"Our [Yao people's] circumcision is of the 'brain' not of the 'penis'": factors behind the resistance to voluntary medical male circumcision among Yao people of Mangochi in Southern Malawi.

Aim: Malawi officially launched Voluntary Male Medical Circumcision (VMMC) in 2012 after the 2007 joint WHO /UNAIDS recommendation that VMMC be a key HIV prevention strategy for Sub-Sahara African region. Malawi data, however, contradicted the findings of three randomized studies conducted in Uganda, Kenya and South Africa between 2005 and 2007. While randomized trials demonstrated that male circumcision could contribute to a 60% relative reduction of HIV acquisition by men through heterosexual intercourse, HIV prevalence in Malawi was highest in the Southern Region where 47% of males were traditionally circumcised yet Central Region had 15.4% and Northern Region, 6.3%. By December 2018, Malawi had only achieved 756, 780 surgeries constituting 31% against the target of 60% of eligible men. The low achievement was due to resistance to services even in traditionally circumcising Yao communities. This study sought views of Yao respondents in Mangochi district, in Southern Malawi, on VMMC. Methods: 156 participants were interviewed (103 males and 53 females): 15 FGDs (involving 86 males and 50 females); 17 IDIs (involving 14 males, 3 females); 3 Key KIIs (involving 3 males, 0 females). For this paper, the authors only analyzed FGDs, IDIs and KIIs. Quotes from FGDs were not significant. Results: The study identified that VMMC: a) did not contribute to societal moral values; b) involved female circumcisers; c) threatened chiefs' political authority and economic gains; d) threatened continuity of jando; e) was impotent against witchcraft; f) provided by inefficient providers; g) resembled Yao circumcision; h) wrongly translated as 'm'dulidwe wa abambo.' Conclusions: The key barrier to VMMC services in Yao communities of Mangochi was the mistrust between government and implementers on one hand and Yao communities on the other due to inadequate engagement prior to the rollout of services.

Ethnobotanical survey of plant species for herbal tea in a Yao autonomous county (Jianghua, China): results of a 2-year study of traditional medicinal markets on the Dragon Boat Festival.

BACKGROUND: Herbal tea is widely consumed in Jianghua, a Yao autonomous county in Hunan Province, China, to prevent and treat diseases. The materials in herbal tea at the traditional medicinal markets at the Dragon Boat Festival remain unknown. The aims of the paper were (1) to specifically investigate the materials of herbal tea used by Yao nationalities in Hunan Province, (2) to record the most common and the culturally important medicinal plant species in the markets, and (3) to compare the medical plant tradition both used for herbal tea between the Jianghua and Lingnan regions. METHODS: During 2016-2017, 215 vendors were interviewed at traditional medicinal markets at the Dragon Boat Festival in Jianghua to record plants used for herbal tea and to document traditional knowledge of their medicinal function, habitat, and conservation status. Bunches of medicinal plants were purchased to identify the species and to prepare voucher specimens. Cognitive salience (CS) based on free-lists and use value (UV) were calculated to analyze the cultural importance of medical plants; other quantitative methods (coefficient of similarity and chi-square analysis) were applied for comparison of herbal tea tradition between the Jianghua and Lingnan regions. RESULTS: A total of 169 species belonging to 66 families and 142 genera were recorded in herbal tea to treat health conditions in the study area. There were 30 health conditions that were recorded, with heat-clearing and detoxifying being the most common medicinal function, followed by treating rheumatism and promoting blood circulation. Of the 169 species, 97 were herbs. The whole plant was the most commonly used plant part in the preparation of herbal tea. According to the national evaluation criteria, three of these species are listed on "China's red list" and registered as vulnerable (VU). By comparing the coefficient of similarity of herbal tea plants and the number of mentions for part(s) used in Jianghua and Lingnan, the medicinal plant tradition is different in two areas. CONCLUSIONS: Herbal tea in Jianghua reflects the cultural diversity of the Yao people and the plant diversity of the region. Future research on the safety, efficacy, and the adulterants of herbal tea are needed for sustainable utilization.