Firearm fatalities in the Transkei region of South Africa, 1993-2004

Background. Firearms are a causative factor in much violence-related morbidity and mortality, including suicide. Interventions focus on stricter gun control. In South Africa multisectoral collaboration is needed in this regard. Objective. To determine the incidence of firearm-related deaths in the Transkei region and to understand the underlying causative factors. Method. A record review was undertaken of 10 860 medicolegal autopsies performed between 1993 and 2004 at Umtata General Hospital. Results. Between 1993 and 2004 10 860 autopsies were performed on patients who died as a result of trauma and other causes at Umtata General Hospital. The average number of gunshot related-deaths during this period was 48.4 per 100 000 of the population per year. The rate increased from 27/100 000 in 1993 to 42/100 000 in 2004. Firearm-related deaths accounted for 29% of all traumatic deaths, and males (82%) outnumbered females 4.6:1, although there is an increasing incidence among females. About 50% of these deaths were in the 21 - 40-year age group. Interpersonal violence, poverty, and use of drugs and alcohol were common underlying factors. Conclusion. There is a high incidence of firearm-related deaths in Transkei. Stricter gun control is required.