Unless you’re a healthcare worker, you’ve probably never seen anything like the pictures on Ulwaluko.co.za. “Please be warned that this website contains graphic medical images of penile disfigurement under ‘complications’ and ‘photos’,” it alerts visitors to the site. You need to be 13 years old or above to enter, the warning continues.

I first saw the images while researching initiation schools last year. Dingeman Rijken, a Dutch doctor who works at Holy Cross Hospital in Flagstaff, Eastern Cape, and has treated over 200 boys injured at initiation schools around Pondoland, sent a file classifying the different complications experienced at initiation schools.

There’s a range of categories of penile complications. There’s local sepsis, from the discharging of pus to gangrene. Some boys have wound defects to the penile shaft, from moderate loss of penile skin to complete loss and gangrene. Then there’re injuries to the glans, from the loss of epithelium to tissue loss and, you guessed it, gangrene.

Over a cappuccino in one of Braamfontein’s hipster cafés, I brought the file up on the laptop screen. The images made me gag, spitting the coffee back in the cup. I closed the laptop and looked around to see if anyone was looking over my shoulder. When it was clear, I reopened the gallery of injured, rotting penises but couldn’t look and closed it once more.

The Community Development Foundation of South Africa (Codefsa) found the images on Ulwaluko so graphic that it complained to the Film and Publications Board, asking for the site to be closed for featuring “pornographic” and “extremely sexual explicit pictures”. The application to ban the site was supported by the Congress of Traditional Leaders SA (Contralesa), which argued that the cultural practice is supposed to be kept secret from outsiders, especially women and the uninitiated. The Ulwaluko site doesn’t only show the graphic images but also describes what happens at Mpondo initiation schools.

Many of the public complaints the website received agreed. “I feel bad about this, [be]cause our culture has been kept as a secret to other people. And now everyone knows what happens in the Bush and who would want to go for Circumcision after seeing this. I know people are dying there but come up with a better plan,” wrote one visitor. Another threatened Rijken, “You bitch white people must leave our ritual alone, and if I can see you I will real kill you with my hands.”

The PFB found in Rijken’s favour. It ruled: “The website contains material which may be very disturbing and harmful to children. However it must be borne in mind that even though the website contains graphic images, it is a bona fide scientific publication with great educative value. The website highlights the malice that bedevils this rich cultural practice. It does not condemn this rich cultural practice but makes a clear plea for it to be regulated so that the deaths do not occur. This has been extensively covered in the media and is a matter of public concern, specifically to South Africa.”

Ulwaluko was told to ban viewers under the age of 13 because they wouldn’t be able to understand the site’s educational value. As well as complaints, Ulwaluko has also received numerous letters of support. They range from thanking the site for “exposing” the practice to even offering to host the site abroad if it gets banned in SA.

An appeal to the PFB was launched by Codefsa. It argued Rijken violated his patients’ rights to confidentiality, was undermining cultural rights and customs, and promoted pornography. He responded to each in turn.

Each photo was used after obtaining consent, he replied, and many of the boys want to share their horrible experiences. It’s the deaths and mutilations that undermine cultural rights, not the website, he argued. “Any person who derives sexual pleasure from viewing the photographs suffers from a serious paraphilia. Therefore this complaint is nothing short of absurd,” he said on the allegations of porn. On Tuesday, the FPB appeal tribunal upheld the original decision, with the added requirement that viewers also be warned that the site could be disturbing for those with cultural sensitivities.

Over 80,000 boys went to initiation schools around the country in 2012 and in the Eastern Cape alone over 800 have died since 1995. Every season, when the media reports that dozens of injured or dead boys have died during initiation, government leaders bemoan illegal schools that operate without authority, the necessary health professionals, and flouting the most basic rules. Rijken works among the AmaMpondo, which features particular problems. Over 150 years after the practice was stopped by King Faku, it became popular again in the 1980s. There’s much demand and much money to be made, but in some areas lack the necessary institutional knowledge.

Ulwaluko was a considered response to the problem. While government says it’s cracking down on illegal schools and helping to monitor the different sites, Rijken had little confidence last year that the situation was improving. Key to the issue is the role of traditional leaders. Speaking to them, there’s little recognition of the tragedy, no sign they understand or take responsibility for so many deaths.

Rijken proposed last year that in his area the number of initiation sites be reduced from 69 to seven, one per chief, to improve monitoring. They’ve trailed the idea on a small scale and believe it works. His idea to centralise the circumcision process wasn’t accepted, despite some community support. He also believes the circumcision practice should be performed by medical practitioners.

Archbishop Desmond Tutu has also weighed in on the problem. “The guardians of South African health and culture must find the means to work together to protect the sanctity of our traditional practices,” he said in January. “We must protect these practices, but we must avoid placing too much focus on the physical and psychological ordeal.” Rijken agrees schools would benefit if they place a greater focus on teaching culture rather than circumcision and physical feats to be endured.

“Radical change is needed,” says Rijken. His work on the issue has earned him a meeting with Contralesa next week. If they come up with a suitable plan to combat the deaths and injuries, Ulwaluko will take the photos down from its website. Until then, the photos will remain. They’re confronting, but hardly compare to the shocking numbers of young men who die or get their penises amputated every year due to unsafe circumcision practices in some initiation schools. To confront their grievances with the website, traditional leaders will first have to confront the problems that have gone on for far too long. DM

Photo: Initiates walk bare footed as part of tradition in the field outside an initiation school in the Eastern Cape, South Africa, July 19, 2006. Every year thousands of youths leave their parents to spend weeks in the care of traditional leaders at an initiation school where they are circumcised.  REUTERS/Siphiwe Sibeko