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In this short non-fiction photographic essay, I document the procedure of a male circumcision as performed by a town-doctor in Ayen. Within five minutes, the removal of the foreskin of Richard’s penis was perfectly done. On the account of hygiene, it is evident in the black leather bag which houses the clinical tools, the simple dress and the glistering Sanya motorcycle of the town-doctor in a dusty environment like Ayen, due to several untarred roads. His tools skilfully arranged in the midget clinical bag, though, neatness in this case is subjective, particularly when standard is been put to test.


In Ayen, a village in the north of Lome, in Togo, the villagers prefer committing their health matters to the private community health workers than to the government health service officials who only attend to patients during the working hours. They complain of lack of medical equipment, shortage of medication, and electricity. The private health workers go about the village with their motorcycles or bicycles on a daily basis to examine and administer treatment to the patients damning all the consequences.  

Ideally, this mini-surgical operation is done by a paediatrician, obstetrician, family medicine doctor, surgeon, or urologist. And occasionally, religious/traditional groups have their ways of circumcising their newborn babies. In Judaism, circumcision (brit milah) is performed by a Mohel in a synagogue on the eight day and an Islamic priest perform Khitan on the eight day or later and Oloola perform circumcision in the Yoruba traditional system on a designated day.


Most people living in rural settlement like Ayen cannot afford to go to private hospitals or even the so-called government health centres and so, they call the attention of their neighbour’s daughter who is an auxiliary nurse, trained as an apprentice by another auxiliary nurse in her so-called clinic. There is a serious problem of standard in the health sector in some countries in Africa. It’s more complicated in countries within the ECOWAS states.

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