Short Report
Is unemployment a major
reason for firearm attacks
in rural South Africa?
Ogunbanjo,GA, MBBS, MFGP (SA), M Fam Med (Mcdunsa),FACRRIVI
Dept. of FamilyMedicine {6,Primary Health Care, Mcdical University
of SouthernAfrica (MEDUNSA), Pretoria,SouthAfrica
Sotade,BO, MBBS, M FarnMed (Nledunsa)
Formerlyof the Church of ScotlandHospital,
Tugeli Ferry, KwaZulu-Natal, South Africa
Correspondence to:
ProJ. Gboyega A Ogunbanjo
Dept of FamilyMedicine fri PrimaryHealth Care, Medical Universityof SouthernAfiica
PO Box. zzz. Medunsaozoa SouthAfrica
E -mail: [email protected]
(SA Fam Pract 2oo7:45( to): t8- rg)
Introduction
In South Africa, firearms are
increasinglyusedin interpersonaland
factionalviolence.In a five yearperiod
(1987- 1992),gunshotwoundsofthe
torso increasedby 300% in KwaZuluNatal.r During the sameperiod, King
Edward VIII Hospital in Durban
recordeda mortality rate for firearmrelatedinjuries of eight times that for
stabwoundsand "direct admissions"to
the mortuary, three times as common
in casesofgunshot woundscompared
with stabwounds.2 In our descriptive
study,all casesoffirearm attacksseen
at the Churchof ScotlandHospitaland
the government mortuary at Tugela
Ferry in KwaZulu-Natal between
December1998and May 1999 were
reviewedto find out the reasonsfor the
attacks.All patients treated at the
hospitalfor non-fatalfirearm injuries
were interviewedusing a pre-tested
questionnaireand records from the
district surgeon and police were
examinedto identify all fatal firearm
injuries.
Profile of the victims
One hundredand fifty casesoffirearm
injurieswere identified and reviewed.
Seventy-fourof thesepeople (49,4%)
r8
Keywords:
unemployment,
sustainednon-fatal injuries and were
all treated at the hospital, while 76
(50,6%) died from their injuries and
were takento the govemmentmortuary.
There were 124 male (82,7%) and 26
female(17,3%) victims.Slightlymore
than half of the victims (79; 52,7%)
were betweenthe agesof 20 and 39,
and 95 (63f%) were unemployed.In
addition,therewas a preponderance
of
males among the victims with fatal
firearminjuries(68 out of 76;89,5%).
Reasons for the firearm injuries
The majority of the victims (79,4%)
could provide no reasonsfor the firearm
attacks,while only a fifth reported
reasonssuch as car hijack, robbery,
interpersonalconflict, taxi violence and
attemptedsuicide(TableI).
firearrn attacks, victims, South Africa
The most common causesof death
amongthe fatally injured victims (n :
76) were massivehemorrhagefrom
firearm injury site(s)and brain damage.
The authorsnotedthat firearminjuries
in this rural settingwere predominantly
a male phenomenon,with a male to
femaleratio of 4: l. As a public health
issue,the impactof theseattacksamong
males is very striking. The male
preponderance
might be attributedto a
high level of unemploymentand
increasedaggressionamongmales,who
are more likely to settle interpersonal
conflictsby physicalmeansor by using
firearms.3'a's'6
Undeterminable.intentionalassaultand
homicide have been shown to be the
most frequentreasonsassociatedwith
firearmattacksin urbanareas.T[n our
ableI: Reasonsfor firearm
Reasons
Frequency
Percentage
Unknown
t19
19,4yo
Car hijack
9
6,}yo
Robbery
A
2,7yo
lntemenonalconflict
14
9,3yo
Taxi violence
2
1,3%
Attemptedsuicide
2
1,3yo
Total
150
1000
S A F a mP r a c t2 o o 3 ; 4 b ( r o )
nt':,l_:
lt''1"r"
study,the samecouldnot be saidof this
rural area,as the majority of victims
had no record of the reasonsfor their
attacks.We suspectthat the victims
with non-fatal injuries were afraid of
possibleretaliationor reprisalby their
assailants
anddid not reportthereasons
to the police or doctorwhen they were
seen to. Powell arrdTanz noted that
families in urban communitieswith
income below the poverty level
accountedfor a high percentageof
It seemsthat our finding of
assaults.E
high unemploymentamong the victims
of firearm attacksmight be unique to
this rural areaof SouthAfrica. In this
study, firearm attacks seenat Tugela
Ferry were predominant amongst
unemployedyoung men betweenthe
agesof 20 and 39. It would be important
OF SOUTHEBN AFRICA
AznrakD, Altun G, Bilgi S, Yilmaz A.
Firearmfatalitiesin Edime, 1984-1997.
Forensic Sci Int 1998;95(3):2319.
Elfawal MA, Awad OA. Firearm
fatalities in Eastern Saudi Arabia:
impact of culture and legislation.Am
J ForensicMed Pathol 1997;18({):391-6.
Strong RW. Gunshot wounds of
Adolescents.
Metl J Aust I 980;I : 1l3-5.
6 . ByarugabaJ, Kielkowski D. Reflections
on trauma and violence-relateddeaths
in Soweto,July 1990-June1991. SAMJ
t994;84(9):6r0-4.
References
7. Wigton A. Firearm-relatedinjuries and
deathsamong children and adolescents
1. MuckartDJJ,MeumannC, BothaJBC.
i n C a p e T o w n 1 9 9 2 - 1 9 9 6 .S A M J
The changingpatternof penetrating
1999;89:407-10.
torsotraulnain KwaZulu-Natal- a
Powell EC, Tanz RR. Child and
clinicalandpathological
review.SAMJ
adolescentinjury and deathfrom urban
1 9 9 5 ; 8 51( )l : 1 1 7 2 - 4 .
firearm assaults:associationwith age,
2. MuckartDJJ.Trauma- themalignant
race, and poverty. Inj Prev
e p i d e m i c .S A M J 1 9 9 1 ; 7 9 : 9 3 - 5 .
1999;5(l):41-7.
for futurc studies to focus on the
relationshipbetweenunemployment
and firearm attacksin the country.We
believe that the provision of
employmentopportunitieswill help to
reducethe incidenceoflirearm injuries
in this rural area,and possibly also in
other parts of the country. This is an
exampleof a social issue that has a
direct effect on the public healthsystem.
MASTTRS
DTGRTT
IilTAMITY
MTDIflNT
6
PRI}'|ARY
IITATTII
ORT,
I{TDUNSA
(tamily
MMed
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tilKl
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