South Africans are more likely to be shot than suffer any other kind of unnatural death as gun crime pushes the country’s violent death rate to up to eight times the global average, a study showed on Tuesday.

Firearms and alcohol were key culprits in the report by the Medical Research Council, providing a fresh illustration of the dangers of life in a country known for some of the highest rates of violent crime in the world.

The survey showed 48 percent of more than 22,000 unnatural deaths surveyed were caused by violence. Firearms made up 28 percent of the total and sharp force injuries, such as stabbings, accounted for 15 percent.

Twelve percent of those suffering unnatural deaths were pedestrians hit by vehicles.

“A lot of these deaths take place in the home or on the streets,” said researcher Richard Matzopoulos. “A firearm gets picked up. If there hadn’t been a firearm in the house it wouldn’t have been a fatality.”

A decade after the end of apartheid, analysts estimate South Africa has between one and four million illegal firearms in circulation, prompting the government to declare an amnesty aimed at getting them off the streets.

Comparing violent deaths internationally was difficult, Matzopoulos said, but South Africa’s rate was some six- to eight-times higher than the global average - although figures were largely only available for developed countries, meaning other dangerous countries in Africa, Asia and South America are not represented.

While many affluent urban South Africans live in secure compounds behind electric fences and razor wire, the report showed most violent deaths took place in impoverished suburbs and townships such as Soweto or Hillbrow.

Men were more than four times more likely to die a violent death than women, the survey showed.

Violent deaths were most likely to occur in the late evening or early hours of the morning, with over 40 percent taking place on Saturday or Sunday, researchers said, suggesting this was when many victims were drunk.

Of those killed with a gun, 38 percent had alcohol in their system, while 72 percent of stab victims had been drinking.

Medical staff say many shootings take place after drunken arguments turn violent, and Matzopoulos said drunks stumbling through inner cities at night were also more likely to fall victim to violent crime.