A South Africa teenager has died of malnutrition during initiation rituals in the Eastern Cape province.
He is the ninth youth to die this year during the initiation process, which involves weeks spent living in the bush, followed by circumcision.
Others died from circumcisions that led to infection or gangrene.
South Africa has taken steps to reduce the number of initiation-related deaths, but fatalities still occur every year - many in the Eastern Cape.
In the latest case, a group of youths had been kept in the mountains for three weeks and denied food, Eastern Cape provincial health department spokesman Sizwe Kupelo said.
"They look like skeletons," Mr Kupelo told the South African Press Association, adding that a man who had posed as a traditional healer was expected to be arrested in connection with the death of one boy.
"We don't understand why a human being can do something like this. This is against the custom, it is contradicting custom," Mr Kupelo said.
On Monday, another Eastern Cape youth died as the result of a botched circumcision - the eighth since the start of the current winter initiation season - and two more were hospitalised.
One of the two who are in hospital was reportedly circumcised by a traditional healer registered by the government in terms of a scheme to reduce the number of botched circumcisions.
There has been particular concern over circumcisions being carried out by inexperienced practitioners, in unhygienic conditions and using unsterilised implements.
Do you think being initiated is worth the risk if the rituals are dangerous? Or does social pressure in Africa mean it is too difficult to say no - like the Kenyan girl who bled to death last week after circumcising herself because she was being teased? Let us know about the initiation rituals in your country and whether you think there should be more regulation using the form below.
A selection of your comments will be broadcast on the BBC's Focus on Africa programme on Saturday 1 July 2006 at 1700GMT.
Such rituals are extremely important for a South African male. One Eastern Cape gardener of ours, although in his 40s was called 'boy' his whole life by his peers because he had never been able to afford the fee towards the ritual. Unless a South African male is circumcised, he is not a man. But it's not a life threatening thing and I think quite a few people will be offended by the subtle suggestion that the Xhosa initiation ceremony for males is equivalent to female circumcision. Males who have been circumcised tend not to spend the rest of their lives in physical pain (unless the operation has gone wrong), unlike females who have undergone the supposedly equivalent operation. There is no comparison to be honest.
Charles, Delft, Netherlands
I am surprised that the emphasis here is not on at what age initiation is done rather on the worth of it at all. I believe African leaders especially our health policy holders should put more effort on the awareness to give on early initiation in infants and not later. In The Gambia where I live, most boys are initiated/ circumcised after they are more than 5 years old and some even at their late teens. Girls' circumcision too is very rampant. The rituals involved are nothing to write about. They are beaten, starved and subjected to inhuman treatments which to one's dismay are taken to be normal. I want to advocate that there should be more regulations to cub various cultures supporting any form of initiation after infancy.
Majidah, Banjul, The Gambia
My stepmother works as a nurse in one of Cape Town's hospital and it's apparently not uncommon to see a troop of young boys come hobbling in to have the damaged repaired after having undergone traditional circumcisions. They're the lucky ones though. This is a barbaric and outmoded custom, which is inconsistent with South Africa's vision of the future.
Rob Schmitt, Edinburgh, UK
I am a South African Lawyer working and living in England. It is intolerable that ritual related deaths are still occurring in South Africa. The South African government is at fault to allow such procedures to take place that ultimately amount to neglect, assault and in some instances, culpable homicide of children. It highlights the fact that children need more protection and more needs to be done in affording children that protection. This is not the Stone Ages - wake up South Africa and put an end to cruel, outdated and inhumane rituals!
anon, London, England
Rituals, initiations, they all have their meaning and sense. But as all things in live, they too should evolve. Mutilating - which is what female circumcision really is - never made sense to me. Nor punishing someone because he is "not manly" enough.
Inge, Antwerp, Belgium
By all means have a circumcision ceremony, but performed by people who actually know that dirty knives and hands cause infections.
Jim, York UK
In Zambia we have a simple ritual that makes you a man, that is one week before marriage you have to mate with 4 women in in one night this is called ngamisi, but if you have 7 women this is called nugamuso (greater man),this makes you a respected member of the tribe, nugamuso is very difficult and not all men have this status.
Kwame Dala Kuni, London, UK
Circumcision is very important for every male regardless of where you come from. I believe that circumcision must be done by well-trained practitioners who have the requisite instrument to perform this task. Those who are not trained are involved in this, are doing it for ritual purposes. In fact why should young boys be taken into the forest to be circumcised? This act is completely demonic. Let the government of South Africa persecute those involved in such a barbaric act.
Andrew A Don, Monrovia, Liberia
No amount of self respect derived from an initiation rite or the dangers associated with it is good enough for young to die for. African society needs to transform from the age of uncivilization and harmful traditional practices to one that truly reflects the mode of transformation
Francis Sheku , Sierra leone
If it's that necessary as I believe it is to those who undertake it, let it be done in hospitals. Not in the bushes. That is more of archaic and dehumanising. Can't they really do it in hospitals and be men? I did it hospital and the experience was nice. However, don't interfere with women.
