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

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Abstract

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.

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Notes

  1. Interview with Dr. Marina Anghileri, Ministry of Health Matany mission hospital, Uganda, 21 June 2001. When I visited the Doctor she was so scared that she was even not willing to allow any interviews.

  2. See Anderson [4], Abrahams [2], Bukururu [10], Fleisher [16, 17], Egesa and Mkutu [15], Heald [27, 29], Mkutu [50].

  3. Mkutu [45].

  4. Abbink [1], Mkutu [45, 46, 48, 49], Anderson [3], Quam [63], SNV/Pax Christi [69], SNV [68]. Knighton [34], Bollig [7, 8], Walker [75], Dietz [14], Lamphear [35], Cappon [11], Fukui and Turton [18], Niamir-Fuller [53], Ndagala [52], Novelli [54, 55], McCabe [41].

  5. Field interviews done by the author in 2000–2004; Mkutu [45, 48], Pkalya et al. [61], SNV/Pax Christi [69], SNV [68], Niamir-Fuller [53], Mkangi [43], Belshaw and Malinga [6], Lamphear [35], Gulliver [25], Odegi Awoundo [58], Pazzigalia [60].

  6. Mkutu [44], Novelli [54], Niamir-Fuller [53], Heald [27], Hendrickson [30], Gulliver [25], Riamriam [64], SNV/Pax Christi [69].

  7. Mkutu [45]: for the agro pastoralist in Tanzania see Bukururu [10], Abrahams [2], Anderson [3], Tornay [71].

  8. Mkutu [45, 46, 48], SNV [68], SNV/Pax Christi [69], Gomes and Mkutu [19], Mirzeler and Young [42], Quam [63], Knighton [34], Walker [75], Belshaw and Malinga [6]. Noveli [54], Heald [26, 27], Tornay [70].

  9. See Heald [27, 28], Mkutu [48].

  10. Belshaw and Malinga [6], Mirzeler and Young [42], Ocan [57], Muhereza [51], Knighton [34], Fleisher [16, 17], Heald [26], Mkutu [44–46, 48, 50].

  11. See for example the military operation to flush our Ethiopian Oromo liberation front (OLF) rebels in Moyale Kenya. The conflict is spilling arms into Kenya. See Kenya Times 18 June 2004. http://kentimes.com/18jun04/nwsstory/news22.html. See also Daily Nation 18 June 2004 “Search for Ethiopian rebels is stepped up.” Seven guns and 70,000 bullets, landmines and grenades have been recovered from the armories belonging to OLF. See more in Mkutu [46, 48].

  12. Mkutu [48], SNV/Pax Christi [69].

  13. Interviews Moroto and Kotido October–November 2004.

  14. Makinda [38–40], Kinsella [33], Porter [62], Lefebvre [36], Lyons [37].

  15. Muhereza [51], Mirzeler and Young [42], Belshaw and Malinga [6], Mkutu [45, 46, 48], Gomes and Mkutu [19], Ocan [57], Quam [63], Patman [59].

  16. IRIN, 3 February “Amnesty and Peace groups urge International Criminal Court to probe government army too”

    Note that for many years Sudan government armed, trained and sheltered the LRA [Lord’s Resistance Army] in its territory and gave them the means to commit their crimes.

  17. African Confidential, 9th August 2002:1; Nyaba and Otim [56]; for facts on the supply of small arms by the current Ethiopian government to Dassanech see Tornay [71]. Toposa also received 50,000 small arms from the government excluding landmines see AFRICANEWS 68, November 2001.

  18. See for example IRIN 8 September 2003. “The Uganda government admitted using militia groups to fight the Lords resistance army.”

  19. Interview elder Koritantoyo Nakiliro, 2 February 2003.

  20. This include the vigilante groups and militia and warriors.

  21. See Mkutu [46, 48]. On arms flows in the entire North Rift region. See SNV/Pax Christi [69], Gomes and Mkutu [19] on vigilante on the cross border areas.

  22. SAS [67]: 174–175 and 201–202.

  23. Government of Kenya Economical Survey [21]: 44

  24. GoK [22]. Poverty Reduction Strategy Program 2001–2004: 59

  25. Mkutu [48]

  26. SNV [68]

  27. Research and policy tends to focus on supply-related issues such as the production and the mismanagement of stockpiles, inter-state transfers and illicit trade, technical aspects of weapons tracing, marking, collection and destruction, and on legal or normative regimes designed to stop the flow of weapons. See SAS [66]: 155.

  28. Karamoja and Sebei in Uganda and Pokot, Turkana and even Tranzonia in Kenya.

  29. West Pokot and Karamoja was part of the Eastern Province of Uganda until 1926, parts of the Eastern Province of Uganda including West Pokot was moved to Kenya by the British government.

  30. Kotido (2), Moroto (2) and Nakapiripirit (1) see http://www.health.go.ug/health units.htm.

  31. The expectation is the Kuria in Kenya who rustled cattle from within see Heald [28, 29]. For the Pokot it is illegal to rustle cattle from within.

  32. Based on the final results of the September 2002 National Population and Housing Census, Kotido District, which includes the newly created district of Kaabong has a population of 605,322 (302,206 males and 303,116 females). Moroto District has a population of 194,773 (98,145 males and 96,628 females). Nakapiripirit has a population of 155,150 (78,284 males and 76,866 females). These figures are questionable, how can a population increase from nearly 300,000 (1991) to nearly one million in 2003?. See Mkutu [48], Chapter 1 UBOs [72]. However, increase from 1991 figures to current figures is question see Mkutu [50].

