The impact of adolescent initiation rites in East and Southern Africa: Implications for policies and practices

ABSTRACT The present formative research study reviewed existing literature relating to adolescent rites of passage and initiation ceremonies in East and Southern Africa (ESA), with a focus on Eswatini, Malawi, South Africa and Zambia to assess the impacts of these rites on youth in these countries. Research was conducted entirely online using Google, Google Scholar and the Widener University (US) database. The research found different cultures maintain a range of customs and practices to prepare young people for their roles and responsibilities as adults, and that some initiation practices have negative impacts on the physical, emotional and psychological health and well-being of adolescents. The research supports the conclusion that it is important to have policies and programmes that are designed to protect the rights and welfare of young people in ESA, and that local leaders and stakeholders play invaluable roles in determining and maintaining any changes to existing practices.


Introduction
In 2018, approximately 32% or 192 million of the total population in the East and Southern Africa (ESA) Region were between the ages of 10 and 24. Ten-to 14-year-olds make up 38% of that population while 15-to 19-year-olds and 20-to 24-year-olds make up 33% and 29%, respectively (United Nations Department of Economic and Social Affairs, 2019).
Adolescence is a period of great growth and development, and life experiences can have significant and lasting impacts, both positive and negative. As a result, adolescence is a time of great vulnerability. Human rights violations, particularly sexuality-related abuses, remain prevalent. Gender-based violence, child marriage and sexually-based adolescent initiation practices threaten the health and development of far too many young people worldwide (United Nations Department of Economic and Social Affairs, 2019).

Limitations of the RESEARCH
As with any research, there are limitations to this literature review. While some of the research included statements from individuals who had experienced a rite of passage, most were intellectual discourses about the practices and quotes from professionals working in various communities (Kamlongera, 2007;Pemba, 2012). First-person accounts may be limited because of the veil of secrecy surrounding initiation rites and the social consequences for individuals who speak out (Kamlongera, 2007). Data collected from individuals who were willing to speak represented an extremely small sample size (Pemba, 2012). In addition, qualitative responses were often conflicting/contradictory, based on personal experiences and what researchers and research participants had heard anecdotally (Siweya et al., 2018). For example, some community leaders maintain that initiation ceremonies are no longer being practised, or that rites receiving the greatest criticism have been discontinued. Community members, however, often revealed that to be untrue (Kamlongera, 2007;Malawi Human Rights Commission, 2006). Finally, some initiation rites have been changing over the years, so some of the research quoted may not reflect the most current practices. All of this indicates a range in accuracy about which rites of passage are still being practised, and how, where and by whom they are performed.

Adolescent rites of passage: east and Southern Africa
In much of ESA, adolescent initiation ceremonies and rites of passage were found to have numerous similarities •Adolescents receive strong pressure to participate, with serious social consequences for those who do not (Girls Empowerment Network Malawi (GENET), 2018).
•Rites of passage are deeply rooted in a cisgender (when a person's gender identity matches the sex they were assigned at birth) gender binary and centred in heterosexuality (Siweya et al., 2018), particularly for boys (Nkosi, 2008).
•Lessons about sex and sexuality are an important part, including, for girls, how to please their future husbands (Sotewu, 2016).
•Boys are circumcised, but girls do not undergo female genital mutilation (FGM). Male circumcision is done partly because of cultural values, and partly as a component of HIV reduction strategies. Men who undergo circumcision are seen as dominant over women and uncircumcised men (Banwari, 2015).
•Infliction of pain is often characteristic of ceremonies for boys, as is the pressure to endure it without complaint to display masculinity (Nkosi, 2008;Siweya et al., 2018). Boys who are circumcised in hospitals may not be considered "real men" because they did not learn to tolerate pain (Barker & Ricardo, 2015).
•Some girls are subjected to "virginity testing," either a physical examination to determine whether the hymen is intact, or intense questioning every month during menses (Kang'ethe, 2013;Padmanabhanunni et al., 2018).
•Shaving the head, arms, legs, genitals, regardless of gender, is common but not universal (Bullock, 2015).
•Either a single adult or group of adults is/are charged with the initiation ceremony in order to maintain cultural traditions; •Food, dress, dance and songs are part of the rituals (Kangwa, 2011;Sotewu, 2016).
Aside from these commonalities, certain adolescent rites of passage were country-specific.

