On 27th July, 2021, Makerere University joined the rest of the world to mark the 1st International Drowning Prevention Day. This follows a historic resolution by UN Assembly to declare 25th July the World Drowning Prevention Day.
This day was set aside to raise awareness about the devastating effects of drowning on families and communities globally.
According to WHO Data, an estimated 236,000 people drown every year, and drowning is among the ten leading causes of death for children aged 5-14 years. More than 90% of drowning deaths occur in Low- and-Middle-Income-Countries (LMICs), with Africa being among the most affected region.
While moderating Uganda’s webinar to mark this day under the Ugandan theme ‘Drowning: recognizing the silent burden and a call to action’, Dr. Olive Kobusingye, a Senior Research Fellow and Head of the TRauma, Injury And Disability (TRIAD) unit at Makerere University School of Public Health in a special way welcomed over 100 participants to the zoom session. She remarked that drowning is a big problem which affects many different types of people adding that it is preventable with good planning and investments at national and community levels.
‘’Nationally, we need to plan systems for gathering data, we need a work plan, resources, agencies and people mandated to prevent drowning. At the community level we need sensitization about the risk of drowning, we need people to report drownings when they happen, and we need them to participate in prevention efforts for the community (e.g. sensitization campaigns) and individuals (e.g. always wearing a life jacket when on water and heeding weather forecasts and warnings on dangerous waves on lakes)’’ Dr. Kobusingye explained.
Citing multi-sectoral approach, Dr. Kobusingye stressed the importance of different sectors working together to prevent drowning.
‘’Multiple sectors need to work together to bring about effective drowning prevention, but so far every sector is on their own. Some of the key sectors are not engaged at all. The lack of consensus around a common strategy and plan means that little action is taken’’ she added.
Moving forward, Dr. Kobusingye advised government to prioritize the fishing industry by providing leadership, coordination capacity and working with the private sectors to prevent drowning.
Presenting findings of a two-phased countrywide survey on drowning at the webinar, Frederick Oporia, a Research Associate and PhD Fellow at Makerere University School of Public Health revealed that drowning is among the silent leading causes of injury-related deaths in the country, and the most affected are fishing communities.
Highlights of the findings
Frederick noted that in the first phase, a total of 1,435 fatal and non-fatal drowning cases were recorded in administrative sources of 60 districts; 1009 (70%) in lakeside districts and 426 (30%) in non-lakeside districts.
’’In the seond phase, further exploration in just 14 districts out of the 60 was done. This phase involved community interviews. Through these interviews, a total of 2,066 new drownings were found, a number far higher than what was found recorded in administrative offices of 60 districts’’. he cited
Regarding demographics, he said fatal victims were predominantly male (85%), and mostly among the young adults with the average age of 24 years. Almost half (48%) of these drownings were related to an occupational activity. The study found that there was gross under-reporting of drowning incidents, partly because of the belief of most communities that drowning is ‘a will of God’ and so there’s no need to report what God has decided.
The majority (95%) of the people who drowned from a boating-related activity were not wearing a life jacket at the time of the incident.
To address these cases, Frederick revealed that MakSPH together with different stakeholders have developed the first ever National Water Safety and Drowning Prevention Strategy for Uganda. The strategy is hoped to guide all the efforts on drowning prevention in the country. As part of this strategy, he emphasized the importance of installing barriers to control access to high risk water sources, teaching children survival swimming skills, sensitization in communities to enhance behavioral change, safe boating and shipping regulations, training of first responders in safe search, rescue and resuscitation, building resilience and managing flood risks among others
In efforts to prevent drowning, Henry Ategeka, Principal Marines Inspector at the Ministry of Works and Transport revealed that the ministry has been donating some life jackets to police marines and some communities in dire need. He also said that there are plans by the government to strengthen laws around navigation to promote safety on Uganda’s water bodies.
As part of these plans, CP Ubaldo Bamunoba, the Commandant Marine Police said the country is in the process of unveiling a water safety strategy to curb drowning.
Mr. Ubaldo further revealed that his department is establishing several rescue centers at all major water bodies to support the rapid rescue operations. He also pointed out capacity building and marine training as one of the key mechanisms needed towards drowning prevention.
