Simamkele Scotty Dakwa, 19, was not sure he would survive. On televison he had seen boys who had penile amputations - and now here he was, in pain at his own initiation school. He tried to avoid thinking about his fate if the pain got worse and about missing his family. “I tried by all means to be a strong man,” he says.

Like thousands of other boys across South Africa, Dakwa went to a traditional initiation school this winter. The secretive practice differs across cultural groups but generally involves boys camping for weeks, secluded from their families and women, learning lessons from their elders. It includes circumcision with a spear, surgical blade or knife.

Almost 90,000 young men were initiated last year from different communities across South Africa - typically those with roots in amaXhosa, Xhosa, Pedi, Ndebele, Shangaan, Sotho or Tswana groups. Initiates can be as young as 12.

Dakwa’s illness was minor and he made it through the initiation. Others aren’t as lucky. During June and July, 34 boys died and since 2012 there have been at least 153 fatalities, largely due to botched circumcisions exacerbated by negligence and assault. Many more boys have been injured – 1,865 between 2008 and 2012.

According to Inkosi Sipho Mahlangu, deputy chair of the National House of Traditional Leaders, 80% of the initiates who died this year went to illegal schools not approved by the government. To qualify as a legal initiation school, boys must be pre-screened by a health professional and traditional surgeons must attend government training. Peer pressure

While it is each boy’s choice to go through the initiation, peer pressure plays a role. In Xhosa communities, those who have not been initiated are called inkwenkwe (boy), a harsh insult.

“In my community a lot of boys went through initiation,” explains 19-year-old Aubrey Nkinqa, who was initiated this year in Eastern Cape province. “That is why I had to do it because I wanted to be the same as them. I wanted to be a man.”

In recent years there has been a 4-5% annual increase in initiation enrolments nationally. Mahlangu says he has seen more families in cities wanting to tap into their culture. “I think people are trying to find affirmation and a sense of belonging,” he says.

Abduction

Boys are charged to go to initiation schools. Unofficial schools, where children are often taken without their parents’ consent, have sprung up to turn a quick profit. While dozens of these schools were raided by the police this year, there is no national legislation outlawing them.

Anna Khumalo’s 16-year-old son was on a trip to the store when he was kidnapped along with 22 boys and taken to an illegal initiation school 30km away in Soweto. After two weeks frantically searching for her son, men came to Khumalo’s house demanding 900 Rand ($64) to get him back. She only had 450 Rand ($32). When the police finally recovered the boys they were malnourished, and had been whipped and burnt with cigarettes.

Tom Mothopeng’s 14-year-old son was also abducted. “I don’t know where to go. I don’t know what to do,” he says. “What do you do when you are a dad and your son tells you ‘Dad I don’t trust the police’?” Mothopeng is scared because the kidnappers are still in the area and have threatened to kill the boys if their parents don’t pay more money.

“This guy came telling me if my child comes back here he’ll cut his head off,” adds Khumalo, a single parent who survives on a government grant. She relocated her son to another community where he will be safe.

Legislation versus tradition

A new law is being prepared to allow the organisers of unofficially initiation schools to be prosecuted. Currently, only those responsible for assault, negligence and deaths are charged.

Sipho Cingo, a traditional nurse at an initiation school near Flagstaff, Eastern Cape, says the new law could put him out of business. Cingo cared for 30 boys this winter. He stopped registering his school because he claims it led to women interfering with the male custom. He has noticed a changing attitude towards initiation from traditional leaders in his area. “They don’t want to play the leading role any more when it comes to circumcision.”

In the past, the different stakeholders trying to address the problem have struggled to collaborate. “Traditional leaders are worried about the eradication of the Xhosa culture,” says Zolani Barnes from the TB/HIV Care Association, which promotes medical male circumcision (MMC) to make initiation safer. “Some of them feel MMC will do away with traditional circumcision.”

Dingeman Rijken, a doctor who has treated hundreds of boys suffering from botched circumcisions, agrees that changing traditional leaders’ attitudes is the biggest challenge. “But national government departments show a lack of interest and are mostly focused on dealing with problems after rather than solving them beforehand,” he says.

When Rijken developed and championed a best-practice manual for restoring the health of boys who have been through initiation schools he was threatened with suspension from his public hospital post. The provincial health depeartment claimed he was undermining government efforts.

Pedi traditional leader Kgoshi Malesela Dikgale works in Limpopo, where few fatalities have been recorded in recent years. He believes unofficial initiation schools should not taint those complying with regulations.“Schools must send any boy with health problems to the hospital and health professionals can come to check the schools, but nothing more,” he says. “If you want to go to the initiation school while you are not a graduate of the initiation school, I am telling you you won’t come back.”

While new government guidelines support health professionals assisting traditional surgeons during circumcisions, at the community level the resources remain inadequate. Patrick Dakwa help boys who have suffered from penile amputations to integrate back into their communities and Thobile Tanzi monitors initiation schools with the Flagstaff Traditional Community Forum. Both struggle for funding.

It’s unlikely the complex issues of dealing with initiation schools and protecting the boys involved will be solved soon. The government trumpets a “zero tolerance on initiate deaths” policy. Yet, according to the latest annual performance plan from the department of cooperative governance and traditional affairs, their more realistic aim is to reduce fatalities by 10% a year.

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