Common adolescent rites of passage: eswatini
The literature about current rites of passage in Eswatini is limited and inconsistent. Several sources assert there is no adolescence, only childhood and adulthood; one is a minor for as long as one's parents are still alive (Mavundla et al., 2019;Mngadi, 2007). The most current statistics from the government do not mention rites of passage, so the extant literature speaks much more to historical observations. It appears, however, that two rites are still being practised to a certain extent: Lisango and liguma.
Lisango and liguma refer to younger boys sitting with older men and younger girls with older women to receive wisdom and advice (Mavundla et al., 2019). Lisango and liguma reinforce stereotypical gender roles and responsibilities; boys and young men are taught to be leaders and in control, girls and young women are taught to be submissive and how to be good wives and daughters-in-law (Mavundla et al., 2019). Girls are expected to remain abstinent until marriage (umcwasho), although once they are 18 they may engage in non-intercourse shared sexual behaviours (Van Rooyen & Hartell, 2010). Past male initiation rites included circumcision, which today is done more for HIV reduction than for cultural observance (Avert, 2009;Maibvise & Mavundla, 2014;World Health Organization, 2009).

Common adolescent rites of passage: malawi
Malawi is a country with over a dozen documented ethnic groups (Dionne, 2015). The types and frequency of participation in initiation ceremonies range depending on region and the cultures represented in each (Skinner et al., 2013). Initiations are concentrated in the south and in rural communities (Ahmed, 2014;Glynn et al., 2010;Ekine, Samati & Walker, 2013). Most of the available literature focuses on rites practised by the largest groups: the Chewa, the Lomwe and the Yao. Among the Chewa people, initiation ceremonies can happen between ages 8 and 18; as in other countries, most take place around the onset of puberty (Mutale, 2017).

Rites of passage for girls.
According to the literature, initiation rites for girls in Malawi have similarities. Some of the reported lessons taught to girls include: • They should not have sex before marriage. Out-of-wedlock pregnancy could bring shame to their families and put the girls' health at risk.
• They should avoid associating with girls who have not undergone initiation.
• They should not eat eggs; this could affect their ability to become pregnant in the future (Kangaude, 2017;Munthali & Zulu, 2007).
The most commonly documented practice for girls in Malawi is chinamwari, which teaches girls about menstruation, 'good morals,' HIV and AIDS and gender roles. Isolation from the community can last from one week to several weeks. Practices also include Labia Minora Elongation (LME), 'the expansive modification of the . . . labia minora' by pulling on them using oils, creams or other instruments (Martınez Perez et al., 2013;Shiva Kumar et al., 2017). Another part of chinamwari is learning how to move during sexual intercourse (Kangaude, 2017;Munthali & Zulu, 2007).
During initiation, girls dance naked to songs filled with sexual innuendos and explicit language. Attendees can pay a fee to touch the girls' breasts (Malawi Human Rights Commission, 2006). Once girls have completed initiation they are to have (usually unprotected) vaginal sex with a man to demonstrate they will be able to please their future husbands (Ahmed, 2014). This fisi ('hyena') is an older man who may be hired by a girl's parents or the initiation rite leader (Butler, 2016;Glynn et al., 2010;Munthali & Zulu, 2007;Skinner et al., 2013). Unprotected sex is encouraged, as it is believed the fisi, hand-picked for his 'good morals,' cannot have HIV or other STIs, so his semen cleanses or purifies the initiate (Maleche & Day, 2011). In one report, however, a fisi confessed to having HIV, which he keeps private when being hired (Butler, 2016). After her sexual experience with the fisi, a girl is presented to the community as an adult. Although the fisi practice was outlawed in Malawi in 2013, many girls still report being told they need to participate in it (Hauchard, 2017).
Initiation rites in the east and southern regions of Malawi include msondo and cindakula, performed before and after menarche, respectively. Msondo involves inserting a boiled egg into the vagina to break the hymen. Cindakula teaches girls how to move their bodies during sexual intercourse (Kamlongera, 2007).

Rites of passage for boys.
Traditional circumcision has a long history in certain ethnic groups, such as the Yao. Historically, Yao boys were circumcised in isolation, and considered men when they returned to the community (Mkandawire et al., 2013). More recently, medical circumcision is practised to reduce HIV and other STIs. Circumcision differs from one locality to another. In some areas, only the frenulum is cut; in others, the foreskin is removed, sometimes by the initiation ceremony leader, or Ngaliba, using their fingernails (Mkandawire et al., 2013). The initiation can last four weeks or longer to let the circumcision sores heal.
Language used during the initiation rite is sexually-explicit (some of the literature describes it as 'obscene' ;Malawi Human Rights Commission, 2006). Boys are taught basic information about girls, including to not have sex during menses or after their partner has given birth or terminated a pregnancy. The morning after the ceremony, graduates are shaved and bathed at the river, treated to a celebration feast and given new names as a symbolic transition into adulthood (Malawi Human Rights Commission, 2006;Pemba, 2012). Boys are encouraged to have sex at the conclusion of the initiation (Munthali et al., 2004).

