Living in a death trap

With 600 deaths and 270,000 hospital admissions every year, home is becoming one of the most hazardous places for children under 16:

Home accidents causing disability and death in children under the age of five has seen an upsurge, both globally and in Sri Lanka, in recent years, with latest statistics citing injuries sustained in home accidents as being one of the top five leading causes of death in this age group. It also accounts for one fifth of annual hospital admissions across the country.

Paediatricians have found that most injured children who suffer from long term disability and chronic pain are unable to perform age-appropriate everyday activities to their fullest potential during their lifetime.

The tragedy is that these horrifying injuries that rob children of their right to a happy carefree childhood, in a vast number of cases, occur due to lack of adequate safety devices in the homes or sheer neglect on the part of those looking after them. Nearly 98% of the accidents could have been prevented, had those caring for them - be they parents, grandparents or hired baby sitters carried out their task of protecting the children from harm, with greater responsibility and accountability.

Here two leading child experts share their views on debilitating injuries sustained in the home-front, a subject which they emphasise is eminently preventable.

Excerpts …

Dr Deepal Perera, Chief Consultant Paediatrician, Cancer Hospital Maharagama

Q: Home accidents are increasingly on the rise with children as the main victims. Why is this? Is it because more children are alone without parental care for most part of the day? Or is it because of the irresponsible manner in which they are looked after by their caregivers?

A: Today, we see more accidents frequently occurring inside homes due to several reasons. For one thing, most parents lead busy lives, with mothers having given up their role of full time housewives as in the past, and opting to work outside the home. Children are thus left in the care of grand - mothers or neighbours, who may neglect their responsibility as care givers.

Q: In general, what are the most common accidents that occur in Sri Lanka that affect both adults and children alike?

A: Poisoning due to chemicals, medicines, road accidents, burns, scalds, kerosene oil poisoning. Electrocution, drowning.

Q: Is there a change in the types of accidents that are now on the increase compared to past accidents?

A: Today, the trend is more home accidents. Poisoning cases from chemicals for example have zoomed over the past few years. Unfortunately the victims are largely children and young adults.

A: Poisoning agents I refer to can be found anywhere in the house, but mostly kept in the bathroom and kitchens, e.g. chemicals, acids , kerosene oil, paracetamol

Q: What about medical drugs? Some young adults with suicidal feelings are known to deliberately ingest prescription drugs, such as the ones used by their parents for diabetes and hypertension. What happens?

A: Poisoning with medical drugs is reported very frequently. Children can die if they are not treated urgently.

They should be immediately taken to hospital to be monitored in a hospital setting.

Q: In the case of minor injuries in home accidents involving young children what advice do you give parents?

A: Minors injuries can be managed at home. The wound should be washed thoroughly and treated with an antiseptic solution

A: Some poisons can be treated by inducing vomiting. However if poisoning is by ingesting acids, alcohols and kerosene oil, it is very important that no attempt is made to induce vomiting, which can aggravate the situation. There are also specific antidotes for some kinds of poisoning .

Q: What is the advice you give to parents on the ‘dos’ and ‘don’ts’ in cases of poisoning in children?

Definition of injury

The World Health Organisation (WHO) defines injury as a bodily lesion resulting from an acute exposure to physical agents such as mechanical energy, heat , electricity , chemicals and ionizing radiation , or an impairment of function of sudden lack of essential agents such as in drowning, strangulation or freezing. Injuries can be categorised in a number of ways – intentional or unintentional. Intentional injuries include violence while unintentional include road traffic accidents, drowning , burns, fires and falls and home injuries. According to Epidemiology data on injuries in Sri Lanka categorised under the indoor Morbidity and Mortality Register, traumatic injuries continue to be the leading cause of hospitalization since 1995 . Source – Health Ministry

A: They should get advice from a qualified medical officer. It is best to take the person, especially if it is a young child or elderly person, to a hospital. If the doctor treating the patient is uncertain about how to detect or treat the patient, he can always get the advice from the Poisons Information Centre at the National Hospital of Sri Lanka.

Q: Drowning is also a frequent accident that occurs at home. Recently we have been reading reports of children drowning in small buckets. Your comments?

A: Drowning is an increasing trend. This again is due to young children not being supervised well. Just recently we had a case of a child drowning in a tank prepared for ornamental fish. So, parents and care takers must be watchful when a toddler goes near any container that has water in it.

A: The safety of children is the responsibility of all adults. One must remember that children are still developing and not small adults, capable of looking after themselves without proper supervision.

Q: What about road accidents where children are among the many pedestrians who die due to careless, drunken and speeding drivers?

A: In Sri Lanka, road signs and road rules must be strictly regulated and implemented. Penalties for drunken drivers should be increased. Three-wheel drivers and motor cyclists who are both victims and offenders should be advised.

Most importantly, children must be taught how to cross the road and observe road rules.