Madam Speaker
The customary initiation is an age-old tradition that is practiced across the length and breadth of our country with an impact that varies from community to community. The deaths of initiates have been a source of deep concern in our society.
The number of serious injuries and deaths that remain associated with this custom are unacceptable and preventable especially considering the advances in modern medical technology available.
As a public representative and a member of this Parliament, as a member of the ANC who respect our diverse culture and traditions, as a professional medical doctor or as a parent, like all the members here and many more outside this house, I cannot reconcile with the number of these injuries and deaths at this day and age.
I believe these deaths have become a crisis that cannot be tolerated or ignored and we should use the approach that we employ in fighting epidemics—an all-out battle!!
In 2024, a total of 101 089 initiates went for initiation in all provinces. A very small number is recorded in KwaZulu-Natal, since, for historical reason, mostly voluntary medical male circumcision is practiced in that province.
According to the departmental reports, there were 5229 initiation schools countrywide, of which 3667 were in the Eastern Cape. In the same season there were 199 illegal schools and 73% of which were in the Eastern Cape.
According to available statistics in the period from 2019 to 2024, 1427 initiates ended up with hospital admissions in the Eastern Cape. Those resulted in 476 deaths; and 77 of whom ended up with penile amputations.
Imagine this number: 476 young people died in a 5-year period and yet they were well before going into initiation. These deaths are unacceptable and should never have happened.
Worrying also was that there were 25 records of serious assaults. Clearly assaults are an abuse of the custom and must be stamped out.
Furthermore, ‘according to statistics provided by the Eastern Cape Department of Health (ECDOH) (2019), between the years 2006 and 2018 at least 8,239 initiates were admitted to the hospital because of various injuries and complications related to the ritual. Furthermore, not less than 769 initiates died in that 12-year period. Another 303 suffered penile amputations during the same period (ECDOH, 2019).’ No one has spoken about the deep psychological trauma suffered by the victims, the mothers, the families and associated communities as a result of such mutilation.
The African National Congress respects the diverse cultures of our people but also believes that these cultures must be practiced in line with the prescripts of our Constitution. In terms of the Constitution of South Africa, (section 9.(1) “Everyone is equal before the law and has the right to equal protection and benefit of the law”.
All these deaths and injuries should be prevented and our youth must be protected by the law because practicing their culture, traditions and customs is also protected by the Constitution, in Section 185.1(a), which
refers to the promotion of “respect for the rights of cultural, religious and linguistic communities.”
There are best practices in different provinces such as Limpopo and Mpumalanga; which record low fatalities despite enrolling large numbers of initiates. In 2019 Limpopo registered 58 000 initiates without a single death. In 2013 Mpumalanga lost 30 initiates, and embarked on improving culture, hence in 2017 Mpumalanga enrolled 30 000 initiates and lost three lives.
Notwithstanding the legislation, these unacceptable deaths of initiates persist, especially in the Eastern Cape, which recorded the highest number of deaths countrywide. While deaths occur across the province, the hotspot districts include the Alfred Nzo and OR Tambo districts.
Most causes of death are predictable and avoidable, commonly involve: dehydration (with kidney failure, dizziness and sudden collapse); circumcision wound infection and sepsis (with fever, delirium, septic shock); relapse of untreated pre-existing ailment (convulsions, asthma, pneumonia, heart failure) and negligence or criminal activities (such as assault, fractures, drowning, suicide, burns, etc).
In response to these alarming deaths and hospital admission figures, the Government led by the African National Congress. piloted the enactment of The Customary Initiation Act (Act No 2 of 2021), by this Parliament, which became law in 2021.
This legislation aims to address this phenomenon of illegal initiation schools and regulate initiation practices by ensuring the enforcement of safe practices and prevention of negligence, illegal and harmful practices that result in injuries and deaths. This legislation has created structures of various governmental and civil society and traditional leaders to monitor the initiation custom and enforce the legislation.