Common adolescent rites of passage: south Africa
Rites of passage for girls. Intonjane is a rite of passage among the Xhosa people that begins with menarche (Padmanabhanunni et al., 2018). Girls are secluded from their communities and taught about their bodies, hygiene, menstruation and more. Ceremonies are often done at initiation schools, which girls say they feel pressured to attend to show their respect for traditional authority (Froneman & Kapp, 2017;Malisha et al., 2008). Initiation ends with an elaborate celebration with dancing, singing and offering of gifts to the initiates' ancestors (Malisha et al., 2008;Padmanabhanunni et al., 2018).

Rites of passage for boys. Ulwaluko, traditional circumcision and initiation into manhood, is an
ancient rite practised (though not exclusively) by the amaXhosa (Banwari, 2015;Nkosi, 2008). Boys must demonstrate strength and willingness to take risks to show they are prepared to protect their families and be contributing community members (Siweya et al., 2018). They receive gifts at the conclusion of initiation to represent they are now capable of receiving property independently from their parents (Siweya et al., 2018;Vincent, 2008). They are then expected to take on greater social responsibilities (Ramokgopa, 2001;Siweya et al., 2018;Vincent, 2008).
Among the Venda, initiation usually lasts for 3 months and, as in other areas, begins in isolation so boys can demonstrate their survival skills, and includes circumcision (Malisha et al., 2008).
Some adolescent initiation rites for boys take place in initiation schools. Some schools have trained leaders running them, others are bogus schemes to make money from unsuspecting parents. Over the years, several hundred boys have been injured or died because of unsanitary, unsafe conditions, resulting in a bill being introduced to regulate South African initiation schools (South African Broadcasting Company (SABC), 2018). As of the writing of this document, the bill has not yet been voted on by the National Council of Provinces.

Common adolescent rites of passage: zambia
Rites of passage for girls. Zambia, like Malawi, has many Chewa people, and so the initiation ceremony for girls is also called Chinamwali or Chisungu (Mutunda, 2016). The rituals focus on menstruation and the power of menstrual blood, which is considered sacred. During menstruation, a girl's parents must remain sexually abstinent. After menarche, rituals involving stories, dancing and songs are performed (Mutale, 2017). Menstrual blood is handled cautiously, because touching it is believed to lead to infertility. The initiate is taught to not have sexual intercourse during menstruation, and that a menstruating woman should neither cook for others nor salt her own food (Kangwa, 2011).
Lessons about the essential roles of women are delivered through songs, dancing and marriage emblems (Kangwa, 2011). Initiates are taught how to have sex by adult alangizi. After the threemonth initiation, they are sent to an older man in the community to show what they have learned, as in Malawi. If they were not sufficiently trained in the eyes of this man, they must return for additional training (Labous, 2015).
Zambia's practices also include LME. Among the Bemba, elongated labia (malepe) are considered visually attractive, thought to increase sexual pleasure for both partners and believed to help open the vagina to facilitate future childbirth (Kaunda, 2013;Perez et al., 2015). Part of the Chisungu initiation includes inspecting girls' vulvas to see whether they have practiced LME (Kangwa, 2011). Some girls (and women) participate in a type of genital cutting (not FGM), in which they make razor cuts around their genitalia and apply umuthi, which dyes the scars. They are told this will enhance their partner's sexual pleasure (Mutale, 2017;Perez et al., 2015).

Rites of passage for boys.
While girls are initiated individually in their village, boys are initiated in groups in the bush, where they are challenged to prove their strength and masculinity through ore 'harsh' activities (Martınez Perez et al., 2013). As in other ESA countries, the male rite of passage includes circumcision, a practice that, although connected to reducing HIV transmission, is practised less frequently in Zambia (Olesen et al., 2012).

Discussion
The existing literature documents the physical, psychological, emotional and/or social impacts initiation rites have on adolescents. There are conflicting feelings in all four countries on the positive value vs. negative impacts of the initiation rites discussed in this document. It is difficult to categorize the rites as exclusively positive, negative or neutral, as some practices have positive as well as problematic aspects. It is clear that girls are affected disproportionately by negative consequences of initiation rites (Kapungwe, 2003). This may reflect the limited number of practices for boys vs. girls, as well as the accompanying expectation of boys to suppress any complaints.

