Cape Town, South Africa - A South Africa teenager has died of malnutrition during initiation rituals in the Eastern Cape province.
He is the ninth youth to die this year during the initiation process, which involves weeks spent living in the bush, followed by circumcision.
Others died from circumcisions that led to infection or gangrene.
South Africa has taken steps to reduce the number of initiation-related deaths, but fatalities still occur every year - many in the Eastern Cape.
In the latest case, a group of youths had been kept in the mountains for three weeks and denied food, Eastern Cape provincial health department spokesman Sizwe Kupelo said.
"They look like skeletons," Mr Kupelo told the South African Press Association, adding that a man who had posed as a traditional healer was expected to be arrested in connection with the death of one boy.
"We don't understand why a human being can do something like this. This is against the custom, it is contradicting custom," Mr Kupelo said.
On Monday, another Eastern Cape youth died as the result of a botched circumcision - the eighth since the start of the current winter initiation season - and two more were hospitalised.
One of the two who are in hospital was reportedly circumcised by a traditional healer registered by the government in terms of a scheme to reduce the number of botched circumcisions.
There has been particular concern over circumcisions being carried out by inexperienced practitioners, in unhygienic conditions and using unsterilised implements.