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Initiation schools open doors for HIV treatment


Basotho are gradually dumping norms blamed for rising Human Immunodeficiency Virus (HIV) statistics in initiation schools.

Initiation schools’ common practices like sharing of razor-blades are shunned and infected initiates now continue their treatment while undergoing traditional training.

According to Basotho culture, initiation is a form of training that boys undergo to become responsible and respective men. It is expected that every boy will eventually attend initiation school as those who don’t, are mocked and are considered as cowards.

The schools have been known for traditional healing where traditional doctors have total control over the safety and health of the initiates.

The traditional healing is best known for usage of razor-blades among others to perform the rituals which usually aggravate the spread of communicable diseases like as HIV/ AIDS if not done appropriately.    

Circumcision is just one component of the full initiation ritual. Details are not readily discussed in public and the tradition is regarded with the utmost respect and most Basotho are said to still prefer traditional circumcision.

The initiation however remains a universally sacred tradition shrouded in secrecy between the initiates and their elders and this makes it difficult for professional doctors to intervene where health services are required.  

In a move to combat these challenges, Boramephatho from Semonkong have launched campaign to administer HIV testing on all boys before being admitted to the initiation schools.

According to one initiation leader, Malefetsane Monyamane, those found to be HIV positive start treatment and continue taking ARVs throughout their initiation process.

Monyamane is one of the five initiation leaders who were on July 26, 2019 honoured by St Leonard Health Centre for adopting HIV/AIDS testing in their schools in 2018.

He opened the school with 30 initiates back in 2014 and during that time, Monyamane said he did not know about HIV and his boys were not allowed access to professional healthcare services. “It was only in 2018 when St Leonard administration opened our eyes on the importance of testing boys before being initiated.

“As Basotho, there are some certain things that we do not believe in, especially the modern healing but St Leonard played a major part in showing us the risks of not treating HIV/ AIDS.” said monyamane.

He added according to the initiation norms, all initiates have to share almost everything and this was the factor that made it difficult for them to bring along their medication as they went through the initiation process.

Before this campaign, Monyamane said they used one razor-blade to perform the rituals on all initiates but currently, “we have advised each other and every initiate is obliged to bring along their tools”.

Monyamane blamed high rates of mortality among initiates on lack of proper health services when one became sick during the process. “Most of our boys died in the initiation schools and surely for some of them it was because of HIV/AIDS.”

In Lesotho, men voluntarily opt for traditional circumcision in initiation schools or the medical option in health clinics-Voluntary Medical Male Circumcision (VMMC).

VMMC has been promoted as an effective HIV prevention strategy to reduce HIV-negative men’s risk of HIV infection.

Despite this strategy being applauded for positive results in the fight against HIV, it’s practice in the highlands parts of Lesotho has met resistance with the boys still preferring traditional initiation schools.

Notwithstanding this predicament, St Leonard Health Centre has made history in Lesotho by breaking the culture that initiation schools are secrets and no outsiders could interfere with their activities.

According to the health centre Manager, Sister Constance Leuta, there is nothing wrong with initiation schools as long as initiates test for HIV before being admitted.

The health centre works closely with initiation school leaders surrounding Semonkong to reduce HIV infections within the young adolescents before and while they are at the initiation schools.

Impressed by the good working relations between the health centre and the initiations schools, Sister Leuta acknowledged male health professions who facilitate working relations between the centre and initiation schools.

“We have male health professions who take medication to the HIV-positive initiates while they are at the initiations, in order to reduce new infections as well as keeping those already taking ARVs (antiretroviral) healthy,” said Sister Leuta.

Sister Leuta admits it has always been a common cultural believe for Basotho that there is no easy way for outsiders to get close to initiation schools.

“But here in Semonkong we are talking a different story.

“If we really want to fight HIV/AIDs we should work together with all sectors of the community including initiation schools.

“Our approach to those people should be outstanding, we should respect them for the way they are doing their things as per the culture, educate them until they understand how crucial it is to work with health professionals.

“Here in Semonkong, no one goes to initiation school not knowing their status, they all know that because their leaders have made it easier for everyone,” she said.

She adds: “Prevention of new HIV infections is one of the biggest hopes to fight against HIV pandemic.”

Lesotho is one of the countries, most severely impacted by HIV/AIDS in the world, making the country the second highest HIV prevalence rate of 25 percent in the world.

However, in Lesotho especially in the highlands, the most common type of circumcision is not performed in a clean or safe setting by trained health professionals.

With the recent findings that male circumcision significantly reduces a man’s risk of acquiring HIV the practice is receiving renewed interest as the world looks to understand what this will mean for HIV prevention.

According to current estimations, approximately 30% of all males across the world representing a total of approximately 670 million men are circumcised.


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