Physical impacts of adolescent initiation rites
The most commonly documented physical concern for boys is risk of injury or death from infection from cultural circumcision and initiation practices designed to toughen them (Banwari, 2015;Kang'ethe, 2013;Nkosi, 2008). Malawian males who participated in an initiation rite also were more likely to have sex earlier than those who had not (Munthali & Zulu, 2007;Pemba, 2012;Stephenson et al., 2014). Early sexual onset is linked repeatedly in the literature to negative health outcomes, such as multiple sex partners, higher risk for STIs, including HIV, and unintended and early pregnancy (Carli et al., 2014;Epstein et al., 2014;Olesen et al., 2012;Santelli et al., 2017;Scott et al., 2011;Shrestha et al., 2016).
Aside from the reported physical impacts of labial pulling (pain, itching, swelling, and difficulty urinating), LME is seen by some as keeping girls and women subordinate, which in turn can increase their vulnerability for HIV infection and too-early pregnancy (Malawi & Widsaa, 2005;Martinez Perez et al., 2015). The fact that a fisi does not usually wear a condom also increases risk for HIV and other STIs and pregnancy. Early pregnancies tend to carry higher risk of miscarriage, fistula, or even death (Ahmed, 2014), and medical care is often inaccessible due to poverty or lack of infrastructure in rural areas. Early pregnancies can also lead girls to drop out of school, which limits their futures (Girls Empowerment Network Malawi (GENET), 2018;Labous, 2015).
Focusing exclusively on minimizing the physical impacts of adolescent initiation rites is insufficient. Proposing, for example, that sexual initiation rites can continue if a man wears a condom ignores the psychological and emotional impacts of the rites (Kamlongera, 2007;Malawi & Widsaa, 2005). It is imperative, therefore, that communities review the psychological, emotional and social impacts of initiation rites as well.

Psychological, emotional and social impacts of adolescent initiation rites
Psychological, emotional and social impacts are connected to self-esteem; self-esteem is related to sexual decision-making and health outcomes (Ethier et al., 2006;Kerpelman et al., 2013;Van de Bongardt et al., 2016). The positive social and emotional impacts of adolescent initiation rites include contributing to young people's identities and a more respected social standing in their communities. Fulfiling gender roles is seen as positive by both initiates and their communities. Lisango and liguma, for example, contribute to young men feeling more assertive and better-prepared to take on positions of leadership (Mavundla et al., 2019). While some girls felt empowered by the sexuality lessons, the accompanying message is that their value depends on how feminine and attractive they are, and whether they can please men sexually (Ekine, Samati & Walker, 2013).
In one study, physical discomfort notwithstanding, LME was seen as a positive tradition connected to cultural identity (Martınez Perez et al., 2013). Some Zambian women who had malepe reported feeling more accepted by partners, relatives, and the community (Martınez Perez et al., 2013). Connected to this was a sense of happiness and well-being that fulfiling cultural expectations preserves a country's history and identity.
Another positive impact of the rites is the sexuality education. Since it is generally considered taboo to speak about sexuality, ceremonies create a space for discussing it freely (Kangwa, 2011;Warria, 2018). At the same time, however, the extent and accuracy of the lessons are inconsistent, and health-related misinformation is often propagated. For example, some research participants reported being told that having malepe protects them from STIs and HIV (Martınez Perez et al., 2013).
Emotionally, holding a person up to an appearance or performance standard can lead to stress, negative self-perception and lower self-esteem and self-efficacy. Some girls who do not participate in LME, for example, experience fear and shame, which is exacerbated by their peers (Martınez Perez et al., 2013). LME is intrinsically connected to femininity, and girls are told if they do not have elongated labia, they are undesirable (Martınez Perez et al., 2013). The emotional impacts of feeling judged can affect physical health as well. Fear of judgement and stigma was reported to inhibit some girls and women without malepe from seeking routine or even emergency gynaecological care (Martınez Perez et al., 2013).
Initiation rites require young people to miss school, which can, in turn, put students behind and have an impact on their ability to graduate. This puts their financial futures at risk, as it is harder to earn a higher paying job without an education, especially for girls and women (Malawi Human Rights Commission, 2006). Finally, some girls shared that participating in rituals evoked self-consciousness and embarrassment due either to requirements to dance fully naked in front of others, or the fact that their menarche was being discussed publicly (Padmanabhanunni et al., 2018).

