Small dangers as lethal for young children as big ones

THE trauma admissions ward at Red Cross War Memorial Children’s Hospital in Cape Town is full of youngsters with preventable injuries.

Every year the hospital treats 10 000 children for trauma, roughly 20% of them for swallowing objects or caustic liquids. These ingestion injuries, involving objects from batteries to condoms, can be fatal.

Such accidents are common among toddlers, and researchers, writing in the South African Medical Journal this week, said regulations were needed to prevent them.

Professor Sebastian van As, head of the hospital’s trauma unit and co-author of the study, said: “There is a range of objects which are dangerous and can kill children. A simple rule is to make sure all objects under 3cm are kept out of reach of kids under three years old.”

Batteries and magnets can be deadly because of potential currents and attractions which may cause perforation in the walls of intestines and bowels.

Childsafe South Africa assistant director Chiedza Mavengere said the objects most commonly swallowed by children aged four to nine were R1 and R2 coins. Boys were most susceptible, she said.

Usually the objects pass uneventfully through the bowel, but in some cases they get stuck and surgery under sedation is needed.

The researchers said some commercial objects which should be recalled were small (neodymium) magnetic balls, marketed as “executive toys” in the US.

Van As, who is president of Childsafe South Africa, said greater awareness among parents and children — combined with legislation against commercial hazards — could reduce ingestion risks.

Joan van Niekerk, president of the International Society for the Prevention of Child Abuse and Neglect, said caregivers would benefit from a greater awareness of how to keep children safe.

“Some people do not realise the extent of the danger of leaving certain substances where children can reach them,” she said.

In a medical journal editorial, Van As said children worldwide were the main victims of injury and violence, with children in lower- and middle-income countries most at risk.

“The vast majority of injuries in young children occur in and around the home, while older schoolgoing children are the most vulnerable on their way to and from school,” he said.

The good news is that minibus taxi drivers who take kids to school can be DANGEROUS GAME: X-rays of a child who swallowed a R5 coin WARNING: Sebastian van As rewarded for improving their road manners, an experiment in Cape Town has found.

Van As, who helped implement the pilot project, said: “Trackers were put in school minibuses and every month the best and most improved drivers were rewarded and the best driver for the whole year got his own taxi.”

The drivers improved the safety of their driving and vehicles, and on average performed better than members of the public, according to the results of the quasi-experimental study, published in the latest South African Medical Journal.

“Overall these vehicles recorded lower percentages CONCERNED: Dumisile Nala of speeding, lower harsh braking and lower average harsh cornering and acceleration than general drivers,” said the report.

The school-transport industry had been plagued by safety concerns, it said.

One case which made headlines involved a taxi driver in Cape Town who killed 10 children in his vehicle by driving through a level crossing when the red light was on and being struck by a train.

Speeding, driver fatigue, drunk driving and the absence of seat belts are among the risks for passengers.

The safe travel programme, sponsored by the Discovery Trust, has been running for about three years and Van As hopes it will be expanded.

In South Africa the main causes of children’s injuries and deaths are, in order, traffic accidents, drowning, burns, falls and the ingestion of foreign objects and liquids.

Van As said: “A child in South Africa has 10 times more chance of dying than a child in Germany, and the risk of ending up in hospital is 25 times higher.”

Dumisile Nala, executive director of Childline South Africa, said a study on preventable deaths had found that children crossing a road without supervision and being hit by cars were also a major concern.

“In most of these cases young children were not being properly supervised or monitored,” she said, noting this could be a sign of neglect.

The vast majority of injuries in young children occur in and around the home