  33. See http://www.health.go.ug/health units.htm.

  34. Kabongo became a district this year; initially the district headquarters for the region was Kotido.

  35. GOK [20].

  36. Interview Stephen Kaadu, 20 June 2001

  37. The ratio of doctor to patient in West Pokot is 1:84. This is 528 in a population of 337,870 people. West Pokot Annual report 2002–2008, 2002:8

  38. For an extensive write up on the methods see Mkutu [48] chapter 1.

  39. If it is reported that the enemies made the injury the cost is 100,000 UgSh. But if a warrior is shot during raiding the cost is 200,000 Uganda Shillings. Interview medical officer, Name withheld, Moroto 27 November, 2004

  40. Interview Peter Lodonga, Nursing assistant Lopotuku dispensary, 29 September 2004

  41. See SNV [68]

  42. Observations in the field, 19–23 November 2003 See Mkutu [46, 48], Gomes and Mkutu [19], SNV/Pax Christ [69]. for vigilante formation in Karamoja.

  43. Peterken former Resident District Commissioner. Interview, Nakapiripirit, Uganda, 26 January 2003.

  44. Dr Kaadu, Stephen, former Doctor at Amudat mission hospital Interview Amudat, 18 June 2001. Also Dr. Motanya, David, former Ministry of Health in charge, Kapenguria District Hospital, Interview, Kapenguria, August, 2002.

  45. SNV/Pax Christi [69]: 34–45, Mkutu [46]

  46. Due to a road ambush of the supervisor at Matany, and because a big raid had just taken place, she was so upset that she refused to release any data.

  47. Superintendent of Matany Hospital. Interview, Matany, 20 June 2001. On the day of the interview a big had taken place and 17 warriors had been brought to the hospital.

  48. The hospital charged 20,000 Uganda shillings before they would touch any one admitted with a gunshot wound. The purpose was to discourage cattle raiding.

  49. Interviews in June 2001, and also interviews at Amudat, 27 January 2003. Interview with a Solider based in Nakapiripirit noted that over 1000 people have been killed due to banditry on the Namalu-Moroto road.

  50. Nurse, name with held, Interview, Amudat Hospital, 27 January 2003.

  51. Records of District Health Office, Nakapiripirit, July 2001–2002.

  52. Various sources from Kangole, Moroto, Namalu and Amudat, Uganda. See SNV [68]. Note that the Lutheran World Relief is trying to assist women in Nabilatuku to buy grain to sell But most of the women invested their money in local brew as it gives them better returns. See for example Daily Monitor 2 June 2003. http://www.monitor.co.ug/archives/2003main/jun/news/0602/news8.php. It notes that waragi (local beer) drinking has heightened insecurity is and therefore a cause of deaths in the area.

  53. Motanya, David, Interview, Kapenguria, 22 May 2001

  54. Adome, Lokwi, Local Council Chairman Kotido, Interview, Moroto, 22 November 2003.

  55. Amukuriate Dispensary staff. Interviews, Alale, West Pokot, 2 August, 2002.

  56. Ibid.

  57. Cheboi Florence, op. cit.

  58. Interviews Medical Superintendent Kapenguria District Hospital, Kapenguria, August 2002. The District commissioner concurred and not that at least in a month there is always one or two raids with many people injured. Interview Kapenguria, August 2002

  59. Police Daily Occurrence Records, Kapenguria 2000.

  60. Interview Alale, August 2002, Interview of warriors in Panyangara Oct 2004.

  61. Interview Edison Achia, Moroto 2 October 2004.

  62. SNV [68].

  63. Interview young girl of 15 in Loputuk 29 October 2004.

  64. Interviews Lotirir mothers group, 1 October, 2004

  65. Interview Novelli, Moroto 17 July 2001; See Novelli [55]

  66. For details on governance and marginalization in pastoral areas in the north rift see Mkutu [48, 50].

  67. Field research Alale, Kenya 2002 see Mkutu [48].

  68. Interviews in November 2004 indicated that before you are operated it is now 100,000 and if wounded while in a raid it is 200,000 Uganda shillings.

  69. Daily Nations 18 August, 2005 “20 million Kenyans can’t afford drugs” http://www.nationmedia.com/dailynation/nmgcontenterty.asp?category_id=1&newsid=55310 assed on 18 August. The study compared drug prices in 53 public health facilities, 57 private and 47 missions’ health centres.

  70. Ibid.

  71. Mkutu [45]: 7, Mkutu [47, 48], SNV Pax Christi [69], SNV [68], Gomes and Mkutu [19], Belshaw and Malinga [6], Quam [63].

  72. Mkutu [46, 48], SNV [68], SNV/Pax Christi [69], Knighton [34], GoU [24].

  73. See for example WHO [78] which argues that they are among the top five contributors to the global health burden among people aged 15–44.

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Acknowledgement

Thanks to SNV-Uganda for giving me the opportunity to work for them as an advisor and enabling me collect data. Thanks to my editor Tessa Mkutu, who is a general practitioner in Ashcroft Surgery, Undercliffe, UK.

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    Kennedy Agade Mkutu

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Mkutu, K.A. Impact of small arms insecurity on the public health of pastoralists in the Kenya–Uganda border regions. Crime Law Soc Change 47, 33–56 (2007). https://doi.org/10.1007/s10611-007-9056-6

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