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David* of Pretoria plunges a needle into the bottle and fills a syringe. He pulls down the waistband of his school pants with one hand and deftly injects himself with the other.
As the animal hormone courses through his young body he has one thought on his mind: first-team rugby. It's hard to believe school-boys, even in primary school, are so desperate to be heroes on the rugby field they'd inject themselves with animal hormones. But it happens and Pretoria sports doctor Henry Kelbrick has the proof in his consulting rooms: several glass bottles each half-full of the illegal substance, thought to have been smuggled in from Spain or Mexico.
"I found them on two boys a few weeks ago. They're both 13 and come from ordinary homes. They got the stuff from gym instructors. I couldn't believe it. This is used on race-horses and dogs,'' Henry says.
He's a former Northern Transvaal rugby player who specialises in sports medicine.
At his practice at Loftus Versfeld Stadium in Pretoria he has seen several cases of children, parents and coaches going to extremes for the sake of school rugby over the past few years.
The consequences can harm a child for life. Take the kid who's now an epileptic as a result of pressure to play. And the one who almost played Craven Week rugby with a broken neck.
Henry has decided enough is enough.
"I can't keep quiet any more. Things are getting completely out of control.''
In this exclusive interview with YOU he lifts the lid on abuses in South African school rugby that are likely to make your hair stand on end.
Absurd extremes
Rivalry in school rugby is taken to absurd extremes, Henry says. It has increased sharply especially in the past five years. Some parents and coaches are fanatical about winning, which places immense pressure on children and leads to injuries.
"Neck and head injuries are drastically on the rise among schoolkids, even in primary schools. I used to see one case in six months. Now I see one a week.''
Recently a father walked into Henry's surgery with a 12-year-old boy who'd hurt his neck in a match. The injury was serious x-rays showed his neck was broken.
"When I gave the father the bad news he wanted to know how we could get his son fixed in time to play in Craven Week in 10 days' time. I had to pinch myself to make sure I was hearing right.''
Had the boy played there was a good chance he would have been paralysed for life. In another incident a rugby player at a leading Pretoria school was concussed twice in a short period of time.
"His doctor told him not to play rugby for the rest of the year but he was under a lot of pressure from his parents and coach and played in an important match.''
He was tackled hard and once again concussed.
"He sustained brain damage and started suffering from epilepsy. He'd also been a promising tennis player but now he probably won't be able to play either sport again,'' Henry says.
Ignoring doctors
Boys with serious injuries often play matches against their doctors' advice at the insistence of their parents and/or coaches, he says.
If a boy sustains concussion for the first time he shouldn't take part in sport for at least three weeks. The second time he should sit out the season and the third time he shouldn't play rugby for a year. If someone with concussion suffers another blow it can result in brain damage, epilepsy or even death, Henry warns.
"Any loss of consciousness is classified as concussion even if the person was out for only a second.''
It's for this reason some parents and coaches encourage children not to tell a doctor they were knocked out.
"You get a dad who'll search until he finds a doctor who'll declare his son fit to play the next Saturday's game even though he knows the child has a concussion.''
More serious
Rugby injuries among schoolboys are becoming more serious, among other reasons because the boys are getting bigger. Good nutrition could be an explanation but a big factor is tougher exercise programmes and supplements.
Some supplements are healthy but there are many that aren't and may even be illegal.
"One father was determined to make a rugby star of his slight 16-year-old son,'' Henry says. "He asked me how his son could gain 20 kg of muscle before December this year.''
Another father brought his sick son to see him. "The boy was jerking uncontrollably. He had serious symptoms of Parkinson's disease.''
Henry asked what he had been giving the boy. The man produced two shopping bags of supplements and all sorts of other substances, the most dangerous of which was a growth hormone with which he'd been injecting his son every day.
"The boy had to be hospitalised and an intern spent five days gradually weaning the child off the stuff.''
Illegal substances
Some parents encourage primary school boys as young as 11 to take supplements such as creatine or illegal substances such as steroids.
"You wouldn't believe what they give kids. And then they don't understand why they later develop diabetes, become aggressive or suffer from attention deficit disorder.''
