JOHANNESBURG (AP) — At least 41 young men have died as a result of circumcision procedures as part of traditional initiation activities in South Africa in November and December, authorities said Tuesday.

Traditional initiation is a rite of passage into manhood for young men that is practiced annually by various ethic groups in Africa, including parts of South Africa. Among them are the Xhosa, Ndebele, Sotho and Venda communities.

Traditionally, young men are isolated at initiation schools where they are taught cultural values and responsibilities as they become adults. The circumcision part of the initiation results every year in the deaths of some initiates, forcing the government to intervene through legislation.

The laws force initiation schools to be registered with authorities, but this has not stopped the proliferation of illegal initiation schools where many of the deaths are reported.

Parents are expected to pay for their children to be accepted into the initiation school for the prescribed period, which for some is a financial motivation to start an unregistered initiation school.

Initiation periods typically run during winter (June-July) and summer (November-December) school holidays.

South Africa’s Traditional Affairs Minister Velenkosini Hlabisa told local broadcasters Tuesday that 41 initiates died during this year’s summer initiation. He blamed negligence on the part of both the initiation schools, including registered ones, and parents for not adhering to safety standards and medical advice.

Hlabisa said some of the unproven advice often given to the young men is to avoid drinking water in order to heal faster.

“There is negligence in terms of meeting health standards in some of the initiation schools. If you take your child to an initiation school, you never make a follow-up, you do not monitor, you do not go there to see whether the child does drink water, you are placing your child at risk,” he said.

Eastern Cape province has been identified as a hot spot for the death of initiates, totaling 21 so far.

Hlabisa said 41 people have been arrested in relation to illegal initiation schools, including parents who had supplied wrong ages for their children to be admitted.

Only children who are 16 years and above may be admitted to initiation school with parental consent, according to South African law.

Traditional initiation is widely practiced in African communities, with the return of the initiates often characterized by joyful, cultural celebrations.