Impact of small arms insecurity on the public health of pastoralists in the Kenya–Uganda border regions

Small arms must be considered as a public health problem, but quantifying the public health impact of small arms is difficult and studies are sparse in areas of conflict. This study considers the remote cross border area between Kenya and Uganda where pastoral conflict in the form of cattle raiding with the use of small arms has escalated in recent years, and where health facilities are scarce. Hospitals and clinics in Karamoja, Uganda, and West Pokot, Kenya were visited by the author, to collect any available data on small arms injuries. Interviews with hospital staff helped to provide further insight into the statistics. Statistics showed that most injuries were sustained during raiding, though worrying incidences of injury among noncombatants and young children were found. Many serious injuries and limb fractures were documented, likely to have some long-term implications for pain, growth, disability, and livelihood. Deaths and injuries are likely to be significantly underestimated by the statistics, due to problems of transport, insecurity, deaths prior to arrival, admission fees for some facilities, and fear of reporting injuries due to the criminal element. Police statistics support this conclusion. The situation appeared to be worse in Uganda as opposed to Kenya, but cooperation between the two countries is needed since pastoralists readily cross the borders both to raid and to attend clinics and hospitals