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NOTE: This article is part of a nine-part sequential narrative series on initiation practices in SA. Answer the question at the end of the article to continue with the narrative or view the full series at The Perilous Path To Manhood.


Customary male circumcision is a relatively new tradition in the Mpondoland area of the Eastern Cape, where Kwanele Samuel lives.

Because of this, the area has the fewest experienced traditional surgeons and nurses, the most illegal initiation schools and, year after year, the most deaths among initiates. This is why it is crucial that their male relatives keep track of their progress at initiation schools.

Eastern Cape house of traditional leaders chair Inkosi Mwelo Nonkonyana has raised concerns about the numbers of boys under 18 who have been illegally circumcised, especially in the Mpondo areas.

The provincial department of co-operative governance and traditional affairs does not keep statistics of how many initiates have died in Mpondoland areas compared to the rest of the Eastern Cape. Keep an eye on news reports on initiate deaths, though, and more often than not you will find them to have occurred in that part of the province.

Eastern Cape house of traditional leaders chairperson Inkosi Mwelo Nonkonyana.
Custodian of tradition Eastern Cape house of traditional leaders chairperson Inkosi Mwelo Nonkonyana.
Image: supplied

The latest report to the national council of provinces by the Eastern Cape department of health, dated 2016, found that in the preceding 10 years there were 12,310 legal initiation schools and 42,396 legal initiates, compared to 334 illegal initiation schools and 707 illegal initiates. Most illegal initiation schools were in the Mpondoland districts of OR Tambo and Alfred Nzo, where they remain a “persistent challenge”.

Most initiates’ deaths, the report found, were caused by septicaemia, dehydration, gangrene, kidney failure and assaults. No other report has been tabled and the province referred all questions to the provincial house of traditional leaders and department of co-operative governance and traditional affairs.

Initiation schools could not be reached on time as they were scattered throughout the province and often not easily identified. Sepsis had been observed as the most common occurrence in most initiation schools
2016 Eastern Cape department of health report

The 2016 report also found that not every district or local area in the province had established initiation forums to help regulate the custom and ensure it was performed in accordance with the act. The report says other circumcision schools were not easily accessible to monitoring teams as they were in mountainous terrain. 

“Initiation schools could not be reached on time as they were scattered throughout the province and often not easily identified. Sepsis had been observed as the most common occurrence in most initiation schools,” the report found.

The report says there was a high rate of substance abuse by initiates in many initiation schools, and that parents were reported to be against the medical treatment of their children with antiseptic ointments and bandages.

“Discrimination against initiates who sought medical help occurred both by peers and communities. It was observed that underage circumcision was occurring in the Mpondoland area.”


Kwanele Samuel and his family have to choose an ingcibi. Do they choose an experienced practitioner who is registered with his local chief and the Eastern Cape department of health?


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