocide. In 2010, Haiti, already the victim of more than two centuries of extreme poverty, dictatorships and U.S.-led military interventions, experienced a 7.0 earthquake that resulted in the deaths of more than 100,000, and displaced 1.5 million of the tiny country’s 10 million people. Since then, Haitians have been hit by serious outbreaks of preventable disease, including cholera, tuberculosis and AIDS. According to the United Nations, life expectancy is 61 years for men and 64 for women."
Poor, poor Haiti... Let's circumcise them and worry about feeding them and improving conditions for them later!
"The health challenges that Haitians are very similar to those experienced in Africa, and the training is seen as critical in addressing those obstacles. 'Like there was in Rwanda, there is a need to train surgeons in Haiti to carry out a quick, safe and painless infant circumcision technique,' Pollock explained."
More like "Hatians are as vulnerable as the Rwandans, I know a good PR opportunity when I see one, and I need to be there to take advantage."
"'In regards to what accounts to gaps in circumcision rates, there may be a deficiency in trained surgeons to carry out the surgery in an acceptable manner, along with variations in social and cultural norms that influence the choice to have circumcision.'"
That Haiti's problems are attributable to "gaps in circumcision rates" and "deficiency in trained surgeons" and that "the social and cultural norms that influence the choice to have circumcision"(because having circumcision is the only acceptable choice?) are Pollock's own conjecture. Here, we see Pollock trying to justify and necessitate himself. Haitians "need" circumcision, and he's the man they should send to give it to them.
"The ultimate intention of the training, Pollock said, is 'to set up a national program accepted by the population, to introduce infant circumcision safely and effectively, and have it evolve to become a widespread practice throughout the country, thereby reducing the transmission of multiple diseases, including AIDS.'"
What he means to say, of course is that his ultimate objective is to proselytize Haiti, and to install infant circumcision as part of their culture, under the pretense of HIV prevention. He hopes to complete the training, and then be able to boast about it on newspapers, whatever the outcome. The training hasn't even happened yet; Pollock is asking for funds in this article, but he is already boasting the project as eminent.
"Pollock’s visit to Haiti will involve intensive training. 'My goal is to carry out a similar plan to what we executed in Rwanda. I worked with physicians there weeks ahead to set up a surgical schedule of 20-to-30 infants per day, over four-to-five days of operating. After working with doctors on models that I brought to demonstrate the technique and do the primary teaching, they moved to assist me with the surgeries and eventually carry them out under my supervision on the infants booked for circumcision.'"
He hopes to replicate in Haiti, what he did in Rwanda, but there is a huge difference; whereas circumcision is already a part of the culture in Rwanda and the rest of Africa, it is not part of the culture in Haiti, or the rest of the Caribbean. It has been very easy for circumcision advocates to get people on-board the circumcision gravy train in countries in Africa where circumcision is already prevalent as a cultural practice, but it is proving to be a challenge in areas where it is not; Swaziland, where the Soka Unkobe project failed to yield results, is a good example. Whether or not Pollock achieves the same results in Rwanda will remain to be seen; will he be able to convince enough Haitians to circumcise their newborns, enough to yield his 20-to-30 infants per day?
Here are some more interesting facts; while HIV prevalence rates are high in both Rwanda and Haiti (2.9% and 2.1% respectively) as well as a low prevalence of circumcision (less than 20%), the HIV prevalence rates in both of these countries are relatively lower than in Swaziland (HIV rate 26.5%) as well as other countries with higher circumcision prevalence (25-50%). Kenya and Tanzania, with circumcision rates of 84% and 70% respectively, also higher rates of HIV (6.1% and 5.1%).
And here's where it gets interesting...
"The training in Haiti, part of a nongovernmental public health initiative, will be partially supported by charitable donations."
In other words, it hasn't happened yet...
"The commitment from my end for Haiti will include a week away from my practice and the commitment to help raise the $25,000 for the mission to take place. The plan is to raise $25,000 from the Vancouver community in the next seven days or so as to be able to launch the teaching mission in Haiti by the end of the summer."
"If you build it... they will come..."
"'During the week in Haiti, I will train two physicians, who will then train other physicians once our team leaves. I will maintain follow-up with these physicians to help them manage any issues that should arise.'" The goal is to create a sustainable public health campaign and donated funds not only will go towards covering the costs for the week, but also for 'the next 500 infants once we leave.