Sexual initiation practices as human rights violations
Reinforcing traditional, restrictive gender roles can result in practices that violate human rights, such as child marriage and FGM. Even with a greater focus on gender equality in ESA in recent years, the power structure is still patriarchal. Many rites of passage have strong gender role components that are designed to keep men strong and women subservient. Boys are socialized to acquire and guard physical and social power; girls are socialized to be passive and accommodating. This tends to limit girls from exploring their potentials beyond being wives and mothers (Malawi & Widsaa, 2005). Sexual initiation rites are seen by some as hazardous to girls' and women's overall health and wellbeing, that they violate girls' and women's rights to be able to choose a sexual partner, and to be able to say whether and when someone can touch their bodies (Malawi & Widsaa, 2005;Malawi Human Rights Commission, 2006;Warria, 2018). Some practices also communicate to boys and men that they have the right to touch a girl or woman, or to expect sex, whenever they wish.
The greatest amount of criticism of girls' rites of passage is towards the fisi and similar practices. Most researchers who have written about the ritual agree it is exploitative, and therefore a violation of girls' and women's rights (Malawi & Widsaa, 2005;Warria, 2018). There are numerous concerns relating to consent and self-determination and the power inequalities that are reinforced by this practice. Forcing girls to have sex with adult men violate girls' selfdetermination, particularly when girls cannot say whether they want to participate. Considering the age of initiates, some researchers consider sexual initiation practices statutory rape (Kamlongera, 2007;Leary, 2016). Warria (2018) notes that the fisi ritual is not always restricted to adolescence, and so girls and women may endure it more than once. This reinforces how vulnerable girls and women remain, particularly in rural areas. The long-term emotional consequences of rape and sexual abuse are well-documented around the world (Hillis et al., 2017;Meinck et al., 2016;Shiva Kumar et al., 2017). This means the three guiding principles of the United Nations Convention on the Rights of the Child (UNCRC) -the right to life, survival and development, the right to participate, and the best interests of the girl child -are being violated by the sexual 'cleansing' ritual. Separate from concerns about the fisi practice is labial pulling, which is included in the World Health Organization's definition of FGM (World Health Organization, 2009).
Although rites of passage are intended to educate young people about their cultures and roles and responsibilities in adulthood, some impede the obtainment of the SDGs, especially SDGs 3 and 4. Others contradict statements supporting human rights and adolescent rights by impeding young people's access to education; contradicting the region's shared commitment to gender equality and equal access to sexual and reproductive health and rights; and threatening the collective goal of promoting overall health and well-being for adolescents. When one SDG is affected, other consequences follow. Girls who become pregnant as teenagers are less likely to complete their education; with less education, they are less likely to secure a self-sustaining job; without a good-paying job, they are dependent upon a marriage and susceptible to being trapped in an unhealthy or abusive relationship. When boys are told they need to prove their masculinity, they often behave in ways that perpetuate toxic masculinity, gender inequality, and even violence against others.

Conclusion
For decades, there have been calls worldwide for greater gender equality. Even though progress has been made, cultures feel strongly about their identities, and want to teach their cultural values to youth to keep their traditions alive from generation to generation.
It is important to remember that many adolescent rites of passage have been around for generations, and are valued deeply by the communities practicing them. It is equally important to note that not every rite of passage has negative impacts, and that in some cases, organizations are emerging with programmes and plans for supporting gender equality through the rites. While it is positive that young people are receiving sexuality information as part of their initiations, the extent of the lessons is limited. With no oversight, it is not known how accurate the information is -as well as whether it is delivered in a way that builds positive self-esteem and self-efficacy, rather than using fear or shame or reinforcing role stereotypes. Far too many cultural rites of passage violate adolescents' rights, even as their intentions are firmly rooted in history and tradition. The core valueshelping adolescents learn about their cultures and prepare for adulthood -are sound ones. At the same time, however, the physical, social, emotional and psychological harm of too many of these practices requires serious review at the country and local levels. The movement towards change needs to be a collaboration between local spiritual, community and political leaders working in together with country-level legislators.
UNFPA intends to apply the findings from this literature review into the SYP programme to ensure integration of alternative rites of passage into current and future programming, both within UNFPA and with UNFPA partners. The more individuals in different countries are connected with each other to learn about what is being done in similar countries, the greater the potential for eliminating practices that are clearly harmful to youth.