This week 200,000 festival-goers are gathering in Mutoto, Uganda, where they will enjoy the music, dancing, party atmosphere and the traditional ritual circumcision without anaesthetic of at least 1,000 teenage boys.

Males from participating tribes are told that if they do not volunteer they will be captured and circumcised by force. One MP said the chilling words: “If you know any Mugisu who is dodging the circumcision, show him to us and you will get sh500,000 [£115] as a reward.” The Ugandan Tourist Board is marketing this as a major tourist attraction, with the blessing of President Museveni. This comes just two weeks after a mob in neighbouring Kenya reportedly abducted at least 12 men from different tribes and forcibly circumcised them in the street. Dozens more were said to be camping outside the police station for protection. No one has been yet arrested for the assaults.

Every year across sub-Saharan Africa, hundreds of thousands of boys and young men submit to initiation ceremonies. The specifics vary, but typically youths will spend weeks living near-naked in temporary shelters with minimal sleep, food and water. After the operation the penis is bound tightly with sisel leaves.

The human devastation left in the wake of these traditions is horrifying. A recent report by South Africa’s Commission for the Promotion and Protection of the Rights of Cultural, Religious and Linguistic Communities calculated that in the Eastern Cape and Limpopo provinces alone at least 419 boys have died since 2008, and more than 456,000 initiates have been hospitalised with complications.

Deaths commonly occur through dehydration, blood loss, shock-induced heart failure or septicaemia. And there are estimated to be two total penile amputations for every death. Countless numbers of participants are left with permanent scarring or deformity. Urologists describe seeing patients whose penises have become so infected and gangrenous they literally drop off.

Most ceremonies are nominally voluntary, but it is questionable how easy it would be to resist the cultural pressure to take part. One young South African who spoke out after his penis was amputated following a botched circumcision was severely beaten as punishment for shaming the ceremony. When women elders condemn what is happening to their sons, they are vilified by tribal leaders.

Authorities acknowledge the scale of the problem. The Western Cape cultural affairs executive member Dr Nomafrench Mbombo has said the deaths across South Africa should be seen as nothing less than a national crisis. The South African Human Rights Commission calls it “endemic carnage”. Various laws have been passed or proposed, and some money has been found to support medical circumcision as an alternative, but still boys die by the dozen.

Perhaps most shockingly of all, we have no idea of the true scale of the problem. South Africa has relatively well-developed governance and public health systems, but many initiation schools are unlicensed and illegal, so the full toll of death and injury may be hidden. In other countries tragedies simply go uncounted.

The international health, human rights and development bodies that could fund and conduct research or support local efforts to contain the problem are distinguished only by their silence. The last time the World Health Organisation (WHO) published anything significant on this problem was in 2009, when it made a few nods towards the devastating health consequences, but primarily concerned itself with how such initiations could be employed in the drive to circumcise African men as an Aids prevention strategy.

It may well be that the continent-wide circumcision campaign to prevent Aids is a principle cause of the institutional silence on the issue. It seems likely that the WHO, UNAIDS and similar bodies are reluctant to say or do anything that might undermine the drive. Leaving aside the ongoing epidemiological debate about the effectiveness of the strategy, it is self-evident that non-clinical circumcision can be actively harmful, leaving bleeding wounds or incomplete removal of the foreskin which can increase risks.

There may also be a fear that interfering in traditional customs could be seen as cultural imperialism. In effect this entails abandoning those within countries and cultures who are desperately striving to change habits. As Mbombo told me: “The Western Cape government would welcome any involvement by the international community or development bodies such as WHO, Unesco or Unicef in assisting with bringing awareness to local communities in South Africa about the health risks and benefits of traditional rituals like initiation and circumcision. The government believes that initiation and/or circumcision is a cultural practice with health implications. We support the administering of this practice, however it must be done in a way that does not jeopardise the health and wellbeing of the young men.”

Dr Kegakilwe of the Rural Doctors Association is understandably wary of international bodies trampling over traditional customs, but noted: “The relevant people to pronounce the correctness of the procedure are the traditional authority and the health department. The [wider] health community should only come in if the procedure at its best is having negative health consequences to the population and/or is anti-human rights.”

There is much to be admired in the rituals and ceremonies that mark the transition of African boys into manhood. The South African constitution rightly protects traditional cultural mores, while legislation forbids practices that are unsafe, injurious or violations of the rights of children. Within South Africa and many other countries, there are many courageous campaigners who seek to reconcile these ambitions. They need and deserve the support of the international community, not its indifference.