1. The Impact of Violence on Youth in South Africa
Hilton Donson, Anesh Sukhai, Kopano Ratele, Ashley van Niekerk, Luanne Swart, Mohamed Seedat
MRC-UNISA Safety & Peace Promotion Research Unit
NIMSS 2007

2. The problem
Violence and injuries are the second leading cause of death and lost disability-adjusted life years in South Africa.
South Africa’s injury death rate is nearly twice the global average.
The high injury death rate is driven mainly by interpersonal and gender-based violence, followed by traffic c injuries, self-inflicted injuries, and other unintentional injuries arising from fires, drowning, and falls.
Violence is profoundly gendered, with young men (aged 15–29 years) disproportionately engaged in
violence both as victims and perpetrators.
Half the female victims of homicide are killed by their intimate male partners and the country has an especially high rate of rape of women and girls.
The social factors driving the problem include poverty and unemployment, patriarchal notions of masculinity, vulnerabilities of families and exposure to violence in childhood, widespread access to firearms, alcohol and drug misuse, and a weak culture of enforcement and failure to uphold safety as a basic right.
The government should identify reduction in violence and injuries as a key goal and to develop and implement a comprehensive,

3. Violence can be prevented
Violence is not inevitable. Like polio and other public health threats, violence can be prevented.

4. Violence is learned in the home
More than 3 million children witness physical and verbal domestic abuse in their homes each year (Horn, 2000; Carlson, 1984; Jaff, 1990). Effects of witnessing domestic violence can include traumatic stress reflected in higher levels of depression and anxiety, attention and learning problems, and greater likelihood of developing aggressive and anti-social behavior (Hawley, 2000).

5. Violence is learned by being victimized by intimates
826,000 children in the United States were maltreated in 1999 (US DHHS). Experiencing child abuse and neglect increases the likelihood of arrest as a juvenile by 53% and of committing a violent crime by 38% (Widom, 1992).

6. Violence is learned from peers
• One in 7 school children is either a bully or has
been the victim of a bully (Brooks, et al, 2000;
Batsche G, et al, 1998).
• Between 10% and 30% of teens experience
violence while dating. This is not surprising in
light of a survey of two Chicago high schools,
in which 28% of boys responding believed that
“girls needed to be punched or slapped sometimes”
(American Medical Association Alliance, 1999).

7. Alcohol & drugs
50% of youth homicide victims have elevated blood alcohol, as do 50% of youth who commit homicide (Adams et al, 1992; Prothrow-Stith et al, 1992; Mann et al, 1998).

8. Gangs
Youth gangs are responsible for a disproportionate share of all criminal offenses, both violent and nonviolent (Snyder et al, 2000).

9. Factors that “protect” youth
Relationship with a responsible adult Positive school experiences Plans and dreams (future orientation) Ability to control impulses (Search Institute, 2000)

10. National Injury Mortality Surveillance System
NIMSS was launched in 1999 to inform on the extent of deaths due to non-natural (n/n) causes
Goal is to establish a permanent system that will help
Describe the incidence, causes, and consequences of n/n deaths
Prioritise injury and violence prevention actions
Identify new injury trends and emerging problems
Monitor longitudinal changes in the profile of n/n fatalities
Evaluate possibilities of direct and indirect violence and injury
NIMSS is the most detailed source of information on the who, what, when, where and how of fatal injuries in South Africa

11. Overview of NIMSS In 2007 - national coverage
21 mortuaries in 6 provinces, with full coverage in SA's four largest metropolitan cities:
Cape Town, Durban(Ethekwini), Johannesburg, Pretoria(Tshwane)
Non-natural (n/n) deaths
about 55% of all n/n mortality
N/N deaths per annum

12. Apparent manner of death for all ages (n = 33520)
NIMSS 2007

13. Apparent manner of death for children 0-14 (n = 2708)
NIMSS 2007

14. Apparent manner of death for youth aged 0-19 (n = 4727)
NIMSS 2007

15. Apparent manner of death for ages 15-29 (n = 11271)
NIMSS 2007

16. Violent deaths by age (N = 11 304)
This chart shows a breakdown of violent deaths by age category. The highest number of violent deaths occurred among the year age group and were generally high between the ages of 15 and 44 years.

