Accidents, Injuries, and Safety among Artisanal and Small-Scale Gold Miners in Zimbabwe

Artisanal and small-scale gold mining (ASGM) employs 14-19 million people globally. There is limited research on accidents, injuries, and safety in Zimbabwe's ASGM. This study investigates the prevalence of accidents and injuries, as well as the associated risks and existing safety practices. A cross-sectional survey was conducted among artisanal and small-scale gold miners. Data from 401 participants were analyzed using descriptive statistics and regression analysis. The prevalence of accidents and injuries was 35.0% and 25.7%. Accidents associated with experiencing injuries included mine collapses and underground trappings. The major injury risk factors were digging, blasting, being male, being 18-35 years old, crushing, and the underground transportation of workers and materials. Injuries were reported highest among the miners working 16 to 24 h per day. Participants had heard about personal protective equipment (PPE). There was training and routine inspections mainly on PPE use. Mine owners and supervisors were reported as responsible for OSH, which was mainly PPE use. Practices including the use of wire winch ropes and escape routes were rare. There was ignorance on underground mine shaft support. The mining regulations that had the potential to introduce comprehensive safety controls were not adaptable. We recommend applicable health and safety regulations for Zimbabwe's ASGM

Health and Safety Risk Mitigation among Artisanal and Small-Scale Gold Miners in Zimbabwe

Artisanal and small-scale gold mining (ASGM) is often associated with no or compromised attention to health and safety. Although headlines of fatal accidents in Zimbabwe characterise ASGM, little attention is paid to prevention strategies. This study, therefore, explores health and safety risk mitigation in ASGM in Zimbabwe to inform prevention strategies. A qualitative design was used with focus group discussions and in-depth interviews. Data were analysed using thematic analysis, coding, and descriptive statistics. Reported factors contributing to compromised health and safety included immediate causes, workplace factors, ASM related factors, and contextual factors, with interconnectedness between the causal factors. In addition, factors related to ASGM were significant. For risk mitigation, formalisation, organisation of risk reduction, behaviour change, and enforcement of prevention strategies is proposed. A multi-causal analysis is recommended for risk assessment and accident investigation. A multi-stakeholder approach could be considered for risk mitigation including community and public health interventions. However, risk mitigation has been characterised by gaps and weaknesses such as lacking ASM policy, lack of capital, poor enforcement, negative perceptions, and non-compliance. Therefore, we recommend addressing the threats associated with health and safety mitigation to ensure health and safety protection in ASGM

An analysis of trends and distribution of the burden of road traffic injuries in Uganda, 2011 to 2015: a retrospective study

Introduction: gobally, 1.3 million people die from road traffic injuries every year. Over 90% of these deaths occur in low-and-middle-income countries. In Uganda, between 2012 and 2014, about 53,147 road traffic injuries were reported by the police, out of which 8,906 people died. Temporal and regional distribution of these injuries is not known, hence hindering targeted interventions. We described the trends and distribution of health facility reported road traffic injuries in Uganda from 2011 to 2015. Methods: we obtained monthly data on road traffic injuries, from 112 districts from the Ministry of Health Uganda. We analyzed the data retrospectively to generate descriptive statistics. Results: a total of 645,805 road traffic injuries were reported from January 2011 through December 2015 and 2,807 deaths reported from 2011 through 2014. Injuries increased from 37,219 in 2011 to 222,267 in 2014 and sharply dropped in December 2015 to 57,149. Kampala region had the highest number of injuries and deaths (18.3% (117,950/645,805) and 22.6% (634/2807)) respectively whereas Karamoja had the lowest injuries and deaths (1.7% (10,823/645,805) and 0.8% (21/2807)) respectively. Children aged 0-4 years accounted for 21.9% (615/2807) deaths; mostly females 81% (498/615) were affected. Conclusion: road traffic injuries increased during 2011-2014. Injuries and deaths were highest in Kampala and lowest in Karamoja region. It was noted that health facilities mostly received serious injuries. It is likely that the burden is higher but under reported. Concerted efforts are needed to increase road safety campaigns in Kampala and surrounding regions and to link pre-hospital deaths so as to understand the burden of road traffic crashes and recommend appropriate interventions

Adherence to oral HIV pre-exposure prophylaxis among female sex workers in Kampala, Uganda