Mr. Sowed Suwagudde, Assistant Commissioner International Transboundary Water Resources at the Ministry of Water and Environment also stressed the need for partners to work together. “Water cuts across a number of sectors and if we are going to have success for our strategy, we will need to bring them all on board because they interact with the water environment.”
In his remarks, the WHO Uganda Country Office Representative, Dr. Fatunmbi Bayo Segun congratulated Uganda for marking the first ever World Drowning Prevention Day, adding that 2.5million drowning deaths in the last decade should remind everyone about the seriousness of the neglected injury. Moving forward, he emphasized the need for a multi-sectoral approach in reducing the burden of drowning.
In her closing remarks, the Minister of State for Relief, Disaster Preparedness and Refugees–Hon. Esther Anyakun acknowledged drowning as one of the leading causes of death, not just in Uganda but worldwide. She highlighted drowning as a silent burden with huge economic implications on the country thus calling for a multi-sectoral approach to counter it. She equally thanked Makerere University for taking lead in co-designing Uganda’s first drowning prevention strategy.
The webinar organised by Ministry of Water and Environment in Partnership with Makerere University attracted over 100 participants including policy makers, technical experts, researchers, civil society organizations, and researchers. Among issues discussed in a Q&A Session were causes of drowning, perceptions, laws, data, and policies around drowning. At this webinar, it was agreed by all participants that tackling drowning, a neglected injury needs a multi-sectoral approach where different sectors work together.
In a significant stride towards improving maternal healthcare outcomes, a recent study conducted by researchers has shown that an integrated intervention consisting of peer support, mobile phone messaging, and provision of mama kits at the household level is successful in increasing the proportion of facility-based births. This groundbreaking research comes at a time when Uganda is still grappling with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births and neonatal mortality rate also at 22/1000 live births.
In the 2024 BMJ Published study titled “Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomized controlled trial in Northern Uganda by researchers namely; Dr. Victoria Nankabirwa and a team including David Mukunya, Grace Ndeezi, Beatrice Odongkara, Agnes A Arach, Vicentina Achora, Levi Mugenyi, Mohammad Boy Sebit, Julius N Wandabwa, Paul Waako, Thorkild Tylleskär, and James K Tumwine, sought to evaluate the effect of the integrated intervention package on increasing the proportion of health facility births compared to routine government health services. Read More
SMART4TB Early-Stage Investigator (ESI) Scholar Program Cohort 2 Phase 1 Now Open for Applications Applications Due March 14 2024 Call for applications
Supporting, Mobilizing, and Accelerating Research for Tuberculosis Elimination (SMART4TB) is an initiative made possible by the generous support of the American people through the United States Agency for International Development (USAID) that aims to transform TB prevention and care. SMART4TB has launched an important capacity strengthening activity, the Early-Stage Investigator (ESI) Training and Mentorship Program. The program’s main objective is to train and support young investigators to develop, implement, and lead their own studies aligned with their national and local TB research priorities.
Investigators within 10 years of receiving their most recent degree or who are new to TB research, based at an institution participating in SMART4TB studies, and supported by their local institutional leadership will be eligible for participation in the program. The program has 4 sequential phases, each with specific eligibility criteria and deliverables required before advancing to the next phase.
Completion of all 4 phases will require the ESI to commit to an intensive training curriculum that includes: 1) Specific courses focused on competencies required for the design, implementation, and analyses of TB research 2) Close 2:1 mentorship from both a local and a SMART4TB faculty research mentor; and 3) Access to technical support consultations from SMART4TB experts.
Progress from one Phase of training to the next Phase will be a competitive process and is not guaranteed. ESI who successfully complete all Phase 1 requirements (Scholars Program) will be eligible to apply and compete for Phase 2 (Fellowship Program). Phase 2 applicants that are approved by SMART4TB and USAID will be required to identify a local senior research mentor. ESI enrolled in Phase 2 will also be matched with a SMART4TB faculty co-mentor. The SMART4TB Training and Mentorship Committee (TMC) will monitor the ESI’s progress throughout the program and assess the quality of the training and mentorship provided to the ESI. In Phase 2, each SMART4TB Fellow will be mentored to develop a full research proposal for which they will serve as lead investigator. ESIs who receive approval and support to initiate their research project can apply for Phase 3 and Phase 4 of the program.
