Worldwide, pedestrian injuries are a leading cause of death among children. This form of injury is relatively less frequent in Brunei. AFP
Injury is a major cause of death in children. Death is only part of the problem.
For every child who dies, another 30 or more are admitted in the hospital. Of these, many are discharged with lifelong disabilities.
The role of injury prevention is even more important in countries like Brunei where other causes of death like infection get effectively prevented and treated.
Injury is preventable
Many people believe that injuries result from "accidents" and therefore are not preventable.
About 200 years ago, infections were similarly considered to be beyond our powers to prevent and treat. It's not the case anymore. Yes, injuries also are preventable using current knowledge.
We now have much better understanding of the risk factors for injuries.
Consequently, we are better able to develop programmes for prevention and control of injuries.
Types of injuries
There are numerous ways by which children get injured. But we need to focus on injuries that are frequent and severe and for which proven prevention strategies are available.
The most important of such injuries in Brunei are: motor vehicle passenger injuries, pedestrian injuries, bicycle injuries, submersion, burns, and accidental ingestion of drugs and poisons.
Motor vehicle passenger injuries
Motor vehicle injuries are the leading cause of serious and fatal injuries at all ages. Therefore lot of efforts is to be made in this area.
Specific preventive steps include the following:
a. Child restraint devices: Proper use of appropriate child restraint devices can reduce serious injuries and fatalities by about two-third in children under four years; and by half in older children.
Observation in the United States have indicated that about 90 per cent of child restraint devices are improperly installed; and about 20 per cent of them are seriously misused. Brunei lags far behind developed countries in the use of child restraint devices.
Often as a direct consequence, we see a lot of children getting seriously injured during road traffic accidents. The proper use of child restraints has to be popularised on a priority basis in Brunei.
b. Adolescent drivers are responsible for a disproportionate number of motor vehicle injuries. This is due to their inexperience and is worsened by alcohol or drug abuse.
Perhaps our adolescents need to wait till a bit older before they start driving around unsupervised.
Pedestrian injuries
Worldwide, pedestrian injuries are a leading cause of death among children. This form of injury is relatively less frequent in Brunei.
Injuries typically occur when children run out into the street and are struck by oncoming vehicles. Educational programmes aimed at improving street related behaviour of children can achieve prevention.
This should be supplemented by roadway interventions like proper lighting; provision of sidewalks and speed barriers.
Bicycle injuries
Bicycle related trauma is the leading cause of childhood head injuries in many countries. Bicycle is probably less popular in Brunei.
Use of bicycle helmets can prevent about 85 per cent of head injuries and 88 per cent of associated brain damage.
Parents should be made aware of the need for bicycle helmets. The reluctance of children to use helmets should be reduced by ongoing education about the need and effectiveness of helmets.
Submersion
Drowning is a significant cause of death and disability in children. For every death due to submersion six children are hospitalised. Approximately one-fifth of hospitalised survivors suffer severe brain damage.
Brunei is endowed with tropical climate, long coastline, rivers and lakes, abundance of swimming pools and a sprawling water village. All these make the country particularly prone to occurrence of submersion injuries.
Specific preventive measures should include the following:
a. Parents should be constantly aware of the dangers to children from any body of water.
b. Young children should never be left alone in bathtubs or near swimming pools, ponds, rivers or beaches.
c. Swimming pools should be completely surrounded by a 5-foot fence with self-closing, self-latching gate.
d. Older children and adults, especially in water village, should learn CPR (life support training).
e. Children over five years should know how to swim.
f. No one should ever swim alone.
g. Even when supervised children should wear floatation devices when playing in rivers, streams, lakes or beaches.
h. Use of intoxicating drinks and drugs should be avoided.
Burns and scalds
Approximately 80 per cent of burn related deaths occur from house fires.
Risk factors include age less than four years, overcrowding, single parents, poverty, inadequate supervision, and distance from fire department.
Smoke detectors, when used correctly can reduce death and severe injuries from burns by nearly 90 per cent.
Parents should be aware of these devices, which should be installed and properly maintained in every kitchen.
Children's clothes should be made of fire resistant fabric. Furniture, bedding and home building materials should conform to flammability standards.
Scalds occur from hot liquids. Young children should never be left alone in kitchen or bath.
Whenever a liquid is being warmed or boiled, beware of young children around. Always check tap water temperature when washing / bathing children.
Ingestion of drugs and poisons / choking:
Accidental ingestion of drugs and other harmful materials like detergents and medicated oils meant for external use, is common in Brunei.
Medicines and poisons should always be kept out of reach of children. Food items, like peanuts and roasted seeds, which could be potential foreign bodies, should not be offered to young children.
Toys with pointed edges or small detachable parts should be avoided.
Please remember:
Injuries are a major public health problem causing death and disability in perfectly healthy children (and adults).
They are NOT inevitable "accidents" but tragedies preventable by thoughtful action. Some specifics steps in this direction are described in this article.
Do try to implement them today; tomorrow may be too late for someone you love.
Ministry of Health Public Awareness Programme
Source: Weekend, 20 December 2008
