July 10 – From the SA Medical Journal, June 9 2009 - “Sleeping with a gun under your pillow in South Africa is not that uncommon. Given the soaring crime rates, people live in a constant state of fear and understandably many have taken precautionary measures to try and protect themselves and their loved ones.
Picture: Durban photographer Snowy Smith captured hundreds of small South African children being taught the ‘execution game’ by their adult carers at the Durban marina recently – indicating the atmosphere of gun-related violence in which these children are being raised.
“Sometimes this heightened state of anxiety and terror can result in tragedy – as witnessed last week, when a Sandton man mistakenly shot and killed his domestic worker’s 12-year-old son whom he mistook for an intruder. A few years ago, a former Springbok rugby player shot and killed his own daughter, after mistaking her for a car thief.
“According to the International Action Network on Small Arms (IANSA), a global movement against gun violence, South Africa has the fourth highest gun-homicide rate in the world. It also has the second-highest violent-death rate in the world, with 122 deaths per 100,000 people.
The organisation is calling for a Gun-Free 2010 World Cup in South Africa, following the shooting of an ANC councillor and member of the World Cup local organising committee earlier this year.
But firearm injuries are not just disabling to the individuals and communities they affect, studies show they also place a huge burden on state hospitals.
127,000 bullet wounds a year treated at SA state hospitals:
A recent study published in the South African Medical Journal* states that 127,000 individuals are treated at South African state hospitals each year for non-fatal firearm injuries with bullets. This news makes a mockery of the South African police crime statistics, which show that more than 80% of these gun-shot injuries never are reported to the police, although this is required under the South African legal system. http://www.saps.gov.za
- The study estimates the average minimum cost for treating a gunshot injury at a tertiary hospital in South Africa in December 2006 was R15,722 ($US 2,230).
Based on extrapolated results from the study, the treatment of gunshot injuries at Tygerberg Hospital in 2006 cost the state a whopping R7,825,500 ($US 1,110, 000). The study included all patients with firearm-related injuries who were seriously injured and required admission for more than 12 hours.
Gunshot trends - study findings
- Young male adults made up the majority of gunshot victims (87%) with an average age of 28 years.
- Most were unmarried (89%).
- Most patients sought medical care between 7pm and 7am and mostly over weekends.
- The distribution of bullet entry wounds shows that most of gunshot injuries were in the legs, chest area and head.
- The average length of stay was 5.8 days at an average cost of R2,714 ($US 385) per day.
- Most patients (95%) underwent diagnostic imaging and 38% required surgical procedures in theatre.
- Blood products were given to 16%.
According to the study, the greatest costs were: admission and duration of hospital stay, including ambulance transport and haemodialysis (64%), followed by diagnostic imaging (14%), surgical procedures (12%), and blood products (11%).**
Researchers recommend that “a national costing initiative, utilising a standardised costing system, is urgently required to efficiently determine the real costs of trauma to South Africa’s already under-resourced health system”. http://www.samj.org.za/index.php/samj/issue/view/90/showToc
One important aspect of these gunshot-wounds in South Africa, according to the Institute for Security Studies, is that more than 85% of all the guns used are AK-47 military assault weapons. And these are notoriously difficult to treat, with patients often requiring extensive rehabilibation and long-term hospitalisation. see
The Firearms Control Act
In South Africa, the Firearms Control Act (2000) replaced the Arms and Ammunition Act (1969). The new Act introduces more rigorous firearm control processes and procedures in South Africa, according to the Institute for Security Studies (ISS).
- The Firearm Control Act has forced licensed gun owners to re-apply for their firearm licenses and lock their weapons up in registered gun-safes, with more stringent testing and background checks applied. Of course none of these new rules and laws would ever be applied to the huge criminal gangs which are the primary users of guns, illegal or otherwise.
However, in June the Pretoria High Court ruled that licences obtained under the 1969 firearms legislation will be deemed valid for now. This means that millions of gun owners who have not yet renewed their firearm licences in terms of the new Firearms Control Act have been granted temporary relief.
8,286 confiscated firearms went missing from police control…
- Concerns over the security of the impounded firearms have also been raised. In response to a question in parliament earlier this year, the Ministry of Safety and Security acknowledged that some 8,286 firearms which had been recovered by the SAPS, had subsequently been lost, stolen or otherwise misplaced, said the ISS website.
Joseph Dube, IANSA Africa Coordinator said the 2010 World Cup was an opportunity, and that every football stadium in SA should be declared a gun-free zone in accordance with the Firearms Control Act of 2000. He also called for an immediate moratorium on the carrying of guns and that no new gun licences should be issued until the end of the tournament. "2010 is not only a chance for South Africa to showcase its beauty and thriving businesses to the world, but a chance for the government to show that it is tough on gun crime," he said on the IANSA website.
- * Data was collected from Tygerberg tertiary teaching public hospital in Cape Town, 128 out of 203 gunshot victims were admitted for more than 12 hours
** These figures exclude the costs of staff salaries and laboratory and pharmacy costs.
*** The costs in the study were published in US dollars, these were converted to South African rands, using mid-market rates from 31 December 2006 – when study occurred). The Rand’s value to the US dollar has dropped by 17% since that time.
- Norberg, J, Nilsson, T, Eriksson, A, Hardcastle T, “The costs of a bullet – inpatient costs of firearm injuries in South Africa, South African Medical Journal, June 2009, Vol.99, No.6, pp 442-444. http://www.samj.org.za/index.php/samj/issue/view/90/showToc
- Times Online, http://www.thetimes.co.za/News/Article.aspx?id=914936
- International Action Network on Small Arms (IANSA), http://www.iansa.org/index.htm
- Institute for Security Studies, http://www.iss.co.za/index.php?link_id=19&link_type=12&tmpl_id=2
- The SA Police Statistics, located on their documents page of their website, haven’t been updated since the end of 2007. http://www.saps.gov.za These statistics do not reflect the fact that the country’s state hospitals now treat an average 127,000 gunshot wounds a year.
- AK47 gunshot wounds notoriously difficult to treat http://www.dnaindia.com/mumbai/report_for-doctors-treating-ak-47-bullet-wounds-proves-tough_1211586