At a wild initiation ceremony the Ingcibi, a traditional surgeon, explains the Xhosa way of circumcision. "You slice with the sharp tip of the spear." This particular surgeon is well respected, but there are others who are not so skilled. Their boys end up in the local hospital. In one clinic, 36 boys recuperate from serious circumcision injuries. One is critically ill from his wounds. It is not uncommon here for boys to lose their whole penis. Recently one young initiate who suffered such a fate committed suicide. Such tragedies have inspired a push for reform. The Health Department is campaigning for specialist training schools and for new surgical equipment. Yet resistance to change is acute. There is no community respect for families who seek doctors to circumcise their boys with anaesthetic. "He's not a man. You just tell him you've never been to the bush and endured the pain. A real man can take the pain."

Produced by SABC Special Assignment