Deadly steps to manhood

The Eastern Cape health department has launched a crackdown on illegal surgeons running initiation schools after the death of 37 boys last month from botched circumcisions.

Departmental spokesperson Sizwe Kupelo said 11 illegal surgeons were arrested and more schools are being investigated. “We will stop at nothing to close down these schools and we will enforce the law on those who are responsible for this.”

Circumcision, symbolising the transition to manhood for Xhosa boys, is usually carried out in June and December, during the school holidays.
Each year brings fatalities, usually caused by the use of blunt, unsterilised instruments.

Of the 37 reported deaths, 36 of the boys came from Mthatha or the districts of OR Tambo Alfred Nzo in Pondoland and their deaths were the result of botched circumcisions at illegal initiation schools.

Last week doctors from St Elizabeth Hospital in Lusikisiki joined the fight by accompanying police on raids on illegal schools. “Most of these boys are brought in at the final hour when all we can do is pronounce them dead or amputate their genitals,” said doctor Thandiwe Ramophosa. “We decided to go to the schools ourselves and treat the boys while there is still a chance of saving their lives.”

The doctors rescued 38 boys who were left alone in an abandoned house; most of them were between 13 and 16. Kupelo said some of the boys had lost the tip of their penises to gangrene, and six had suffered “spontaneous amputation” in which septicaemia eats away the flesh.

Prince Ntandoyesizwe Ndamase, of the Nyandeni Kingdom in western Pondoland, said many of the illegal surgeons charge R1 000 for circumcisions even though they lack proper training and nursing staff. He said the boys are left unattended and are vulnerable to abuse.

The department of health found that most of the boys came from mother-headed households where the fathers were either dead or working on mines.

Women are not allowed to become involved in initiations, meaning that the boys join initiation schools without their mothers’ knowledge.

The children are also afraid to take on the illegal surgeons because many are respected community members. 

Because of the many deaths, the provincial health department pushed for legislation to regulate circumcision in 2001. Kupelo said since then 425 medical officers have been trained in the proper methods.

The Application of Health Standards in Traditional Circumcision Act licenses initiation schools and subjects them to regular health department checks. Illegal surgeons face up to 15 years’ imprisonment for non-adherence.

The Act stipulates that those undergoing circumcision must be at least 18 years old and have parental permission. Parents are required to sign a document at the department giving their consent and declaring the date and school where the circumcision will take place.

The children must be examined for the presence of sexually transmitted and other diseases that could affect their health during initiation. Only trained surgeons and nurses with permits are allowed to perform the circumcision rite.

Prince Ndamase said there should be harsher punishment for those who continue to practise illegal circumcisions. “These boys are our future and we feel bad as traditional leaders when we watch them die like this every year.”

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