Traditional circumcisions in South Africa have claimed the lives of more than 50 boys and young men since June. Most of those have died following illegal traditional surgeries in a small area of the Eastern Cape province.
It is an ancient tradition for Xhosa teenagers in the Eastern Cape. Come winter, young men gather in small groups on the cold peaks of the Drakensberg mountains or in the forests along the rivers to undergo manhood training. This included traditional circumcision with an assegai, or spear, by an ingcibi or traditional surgeon.
In times past, the ingcibi was always skilled and the traditional poultices used so effective that few initiates experienced any side effect, apart from the initial pain and the healing process.
But more than a decade ago, standards had declined to such an extent that initiates began dying or suffering severe complications. In 2001 the Eastern Cape provincial government put a law into place requiring that ingcibi's be licensed in a process in which they were trained to learn about modern health and hygiene standards.
Sizwe Kupelo of the Eastern Cape Department of Health tells VOA that compliance with the new measures has been good and that overall deaths have declined. But he says in two regions of the province, where this year 41 young boys died, things are different.
"Except for the former Transkei [homeland], or Tambo and Alfred Nzo district municipalities, where you still have children being circumcised, taken away from their homes, without the permission of their guardians or parents; taken to the bush, or either on top of the mountain, hidden there until some of them die, or only brought to the attention of the authorities when it is too late for government or for doctors to save them, but only to certify them dead," Kupelo said.
Kupelo says since the start of June, with the cooperation of the police, the health department has rescued 200 boys. But he says despite much work in the regions the task remains difficult.
"We are also trying to track down, not only illegal circumcision schools, but also all the perpetrators, but communities continue to frustrate our efforts," Kupelo said. "Because these perpetrators are among the communities, but they are not identified by these communities, as a result they get away with murder."
The reasons for the situation in the two regions are complex and are at least in part driven by a culture of peer pressure that has built up among boys, some as young as eight-years old, who are demanding circumcision. It is a development not fully understood by health and social workers as traditionally initiates are around age 16 and older.
The demand is being fulfilled by so-called traditional surgeons who Kupelo says are unskilled, illegal, unscrupulous and are motivated by greed. The consequences are catastrophic for the boys, many who die and some who live but suffer spontaneous penile amputations as a result of gangrene and sepsis.