Why our boys die: The screams and stench of botched circumcisions

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.

Researcher Mmampho Gogela, the head of the Centre for Learning and Teaching Development at Walter Sisulu University in Mthatha, attributes many of the more than 1,100 initiate deaths over the past 12 years to complications after botched circumcision procedures.

“There are also frequent reports of dehydration and physical violence in initiation schools,” Gogela found in her 2018 study on the subject.

A presentation by the provincial department of health, dated November 6, stated that of  this winter season's 23 fatalities, seven boys died of septicaemia, four each from injury and dehydration, two each of excess bleeding, pneumonia and aspiration (when someone dies after breathing in food or drink), one of tuberculosis and another of gangrene.

Last year's summer season, however, showed a different picture. Of the 30 deaths, 11 were from dehydration, seven from septicaemia, three from food poisoning, two each from asthma and pneumonia, and one each from kidney failure, burns, suicide, multiple injuries and aspiration.

The presentation said dehydration-related deaths and hospital admissions were high because “drinking water, especially during the first to second week of initiation school, is still forbidden” in some areas. It also states that six boys had their penises amputated because their wound dressings were too tight “constricting blood flow and causing gangrene”.

“Deaths and penile amputations are a feature of every circumcision season as a result of sepsis, gangrene and dehydration,” the presentation says.

Also during this year's winter season, four boys were admitted to hospital after being severely assaulted, including one with sjambok injuries, two with head injuries, and one with abdominal injuries.

“Families are not taking full responsibility for the initiation process. They allow young and inexperienced family members to be in charge of the process,” the presentation says.

Long-time Eastern Cape health spokesperson Sizwe Kupelo has described Ngqeleni, outside Mthatha, as the murder capital of circumcision because of the number of assaults that take place there in illegal initiation schools.

Speaking in his personal capacity, Kupelo described what he has seen on raids of illegal initiation schools, such as one in Nkonkoni village, outside Libode, where a 13-year-old boy died after a botched circumcision.

“The department of health was alerted that there was an illegal initiation school and when we arrived with ambulances, the boys ran away into a nearby forest,” he said. A week later, emergency services were called again as the boys’ conditions had worsened.

“We rescued five boys, all with septic wounds. The 13-year-old was the worst of them all,” Kupelo said. The boy, diagnosed with kidney failure and gangrene, died a week later.

But long before that, in 2005, Kupelo arrived at St Barnabas Hospital in Libode to be confronted by screaming nurses.

“I have never heard such screams from nurses before. They were crying, asking me why do we men allow boys to get so bad before taking them to hospital. The stench was so unbearable. The boy was septic, his flesh around his penis was gone,” he said.

Another incident was when they rescued a boy in Mpangeni village in Libode, who had been severely beaten by his own relatives when he started hallucinating due to dehydration.

“As he wouldn’t stop talking and crying, his relatives burnt his hands and feet. In an effort to try healing the burns, they used animal spray on the burnt hands and feet. That boy was deformed for life as he is now in a wheelchair,” Kupelo explained.

Kupelo says many deaths in Ngqeleni are caused by assaults.

“How does a boy lose his leg or arm? Those limbs have nothing to do with circumcision,” he said.

He attributes the deaths in the Mpondoland area to poor community involvement. “The surgery in many cases is done correctly, but the management after the surgery is the problem,” he said.

Kupelo called for a three-year moratorium on circumcisions in the Mpondoland area.

“Take those illegal iingcibi (traditional surgeons) and amakhankatha (traditional nurses)  and train them for six months. When they graduate, no other new iingcibi should be allowed to practise in the area for three years. Initiation schools must be built in all areas in Mpondoland and must be manned by experienced iingcibi and amakhankatha,” Kupelo said.

In case where assaults are reported, Kupelo said the iingcibi and amakhankatha must be charged criminally - but not for contravening the circumcision laws.

Does our initiate receive medical attention in time to restore him to full health?

Yes. Click here to read about the traditional welcome an initiate can expect when he returns home

No. Click here to read about the men who lose their manhood and are regarded as outcasts by their communities