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Economic, social burden of shunning child restraints

ROAD traffic crashes, leading to death or injury, have proved to have major impact on government coffers, while at the same time syphoning resources from the community and families who will be trying to grapple with the sad reality of dealing with victims in the aftermath of a crash.

A study conducted by the World Bank (WB) in 2018 revealed that road traffic crashes cost most countries three per cent of their gross domestic product (GDP).

Experience from highincome countries suggests that as car ownership rise so will the number of vehicle occupant deaths and injuries.

However, there is growing concern that children are one of the groups of the most vulnerable persons as road users especially those living in low- and middle-income countries.

The World Health Organisation (WHO) has declared road traffic injury to be the leading cause of death for children and young adults aged 5–29 years, signaling a need for a shift in the current child health agenda, which has largely neglected road safety.

WHO further estimates that by the end of 2018, a number of 82,000 deaths of children between the age of five and 14 years occurred due to traffic crashes.

According to the Head of Legal Department at the Traffic Headquarters, Superintendent of Police (SP), Deus Sokoni, the Police Report of 2018 showed that on average two children die each month and four others injured in traffic crashes for reasons including failure to use appropriate car seats for children.

“The 2018 Police Report on road traffic accidents shows that 22 children died and 48 others between the age group of 7-12 years were injured. Out of those who died 12 children were female and 9 male, whereas those who were injured include 32 male and female,” said SP Sokoni.

Whereas, statistics from the Muhimbili Orthopedic Institute (MOI) - Emergency Department shows that between January and December 2018 the hospital attended a total of 1,023 traumatic cases for pediatric patients.

On average, the estimated cases being attended by MOI ranges between 85 patients to 100 on each month from January to December whereby the most mechanism of injury is caused by both three and four wheeler motor vehicles or by playing.

According to the data from MOI- Emergency Department, traumatic cases for pediatrics that occur from motorcycles were 173, cars 87, falling while playing constituted 219 and 20 were hit by an object. Such rampant growing rate of injuries could be attributed to lack of awareness on the importance of using child restraints.

Evidence shows that when children are seated in restraints which are in conformity to their weight and body size the risk of injuries and death is reduced by almost 70 per cent.

In an exclusive interview, the MOI Head of Firm Pediatric Orthopaedic, Dr Bryson Mcharo, observed that the unit’s credited studies show that people who do not use some form of protection while riding on motor vehicles, usually when a crash occurs they are most likely vulnerable to injuries and can even succumb deaths.

He pointed out that it is very unfortunate that when the hospital receives a child who has been injured during a car crash, it’s unlikely that the question of whether he/she was restrained on a child car seat comes up. But, the experience is that the majority do not use child car seats when travelling with their children in the vehicles despite of their importance.

He, however, noted that it is very important for a child to be well fastened on a child restraint because the head tends to be bigger than any other part of the body. Thus, when only a seat belt is used the child is likely to hyper flex the neck because the head is big and heavy, meaning that chances of getting severe injuries on the neck and head are huge.

Also, similar cases tend to lead a child to be thrown out of the windscreen of car and sometimes tend to be hit again by another vehicle or crash the head on the ground leading to injuries and sometimes extremity injuries such as breaking hands or legs.

Other injuries include spine, whereas when such occurs there are huge possibilities of the child being paralysed. Based on such trends, it is difficult to determine the mechanisms to which the child incurred the injuries when he is thrown out of a vehicle because their bodies are small.

Economic, social impacts According to Dr Mcharo, the more the injuries are the more expensive it becomes to treat the injuries upon crashes. He noted that the burden of treatment and having to look after the patient is usually heavy and on both ends as from the hospital, the family and the community that surrounds the child.

Previously, if it happened that a child broke a bone on the leg or hand among the treatment measures was to put the patient under traction (special medical ropes tide to the child’s legs or arms). Dr Mcharo explained the reason for tying the ropes was to restore the bones into its normal state something which took about four weeks.

“Imagining both employed and unemployed parent having to attend the child in the hospital for the whole month is quite expensive. In most cases a mother will have to remain with the child at the hospital,” said Dr Mcharo.

Besides, usually when a member of the family is admitted to the hospital, the whole family is usually in motion attending to the patient by bringing food, regular visits of which all this involves time and money.

On the other hand, maintaining a patient for four weeks or more is an enormous expenses to the hospital and government as it includes changing the patient’s beddings every day, a reliable water supply, medicines and sometimes food.

In line with the above, there are some social expenses as the mother and father of the child have to separate for the entire time as one of the parents will be taking care of the injured child in hospital. He added that for married couples one month or so is a very big gap which might lead to some loopholes and some pressure between the spouses.

Such also goes to the remaining siblings, the entire time they will be missing the motherly or fatherly guidance that they are supposed to receive when the parents are present.

Continues tomorrow

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