Quantum communication has been successfully implemented in optical fibres and through free-space [1-3]. Fibre systems, though capable of fast key rates and low quantum bit error rates (QBERs), are impractical in communicating with destinations without an established fibre link [4]. Free-space quantum channels can overcome such limitations and reach long distances with the advent of satellite-to-ground links [5-8]. Shorter line-of-sight free-space links have also been realized for intra-city conditions [2, 9]. However, turbulence, resulting from local fluctuations in refractive index, becomes a major challenge by adding errors and losses [10]. Recently, an interest in investigating the possibility of underwater quantum channels has arisen, which could provide global secure communication channels among submersibles and boats [11-13]. Here, we investigate the effect of turbulence on an underwater quantum channel using twisted photons in outdoor conditions. We study the effect of turbulence on transmitted QBERs, and compare different QKD protocols in an underwater quantum channel showing the feasibility of high-dimensional encoding schemes. Our work may open the way for secure high-dimensional quantum communication between submersibles, and provides important input for potential submersibles-to-satellite quantum communication.