Twenty-one male initiates have already died this initiation season in South Africa, News24 reports. There are concerns that the death toll will continue to rise. While deaths have occurred across the country, the highest number of deaths has been in the Eastern Cape, home of the Xhosa people among whom the initiation ceremonies are most commonly, although not exclusively, practised.

The Cooperative Governance and Traditional Affairs (COGTA) minister Zweli Mkhize announced the new death toll statistics recently. Asked about what his organization and the government plan to do to curb these deaths, Mkhize responded by saying:

"We have issued guidelines which amongst others directs that initiates must be given drinking water and we are aware that this is not happening yet. The local monitoring committees should intensify their efforts to monitor their oversight and, where instances of criminality are detected, together with the South African Police Services, they must act and bring all those responsible to book."

These coming-of-age initiation ceremonies are heralded as being necessary in a young man's life and his passage to manhood. The ceremony itself, called ulwaluko in Xhosa, involves a journey to an isolated area or a mountain and primarily focus on the circumcision of boys which is their entry into manhood. The young men are then are then taught about manhood and masculinity by elder males in what is supposed to instill good moral and social values. The late Nelson Mandela, having been Xhosa, speaks about this sacred rite of passage in his book Long Walk to Freedom.

However, several challenges have plagued the ceremonies over the years and resulted in the unfortunate and often preventable deaths of the lives of many young men. These challenges range from illegitimate initiation schools or centers, hygiene issues and a lack of basic medical knowledge during the performing of the circumcisions as well as looking after the health and well-being of the initiates thereafter.

Many South Africans have accused Xhosa men especially of being silent when it absolutely matters most. This follows the nationwide outrage that was sparked by the 2017 film Inxeba: The Woundwhich sheds light on ulwaluko and centers a queer narrative. Many Xhosa men and people in general, fought for the film to be banned (which it was temporarily) as they felt it was a perverted disclosure of a sacred and private cultural ceremony.

Some of the initiates died from dehydration after not being given water for days. Others died from sepsis, either from the knife used in the circumcision not having been sterile or the onset of infection following the circumcision. One initiate was burnt alive while asleep and another committed suicide by hanging. In an attempt to help regulate initiation practices in the country, the government's National Assembly adopted the Customary Initiation Bill which take effect in 2019.