Prerequisite Phase 1 Eligibility and Application Process ESI interested in applying for Phase 1 of this program must meet the following criteria:
Having a PhD as the most recent degree or are new to TB research; and
Be from a National TB Program (NTP) or institution/site participating in SMART4TB
USAID-approved studies; and
Have a letter of support from their local SMART4TB site/institutional leadership (signed on institutional letterhead).
All applications will be reviewed by the SMART4TB ESI Mentorship Advisory Committee. Final selection of Phase 1 participants will require USAID approval. Selected ESI will be notified by email.
The Secretariat, SMART4TB Early-Stage Investigator (ESI) Scholar Program Walimu Unit 4, Plot 5-7, Coral Crescent P.O Box 9924 Kampala-Uganda Deadline for receiving applications: 14th March 2014 by 5pm. Only short-listed candidates will be contacted.
Additional information To apply for Phase 1 of this program, please click: https://jhmi.co1.qualtrics.com/jfe/form/SV_0NiIqASiPJ92GRE For details about the Phase 1 curriculum and the progress report from the first Cohort, please see the attachments.
Preliminary findings from a study by Child Health and Development Centre (CHDC) -Makerere University have revealed several challenges faced by Forcibly Displaced Persons (FDPs) with chronic diseases like diabetes, hypertension and cardiovascular diseases. This study is specifically looking at FDPs in northern Uganda. Accessing food, water, medicine, clothing, toilet facilities, privacy and support is a challenge for healthy FDPs but for those with chronic diseases, these provisions may mean the difference between life and death.
According to Drs, Ritah Nakanjako and Esther Nanfuka Kalule, who are post-doc fellows at Makerere University, FDPs with chronic diseases are unable to access facilities with medicines. Speaking at the February monthly colloquium of CHDC, Dr. Nanfuka said, “Medicines and medical forms are sometimes forgotten by these patients yet some do not know the names of their medicines. For others, these medicines get finished along the way due to the abrupt movements.” These disturbances in the continuity of care affects their health and wellbeing.
As an example, she referred to the constant need to monitor blood pressure or blood sugar for these FDPs. “Even when facilities are available, you may not have the money to refill medicines or you may not remember the name of the medicine.” She added that the stress and trauma of this kind of situation usually exacerbates these conditions.
Speaking about the rationale for doing this research, Dr. Nakanjako said that non-communicable diseases (NCDs) are largely unrecognized and inadequately addressed in humanitarian settings, something which the Red Cross calls ‘a neglected crisis’. Yet, studies conducted among refugees and asylum seekers across the world report a high burden of NCDs. Uganda hosts over 1.5m refugees, the highest proportion in sub-Saharan Africa with the majority comeing from South Sydan.
“The objective of this study is to examine the experiences of FDPs- which will contribute to knowledge on innovative ways of chronic disease care. This will also contribute to the management of NCDs in humanitarian, low resource settings,” Dr. Nakanjako explained.
This 5-year study that started in 2022 will run till 2026 and is funded by the Novo Nordisk Foundation under the Mobility-Global Medicine and Research Fund. It is a collaboration between three institutions; Makerere University, the University of Copenhagen, Denmark and the Sudan Centre for Strategic and Policy Studies in South Sudan. This research is taking place in Nyumanzi Reception Center in Adjumani district; Nyumanzi Refugee Settlement also in Adjumani district; IDP Settlements in South Sudan; and the Bidi Bidi Refugee Settlement in Yumbe District.
Other challenges revealed by the FDPs with chronic diseases include the fear of drinking recommended amounts of water before or during travel to manage urine and to avoid stop-overs for security reasons.
After arrival at Nyumanzi Reception Centre in Uganda, these FDPs with chronic diseases do not receive any special care. It is only those with communicable diseases like TB. Cholera or Covid19 that get special care. Other challenges include; “a limited range of drugs, maintenance of cold chains for insulin, rationed water, lack of drinking water, lack of sanitary facilities and the congestion.