I feel circumcision for both males and females is not a health or social necessity and therefore, it should not be practised, at least to avoid the danger of such unnecessary suffering and sometimes deaths that are inflicted on our young people. Of course, like all traditional practices, there would be resistance to any attempt to eradicate it, but it is only through the persistence of a few pioneers that we can succeed.
Demba Jawo, Banjul, The Gambia
Some rituals and initiations are not danger; therefore, encouraging some communities in Africa to disband their traditional practice that makes sense to them is not a better idea. Please throw away rotten eggs and leave the best ones!!
Peter Tuach, Minnesota, USA
I think that people have to move with the times and accept that cultures are becoming more modernised. Gone are the days of having to torment young men and women in the name of custom and tradition. It's high time that such abuse of these young be put to an end to avoid the continued and unnecessary loss of lives.
Tawanda Shoniwa, Harare, Zimbabwe
I feel there should now be regulations guiding circumcision procedures, nowadays even people I can consider as amateurs are carrying out these rituals. Traditionally circumcision here in Africa is carried on by people considered experts but that has of changed of late so traditional Healers Associations should come in and inspect the circumcision exercises carried on by the groups practicing circumcision.
LENGANJI SIKAPIZYE, Lusaka, Zambia
It was also a tradition to burn witches, sacrifice your first born to make it rain, remove your enemy's heads as trophies etc etc. Just because it's a tradition or ritual, does not make it right or valid today. One would hope that a new, vibrant and modern South Africa would know this and make it illegal.
Steve, Ashby, England
In the United States there are typically a handful of binge-drinking related deaths on college campuses. The environments in which these deaths occur are often ritualistic in nature, and are considered by many to be a rite of passage. The participants are almost overwhelmingly male. Although it may seem odd to me that someone would subject their body to the kind of abuse seen in parts of Africa, I hold a firm belief that, as the old saying goes, "Boys will be boys." Wherever you live, and however cultures vary, like two bulls butting horns, men will try to prove their manliness to one another. If it wasn't dangerous, it wouldn't be manly.
Andrew, Richmond, Virginia- United States
I believe people need to be educated as to why such customs exist. As a Nigerian born female, I was never circumcised and I believe Female circumcision is a barbaric act against the female with no positive/health benefits at all. As a mother of 3 children, my 2 boys were circumcised as babies by a registered practitioner and under sterile conditions. My daughter is most definitely not. My husband comes from a culture where boys are not circumcised and as such is not but has often expressed the wish to have it done purely on health grounds. I believe Male circumcision at the right age and under sterile conditions is acceptable. In young boys when the nerve endings are in place is however barbaric unless under general anaesthetics.
The problem of initiations these days is no longer a communal thing. People are conducting it for making money and don't care about the young boys. Government must make sure that there are tough rules for those who want to operate initiations without qualifications.
sydney, South Africa, Johannesburg
Initiation is what identifies Xhosa people from other ethnic groups in South Africa. It is our pride and very attached to us. To mention a few Nelson Mandela, Thabo Mbeki, Bishop Tutu, Oliver Tambo, Steve Biko went through the same process. Illegal initiation schools are the problem; the way we do it is still correct. There is a lack of monitoring in some parts of our country, however, which maybe why there are deaths.
Sia, East London, SA
Interesting - few comments from South Africans! The initiation rite historically would have expected the participant to be self supporting in the wilderness - perhaps that is the part that needs to evolve as well as more attention to the understanding of clinical cleanliness by all those involved. Remember also that most of the SA Government probably went through this initiation themselves.
Ian, ex South African
IT IS OUR CULTURE, NO MATTER WHAT, WE CAN'T TROW IT AWAY.
ben benny, sierra-leone-FINLAND
Everyone will agree with me this practice is hygienic medically wise But how it is done rises questions I believe this should be done in hospitals not by quacks. In my tribe, Kikuyu, you can not be accepted in society if you have not under gone the ritual you will be the talk of the village. About the girl who died after doing it on her own, this proves how the community can push one over the edge
Bernard Njuguna, Nairobi, Kenya
I am in full support of male circumcision, but female no. I have three boys by the grace of God and they were all circumcised in the hospital. Why should it be done in the bush in an unhygienic area? I come from the eastern part of Nigeria where they used to circumcise a female in those days, but now you dare not say it to hearing of the elites, because they will term you as a bad person without conscience.
, GARKI ABUJA NIGERIA
Do not condemn what you don't understand.
SOME African Traditions and Ceremonies are so historical and make a lot of sense to those that practice them. There are some Ceremonies we (as africans) have been practicing that put us at great risk of not only inflicting pain but also expose us to the HIV infection and its related issues. Education, Education, Education in order to create awareness and invoke positive change is the only way forward. Just telling them to throw away their traditional practices that makes sense to them is not a better idea.
