Road sense

Road traffic injuries are a major headache for public health systems all over the world, but more so in developing countries - where children and pedestrians are the ones most at risk of serious injury or death.

Each year, road traffic injuries claim the lives of over a million men, women and children in the world. In low-income countries, the proportionally larger number of pedestrians present a very vulnerable target.

South Africa is unusual among developing countries in that it has a well-developed road infrastructure. However, the rural poor are taking up residence around cities, resulting in an uneasy mix of high-speed motorised transport and pedestrians on the same roads.

To raise awareness about the terrible consequences of traffic accidents, the World Health Organisation ( WHO) chose "Road safety" as the theme for World Health Day 2004. The message the WHO wished to send out was that such injuries can be prevented, and should indeed be prevented.

In support of this, the MRC/ UNISA Crime, Violence and Injury Lead Programme ( CVI) hosted a seminar on World Health Day 2004 at the MRC head office in Cape Town.

Prof Anthony MBewu, one of the MRC's two research directors, addressed the seminar about the importance of health research and injury prevention. "We need to spend money on this problem to create an integrated, evidence-based approach that is matched by strong political will.

"For this we need accurate and reliable data that will also help us to evaluate the effectiveness of our efforts," he said.

Prof Louis Molamu, Registrar of Academic Affairs at UNISA, stressed the university's commitment to health research and injury prevention. "We will continue to avail our resources to persons and organisations working on the prevention of road traffic injuries," he said.

Mr Richard Matzopoulos of CVI highlighted the vulnerability of pedestrians - they account for the largest proportion of deaths due to road traffic injuries.

Alcohol is a major contributing factor. More pedestrians than drivers are drunk at the time of a collision, and their average blood-alcohol level is higher than that of the drivers.

But it is not only drunkenness that seems to be a cause of fatalities amongst pedestrians. Lack of supervision and road safety training contribute to the chilling fact that traffic accidents are the leading cause of death in the 5-14 years age group.

Children are more likely to suffer
serious injuries in vehicle collisions

"This is also a socio-economic problem," says Dr Sebastian van As, head of the Trauma Unit at the Red Cross Children's Hospital in Cape Town. "Children in townships don't have safe areas in which to play, so the road becomes their playground."

According to Dr van As, who is also director of the Child Accident Prevention Fund of South Africa, children are particularly vulnerable because, in comparison to adults, their heads are much larger in proportion to their bodies. As pedestrians, children's heads are the point of impact, whereas in adults, the body is the point of impact. This makes children prone to head injuries, which tend to be more lethal than body injuries.

"The bottom line is that no children under the age of eight should be allowed be in traffic without supervision," says Dr van As.