As far as I know from what I've seen here in South Africa, it is a major medical problem when young men are taken on their ritual into adulthood by their sangoma, as it ends with their circumcision, usually performed out in the bush without proper care taken to ensure that it is performed in a sterile environment. It occurs several times a year that a number of young men are taken to a hospital all suffering from infections. Some have to have their penises amputated. Prolly sounds like a laughing matter, but quite a serious problem.