South Africa: Initiation Season - Traditional Nurses On the Frontline in the Eastern Cape

What the report says

AllAfrica carried a Health-e report from 29 July 2026 examining the role of amakhankatha, or traditional nurses, during South Africa’s winter initiation season, based on contributor Tembile Sgqolana’s repeated visits over five weeks to one initiation school in Komani, Eastern Cape, where his son was an initiate. The report stresses that the observations are limited to that school, but uses them to show how much daily responsibility traditional nurses carry.

Health-e reported that the Cultural, Religious and Linguistic Rights Commission recorded 43 initiate deaths across several provinces during this winter season, including 14 in the Eastern Cape. The same figures cited 75 hospitalisations, 180 rescues from illegal initiation schools, more than 100 criminal cases and at least 40 arrests. The report also noted that, in October 2025, the Eastern Cape Department of Cooperative Governance and Traditional Affairs announced training for traditional surgeons and nurses in OR Tambo and Alfred Nzo districts after identifying skills gaps.

At the Komani school visited by Health-e, traditional nurses were described as monitoring wounds, preparing food, watching for illness, supervising initiates and providing discipline and guidance. The first eight days after circumcision, known as ifuku, were presented as especially sensitive because initiates remain in their huts as wounds begin healing. Anele Tatiya, identified as a traditional nurse, said training includes hygiene, diet and general wellbeing.

The report also raised concerns, including observations of some traditional nurses drinking alcohol while on duty and parents bringing alcohol to them. Chief Gwazinamba Matanzima of the Eastern Cape House of Traditional Leaders said the role requires responsible older men who can guide initiates, while the provincial Health Department has linked many complications in initiation seasons to poor wound care, dehydration, malnutrition and weak supervision.