PHUTHADITJHABA, South Africa — When 22-year-old Lamkelo Mtyho entered the sacred traditional circumcision ceremony, his family anticipated his proud return as a recognized man in their community. Instead, three weeks later, they received devastating news of his death.
Mtyho represents one of at least 48 young males who lost their lives during recent initiation ceremonies across South Africa, part of a centuries-old cultural practice that continues claiming lives despite government oversight efforts.
The secrecy surrounding these rituals makes investigating deaths extremely challenging for families and officials alike. Multiple former participants declined to discuss their experiences, while hundreds of unregistered schools operate for those unable to afford legitimate programs.
Authorities typically only report fatalities when numbers become significant, with few legal proceedings or medical examinations following deaths.
These traditional procedures pose serious health hazards due to inadequately trained operators, contaminated cutting instruments used multiple times, severe dehydration, and infected wounds that receive poor treatment in isolated locations far from medical assistance.
Former health minister Zwelini Mkhize addressed parliament last year, stating: “Imagine this number: 476 young people died in a five-year period and yet they were well before going into initiation. These deaths are unacceptable and should never have happened.”
Despite these dangers, hundreds of thousands of South Africans continue participating in ceremonies that occur twice annually, with the next season starting in June.
Mtyho enrolled in an officially registered school near Ngqeleni village in Eastern Cape province with his parents’ approval. These facilities typically consist of basic mud structures or temporary buildings housing dozens of participants away from public view.
His grandmother, Nozinzile, shared the account she received from a school security worker: “They were walking to the river to go and bathe, and along the way he started losing strength and collapsed. That is what we were told. It is said that it was an emergency situation, that the others ran to get water and tried to resuscitate him. When other people arrived there to help, it was too late.”
Speaking with frequent pauses outside the dwelling where Mtyho once helped with tasks like wood gathering, she declined to assign blame and no investigation into his death occurred.
She acknowledged the ritual’s difficulty but never imagined fatal consequences. As her oldest grandchild, Mtyho had planned to seek employment in town to become “the man of the house.”
Traditional Affairs Minister Velenkosini Hlabisa announced the December deaths, noting that participants often receive dangerous guidance to avoid water consumption believing it accelerates healing.
Successful ceremonies conclude with participants returning to their communities, presenting themselves through traditional songs and reciting ancestral lineages while villagers celebrate with music, chanting, and dancing.
Completing initiation grants elevated social standing for marriage prospects and participation in specific cultural activities, crucial considerations for many South African ethnic communities.
While medical circumcision remains available from infancy, cultural expectations drive many toward traditional methods.
Traditional leader Morena Mpembe, who supervises a registered facility in Phuthaditjhaba, Free State province, explained: “Initiation is a culture left behind to us by our elders. We grew up practicing it, as it teaches a young man to respect everyone, including those who are not initiates in society.”
South Africa’s high unemployment and economic disparity make fees for government-approved schools unaffordable for many families, creating demand for illegal alternatives.
Some boys attend unauthorized schools before reaching the legally required minimum age of 16, eager to achieve manhood status.
Mluleki Ngomane, an official with Gauteng province’s oversight body, noted: “It is very difficult for the government to monitor initiation schools which are not registered. They are not known until there is a tragedy of some sort.”
A 2022 legislative visit to Eastern Cape discovered more unregistered than licensed schools in OR Tambo municipality alone, with 68 illegal facilities compared to 66 legal ones.
Government and independent investigations have documented participant abuse, violence among initiates, substance abuse at illegal schools, and even forced participation through kidnapping.
Motlalepule Mantsha, a leader at a Phuthaditjhaba initiation school, observed: “We are seeing a rise in gangs because they want to grow their initiation schools, and we see that as a wrong way of practicing initiation. This is damaging the initiation’s image.”
Since 2021, South African regulations mandate strict health and safety compliance for school registration, admitting only males 16 and older with parental permission. Over 5,000 such facilities currently operate.
Registration requirements include three-month advance applications before each season, adequate surgical equipment preventing reuse, and training for traditional “surgeons” and “nurses” in sanitation, infection control, wound management, and HIV education.
During January and February, authorities arrested at least 46 individuals connected to illegal operations, including 16 traditional surgeons, 28 traditional nurses, and two parents accused of collaborating to falsify younger boys’ ages.
In a separate February case, courts sentenced a 26-year-old man to two years imprisonment for illegally circumcising two teenagers, ages 17 and 18, the previous year.
The Cultural, Religious and Linguistic Rights Commission, a parliamentary oversight body, reported in 2017 that “due to the principles of sacredness and secrecy of this practice, also compounded by the inaccessibility of rural locations,” monitoring schools remains difficult with “clear confusion” about local authority responsibilities.
The commission found that once complications develop, medical intervention comes too late, with some deaths resulting from participants’ existing health conditions, recommending mandatory medical examinations beforehand.
Makhanya Vangile, mother of two initiates, views ceremonies as vital cultural heritage requiring protection but worries about illegal school conditions.
“Here, we have guardsmen from our chief who go and check up on how the boys are being fed, their living conditions and safety,” she explained. “They are able to stop things like boys bringing harmful stuff like alcohol, knives and guns instead of traditional sticks.”
