A centuries-old coming-of-age tradition in South Africa has turned deadly, with at least 43 boys reportedly dying during this year’s winter initiation season and dozens more suffering devastating injuries.
The ceremonies, known as Ulwaluko, are held twice a year and are meant to mark a young man’s transition into adulthood.
But authorities say illegal initiation schools, untrained operators and horrifyingly crude surgical practices have transformed some of the sacred rituals into deadly nightmares.
Tens of thousands of boys and young men take part in the ceremonies each year. Initiates are typically separated from their families, covered in white clay and taken to secluded camps, where they spend several weeks learning traditional customs, survival skills and lessons about adulthood.
Circumcision is a central part of the initiation.
At legitimate schools, the procedure is supposed to be performed by trained traditional surgeons. But officials say rogue operators at illegal camps have carried out circumcisions using spears, scissors and razor blades, sometimes without proper medical care or anesthesia.
The consequences can be catastrophic.
South African media reported 43 deaths during the winter initiation season this year. In 2024, the winter and summer seasons reportedly resulted in 93 deaths and 11 penile amputations.
A South African government-commissioned report found that 322 boys and young men died between 2021 and 2024, while thousands of others required hospitalization or suffered serious injuries and amputations.
Gangrene, sepsis and severe dehydration are among the leading causes of death.
In some cases, officials say boys have also been beaten, stabbed or drowned.
Authorities have blamed many of the worst incidents on criminal groups operating illegal initiation schools with unqualified “surgeons” and “nurses.”
There have also been repeated allegations of boys being kidnapped and taken to illegal camps before their families are ordered to pay money to get them back.
South Africa has tightened its laws in an effort to stop the bloodshed. Unregistered initiation schools are illegal, and traditional surgeons are required to undergo training and certification.
Police also have the power to raid and shut down illegal camps.
Authorities say 42 schools have been closed, 40 people arrested and 180 boys rescued during enforcement operations.
Still, the tradition remains deeply important in many communities.
Young men who do not undergo initiation can face intense social pressure and may be excluded from traditional meetings, community activities and even marriage customs.
Those who refuse can be branded Inkwenkwe, meaning “boy,” a term often used as an insult.
Although the legal minimum age for entering an initiation school is 16, officials say children as young as 10 have reportedly been circumcised at illegal camps.
Velenkosini Hlabisa, South Africa’s minister of traditional affairs, called the latest deaths “deeply concerning.”
“These figures are deeply concerning to us and we send our condolences to all the families,” Hlabisa said.
“They serve as a stark reminder that much more must be done collectively to eliminate preventable deaths, injuries and criminal activities associated with customary initiation.”
Hlabisa condemned illegal schools blamed for deaths, kidnappings and abuse and warned that those involved could face criminal prosecution.
“Respect for tradition must go hand in hand with respect for the law and every initiate’s constitutional right to life, dignity and safety,” he said.
“Every initiate deserves to return home safely and with their dignity intact.”
Survivors have described the intense pressure to take part despite knowing the risks.
Teenager Scotty Dawka, 19, said he entered an initiation school even after seeing a television program about boys suffering amputations.
“I was of course very scared of going,” he told a local reporter.
“In my community many boys went through the initiation before me and I wanted to be the same as them. I wanted to be looked up to as a man in my village by the elders.”
Dawka said the experience was extremely painful and that he became sick, but received treatment and survived.
Other families have told far more frightening stories.
Anne Kumalo said her 16-year-old son was kidnapped while going to a local store along with 22 other boys and taken to an illegal initiation school about 20 miles away in Soweto.
She said she was ordered to pay 1,000 rand to get him back and claimed the boys had been whipped and beaten before police discovered the camp.
In another case, 13-year-old Siyamthanda Siymthanda, from Witbank in Mpumalanga Province, died at an initiation school last year. His family claimed he had been taken there against both his wishes and theirs.
The initiation tradition has existed for generations and has deep spiritual importance for many South Africans.
Former President Nelson Mandela famously wrote about undergoing circumcision as a teenager and the role the ritual played in his transition into manhood.
But secrecy surrounding the ceremonies has also complicated attempts to prevent abuse.
Initiates are traditionally forbidden from revealing details of the ritual, and critics say that culture of secrecy can make it harder for victims to report dangerous conditions.
Some of the most devastating injuries reportedly happen when circumcisions are performed with contaminated instruments or when wounds are wrapped too tightly, cutting off blood flow and causing tissue to die.
Initiates can also suffer severe dehydration because some are reportedly denied water after surgery in the belief that urination could damage their wounds.
When serious infections are not treated quickly, sepsis can become fatal.
South Africa’s winter initiation season runs from roughly mid-May through mid-July. The summer season traditionally runs from November into January.
Officials are now pushing for what they describe as a “zero deaths” approach — insisting that a sacred tradition should never mean families sending their sons away to become men only to receive them home badly injured, permanently disabled or dead.