Question NW3045 to the Minister of Health

Reply:

The Eastern Cape province has the following plans in place in preparations for the initiation season in December 2022, in order to prevent deaths of initiates prevalent in the that province: ambulances, proper nutrition and basic health care services

As part of the Customary Male Initiation, the House of Traditional Leaders coordinates the department Seasonal Contingency Plan which is used to prepare for the initiation season. This plan is used to coordinate the establishment of District Monitoring and Response Teams to ensure coverage of the areas where initiation schools are set up. The teams cover service areas such as clinical essential services and Ambulance Services that are to be on standby to respond to emergency calls from the initiation schools. The department further has the District Initiation Forums and working Committees which are part of Pre-Initiation preparations. These forums conduct awareness campaigns in local schools and communities to as they prepare for start of the initiations season

a) As part of the preparations for the initiation season, all Emergency Medical Service (EMS) ambulances are put on standby in the event of any emergency from the school. The Emergency Communication Centre is accessible as a free service on the 112-emergency number and the appropriate response will then be activated depending on the nature of the incident/illness. Through the District Initiation Forums and Working Committees, EMS is informed about the number and sites of all initiation schools within the province. In the event of an incident, the closest ambulance available to the initiation school will be activated. Given the large number of initiation schools, the number of days for initiation ceremonies and the day-to-day EMS demands, it will not be practically possible to allocate an ambulance to each school, because ambulance services is a response service rather than a service delivered at a given facility only and as such the province will not be able to place an ambulance at all initiation schools.

b) The provincial Department of Health through Nutrition sub-directorate will conduct a one-day workshop to be attended by at least one person per initiation school prior to the start of the initiation. The focus of the workshop will be on but not limited to the following:

• Screening for early identification of undernourished initiates
• Request form for nutrition supplements from the local clinic or hospital
• Provisioning of healthy, nutritious, and culturally acceptable foods including special diets e.g. diabetic diet
• Food safety principles within the context of the initiation schools

Some of the key areas which are part of the Pre-Initiation Preparations is to educate the communities and community leaders about is the importance of good nutrition

c) As per the Act directive and standard operating procedure to ensure eligibility of initiates, all boys going for initiation are referred for health assessment in all the Health Facilities. Basic medical assessment is done on all candidates to exclude and treat any pre-existing medical condition before the initiate is given a clinical clearance certificate as a precautionary measure from the Department for the boy to go for initiation. All boys with pre-existing health conditions are not allowed to go for initiation until such time that the condition has been controlled and such candidate is cleared by the health professional. Where a boy is on a chronic treatment, he and the family, including the Traditional Surgeon and Traditional Nurse, are educated on the importance of ensuring the treatment is continued eve for the duration of the schooling as prescribed by the doctor. Continuous monitoring of such initiates is conducted by the Department of Health monitoring teams.

END.