Injuries transcend racial, gender and social barriers. As the number of injuries leading to deaths have taken a sharp hike globally and in Sri Lanka, prompting the World Health Organisation to urge member countries to take measures to set goals for reducing the risks of injuries and cut deaths and the horrific results of severe injuries by more than half. Data from our own National statistics reveal that around 1 million people are hospitalized due to injuries each year, of which most are adolescents, youth and young adults 15 – 40 years of age.
Carelessness, ignorance of road rules, speeding and drunken driving have been cited as some of the main causes of road accidents which rose during the Christmas and New Year season. The New Year will also see schoolchildren engage in many outdoor sports activities, while in the villages New Year festivities still continue with adults and children playing climbing the grease pole and pillow fights.
The Sunday Observer asked Injury Specialist and Community Physician, Non Communicable Diseases Unit Dr Samitha Siritunga to share some of his expertise with us on what these injuries are, how they impact on our health and how they can be prevented.
Excerpts…
Q. With the Christmas and New Year celebrations over, there is concern that with the re-opening of schools and focusing on various outdoor sports activities, especially, sports meets, many children participating in games could suffer from injuries if preventive measures are not taken by the players. As a Community Physician on Injuries Prevention tell us what kind of injuries can affect children during this season.
A. As people living in a busy world rushing from place to place, we face different risks that may lead to injuries. Injuries could harm any person of any age irrespective of nationality, religion, colour, or social status and occur anywhere, at home, school, on the road or in a public place. According to National statistics, around 1 million people are hospitalized due to injuries each year of which most are adolescents and youth, 15 – 40 years of age. Most of the injuries are due to falls, transport injuries, animal bites, poisoning and drowning, most of them occurring at home, on the road or at school. In Sri Lanka, injury pattern may change from season to season. Injuries occurring in the Sinhala and Tamil New Year season may be different from those during the Christmas and New Year season. During the Christmas and the New Year celebrations and the opening of schools after the year end holidays, children engage in various play activities, ranging from simple village sports to highly technical sports such as, athletics and cricket. These days, we see children coming to medical centres mainly with injuries due to falls, burn injuries due to fire crackers, and also sometimes road traffic injuries.
Q. What are the main reasons for these injuries?
A. It is difficult to give common reasons, the risk factors may be injury specific and different from one injury to the other, e.g. sports related injuries depend on the type of sports activity. There may be inherent factors unique to the particular activity leading to injury. As regards road traffic accidents, the risk factors may be totally different from that of sports injuries and drowning. Generally, carelessness, inexperience and lack of supervision by adults, especially, by parents have been identified as main reasons for fire cracker related injuries and play related injuries among children.
Q. Who are more vulnerable to injuries in sports – girls or boys?
A. Boys are mostly affected. With the increase of age, behaviour of children may be influenced by peers. Inherent risk-taking behaviour of adolescents may also lead to injuries.
Q. Why?
A. When considering sports related injuries, especially, during sports meets, children could lack adequate training, fitness, exercise and also faulty playground equipment may lead to injuries. Additionally, problems could worsen with playing in hot weather.
Q. What about road accidents?
A. Road traffic accidents can be due to numerous reasons, such as, the faults of drivers, or pedestrians, driving under the influence of alcohol, driving in sleepy and fatigue conditions, speed driving, not following road rules, impatience, not taking safety precautions such as, not wearing seat belts and standard helmets in the proper way and transporting more than the accepted number of passengers, especially, in three wheelers and motor bikes.
Q. What are the health outcomes of injuries, especially, sports related injuries among children?
A. These could range from minor problems such as, sprains, strains and minor abrasions, to major problems, such as, fractures, dislocations, internal organ injuries, concussion, and may even lead to death.
Q. What are the measures that could be taken to prevent children from these injuries?
A. We have to take every possible measure to prevent children being victims of injury. It is difficult to state a single action which can prevent a particular injury, as the risk factors leading to each injury is different. Hence, we have to first understand the risk factors leading to the particular injury.
Generally, we can minimize injuries if we are cautious, take safety precautions, be aware of the environment, and changing the environment in a safe way, teaching the children about the hazards of the act and how to act safely under the supervision of adults. This would make it easy to minimize most injuries. If we can minimize the risk factors for road traffic accidents, drowning, sports related injuries, we can lessen the number of victims and the health consequences that could occur. For those engaging in sports activities, I advise them to get a proper physical fitness test at a recognized medical institution under trained medical physicians. Further, they need adequate training and exercise, to ensure their fitness.
Q. How do changing weather patterns and extreme heat during outdoor sports, affect participants?
A. Considering the current extreme heat and alternating cool weather patterns all participants must be vigilant about the weather condition and the environment. In extreme heat make sure that you are well hydrated, and spectators too should stand in the shade and carry parasols whenever possible. There is a need to take adequate precautions at the planning, preparation and organization stage of sport meets as there have been many unfortunate incidents reported at these occasions. Additionally, as we are testing the physical fitness and capabilities of the children through sports meets. However, it is important that schools must have a regular program throughout the year to uplift the fitness of the children not only during the sports meet season but during the rest of the period too.
Q. Any other factors that need to be considered when planning a sports event?
A. Another important action is first aid. If an accident occurs, if we could take adequate measures to give proper first aid at the correct time, we can reduce the death rate, minimize complications and improve recovery. Therefore, everybody should develop a skill in giving at least basic first aid when necessary.
Q. What are the steps that the Non-Communicable Diseases Unit of the Health Ministry should take to raise awareness about this danger among the public and the schoolchildren?
A. The Non-Communicable Disease unit as the focal point for injury prevention in the Ministry of Health, Nutrition and Indigenous Medicine, has taken a number of measures for the prevention and control of injuries among children and the public. This is not solely a responsibility of the Health Ministry, though people think that taking measures for prevention of injuries is the responsibility of the Health Ministry.
It is multisectoral. With the multi sectoral involvement, a number of programs are being conducted in the country for the prevention of injuries. The main focus is on education and behavioural change. Road safety, home safety, child safety, school safety and safety from drowning, are among the many programs initiated by the Unit. Besides, first aid training is a high priority area, and we have started basic first aid training programs for the public.
We are working according to a plan. For planning of these programs and to assess their effectiveness, we need to have a good information system. Hence, the NCD Unit has launched the collection of injury related data since 2017. Every activity is guided by the National injury policy.
Q. Your message to the public on safety during festive seasons?
A. Most injuries are preventable if adequate precaution is taken. A little attention can make a big change. Always supervise your children and guide them towards safety. If something happens, take immediate, correct actions. Become a champion among leaders. Enjoy the season without destroying others’ happiness.