Early in December last year, the Portfolio Committee on COGTA had a three-day oversight visit to engage several role-players in all government spheres, traditional leadership and municipal district and local levels in these areas. During these engagements, the relevant government and community stakeholders adequately demonstrated their commitment and willingness to use this new law, to prevent deaths and eliminate mutilations and negligence that result in the deaths of initiates.
What has been done in terms of the Act
There is strong cooperation amongst stakeholders to inspect initiation schools and close illegal initiation sites, which are not registered or reported to local traditional leaders, have no parental consent or medical screening records or are involved in risky conduct such as assaults, restriction of fluid intake or discontinuing medical treatment of initiates.
Charging of transgressors and immediate investigation of amabhuma that are illegal, in cases of injuries and deaths, has resulted in increased number of arrests and prosecutions.
Much work has been done in contracting with family practitioners to conduct health screening and training of iingcibi and amakhankatha (traditional surgeons and nurses).
Teams of interdepartmental and multi-stakeholder monitoring forums from provincial, district and local levels are all bearing fruit. The committee was informed that these initiatives are slowly turning the tide in an otherwise very conservative custom passed from generation to generation.
This visit helped the committee appreciate better the complexities that have allowed these deaths to persist. The committee found this visit extremely enlightening and sympathizes with the stakeholders responsible for implementing the law and curbing unnecessary avoidable unpredictable deaths.
Complex challenges
Through engagement with local stakeholders, who gave briefings during the oversight visit, there are many complex factors that the committee identified that contribute to the difficulty in curbing initiate deaths.
There is huge peer pressure and stigma that is associated with the underlying factors which perpetuates lack of cooperation with law enforcement processes and allows misinformation to thrive.
Chief among these is poor cooperation of communities, parents and immediate families in anything perceived as imposition by outside or modern influence and government dictating on a custom revered as sacrosanct and an area seen as the unique preserve of the community.
Often, the blame for this custom has been laid on the traditional leaders. Yet families and Parents are the primary decision-makers to whom the custom is ultimately devolved. It is families and parents who give consent for initiation, select and pay the iingcibi (traditional surgeons) and assign the ikhankatha (traditional nurse), provide resources to celebrate the successful passage of initiation, and sadly also conduct the funeral and burial rites in cases of demise.
Families and the local community are the main repositories of information on what happens during initiation and often conspire to withhold such vital information, resulting in unsuccessful arrests and, until recently, a pitifully low rate of conviction of perpetrators. This is why the conviction rate is very low. The non-disclosure of vital information is accepted as part of protecting the custom to whom all – understandably – pay deep respect.
In a case reported in Mthlontlo municipality, peer initiates, and both traditional nurses and surgeons disappeared after the death of the initiate. In a case in Winnie Madikizela Mandela Local Municipality, the collusion of families is suspected in swapping health screening records, resulting in customs conducted in under-age initiates and initiations conducted without medical screening of initiates.
There are also cases of iingcibi with questionable experience, which were reported when initiates who recently underwent the initiation presented themselves as expert surgeons to conduct initiation immediately after exiting initiation themselves. They are suspected to be enrolling initiation schools with a financial benefit as a motive.
Other cases involved an initiate who died of burn wounds when ibuma he was lying in caught fire. In another case, a prospective initiate was found dead by hanging after escaping from an initiation site in a case of suspected abduction by peers.
Practices such as assaults on initiates, secret sites of amabuma located in inaccessible locations due to rock, and ragged topography deep in thick bushes are also standard.
False beliefs and misconceptions aggravate the death of initiates within communities, which generates peer pressure that results in risky behaviours such as withholding water, causing severe dehydration, rejecting medication for chronic conditions and refusing medical interventions when there are complications with initiation.
Also among the challenges are the rejection of involvement of local members in the same community who have undergone the customary initiation who are professionals and health workers trained in modern medicinal, surgical or with nursing expertise. They are viewed with suspicion and are precluded from participating in the customary initiation.
