Concussions during rugby games can have long term effects, especially for youngsters.
SPORT l RUGBY
Her eyes become teary she starts talking about her beloved first born son. Yusuf Zaidi passed away in July 2013, but to his mother, Zulaina Takuwa, the tragic events at that rugby game are still fresh.
On that fateful day, Zaidi, fondly known as Baban by his peers, lined up for his club - Nile - against the Buffaloes in the Uganda Cup at Dam Waters grounds in Jinja. According to witnesses, he suffered a concussion in the game, but was allowed to get back into action, and moments later, he collapsed to the turf. He was pronounced dead by the time he was rushed to Jinja Hospital.
The former student of Jinja Secondary School was not your ordinary 21-year-old. He was juggling school, playing rugby and working at a factory in Jinja town to support his widowed mother.
“Zaidi played rugby because he hoped he would get a sponsor to continue with his education. He loved education, the little money he would get from the factory, he used it to pay his fees and also buy books for his brothers and sisters,” she says
The single mother of seven says the Uganda Rugby Union (URU); the body that is mandated to run the game in the country has never reached out to her with a full report of what happened to her son, not to even condole with her.
According to the mother who struggles to make ends meet in Walukuba division in Jinja municipality, Zaidi had previously suffered another concussion in a rugby game in Mbale.
A concussion refers to a blow on the head, which can affect the normal functioning of the brain. It is the most concussion, the gravest risk one faces in contact sport like rugby. If a concussion adversely affects the brain, it can lead to death.
Zaidi’s case is not an isolated incident. Last year, two Kenya players, Victor Wayodi and Gecheo Ogeto, died after sustaining injuries in a rugby game. A young South African player, Jean-Jireh Yamwimbi, also passed away after suffering a concussion last year. Players from New Zealand, United Kingdom have also suffered a similar fate.
Takuwa, who has a slight disability, does not want another mother to go through the same pain.
Zulaina Takuwa's son died after suffering a concussion from a rugby injury
No figures on concussion cases
How many concussion cases do we have in Ugandan rugby annually? How does the situation compare to 10 years ago? URU does not have this scientific data, which in itself, is revealing.
The general consensus, though, among those who religiously follow the game played with the oval shaped ball, is that the problem is widely spread. Only when concussions have ugly endings like in the case of Zaidi, do they come out in the public domain.
Ugandan rugby great Allan Musoke, believes that active players today stand more risk of concussion because the game has evolved a lot from the early 2000s.
“Back then, the game did not have as much contact as it does today. We were taught to run through spaces, so we evaded tackles. The rugby players today are much stronger than we were, everyone goes to the gym,” he says.
“So collusions are more likely today than back then as everyone is heavier.”
Lower level rugby largely ignored
In the immediate aftermath of the demise of Zaidi, Uganda Rugby Union sought to consolidate players’ safety by insisting on ambulances at league games.
Indeed, it has become standard practice at the big national team and league games in Kampala, to have ambulances and doctors on stand-by. This month, Makerere Impis was awarded a walkover after match opponents - Buffaloes - failed to provide an ambulance.
World Rugby, the governing body for the sport of rugby union around the world, encourages individual unions (countries) to develop their own guidelines and policies, and must use the body’s concussion guidance as minimum standards.
Dr Joseph Kalanzi, the chairman of Uganda Rugby Medical Society, a constituent body of URU, explains that trained medical personnel are deployed at the games,.
“If a player is involved in a contact and shows signs of confusion, or stays down motionless for a while, we automatically assume he has got a head injury, we then go on to remove the player,” he says.
Kalanzi says an assessment, which involves asking a player a few questions is then undertaken.
However, these safety precautions are largely exclusive to the national team and top tier league games. Lower level games do not always have ambulances and medical personnel. The worst affected games are the ties between universities and secondary schools. Isn’t the safety of high school rugby players just as important as the league players in the top echelon of Ugandan rugby?
Brain injuries need more than an ambulance. The fact that there is an alarming shortage of medical personnel equipped to handle rugby-related injuries does not help the situation.
