UNDERSTANDING AND PREVENTING DROWNING IN UGANDA
Drowning is the third leading cause of unintentional injury death; accounting
for 7% of all injuries. Over 90% of the estimated 322,000 annual global
drowning deaths occur in low-and middle-income countries. Although the
burden of drowning is believed to be highest in the WHO-African region, data
collection and surveillance for drowning in African countries is limited. Drowning
prevention strategies require adequate data on the burden and circumstances
of drowning to help ensure data-driven prevention efforts. The World Health
Organization recommends that all countries take steps to improve drowning data
so that prevention strategies can be context-specific.
In bid to contribute to data driven interventions, we carried out a two-phased study in Uganda. The study was conducted in 60 districts of Uganda for a period of 2.5 years (from January 1st, 2016 to June 30th, 2018). In the first phase, records concerning 1,435 drowning cases were found in the 60 study districts. Other than stating that the individual had drowned, there was very little information that could potentially guide prevention efforts.
The second phase was limited to only 14 of the initial 60 districts. In the 14 districts,
a total of 2,066 drowning cases were identified by community health workers and
confirmed through individual interviews with witnesses/family members/friends
and survivors of drowning. Most (1,332; 64%) of these were deaths. Using the
community approach, as opposed to official records, revealed more than three
times the number of drowning deaths in the same 14 districts. Almost half of all
people who drowned were engaged in an occupational activity at the time of the
incident.
These results show that drowning is a major cause of premature death in Uganda,
especially among young adults whose livelihoods depend on water activities.
However, most drownings are preventable through policies and regulations that
reduce exposure to drowning risk, and institution of interventions to ensure safety
around water. Drowning is a multisectoral issue, and all stakeholders (local and
national government, water transport, water sport, education, fishing, health, and
law enforcement) should coordinate to develop a national water safety strategy
and action plan. The strategy could address matters of leadership coordination,
funding, advocacy, awareness raising, prioritization, target setting, and monitoring
and evaluation.