Botched circumcisions in South Africa killed 40 boys and put over 100 in the hospital this month, a health official said Wednesday.
The boys, who were taken into rural areas and circumcised as part of traditional rites of passage, died from gangrene, dehydration and pneumonia, said Sizwe Kupelo, health department spokesman for Eastern Cape province.
Kupelo said practitioners of the rite are often not trained to carry out the procedure and can circumcise up to 50 boys with the same knife without sterilizing it in between.
"In some cases boys were not circumcised but mutilated," he told AFP.
"They use herbs to clean, hence this thing becomes gangrenous and infected," he said.
Kupelo said that the tradition was being exploited by young men in the eastern region of the province, rather than elders who should carry out the procedure.
"There's also an element of commercializing this whole thing. There are no seasoned and experienced traditional surgeons. Everybody's just doing it for profit purposes and there's no proper coordination."
The latest death occurred Tuesday in the town of Tsolo, where a 19-year-old initiate died shortly after being admitted to the hospital.
The death toll prompted traditional leaders to declare a moratorium on circumcisions in parts of the province earlier this month.
Kupelo said health authorities were visiting initiation schools to treat the boys' wounds and take them to hospital if needed.
The Eastern Cape is one of South Africa's poorest provinces and among the few areas where boys are still sent into secret schools for circumcision ceremonies to mark their passage to manhood.
Boys die every year from botched circumcisions by ill-trained traditional surgeons in rural areas. Last year in the Eastern Cape, 91 boys died from complications of circumcisions, 55 of them in June, when the winter initiation season is at its height.