MMC facts


Friday, 6 November 2015
Noordgesig Primary School circumcision incident – the Right to Care facts
1. The Fleurhof clinic where the primary school children went to for circumcisions is not a Right to Care site. It belongs to a private practitioner. Right to Care did not recruit the children nor provide transport. This was arranged by the private practitioner.
2. Right to Care helps to implement medical male circumcision (MMC) through training and technical assistance provided to private practitioners.
3. When Right to Care heard of the incident, it immediately suspended support of the Fleurhof clinic and investigated the matter.
4. The findings: All 144 circumcisions that were done at the site were done properly. All boys are healthy. 
5. The[KM1] issues were the private practitioner’s poor administration, poor communication and poor planning.
6. We support the concerns of the parents. Children should not be recruited from primary schools for circumcisions.
Why circumcisions are so necessary in South Africa
After many years of research, it has been proven that Medical Male Circumcision is one of the most important interventions to prevent the spread of HIV.
Circumcision reduces a man’s risk of contracting HIV by 60% and reduces the risk of getting sexually transmitted infections.
If a female’s partner is circumcised, it reduces her risk of cervical cancer.
More than 1.8 million circumcisions have been done in South Africa as part of the Department of Health’s HIV prevention strategy.
The Department of Health wants to ensure that 4.3 million males aged 15 - 49 are circumcised in five years. If this can be achieved, it will have a significant impact on the HIV epidemic by averting more than 1.2 million infections and it could save the country more than R48 billion in HIV-related healthcare costs.
For further information, please contact Michelle K Blumenau, Turquoise PR & Marketing Communications C 083 273 9891 This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Fleurhof Clinic

Statement on circumcisions at the Fleurhof Clinic

November 4, 2015
Right to Care is a non-profit, section 21 company that has an integrated HIV prevention programme, of which Medical Male Circumcision (MMC) plays an important role.  Right to Care has supported the Department of Health (DoH) in this initiative over the past four years and has completed over 500,000 MMCs, through this partnership.  Right to Care conducts circumcisions through staff seconded to the DoH.  Right to Care also has a private GP programme, where we contract private practitioners to conduct MMCs, through their practices.  The private practices work independently, but receive clinical and recruitment training and are required to meet clinical and reporting standards according to the World Health Organisation (WHO) and DoH guidelines.
A private practice in Fleurhof had a contract (subsequently revoked) as a service provider to conduct MMCs supported by Right to Care.  This practice received the required training and on-site inspections prior to commencing this service on the 2nd of October 2015. 
On October 16th, MMCs were conducted on boys from different schools of which all MMCs were safe and without incident.   The last group of boys that were scheduled to be circumcised on this day were from the Noordgesig Primary School.  
On the evening of 16 October 2015, Right to Care received a notification that the boys from this school were delivered home several hours late from the circumcision and the parents were not communicated with.  Right to Care immediately suspended operations at the site and investigated these claims.  An inspection of the site was conducted by Right to Care and the DoH, where no deficiencies were identified from a clinical standpoint.  
Right to Care also investigated the service provider, met with the school leadership, the parents, the DoH and the Department of Education.  The investigation established that the protocols for recruitment of boys in the correct target age group were not followed and that timeous communication with the parents did not occur.
The Fleurhof site was immediately notified that MMCs would no longer be supported by Right to Care and the service level agreement with Right to Care was officially terminated. This private provider did not meet Right to Care’s established requirements related to recruitment age, communication protocol and operational compliance. Follow-up meetings were conducted with all of the community stakeholders.  Clinical follow-ups were also made with all boys who underwent circumcisions.
Right to Care wishes to state that we have offered psychosocial counselling to the parents and the learners that were affected. This is ongoing and has included both group debriefing as well as one on one sessions. 
Right to Care wishes to confirm that all the 3 boys from Noordgesig Primary School who underwent circumcision are being actively followed by Right to Care clinicians as per the post circumcision protocol. All the boys are alive and well.
Right to Care is appreciative of the families which brought this incident to our attention so that it could be addressed and we continue to support the community and the families to ensure their concerns are heard and responded to. 
For further information, please contact:
Michelle K Blumenau, Turquoise PR & Marketing Communications C 083 273 9891 This e-mail address is being protected from spambots. You need JavaScript enabled to view it
New national guidelines
National Consolidated Guidelines
for the prevention of mother-to-child transmission of HIV (PMTCT) and the management of HIV in children, adolescents and adults
About Right to Care

Right to Care is a non-profit organisation (Section 21) that supports and delivers prevention, care, and treatment services for HIV and associated diseases.

Through technical assistance, Right to Care supports the Department of Health at national level. Support at provincial level is provided primarily in five provinces: Gauteng, Mpumalanga, Northern Cape, Western Cape, and Free State. In addition, through direct service delivery, Right to Care treats patients for HIV, TB, cervical cancer, and sexually transmitted infections.

