An estimated eight people drown every day in Uganda, but health experts say the country does not know how many people survive drowning incidents with permanent or life-changing injuries. The lack of data on drowning survivors means the health system has no clear picture of the long-term burden of accidents on Uganda’s lakes, rivers and other water bodies, despite evidence that many survivors are left with brain, lung and other injuries.
Cliff Asher Alega, a Critical Care Specialist at Aga Khan University Hospital, says the outcome for a drowning survivor largely depends on how quickly they are rescued and resuscitated. He says the chances of surviving without serious injury reduce significantly when a person remains without oxygen for several minutes.
Alega says some survivors are left with permanent disabilities even when they escape death. He says survivors may suffer partial paralysis, brain damage, hearing loss and partial lung damage, among other complications.
Alega says the quality and speed of resuscitation are also critical in determining whether a drowning victim survives and the extent of injury they sustain.
He says the problem is compounded by limited knowledge of resuscitation among some members of the public and even some health workers.
While Uganda has estimates of drowning deaths, there is no routine national data showing the number of people who survive drowning incidents and the injuries they sustain.
A 2016 survey by Makerere University School of Public Health estimated that about 3,000 people drown in Uganda each year in selected districts.
Otto Businge, a researcher at the Makerere University School of Public Health Centre for Prevention of Trauma, Injury and Disability, says the centre has not conducted a specific study on injuries among drowning survivors.
However, he says anecdotal evidence suggests that many people, particularly those living around water bodies, continue to live with injuries and trauma sustained during drowning incidents.
Businge says the research that produced Uganda’s first estimates on drowning deaths recommended that information from drowning incidents be incorporated into the country’s District Health Information System.
This, he says, would have enabled health authorities to track both drowning deaths and injuries among survivors.
Ten years later, the recommendation has not been implemented. Businge says Village Health Teams were subsequently equipped with smartphones and tools to collect community-level health information, but drowning injuries are still not routinely captured.
The absence of routine data has left survivors themselves as some of the few sources of information about the long-term consequences of drowning.
Moses Nsubuga, a drowning survivor, says he has lived with partial paralysis and persistent pain for five years following a boat accident on Lake Victoria.
Nsubuga says he was travelling from Kabulataka Island to sell timber to islands on the Kenyan side of the lake when a wave struck their boat at about 9 p.m.
He says the accident killed two of his colleagues, while he survived after being carried by the waves towards the wreckage of the boat, where he remained until he was rescued the following day by a Kenyan boat.
He says the right side of his body has never fully recovered.
Nsubuga experiences occasional pain and has difficulty moving the affected hand, which was partially paralysed.
He says they were wearing life jackets at the time of the accident but could not save themselves.
Moses Kalanzi, another drowning survivor and founder of SwimSafe Uganda, says the number of people affected by drowning is likely much higher than official estimates because both deaths and survivors with permanent injuries can go unrecorded.
Kalanzi says people who survive drowning but are left with disabilities often disappear from official statistics just as those who die without their bodies being recovered.
He says Uganda needs to strengthen prevention and rescue systems, particularly in communities living around water bodies.
Kalanzi cites poor-quality life jackets and limited knowledge of water safety among communities as some of the challenges contributing to drowning incidents.
Bashir Siriba, who coordinates the national drowning prevention programme in the Police Marine Unit, says the Government is developing regulations to enforce provisions of the Inland Water Act relating to safety on water.
He says enforcement of the regulations will help reduce accidents and improve safety on Uganda’s water bodies.
Police also partly attribute drowning incidents to passenger behaviour, saying some passengers only wear life jackets when they anticipate police operations.
Meanwhile, SwimSafe Uganda has launched the “3000 Campaign” to draw attention to Uganda’s estimated annual drowning deaths.
Kalanzi says the campaign also seeks to equip communities with swimming and basic water-safety skills so that people can respond to emergencies before specialised rescuers arrive.
He says about 5,000 people living in communities around inland water bodies have already received water-safety training outside the new campaign. Kalanzi says empowering communities with swimming, rescue and basic first-aid skills could help reduce deaths and improve the chances of survival following water accidents.
