Over 60 000 children, aged between a month and five years, die in South Africa each year, according to a report released at health summit in Johannesburg. "Many of the children die at home having had prior contact to health services," reads the document, penned by a national committee appointed to investigate the causes of child deaths in the country.
The committee was set up by former health minister Manto Tshabalala-Msimang in February 2008 to review maternal, perinatal and childhood deaths. Its findings are backed by Development Bank of South Africa reports of 2008 and by reports prepared by academics, for medical journal Lancet, on health in South Africa.
Lack of skills contributing to deaths
All these reports suggested the country had the correct health care policies and guidelines, but was struggling to implement them, causing thousands of unnecessary deaths.
Some of the major causes of childhood death listed in the report include diarrhoea, lower respiratory tract infections, conditions associated with HIV/Aids and malnutrition.
Reasons given for maternal deaths included a lack of skills by practitioners in performing caesarean sections, dealing with obstetric emergencies, administering anaesthesia and lack of adherence to protocol.
Health Minister Aaron Motsoaledi told hundreds of health care practitioners at the summit he was "shocked" when briefed by chairpersons on ministerial committees about the issue. Suggestions to reduce deaths included improving the skills of doctors and nurses, strengthening post-natal care and improving quality and coverage of reproductive health services. "We cannot allow a single woman to die in childbirth or neonates to die because of our negligence... It will be crminal for us to allow any of these things to happen. Unfortunately there is no other word for it but criminal." A third of deaths among women and children were avoidable, he said.
Deaths caused by accidents
According to Esmé Abrahams, Netcare Garden City Hospital manager more than 7 000 South African children under the age of 15 lose their lives as a result of various injuries. That translates to approximately twenty children per day.
“Considering how valuable our children are, this is indeed a shocking statistic. And the sad truth is that many of these accidents could have been avoided had the necessary precautions been taken,” says Esmé Abrahams, Netcare Garden City Hospital manager.
Ways to safeguard children
The Paediatric Intensive Care Unit (ICU) of Netcare Garden City Hospital shares some tips and advice on how to keep our children safe and out of harm’s way. “By being more aware of how you can improve your child’s safety in your house and on the playground, you may just save your child’s life,” adds Abrahams.
“Even though it is called an accident, accidents often do not just happen – they can be prevented,” says Prof Sebastian van As, national president of Childsafe in South Africa. He explains the leading cause for childhood injury-related death is motor vehicle accidents, involving mainly pedestrians. “The second leading cause is drowning, followed by burns. The fourth leading cause of child deaths is due to vehicle collisions,” he says.
Where do most accidents occur?
However, the most common place for young children to injure themselves is the place they are supposed to be the safest – around their own homes. “Every parent wants to keep their children safe, without denying them the freedom to explore the word around them,” says Nurse Liesel Theron, unit manager of the Paediatric ICU of Netcare Garden City Hospital.
You can, however, safeguard your house and make it child-friendly by following the following tips. “Some of these may seem obvious, but you’d be surprised at how many children we nurse back to health because the necessary precautions weren't taken.”
Prevention is always the best cure, adds Theron. “It is difficult for those whose lives have not been touched by the tragedy of a child accident, to understand the turmoil associated with it. When this happens, entire families are caught up in the loss with feelings of guilt and are often haunted by a sense of failure – all due to one careless incident. Do not let this happen to you. Help us to safeguard our children. They are our future.”
In the bathroom:
- Never leave the hot-water tap running unattended
- Always check the temperature of the bathwater before letting your child get in – remember, children’s skins are very sensitive
- Never leave young children unsupervised in the bath
- Store medicines in a locked cabinet, out of reach
- Store razors and personal hygiene products out of reach
- Try to buy cleaning products with child safety closures
- Ensure that no electrical appliances are taken near water
In the bedroom:
- Never allow children to play on bedroom furniture unattended, as they may fall off the bed
- Prevent access to electrical appliances
- Plug sockets throughout the home should be covered.
In the kitchen:
- Always turn the stove off at the main switch
- Keep pot handles pointing inwards and try to use the back stove plates
- Keep electrical cords short (especially for kettles) and out of reach
- Store knives and other sharp objects out of reach
- Store household cleaners, polishes, washing powders and insecticides in a locked cupboard.
In the living area:
- Use safety gates at the top and bottom of stairways
- Be mindful of low, unbarred windows and balconies
- Use safety glass or mark large glass panes and doors
- Ensure that no dangling cords from curtains or blinds are in the reach of children
- Secure any large furniture, which may be tipped over
- Keep those little fingers away from TVs and other electrical equipment
- Ensure that sharp corners of tables are protected
- Ensure that carpets or loose rugs are unable to move on a slippery floor.
- Store garden and outdoor home products such as turpentine, paint, fertilisers, gas cylinders and pool chemicals separately and away from
the general living area
- Read the instructions on packs, and separate incompatible products
- Pool chlorine should be stored away from other products to prevent contamination
- A number of these products may also emit toxic fumes, which could be hazardous if inhaled or could even result in a fire if contaminated
- Store out of reach of children, animals and uninformed persons
- Make sure that the storage area is cool, dry and well ventilated
- Do not reuse or refill empty containers
- Ensure that lids are tightly secured after use
- Buy products that have re-sealable or have child-safe closures.
Be water safe:
- Never leave children unsupervised around swimming pools, garden ponds, water features or buckets of water. A child can drown in a small puddle of water
- Restrict access to swimming pools by using a pool safety net
- Teach children to swim from an early stage
- Ensure that your pool water is sparkling blue and free from harmful bacteria
- Do not allow children to push other children into the pool, run around the pool or hold each other under water.
Golden rules of general home safety:
- Teach everyone in your home to memorise the emergency telephone numbers or keep them next to the phone
- Attend a first-aid course and ensure that anyone who is caring for your child does the same
- =Never dismiss your child for reporting potential dangers in and around your home. Reward them for their quick thinking and get them involved in safety.
General road safety tips:
- Children are only physically and emotionally ready to cross the road “safely” at the age of eight years
- Look for the safest route to and from school and accompany your child
- Always make sure your child is visible when walking and cycling. Children should wear reflective clothing
- Helmets are compulsory for all cyclists. Children up to the age of 10 years are extremely prone to head injuries
- All children should always wear a safety belt. Never allow children to stand upright on the back seat
- Always set good examples for children in traffic situations
- Avoid feeding children inside cars while busy driving
- Never allow a child to sit on your lap in the front passenger seat, even if it is for a short distance only.
Sources: Netcare Garden City Hospital by Martina Nicholson Associates (MNA); Sapa, August 2009.
(Joanne Hart, August 2009)