Introduction: In Kampala Uganda, female sex workers (FSWs) have high HIV prevalence (33%). Oral PrEP is a novel HIV prevention intervention that offers hope to decrease HIV incidence in key populations especially among FSWs. Studies have shown that with poor adherence, oral PrEP has no efficacy, and therefore adherence to PrEP is critical among FSWs to maximize HIV prevention. However, implementation data on adherence to PrEP among FSWs is limited so this study sought to assess adherence to PrEP. Specifically, we sought to 1) determine the level of adherence to PrEP among FSWs, and 2) determine factors associated with PrEP adherence. Methods: This cross-sectional study was conducted from November to December 2018; 126 FSWs using PrEP were interviewed using a questionnaire. Adherence was categorically defined as high adherence and low adherence. Logistic regression was done. Results: Using long-term contraception methods (OR 0.06, 95% CI: 0.04-0.77) and not using condoms with clients (OR 0.07, 95% CI: 0.01-0.42) were negatively associated with high PrEP adherence. Conclusion: Barriers to PrEP adherence need to be addressed for successful PrEP implementation to improve adherence going forward. Service care providers should reinforce positive behaviors such as use of condoms devotedly during PrEP breaks

Spatiotemporal analysis of encroachment on wetlands : hazards, vulnerability and adaptations in Kampala City, Uganda

Thesis (PhD)--Stellenbosch University, 2016.ENGLISH ABSTRACT: Wetlands provide vital ecosystem services including water purification, flood control and climate moderation, which enhance environmental quality, promote public health and contribute to risk reduction. The biggest threat to wetlands is posed by human activities that transform wetlands, often for short-term consumptive uses. Population pressure, urbanization and industrial developments, among other factors, have resulted in severe degradation of wetlands. In the face of increased climate variability, several hazards continue to emerge, affecting the vulnerable sectors of society, especially the poor. This study sought to quantify and map the extents and spatiotemporal dynamics of human activities in wetlands, taking a case of Nakivubo wetland that drains Kampala city’s wastewater to Lake Victoria; assess the range of hazards, perceived vulnerabilities and associated factors among wetland communities, and assess the benefits and opportunities informal wetland communities in Kampala Uganda derive from their location in the wetland and how they adapt to minimise vulnerability to hazards such as floods and disease vectors. In order to achieve the study objectives, a mix of methods were used. These included GIS and Remote sensing techniques for analysis of very high resolution aerial photos and satellite imagery (captured in 2002, 2010 and 2014), a survey of 551 households, four focus group discussions among wetland communities and five key informant interviews with stakeholders. Analysis of land cover in Nakivubo wetland showed a 62% loss of wetland vegetation between 2002 and 2014, which is mostly attributed to crop cultivation. Results from the survey showed floods and waterlogging as the principal hazards; however, secondary effects of floods and waterlogging such as disease vectors and diseases affect more people than the floods. Tenants were more likely to be exposed to floods, but less likely to prefer to adapt, and to perceive themselves able to afford adaptation than landlords/homeowners, and households that spend more than US$80 per month were less likely than households that spend less to be exposed to floods. Households that had been exposed to floods before were more likely to perceive themselves as vulnerable. Free water from spring wells and cheaper rental units topped the benefits associated with location while the main benefit associated with the wetland itself is that it supports crop farming. However, cultivation in the buffer wetland vegetation makes it unstable to anchor to the substrate, implying that it will likely be calved away by receding lake waves as evidenced by the 2014 data. With barely no wetland vegetation buffer around the lake, the heavily polluted wastewater streams will further deteriorate the quality of lake water. Furthermore, with increased human activities in the wetland, exposure to flooding and pollution will likely have more impact on the health and livelihoods of vulnerable communities. There is a need for coordinated adaptation strategies that involve all stakeholders, and a multi-faceted approach such as ecosystem-based adaptation needs to be implemented; possibly through zoning out the wetland and restricting certain activities to specific zones so as to enhance equitable utilisation of wetland resources without compromising their ecosystem services and benefits.AFRIKAANSE OPSOMMING: Vleilande bied belangrike ekosisteemdienste soos watersuiwering, vloedbeheer en klimaat moderering, wat die omgewingsgehalte verbeter, openbare gesondheid bevorder en bydra tot risiko vermindering. Die grootste bedreiging vir vleilande is die transformasie daarvan as gevolg van kort termyn menslike aktiwiteite en hul verbruikende doeleindes. Bevolkingsdruk, verstedeliking en industriële ontwikkelings, onder andere, het gelei tot ernstige agteruitgang van vleilande. In die aangesig van die verhoogde klimaat variasie, kom sekere gevare steeds na vore wat die kwesbare sektore van die samelewing, veral die armes, affekteer. Hierdie studie poog om die mate en tyd-ruimtelike dinamika van menslike aktiwiteite in vleilande te kwantifiseer en te karteer, en neem 'n gevallestudie van Nakivubo vleiland wat Kampalastad se afvalwater na Lake Victoria dreineer; evalueer die omvang van gevare, waarneming van kwesbaarhede en verwante faktore onder vleiland gemeenskappe, en om die voordele en geleenthede wat informele vleiland gemeenskappe in Kampala, Uganda put uit hul nedersetting in die vleiland, te bepaal, asook hoe hulle aanpas om kwesbaarheid vir gevare soos vloede en siektes te verminder. Om die studie se doelwitte te bereik, is verskeie metodes gebruik. Dit sluit in GIS en afstandswaarnemings tegnieke vir die ontleding van baie hoë resolusie lugfoto's en satellietbeelde (vasgevang in 2002, 2010 en 2014), 'n opname van 551 huishoudings, vier fokusgroepbesprekings onder vleiland gemeenskappe en vyf belangrike informant onderhoude met belanghebbendes. Ontleding van gronddekking in die Nakivubo vleiland het gewys dat 'n verlies van 62$ 80 per maand spandeer was minder geneig as huishoudings wat minder spandeer om blootgestel te word aan vloede. Huishoudings wat blootgestel was aan vloede voorheen was meer geneig om hulself as kwesbaar te beskou. Gratis water vanaf die lente putte en goedkoper huureenhede het die voordele verbonde aan die omgewing oorskry, terwyl die grootste voordeel wat verband hou met die vleiland is die ondersteuning van gewasverbouing. Egter, verbouing in die buffer vleiland plantegroei maak dit onstabiel om te anker, wat impliseer dat dit waarskynlik weg gekalf sal word deur die afname van meergolwe soos blyk uit die data van 2014. Met skaars geen vleiland plantegroei buffer rondom die meer, sal die hoogs besoedelde afvalwaterstrome verder die meer se waterkwaliteit verswak. Verder, met verhoogde menslike aktiwiteite in die vleiland, sal blootstelling aan vloede en besoedeling waarskynlik ‘n groter impak op die gesondheid en lewensbestaan van kwesbare gemeenskappe hê. Daar is 'n behoefte aan gekoördineerde aanpassingsstrategieë wat alle belanghebbendes betrek, en 'n veelvuldige benadering, soos byvoorbeeld ekosisteem gebaseerde aanpassing moet geïmplementeer word; moontlik deur die sonering uit die vleiland en die beperking van sekere aktiwiteite tot spesifieke gebiede sodat die billike benutting van vleiland hulpbronne kan verbeter sonder om hul ekosisteem dienste en voordele te kompromiseer

Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda.

BackgroundThe burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda.MethodsWe conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials.ResultsSelf-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value ConclusionThis study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths

What could go wrong with cooking? Exploring vulnerability at the water, energy and food Nexus in Kampala through a social practices lens.

Sub-Saharan African cities like Kampala face challenges with rapid urbanization and impacts of climate change. These challenges have exacerbated the struggle to provide adequate infrastructural and socio-ecological services to Kampala's growing poor. Based on a social practices perspective, this paper presents a study of emergent vulnerabilities at the urban Nexus of water, energy and food (WEF) in the informal settlements of Bwaise and Kanyogoga. We employ methods of observation, interviews, focus group discussions and a vision-building workshop to explore the growing vulnerabilities of poor households as they daily navigate deteriorating water quality, rising energy prices and food insecurity. Results indicate that most household-level vulnerabilities relate to energy poverty. Households scale back on water treatment practices such as boiling and the cooking of highly-nutritious yet energy-demanding foods such as beans in efforts to conserve charcoal. Emergent practices of everyday resilience-building include the use of biomass briquettes as an alternative to solid charcoal as well as social networks and capital which allow households to borrow food and energy. We suggest the notion of ‘precarious consumption’ as a tool for understanding emergent everyday vulnerabilities in relation to the urban WEF Nexus service provision and resilience policy-making in cities of the Global South.</p

Opportunities and barriers to effective operation and maintenance of public toilets in informal settlements: perspectives from toilet operators in Kampala

Although classified by the Joint Monitoring Programme (JMP) as unimproved sanitation facilities, public toilets still play a critical role in eliminating open defecation in informal settlements. We explored perspectives of toilet operators on opportunities and barriers to operation and maintenance (O&M) of public toilets in informal settlements. A cross-sectional study design was used. Up to 20 in-depth interviews were used to obtain data on the experiences of public toilet operators. Thematic content analysis was used. Ressults show that opportunities for improving O&M include; operation of public toilets is a source of livelihood; operators are knowledgeable on occupational risks, and the community is involvedin sanitation activities. Barriers to effective O&M include; high operation costs, failure to break even and a lack of investments in occupational health Therefore, there is need to recognise the significance of public toilets as a viable alternative to open defecation in areas where ownership of private sanitation facilities is difficult. Failure to observe the health and safety of toilet operators may further compromise O&M