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Mthatha - For the past three years, nurse Siboniwe Mahleka (40) has been criss-crossing Pondoland, rescuing as many initiates as he can.
Since last Monday, Mahleka, a member of the Nyandeni Monitoring Forum in Libode and Ngqeleni in the Eastern Cape, has been travelling in government bakkies, examining boys in both legal and illegal initiation schools.
Since then, he has referred five initiates to St Barnabas Hospital in Libode. Not a single one in his area has died.
On Thursday, Eastern Cape Health MEC Dr Pumza Dyantyi said 10 initiates had died since the summer initiation season began on November 18.
By late Friday, the death toll had risen to 12. An estimated 40 000 boys have undergone the circumcision ritual.
Deaths continue despite R20 million worth of government interventions, including 35 bakkies ferrying doctors and nurses such as Mahleka to initiation schools around the province, as well as school awareness campaigns.
“We thought our efforts would prevent deaths, but it looks like we need to sit down with our partners and devise new strategies.
"We have over the years put in place strategies and resources and have contracted male nurses and doctors, but the biggest problem for us is that our hospitals are being inundated with these initiates. They are really strained,” Dyantyi said.
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Mahleka works alongside Warrant Officer Makhosonke Gabuza and a group of chiefs led by Nkosi Jongisebe Gwadiso.
Together, they have shut down illegal schools and integrated initiates into nearby legal ibhoma.
Hailing from Dumani village in Ngqeleni, Mahleka often wakes up at 02:00 and is on the road until 23:00.
“Becoming a nurse was a dream come true for me. My passion is saving people’s lives. A nurse is the first hope for anyone who is ill and needs help. We have got to provide that help without fail because we are dealing with people’s lives,” he said.
On Thursday, City Press travelled with Mahleka and the monitoring team to a KwaZaka village, where a traditional healer had been treating his 12-year-old foster son with traditional medicine at an illegal initiation school at his home.
The boy was screaming and had to be pinned down so that his septic penis could be treated. He was rescued and sent to a legal initiation school.
“I am not going to rest until we finally beat initiate deaths in Nyandeni. In my own village, people call me a traitor and all sorts of names because they are opposed to their boys being touched by a medical nurse or taken to hospital. I don’t know whether they would rather have their children die,” Mahleka said.
“The stigma attached to initiates who are taken to hospital and cannot complete the course and become men is what is killing these young men. I wish people would accept medical assistance when it is needed. We take initiates to hospital as a last resort – only when their lives are at stake.”
Mahleka, who works at Nkumandeni Clinic in Ngqeleni during the rest of the year, said he had drained 1.2 litres of urine through a catheter from a 17-year-old initiate at a legal school at Mamfengwini village, Libode. The legal age for traditional circumcision is 18.
“The traditional nurse claimed there was nothing wrong with the initiate and that he was able to urinate. But I realised they were lying. He had an infection and I had to refer him to St Barnabas Hospital,” Mahleka said.
The initiates Mahleka sends to hospital commonly suffer from urinary retention, while others with septic penises suffer blockages that prevent them from urinating.
“The problem is lack of wound care. It is the filthy practices, whereby amakhankatha [traditional nurses] neglect their duties. These traditional nurses also touch many different initiates without washing their hands,” he said.
Dyantyi said Mthatha General Hospital and St Barnabas were the two institutions facing the biggest influx of patients.
“They admitted 19 initiates in one go at Mthatha General. I’m sure there are more by now. At St Barnabas, the figures were around the same.”
Dyantyi said her department had contracted 46 male nurses to work in wards full of initiates to relieve the pressure on permanent staff.
While the post-mortems have not yet been finalised, early indications are that most initiates died from renal failure and dehydration.
Others perished from septicaemia caused by infected wounds.
“All these issues point to the problems of illegal initiation schools because you do not expect to have deaths from septicaemia at legal schools,” she said.
“The deaths are fewer than at this time last year, but they are still too many, particularly because we went all out to raise awareness on community radio. One wonders what we must do.”
In Chris Hani District Municipality, where the summer season was launched, at least four initiates died – the highest figure in a single district.
During last summer’s season, 17 initiates died there out of 46 fatalities in the province.
“The biggest problem we are experiencing in Chris Hani is that people are refusing to be attended to by medical professionals. We thought that because we launched this season there, people would be aware,” Dyantyi said.
She hoped that with the Customary Male Initiation Practice Bill signed into law by Eastern Cape Premier Phumulo Masualle, illegal traditional surgeons would be brought to book.
“It’s going to help because, in the past, there was a reluctance to say a traditional surgeon messed up.”
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