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MPUMALANGA

DEPARTMENT OF HEALTHBRIEFING TO THE SELECT COMMITTEE

ON WOMEN, CHILDREN AND

PEOPLE WITH DISABILITIES

05 JANUARY 2014

COMMITTEE ROOM 2,

120 PLEIN STREET CAPE TOWN

Presentation Outline

1. Purpose2. Background 3. Stakeholders 4. Strategies 5. Role of the Department6. Role of the Ingoma Forum7. Responsibility of the initiate8. Responsibility of the Ingoma Holder9. Training of Traditional Surgeons

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Purpose

To brief the Committee on:

Circumcision deaths in the province during the 2013 season

Strategies by the Provincial Department of Health to prevent

further deaths

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Background

2009 has seen an unprecedented incidents of complications presenting at the

Health facilities from Traditional Circumcision Sites.

Such cases from initiation schools needed attention on corrective surgery and

management.

The Department responded by Establishing a team for medical and

surveillance support to the Ingomas.

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Background

In the year 2013:

134 Traditional Leaders were authorised by His Majesty.

57 traditional surgeons were trained by the forum.

30 148 initiates were covered by the Ingoma forum

31 deaths were experienced.

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Stakeholders

MDOH

COGTA

SAPS

General Practitioners

Traditional Leaders

Social Development

Local Municipalities

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Strategies

Strengthening planning prior departure of initiates and

monitoring of the initiation schools

Dedicate more health professionals to upscale support to the

traditional leaders on health related issues

Legislation of the Ingomas to get them regulated.

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Strategies

To mitigate against the loss of life during the initiations focus

should be on the promulgation of the Ingoma Bill.

The main objective of the Bill:

To regulate the holding of the Ingoma

To provide for the prohibition of forced attendance of the

Ingoma

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Objectives of the Ingoma Bill cont..

To provide commodities for the implementation and monitoring

of health and hygienic standards

To prevent unnecessary loss of life that seeks to undermine the

cultural practice.

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Role of the Department

To ensure availability of resources to train traditional

surgeons.

To conduct health screening to all registered initiates and

treat all minor ailments detected prior to traditional

circumcision.

High risk cases will be classified as not fit to undergo traditional

circumcision.

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Role of the Department cont……

To provide necessary commodities for the period (gloves and surgical

blades)

All initiates on Chronic medication will be given enough supply to

cover the initiation period

Health professionals both from the department and private

practitioners who have undergone initiation to be deployed to assist

during Ingoma at all sites

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Role of the Department cont……

EMS services will be on standby to assist in case of

any eventuality.

Tents will be erected on major site for the management of minor

adverse events and assess initiates for quick referral to the hospital.

Ensuring availability of transport for health professional to

support all the Ingoma sites as per the demarcation/clustering.

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Role of the Department

Provision of Forensic Pathology Services.

Development of a data base for all traditional Initiation

Schools.

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Role of the Ingoma Forum

To provide platform for male discussion and dialogue talks

To share ideas relating to male initiation

To harmonize ideas between tribal and health so as to ensure safe initiation

process.

The identification and co-ordination of stakeholders, their roles, needs and

expectations

Ensure that all Ingoma Holders are authorised by the House of Traditional

Leadership

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Responsibility of initiate

The initiate (minor) must obtain a signed consent form from

parent/guardian

Produce the consent form for the general health screening which is

to take place at least two months before initiation begins

(Ukugwaba)

Take treatment as prescribed by a health professional.

Report without any delay any adverse event for management .

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Responsibility of the Ingoma Holder

The person who wants to hold Ingoma must first obtain

approval for such from the king, queen of the traditional

community or the MEC for COGTA

She/he must also obtain approval for the use of the private

land from the owner or the municipality

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CONCLUSION

The Department acknowledges that South Africa is a country that

embraces cultural diversity. The department strives to create an

enabling and conducive environment .

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Thank you

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