The substances can also cause high blood pressure, kidney damage and skeletal abnormalities and can impede growth.
Many are sold on the black market or are illegally imported.
Even legal supplements can be damaging if they're used irresponsibly. "A biokineticist prescribes a particular dose, then the children think they'll get results three times faster if they triple it.''
Hormones and steroids make kids not only bigger and stronger but also more aggressive, Henry says. "I see injuries in primary school rugby that look as if they're from car accidents. Young boys should not have so much power and aggression they can hurt other children like that."
Not fun anymore
School rugby hasn't been just fun for kids for a long time, Dr Jannie Maree says.He's a Paarl-based clinical psychologist who specialises in sport.
"In the past few years it has become a highly competitive and professional sport.''
That's because schools have become businesses, manager of youth and club rugby for the South African Rugby Union (Saru) Mervin Green says. "The better a school does in rugby the more sports achievers it attracts and the better the `business' export product'.''
Dr Pierre Edwards, head of the Afrikaanse Hoër Seunskool in Pretoria and former Springbok rugby player, says this is why some schools have begun buying good rugby players.
"There are parents who literally tout their kids. They take them from school to school to see where they can get the best bursaries and benefits.''
This puts enormous pressure on the child, he says. "He must know he'll be tolerated only as long as he achieves in rugby. If he's injured and can't play any more he's out of the school.''
Some provincial rugby unions put schoolkids as young as 16 on contract, Mervin says.
It's clear there's a lot more than just rugby at stake, experts say. For a child with rugby talent there's a promise of bursaries, leadership positions, money and a bright future.
Boys who dream of being professional rugby players also realise they have only a few years to make it.
This can lead to them hiding injuries so as not to miss matches, former Springbok captain Joost van der Westhuizen says.
Win at all costs
There's an attitude of "win at all costs'' especially at under-18 and under-19 levels, says Gail Ross of the Chris Burger/Petro Jackson Players' Fund for rugby players who've sustained serious injuries.
Children wouldn't go to these lengths if they weren't being driven by a coach or parent, says Tim Noakes, professor of exercise and sports science at the University of Cape Town.
"Parents and coaches think they're supporting the child when actually they're driving him because of their own insecurities.''
Tough rivalry, exceptionally strong and aggressive kids and fanatical parents and coaches can lead to serious injuries.
"At every school some kids mark the other team's good players and try to get them off the field by hurting them,'' Jannie says.
No stats
Staff at the Chris Burger/Petro Jackson Players' Fund know of parents and coaches using colourful language to encourage kids to hurt the other team's players during matches, Gail says.
There are no official figures for injuries or deaths due to school rugby but the Chris Burger/Petro Jackson Players' Fund keeps records.
South Africa needs a programme that can accurately measure rugby injuries and deaths. For that we need many educational programmes, an accurate reporting system and thorough investigations of injuries.
"We're planning to hold a forum about this over the next few months,'' Gail says.
Solution
The solution to the problems in school rugby lies in cooling the rivalry and once again making it a pleasurable and educational sport, experts say.
"Children can enjoy rugby and learn valuable lessons from it. But that can happen only when winning isn't the main goal," Pierre says.
The first step is to do away with those sought-after trophies. "Schools should rather play friendlies so there isn't this obsession with cups and winning.''
And parents should do the minimum rather than the maximum to support their child in his sport, Tim adds.
"The chances of their son becoming a professional rugby player are very small. Rather give him the chance to enjoy a carefree school rugby career.''
Saru, the Sports Science Institute in Cape Town and the Chris Burger/Petro Jackson Players' Fund will continue to monitor school rugby, inform coaches about safety measures and do research aimed at improving safety.
Their advice to parents and coaches is always to consult experts such as biokineticists or sports doctors when they're considering gym exercise programmes or supplements for their rugby-playing sons or if they suspect a child might be injured. But one of the most important messages they'd like to give children, coaches and parents is: winning isn't everything.
"As long as the pleasure and success of rugby are measured by how many times you win there will be the risk of serious injury,'' Gail says.
"We need to remind everyone constantly what rugby really is: a game that should simply be enjoyed.''
*Not his real name.
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