Support for clinical programmes is delivered through development of clinical best practices, research, training, mentoring, participation in technical committees, provision of facilities and equipment, and secondment of staff, among others services.

Funding and revenue

The chief funding and revenue streams are:

  • The President’s Emergency Plan for AIDS Relief (PEPFAR), managed by USAID
  • Global Fund
  • Private-sector donors
  • Revenue from the private sector for provision of employee wellness services (through Right to Care Health Services)

HIV care and treatment

Right to Care’s Adult HIV and Paediatric HIV programmes support the clinical care and treatment of individuals infected with HIV and associated diseases. Care and treatment is accessible through an integrated model that includes prevention, transition into care, treatment adherence, and nurse initiated and managed ARV treatment (NIMART). Loss-to-follow-up is minimised using innovative approaches, such as automated text messages and patient transfers with electronic records.

On-site and didactic training are provided to clinicians in the public and private sectors. In each province, centres of excellence are hubs for mentoring and training and for referrals of complicated cases.

In its first ten years of operation, Right to Care initiated over 230 000 patients on ARV therapy.


Right to Care’s TB programme provides integrated TB/HIV services for both drug-sensitive and drug-resistant TB. Components of Right to Care’s TB strategy include use of the ‘‘3 Is’’: Intensified case finding; INH Preventative Therapy (IPT); and Infection control in health facilities.

TB symptom screening is done at all healthcare visits. Sputum induction facilities reduce by 10% the number of patients who cannot produce sputum, leading to improved testing rates.

Right to Care has spearheaded the use of the Cepheid GeneXpert MDR TB Rif for rapid diagnosis of TB and of drug resistance.
The diagnosis and management of Multidrug and Extensively Drug-Resistant TB is supported, in particular at Sizwe Tropical Diseases Hospital, Johannesburg. On an on-going basis, Right to Care collaborates in TB research studies.

Cervical cancer

At present, our most important weapon against cervical cancer is an effective screening and treatment programme to detect and remove early cervical dysplastic lesions. Right to Care trains medical officers to perform colposcopic biopsies and large loop electrical excisions (LLETZ). These cost-effective procedures have resulted in greatly improved access to treatment.

Mobile clinics take screening and treatment services, and other women’s health services, to remote areas.


Right to Care’s prevention programmes include treatment as prevention, medical male circumcision (MMC), HIV counselling and testing (HCT), and prevention of mother-to-child transmission (PMTCT).

Right to Care advocates treatment as prevention. Among discordant couples, ARV therapy has been shown to reduce by 90% the rate of transmission from one partner to the other.

Annually Right to Care conducts over 300 000 HIV tests.

Through technical assistance and direct service delivery, Right to Care is supporting the DoH in the delivery of MMC services. MMC is offered as a comprehensive package of services that includes HCT, the provision of condoms, and education for behaviour change. MMC clinics are optimised for high-volumes.

Right to Care’s integrated PMTCT and Maternal & Child Health unit provides technical assistance for prevention for mothers, immunisations, reproductive health services, basic antenatal care, and PMTCT at supported sites.

Pharmacy supply chain management

Right to Care’s pharmacy programme supports the DoH at national, provincial, district, and facility levels. Programme staff members play an important role in the development of pharmaceutical policy. Right to Care supports the Medicines Control Council for the registration of medicines and for the regulation of clinical trials. Right to Care supports the site-level implementation of computerised pharmacy dispensing and information management systems. This includes integration of clinical data systems and pharmacy management systems.

Right to Care Health Services

Right to Care Health Services, a wholly owned subsidiary of Right to Care, offers organisations a comprehensive integrated wellness programme. The programme includes health and wellness screening, health risk assessments, management of chronic diseases, psychological counselling, legal and financial counselling, primary and occupational healthcare services, executive wellbeing, absenteeism, and incapacity and disability management. Clients are provided with comprehensive and integrated reports on all aspects of employee healthcare.


Right to Care’s Training Department develops staff knowledge and skills in order to improve the capacity to provide quality HIV care, treatment, and support. Training courses covering a broad range of clinical subjects are offered to healthcare providers of supported sites. Didactic training is follow up with on-site mentoring.

Skills programmes are conducted for lay counsellors and for non-clinical staff.

Corporate governance

Right to Care is governed by a board of directors, of whom two-thirds are non-executive directors. The organisation complies with King III standards of corporate governance.

Right to Care consistently achieves unqualified audits from its auditing firm, Deloitte and Touche.


Our Vision & Mission

Our Vision

That every individual will have ready and affordable access to quality evidence-based medical services

Our Mission

To respond to public health needs by supporting and delivering innovative, quality healthcare solutions, based on the latest medical research and established best practices, for the prevention, treatment, and management of infectious and chronic diseases


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