The committee learnt from the members of the community forums that voluntary male medical circumcision conducted outside the customary setting is rejected as inadequate for purposes of the custom. Youth who already performed the medical circumcision are obliged to go through the customary initiation.
In modern medical setting which is available, the surgical aspect of the practice is a simple safe and common operation the has no significant side effects.
Changing the law and mindsets
The amendment of the Local Government: Municipal Structures Act, 1998 (Act No. 117 of 1998, resulted in the reduction of participation of traditional leaders in municipal councils, which is where most oversight of customary initiations occur. While traditional leaders are still involved in customary initiation, the committee observed that cooperation is lower than desired, thus turning this misalignment into a serious risk. As result the committee believes this amendment needs to be reviewed to reduce the risks on initiates.
In September last year, the committee called for legislative amendments to the Customary Initiation Act. The envisaged amendments need to assign responsibility and powers to the local and different levels of traditional leadership (amakhosi and izinduna). This will enable the local traditional leadership to enforce safety provisions in the conduct of the custom. Traditional leaders cannot prevail sufficiently over transgressing community members without such powers.
Traditional structures should be adequately empowered with authority and resources to act as the primary agents for local law enforcement. Uma iinkosi zingenawo Amandla omthetho nemali ngeke zikwazi ukuhambela wonke amabhuma emahlathini akude nemizi nsuku zonke abone uma kuvela umonakalo. Ezinye izindawo zidinga izimoto nabantu abaningi ukuyozibheka. The legislation must make traditional leaders directly responsible for monitoring the custom. They insist on proper planning long before initiation seasons and register all practitioners and initiates at the beginning of each year and provide progress reports regularly.
This will promote more accountability and transparency that will enable the enforcement of the law and consequence management in perpetrators. The powers must be reinforced with adequate resources to inspect, monitor and initiate charges on transgressors, otherwise they are helpless.
Traditional structures must be used to deal with this custom because that is where the authority resides, as they are custodians of customs and traditions. The traditional leaders must initiate these amendments so that the existing gaps are closed, the criminal justice system can work effectively, and the negligence resulting in initiation deaths is addressed.
The power of communities
Government, traditional and community leaders need to ensure that the legislation impacts at the grassroots level in promoting healthy and safe initiation practices. For this, we need everybody!
The law must assist to define roles to be played by all stakeholders – in particular the kings, locals traditional leaders, families, initiates, and communities including religious, sports, youth, women organizations and to use their influence to change the mindset by curbing misinformation and eliminating social stigma. The deaths should not be accepted as part of the custom but seen as an unacceptable distortion of the custom that can always be practized safely.
Winning the cooperation of communities lies at the centre of any successful future effort to reign in perpetrators, stamp out commercialization and profit motives and root out the negligence of practitioners.
The government must also work with communities to disseminate accurate information to change attitudes and ensure their cooperation with law enforcement, not tolerating negligence and rejecting injuries and deaths of initiates in customary initiation. For this we need an aggressive communication campaign that runs a whole year round, using all mediums and all available civil society formations. This campaign must begin to debate safer technologically available options to strengthen the custom.
The collusion of peer initiates, parents and relatives in concealing information regarding circumstances surrounding the deaths and injuries of initiates must be countered through an aggressive communication campaign and enforcing the law.
The deaths and injuries must be treated as crises like the epidemics that our country has fought before, wherein massive information campaigns and modern medical expertise are used to inform and mobilise society to encourage healthier behaviour that defeats the epidemics. Pandemics such as cholera, HIV/AIDS and COVID-19 were fought very hard by communities armed with correct information to prevent deaths, and we should emulate this historical aggressiveness.
As a public representative and a member of this Parliament, as a member of the ANC who respect our diverse culture and traditions, as a professional medical doctor or as a parent, like all the members here and outside this house, I cannot reconcile with the number of injuries and deaths at this day and age.