A recently launched website unveiling the secrecy around the annual initiation rituals in the Eastern Cape has sparked a large outcry among sections of the Eastern Cape population, notably the Traditional Leadership. The website was launched by a health care provider after treating mutilated boys across several initiation seasons and failed attempts to work with the traditional leadership in finding solutions.

The Eastern Cape Health Crisis Action Coalition has not created or endorsed this website. We have noted the content of the website and accept that it may be considered culturally insensitive to some. We however also note that the content is factual and describes the conditions under which 825 boys lost their lives during circumcision practices in the Eastern Cape since 1995. Many more have been mutilated and traumatized for the rest of their lives.

The avoidable annual deaths and mutilations of young men as a result of botched traditional circumcisions are an infringement on the right to life, dignity and quality health care. Each circumcision season the reports of deaths and hospitalization of young men feature broadly in the media and each season calls for action are made. Various organisations and stakeholders have called upon Government and Traditional Leadership to find urgent solutions to this crisis.

Following another 38 circumcision deaths in Pondoland in the Eastern Cape over the December 2013 period, Archbishop Emeritus Dr Desmond Tutu, in a recent news report dated 9th of January 2014, called for “an urgent intervention” by the Traditional Leadership and Government. The Rural Doctors Association of Southern Africa and the Junior Doctors Association of South Africa have made similar calls in an open letter to Government and the Traditional Leadership issued on the 14th of August 2013 and offered to be part of the solution as medical doctors.

We call on the Department of Health and Traditional Leadership to take the lead in finding immediate solutions ensuring:

  • Enforcement of the Application of Health Standards in Traditional Circumcision Act (EasternCape) (Act No.6 of 2001), which stipulates amongst others that:
    •  A prospective initiate must undergo a pre-circumcision medical examination by a medical doctor and be over 16 years of age
    • No person may hold any circumcision school or treat any initiate without written permission of the medical officer designated for the area in which the school is to be held
    • A right of access to any occasion or instance where circumcision is performed or an initiate is treated must be granted to the medical officer
    • The traditional nurse must not expose any initiate to any danger or harmful situation and shall exercise reasonable care in the holding of the circumcision school
  • Prosecution of perpetrators of the above Act
  • The names of all initiates at a particular school known and registered at the nearest police station and a copy to be provided to the designated medical practitioner for advice and further care when necessary
  • Police patrolling around initiation schools
  • Improved accessibility to the initiation schools in cases of emergencies
  • Community involvement in the formulation and implementation of solutions

ECHCAC is aware that this crisis is not confined to the Eastern Cape and similar measures are required in other affected provinces. We do not call for an end to the initiation schools, which are originally intended as educational institutions preparing boys to the responsibilities of manhood. We believe they have the potential to function as much-needed and incredibly useful institutions educating young men about values such as human rights, family responsibilities and against societal ills such as gender violence and substance abuse.

The circumcision crisis is seen by some as a fight between modern and traditional practices, or cultural versus health rights. This is not helpful. This is a matter of life and death and as such it places a duty on Government to intervene and requires the Traditional Leadership to effect the necessary changes that will enable initiation practices to continue under safe conditions.

ECHCAC will be monitoring progress in the Eastern Cape closely and expects 0 deaths in the upcoming season.


Treatment Action Campaign – Anele Yawa, 073 555 8849

RuDASA – Dr Desmond Kegakilwe, 082 960 7571

Rural Health Advocacy Project – Kwazi Mbatha, 078 059 9309

The Eastern Cape Health Crisis Action Coalition includes:

  • Association of Concerned Specialists of the PE Hospital Complex
  • Black Sash
  • Budget Expenditure Monitoring Forum
  • Counsel for the Advancement of the South African Constitution
  • Democracy from Below
  • Democratic Nursing Organisation of South Africa
  • Hospersa
  • Igazi Foundation
  • Jubilee
  • Junior Doctors Association of South Africa
  • Keiskamma Trust
  • People’s Health Movement
  • Professional Association of Clinical Associates in South Africa
  • Public Service Accountability Monitor
  • Rural Doctors Association of Southern Africa
  • Rural Health Advocacy Project
  • Rural Rehab South Africa
  • Sonke Gender Justice
  • South African Medical Association
  • Treatment Action Campaign
  • Word Vision South Africa
  • World AIDS Campaign