Readers who would like to donate to the effort “will support an initiative, which will undoubtedly over the years save thousands and thousands of lives,” Pollock said. “It’s intended that Haiti will become a training centre for circumcision in the Caribbean. It is likely that my technique, once taught in Haiti, will soon be shared with multiple countries throughout the Caribbean, multiplying its effect to save lives throughout the entire region.'"
Tho goal is clear:
Pollock hopes to drop a circumcision PR bombshell in Haiti. He hopes this will start a brushfire, which will then spread to the rest of the Caribbean. He has pipe dreams that his little project will plant a seed that will flourish and that he'll be given credit for circumcising the whole of the Caribbean.
I like how he uses the term "saving lives" as a euphemism for getting everyone circumcised, as if circumcision actually did anything to prevent HIV; the sad reality is that circumcision does not, cannot prevent HIV transmission. Not a single doctor or "researcher" can deny this fact. It fails so terribly that circumcised men must still be urged to wear condoms if they want any real protection.
Pollock must be on crack; in Africa it's very easy to convince people in cultures where circumcision is already present, that circumcising their children as newborns is a good idea. What is more likely to happen is that he'll go to Haiti, he'll go back to Canada, and instead of flourishing his project would fizzle, because people would be horrified at the proposition of having the genitals of their children mutilated for dubious benefits no medical organization in the world deems sufficient. And what other Caribbean countries in the right mind would listen to Haiti for anything?
"'So, I’m asking readers and members of the community to reach deep and consider making a financial donation to help us raise $25,000 in the next [several] days to allow this mission to proceed.'"
So in short, this entire article can be summarized as thus; Pollock sees a circumcision PR opportunity in Haiti and he wants people and/or organizations to give him money to do it.
It ought to interest readers that Pollock went to Rwanda on the dime of the Canadian Institutes of Health Research, and the Shusterman Foundation, whose vision, by the way is "To help the Jewish people flourish by spreading the joy of Jewish living, giving and learning," and their mission is "ensuring vibrant Jewish life by empowering young Jews to embrace the joy of Judaism, build inclusive Jewish communities, support the State of Israel and repair the world."
At least for me, the question is, with financial guarantors like Shusterman Foundation, what is Pollock really up to? With this article published on a news outlet that primarily targets Jewish readers, what kind of donors is he hoping to attract for funds? My guess is that Pollock is hoping to attract monies from other Jewish advocates of circumcision, who share his vision of redeeming infant circumcision. Safeguarding a cherished tradition that is increasingly under public scrutiny (not to mention Pollock's main source of income) is the goal, and "saving lives" is the pretext.
Other questions arise...
So in this article, Pollock is both plugging himself, AND he's asking for money. Which leads to asking, if Pollock is performing so many circumcisions, why is he simply not flipping the bill himself? Pollock is trying to come off as if he would be doing the world a favor by traveling to evangelize circumcision in Haiti, but it doesn't sound like he could be too generous if he's basically asking to be reimbursed.
I have two theories:
a) With increasing intactivist activity in the US, and the latest developments in Europe, pickings are slim for him and other mohels, and he feels he should do a kind of PR tour. Since he's not making too much money, he needs the funds.
b) Having others pay his way is simply more PR for him; he can later claim that not only he was "asked" to go to Haiti (like I believe that), he was also given a full ride by "generous people in the international community" who wanted him to go to Haiti that bad.
But lastly, and here's the kicker, with the technological innovations the race to circumcise Africa has spawned, of what use are his "techniques" to circumcise older males? PrePex, for example, boasts a painless, bloodless technique to circumcise older males, which doesn't have to be performed by doctors. Why pay Pollock $25,000 to train doctors to perform cumbersome surgery when the money could be used for PrePex devices? (Not to mention that even if the latest "research" held any water, condoms would still be much cheaper, less invasive and more effective than circumcision?)
In short, given the new technology that doesn't require doctors, aren't Pollock's "techniques" pretty much obsolete?
Indeed, they are. But then Pollock couldn't take advantage of HIV-afflicted Haiti to PR infant circumcision, which is what actually matters to Pollock and his financial supporters.
Neil Pollock's conflicts of interest should be immediately obvious to anyone who investigates his background. He's not interested in HIV prevention or public health. He's concerned with staying in business, not to mention vindicating circumcision to which he has a religious conviction for. This is nothing more than a thinly-veiled circumcision crusade and Haitians ought to be put on alert. It is clear who would donate funds for him, and what their true intentions are.
"All abuse of babies is easier. They are powerless and history will judge us by how we protect the powerless." -Paul Mason, Commissioner for Children, Tasmania, Australia 2007-2010
Where Circumcision Doesn't Prevent HIV