17. Youth violence (0-19) by external cause of death (n= 1195)
M:F ratio
Firearm 4.0
Sharp force 11.4
Blunt force 4.2
Strangulation 0.4
This chart shows that firearms and sharp force assaults were the leading ext causes of violence. There were 7.6 males who died as a result of firearms for every female death. The M:F ratios for sharp and blunt force assaults were 9.5 and 5.8 respectively. For strangulation deaths, more females than males died by this cause, with 0.5 males for every female death.
NIMSS 2007

18. External cause of fatal youth violence, (n= 1195)
NIMSS 2007

19. Violence mortality rates: 2001-2007
NIMSS 2007

20. Fatal youth violence by scene & sex (n= 4596)
NIMSS 2007

21. Leading external causes of fatal violence for youth by Blood Alcohol Concentration (BAC) (n=2430)
NIMSS 2007

22. City comparisons: Leading external causes of fatal youth violence
Durban (n=1205)
Cape Town (n=1436)
Tshwane/Pret.
(n=178)
Johannesburg (n=761) 1
Firearm (51.1%)
Sharp object
(51.3%)
Firearm
(48.3%)
(62.7%) 2
Sharp object (37.6%)
(37.3%)
(28.7%)
(21.9%) 3
Blunt object (8.9%)
Blunt object
(4.5%)
(15.7%)
(9.2%) 4
Strangulation
(0.8%)
(1.0%)
(3.4%)
(0.7%) 5
Other
(1.6%)
(5.9%)
(3.9%)
(5.5%)
NIMSS 2007

23. MRC-UNISA Safety & Peace Promotion Research Unit(SAPPRU)
Objectives of SAPPRU
Conduct trans-disciplinary research to champion violence and injury prevention, as well as peace and safety promotion;
Develop appropriate tools to assess the magnitude, trends and occurrence of crime, injuries and violence, and conditions promotive of safety and peace;
Study the risks, causes and determinants of crime, violence and injuries, and factors supportive of safety and peace;
Identify, support and develop primary prevention, injury control, and safety and peace promotion demonstration and best practice initiatives;
Encourage research translation to inform the prevention and promotive work of governments and social movements; and
Build primary prevention, and safety and peace promotion research and intervention expertise among researchers, policy-drivers, community-based workers and practitioners.

24. The Ukuphepha project is a multi country and multi level research study on child injury prevention and safety promotion. It is the first of its kind. This will work towards reducing injury rates among children. It will involve countries, Uganda, South Africa, Mozambique, Australia, Bangladesh and other.
Ukuphepha means "SAFETY" in indigenous South African lingual. .
Ukuphepha Stsudy
The Ukuphepha project is a multi country and multi level research study on child injury prevention and safety promotion. It is the first of its kind. This will work towards reducing injury rates among children. It will involve countries, Uganda, South Africa, Mozambique, Australia, Bangladesh and other.
Ukuphepha means "SAFETY" in indigenous South African lingual.

25. Ukuphepha Aims

26. Goals
To identify, develop and promote community values, beliefs, attitudes and behaviours that support safety and peace and the prevention of injury and violence
Goal 1:
To reduce and prevent violence and injuries by creating safe environments (social and physical contexts or conditions) that support the promotion of safety and peace and the prevention of injury and violence
Goal 2:

28. Type
Mortality/Morbidity 
Key Distal Factors    
Proximal Factors  
SA Strategies    
Gaps                                     
Service Delivery Priorities           
Lead Dept
Child abuse
* 1050 homicides to
boys and 877 to girls
under the age of 14
(2007)
* SAPS
2009/2010:27
417 sexual offences
against children
under 18 years;
increase of 36.1%
* Vulnerable
groups include:
premature infants,
handicapped
children
* Low level of
family cohesion
* Poverty
* Communities
with reduced
social capital
* Inadequate
housing and
community spaces
* Job loss
within family
* Substance
abuse among
family
* Families
with large
number of
* Mother
having
children at
young age
* Child care Act
1983
* Regulations
relating to safety
measures at
schools
* Guidelines for
the prevention
and management
of sexual violence
and harassment
In public schools
* No focus on
regulations
regarding
reporting
of child abuse
Offences
* Major back log
cases among
social workers
* Increase child
care Services
* Strengthen
social service
resources for
child protection
functions
* Availability of
treatment and
rehabilitation for
addicts
* Reduce alcohol
& drug
accessibility
* DOH
*DBE
* DSD

29. Acknowledgements Colleagues at MRC –UNISA SAPPRU
Staff and pathologists at participating mortuaries and Forensic Medicine departments.
National and Provincial Departments of Health
State Forensic Chemistry Laboratories
South African Police Services
Department of Arts, Culture, Science and Technology
NIMSS 2007