Only one Ugandan - Kalanzi - has undergone a third level Immediate care in rugby course. The second level course has only six trained personnel. The basic level of care training has been offered to 50 people.
Kalanzi admits that a lot more needs to be done to get more personnel trained to adequately deal with head injuries at all levels of rugby in the country, not just with the national team and league games.
“We have not trained enough staff to handle rugby at lower levels. We hope to train more people to cover the gap,” he says.
School players more vulnerable
The lack of adequate attention to rugby in schools is even more unfortunate as new evidence emerges that younger players are more vulnerable to the effects of concussions than adults.
A 2012 research done by David Ellemberg, a professor of kinesiology at the University of Montréal in Canada, says the part of the human brain that is responsible for working memory undergoes a growth shot during adolescence, making teens more fragile to the effects of concussions.
Dennis Etuket, the rugby coach at King’s College Budo, one of the powers in schools’ rugby in the country, is well aware of such studies.
“Even the slightest of knocks can be more damaging for a young player. In some cases, one will have to stay out for up to two months after a concussion case that should have kept out an older player for two weeks,” he says.
The schools largely rely on nurses they employ to handle injuries, yet these nurses, much as they know how to offer general first aid, are not usually trained in handling brain-related injuries in sports.
A source reveals that even schools representing the country at the East Africa Secondary School Games are not assigned trained personnel to handle rugby specific cases. Rather, they have to depend on one medic who handles all sports.
Rugby is one the country’s fastest growing sports as newer schools like Kololo SS, Hana Mixed School, London College take on the traditional big three - Namilyango College, King’s College Budo and St. Mary’s College Kisubi.
With support of charity, Tag Rugby Trust, rugby has been introduced to over 240 primary schools around the country.
With more youngsters playing rugby today than ever before, John Bosco Okwaja, the games teacher at Namilyango College, says URU should do more for grassroots rugby.
“The youngsters in these schools are the future of Ugandan rugby. Yes, the Union is doing a good job with the national team and the league, but more work needs to done with the schools.”
Long term effects of concussion
Uganda Rugby Cranes captain Brian Odong says as an active player, it is difficult to shut out thoughts of the long term effects of concussion.
“Of course, I am worried when I hear about how concussions can affect our brains as players in the long run, especially when I am off the pitch, but when I am on it (the pitch), I give it my all,” Odong says.
“As women, we play fewer games than the men, but that does not mean we have lesser chances of getting concussions,” Irene Namapii, the chairperson of the Uganda Women’s Rugby Association, says.
So what are these long term effects of concussion that scare Odong and Namapii?
Several scientists have linked repeated concussions to higher risks of one suffering from Chronic Traumatic Encephalopathy (CTE), Parkinson's disease, depression and other mental health complications.
Rugby is a contact sport that is quickly being picked up by schools
International concussion expert Dr Bennet Omalu, who was portrayed by actor Will Smith in the 2015 movie ‘Concussion’, has even called upon parents to stop their children from playing rugby.
Omalu, who discovered Chronic Traumatic Encephalopathy (CTE) has been at the forefront of highlighting effects of sports such as American Football and rugby have on the mental health of players.
Although it is important to note the long term effects of concussion are still subject to heated debates, one thing is certain; rugby is yet to get clean bill of health.
Time to act is now
Takuwa wants rugby officials in Uganda to take concussions in rugby more seriously by having thorough check-ups on players.
“I do not know much about rugby, but after the death of my son, at least I know it can be dangerous. Players who have had injuries to their heads should not be allowed to play until a complete scan on their brains,” she says.
For Musoke, the silent weapon of tackling concussion rests on the improvement of coaching standards. He says stakeholders need to find a way of improving the standards of local coaches in the country.
“The collision in the rucks aside, you get a concussion because you are not tackling right, or because you have been tackled the wrong way. We need to do a lot of work on this. Our coaches need refresher training,” Musoke reasons.
Kalanzi agrees that rugby players should be taught how to get low with their tackles and to hit with their shoulders.
“We should have zero tolerance to high tackles.”
The effects of concussion have led to some calls for brain screening of rugby players, even for those that have since hung up their boots.