Involving them to make informed decisions based on risk and benefits of some pratices is vital. Remember change is a process.
paulo muzuza, Luanda - Angola
If, as Kwame Dala Kuni alleges, the Zambian ritual to make you a man requires that you have sex with four women in in one night a week before you marry, then I would prefer to marry a boy.
Anonymous Woman, Stellenbosch, South Africa
I don't even know how I was circumcised. In Cameroon children are circumcised after few days of birth. It is done after child's birth because it is believe that the child's body is still tender and after circumcision the wound will heal quickly rather than allowing the child to grow big.
Initiation rites are very very important to Africans way of life. Let's not change our whole way of life because of few accidents and advice from our "educated friends". We need to improve our ways of doing them but NEVER CHANGE THEM. Let them adopt them to today's set up but rituals should be practised. Initiation ritual are the only form of education that Africans can maintain, as we all know what are side effect of relying only on Western education that really don't have much in terms of African traditions and way of life
In Ghana, male circumcision is very important. It's not so common to see an uncircumcised boy or man. In most cultures here, a male child is circumcised when he's eight days old as such the mother nurses both the penis and the navel wounds at the same time. I think it's much better than being circumcised when you're much older. In recent times, it's done on the day the child is born by the nurses at the hospital and this I think is even much safer.
Adelaide, Accra, Ghana
I notice African commentators are mostly for this practise and others mostly against. Why should we drop our traditions because some find them offensive? What do you have on offer to replace our long-held beliefs?
Nkhrahanye L. L. Mfengu, Gauteng, South Africa
There is nothing wrong with the tradition of circumcision - Jewish people also require their sons to be circumcised. The problem comes with the health risks. There is no need to endanger young men in modern South Africa. I admire that the government tries to be tolerant of the various cultures that make up our society and has sought to regulate traditional healers; they simply haven't gone far enough. Traditional healers should have to pass tests, and perhaps doctors should be on hand during the ceremony so that if anything goes wrong it can be dealt with immediately. Banning the tradition may anger rural Xhosa society and create rifts. Even Mandela wasn't considered a "man" for years because he'd cried out during his initiation!
Alistair Mackay, South African in Edinburgh
Ok here we are dealing with a lot of issues, first tradition and the respect for it, then intimidation, money, unqualified people, hygiene and HIV. Traditions I think is very important and even though we as people that see ourselves as enlightened don't have the right to decide what traditions are to be kept and which are to be changed or left. There are cases in the north where the boys are forced by one or the other means to attend an initiating school. The people have to dish out a lot of money for this tradition and I think we should instead of stopping it see how this is run and try and regulate it. Policing this might be a problem and I don't think that this will be overcome in the near future we need to open our mouths and point out these wrong doings out to the authorities. Since there is money involved people that don't have a clue of what they are doing are getting into the trade to make a quick buck and in the end up killing boys that could have made a significant contribution into making this an even better country. How to improve hygiene I don't have a clue maybe taking the group to local clinics or creating mobile clinics to assist the people with this. Lastly there has been some research done on circumcision and HIV and they found that men that are circumcised have a less likelihood of contracting HIV than men who has not been circumcised.
Driaan Fourie, Pietersburg, South Africa
The comment comparing frat-boy boozing with young kids being forced to starve or undergo unsanitary circumcision is simply absurd and once again illustrates how out of touch the average American is from the rest of the world!
GD, Bulawayo, Zimbabwe
Israelis by tradition circumcise they male children in accordance with their holy scriptures and have never been called barbaric or backwards instead they utilize modern technology to do this safely.
Why must every African tradition be stripped, made to look barbaric and even have laws put in place to put an end to our traditions instead of training, educating and putting forth laws to allow our traditions to be practise in a safe and in a so-called civilized manner?
Adjoa Brobbey, Vancouver, BC, Canada
Coming of age rituals are something we are sorely lacking in Western culture, hence the episodes of binge drinking, etc., where young adults attempt to "prove" their adulthood (not just manliness). However, surely there is some way to maintain the cultural meaning of coming of age in S. African (and other) societies, without mutilating the genitals of children (male or female), particularly when such mutilation is done without the slightest understanding of hygiene or anatomy. Unfortunately, because these initiations are a cultural expression, laws forbidding them, opposed from above, are unlikely to cause any lasting change. As another commentator remarked, the change must come from brave, educated pioneers who live within that culture.
, Springbrook, AB, Canada
This practice has been there since time immemorial and there is nothing wrong with it. Only thing is that, here in Kenya, most iniates go to hospitals for the circumcision. So S Africans live up to the moderns times, take your boys to hospitals for the rite.
jbabu, Nairobi, Kenya
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