Health officials in South Africa have moved to tackle the deaths of many young men after traditional circumcision, after a 39-year-old man died following the "passage to manhood" ritual.
Officials said six deaths were recorded last week alone, and 120 people were treated in hospital for infections.
Boys of 18 are circumcised during the mid-year or end-of-year school holidays. The ritual takes place in the open air, performed by a clan elder who uses the tip of his spear to cut away part of the foreskin (the skin covering the head of the penis).
The custom has been widely criticised because it is done by untrained elders in unsterile conditions. Health officials say it causes many severe infections that can need amputation and sometimes lead to death.
Health department spokesman Sizwe Kupelo said 91 people died last year, 56 of them during the mid-year holidays. He added that five traditional surgeons had been arrested and that the government had banned circumcision in several areas where deaths were high.
Many doctors at the department said the situation was unacceptable: customs and traditions should be respected unless they become a danger to health or life.
Circumcision has become more popular because some studies suggested it lowers the risk of HIV, as the foreskin is especially vulnerable to the virus. The World Health Organization estimated that circumcision could prevent 4 million HIV infections between 2009 and 2025.
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