By ASIVE NGXOWENI AND SIBABALWE TAME
As initiation season is about to kick off, the Sarah Baartman District Department held one of the various training workshops for iingcibi namakhankatha (traditional surgeons and nurses) in October, at the Graham Hotel.
Among the stakeholders present were representatives from the Sarah Baartman District Department of Health, Makana Municipality, and the Isiko Loluntu organisation for traditional surgeons and nurses. Initiation coordinator for the Sarah Baartman District Mr Makhi Mka, said that the workshop was a refresher course for iingcibi namakhankatha in preparation for initiation season.
The workshop served to fix any challenges that traditional surgeons and nurses faced. More importantly, the Sarah Baartman District’s main aim is to prevent deaths, during initiation season, which they have successfully managed to do for the past 14 years.
Covid 19 protocols beforehand
According to nurse Nande Picani, while there are fewer cases of Covid, it is still a health risk. This means that everyone involved in the initiation school needs to get tested, including the traditional surgeons and nurses. Picani adds that if the initiate plans to go into the initiation school on Saturday, for example, he should have been tested by Wednesday of that week. If the results are positive, then the potential initiate will have to wait 7 to 10 days to get tested again as preparation for initiation.
Picani added that when in the initiation school, Covid can be contained by following these protocols:
- Not having too many people in a tent at a time – to maintain social distancing;
- The initiates should stay in their own tents and not visit other tents;
- Everyone should use clean water to clean (and not sanitiser because it is flammable);
- If a child gets sick, the health department should be notified so that they can provide treatment support.
Hygiene at the initiation school
One of the most important aspects of ensuring the success of the initiation schools is hygiene. Professional nurse Lutho Mshiya said that water is the main contributor to hygiene since sanitiser cannot be used. He further highlighted that running water is the best and the way to achieve this is by hanging 5-litre bottles of water in a tree and creating a makeshift tap which can open and close the bottle.
When it comes to hygiene, one of the most important practices is keeping the traditional surgeons’ and nurses’ hands and instruments clean. This means that they should always clean their hands when going from one initiate to another. The running water then comes in handy because they can use it and by keeping it clean, germs and disease cannot travel and this further prevents the department of health from going into the schools as this may lead to stigma.
While water is vital during initiation season, one member from Isiko Loluntu raised a concern about Makhanda’s own water crisis. That although the municipality is meant to provide water to the schools, not all the initiation sites received water during the previous season and the onus was on Mr Mka to deliver water to them.
Prevent dehydration, give them water
“Dehydration causes a lot of problems,” said Mshiya. For example, 3 days without water leads to pneumonia.
He emphasises that water prevents a lot of health problems. When asked about how much water is sufficient, he responded by saying there is nothing like too much water because it helps clean the system.
Sepsis can often lead to the malfunctioning of certain organs and even death.
“If we practice hygiene and hydration, then sepsis is preventable,” said Mshiya.
He said that while the Sarah Baartman District has not had such cases in the past, if such cases do arise for some reason, then the department of health needs to be involved.
Professional nurse Mr Zama Mbatyoti also added that another issue that may lead to sepsis is not changing bandages regularly and that traditional nurses should regularly check them.
Haemophilia is a medical condition where the blood clot is severely reduced. Professional nurse Mr Zama Mbatyoti, states that usually this illness is detected when the child is still young. Therefore when they go into the initiation school, measures can be put in place to support the child.
Mbatyoti said that while the traditional surgeons and nurses should be aware of this condition, there has never been a case reported in the Sarah Baartman District.
According to Mbatyoti, some people are born with epilepsy while others develop the condition later in life.
A concern raised during the workshop is that the traditional surgeons and nurses had no first aid training to deal with such conditions. Sarah Baartman District initiation coordinator Mka, noted that first aid training should be provided for them.
If a child tests positive for HIV, their status remains confidential. This is to protect the child and is also in line with the POPI Act. In order to protect themselves, iingcibi namakhankatha should follow safety measures anyway, when dealing with the initiations.
If a child tests HIV positive, then they will start treatment immediately. If the child’s viral load is too high, then the child cannot go to the initiation school until their viral load is normal.
Forms related to screening
In order to go to initiation school, the child should go to the clinic 2 weeks before the initiation process so that they are aware of their health and be aware of any illness they may have.
There are forms that they will need to produce before they go into the initiation school. If a child is screened in a clinic outside of Makhanda, they need to provide filled-in forms from the clinic they attended.
Makhanda clinics and times for screening
- Raglan Road Clinic – Mondays to Thursdays from 14:00
- Tantyi Clinic – Tuesdays to Thursdays from 14:00 (Friday morning is according to the booking system)
- Extension 7 Clinic – Tuesday to Friday from 14:00
- Joza Clinic – Everday except for Wednesdays
- Day Hospital (for towns and farms)
Issues faced by traditional nurses and surgeons
- Initiation sites have become dumping areas. The waste also includes surgical needles and drugs which creates a health hazard. This issue was reported to the Makana Municipality whose responsibility is to clean the sites.
- Lack of water is an issue because the initiation school relies heavily on water, especially for hygiene purposes and to prevent dehydration. When water does get delivered to the sites, there should be an equal distribution.
- Families sometimes do not follow protocols on how the process of initiation is conducted by the traditional surgeon and thus can create a health hazard.
- There should be monitoring of the number of initiates for which the traditional surgeon is responsible because each surgeon should have a limited number.
Makana Municipality responsibility
Makana municipality representative and public participation officer Afika Adams, informed the traditional surgeons and nurses that he will take note of all the matters that were discussed and will provide a follow-up from the municipality.
Gaga added that the Makana Municipality should take responsibility for the process and insure that the sites are clean.
Sarah Baartman District support
Sarah Baartman spokesperson and councillor Ms Nomhle Gaga, thanked the traditional surgeons and nurses for their service and that the government is in support of the initiation process.
Gaga added that a Moral Regeneration Programme will be in place and this speaks to Ubuntu. She requested that when the young men come back from the initiation school, they should be part of the programme.
Isiko Loluntu’s secretary Mr Xolani Simakuhle added that when the initiates return, the programme will be beneficial to them because they are also taught the principles of ubuntu and how to conduct themselves as men.