The most critical factor distinguishing swimming in natural bodies of water from controlled environments is the ever-present catalogue of health issues and biological hazards. The foremost concern across much of the region’s slow-moving or shallow lakes and rivers is Schistosomiasis, commonly known as Bilharzia. This parasitic disease is contracted through exposure to water contaminated by freshwater snails that carry the parasite larvae. While higher-altitude lakes like Bunyonyi are often reported to have lower incidence rates, experts universally advise extreme caution. Any natural water exposure, particularly for extended periods, should be followed up with appropriate testing and prophylactic treatment, emphasising that clear water does not equate to clean or safe water. Furthermore, water quality can fluctuate significantly, particularly during rainy seasons when runoff from agricultural areas introduces various chemical and bacterial contaminants.