THE lack of awareness and corruption go hand in hand in the high death of healthy children – aged 8 and below – in vehicle accidents in South Africa.
This is accompanied by the high number of drivers on the roads without the required licences, a high rate of drunk drivers, as well as unroadworthy vehicles.
An analysis into the deaths of children killed by vehicles also found that the country’s roads are generally in a poor condition. All this combined leaves children, breadwinners, pedestrians and others, at the risk of being involved in accidents.
Vehicle accidents are the single biggest killer of healthy children. They can also suffer severe brain injury, which leaves them with a long-term disability. This often leaves them, their families, communities and the health system heavily burdened.
In a report, the National Library of Medicine, in 2019 said there was lack of compensation through existing national legislative and insurance agencies for most of the population, including children, and when it was, it was markedly insufficient in many cases.
“Access to medical care and rehabilitation is inadequate for the majority of South African children, although there are valiant efforts on the part of professionals working within the primary health care model to provide the support to the children and their families not offered by existing educational and school structures."
The burden on families, caregivers and the healthcare system is significant, and, children have the added impact of long-term effects from injuring the developing brain. There has been recent recognition that even mild traumatic brain injury caused persistent neurocognitive and behavioural alterations.
The Child Accident Prevention Foundation of South Africa, in 2021, said no fewer than 84% of children in vehicles were restrained when in vehicles. Some 80% of children injured in collisions were not restrained.
And, according to the international Injury Facts report of 2022, parents were generally unaware of the need to ensure their children were restrained. Even when they were, there was generally a lack of awareness about the impact of having no seat belts, or the required car seats, to ensure children were safe on the roads.
Parents who’s children lived with lifelong brain injuries from the impact of vehicle accidents, when interviewed for a report by the Library of Medicine, explained that they had either neglected the restraining of their children as they assumed driving carefully would keep them safe, or they could not afford car seats.
Sethabile Dlamini, the mother of a 15 year-old son living with such a brain injury that he required round the clock care, said: “I always imagined it was safe when we went down the road.
Not even the police asked us whenever we went out, so it became a norm to have him and his siblings sit, stand or do whatever they wanted after the car started moving.”
But, she said, hitting a pothole, as she drove along the R80 road from Soshanguve to town in Pretoria, threw the boy through the windscreen. “He hit the road so hard that he could not even cry. There were no visible injuries, and it would only be after the ambulance arrived that I realised he was hurt.”
And so, after being in an induced coma for a month, coming back to being a baby at 10 years old, was a shock. “He could neither talk, voluntarily turn his head, not use his body as effectively. He was a bright active Grade 5 boy, who ran everywhere, spoke non-stop and had a bright future ahead of him.
“That all went away, and today he needs nappy changing, feeding, his mouth is constantly hanging open… and the cost of keeping him clean and alive, is something I cannot even talk about.”
Boipelo Hlatshwayo said all she did was look at a text message. “The car in from of me stopped and my baby, who was on her sister’s lap, fell against the door and hit her head.” The then-two year-old reverted back to being a small child. “She is now 6 and has not developed since.”
They, and others, said no one had ever mentioned the importance of proper restraining, nor had the issue of car and booster seats ever been spoken about.
“I honestly thought car seats were a waste of time and money, were more to show off… I doubt anyone from my township of Mabopane even understands why they should have children in car seats.
“(This) despite police being at every corner and accepting bribes if we drive through a stop sign, without reminding even us, as adults, to buckle up.”
Arrive Alive often raises awareness on child safety. It has said: “Carrying a baby in your arms or a child on your lap in the car is a road risk. Some parents believe they will be able to hold on to the baby or child, while research has shown that passengers have less than half a second to react in a collision or sudden stop.”
They said that when a vehicle collided or suddenly stopped at 50-60km/h, the weight of occupants or objects in the vehicle multiply 30 to 60 fold. “If a baby weighs 10kg, the force at the moment of impact is equivalent to a weight of 300kg.
“No adult will be able to hold on to the baby or child. They would be thrown about inside the vehicle, injuring themselves and quite possibly seriously injuring (or even killing) anyone else inside the vehicle. They are also likely to be ejected from the car through one of the windows.”
They added that at 25km/h, a small child sitting or standing next to the driver can be killed in an emergency stop if its head hit the windscreen/interior of the car. At 40km/h the blow to a child’s head is the same as dropping him/her from six metres onto concrete.“
This, traffic officer Constable Nick Mabunda added, was in addition to parents who allowed their children free movement inside the vehicle, with drivers sometimes having them on their laps while driving.
“Education and awareness need to start from the moment people learn how to drive, even before. Because, if it is ingrained in their minds, they will never allow this.”
Roads are generally bad, especially after heavy rains; people tend to drive carelessly, stopping and taking off at a whim. Never mind other drivers, who can put one in danger no matter how careful one is, the Pretoria police officer said. He added that different spheres of government, NGOs and NPOs needed to band together to raise awareness.
“It is argued that we live in a society where seatbelt usage can’t be policed, but during Covid19 lockdown, people were being arrested for walking on the beach.
“This is a case where there is abundant evidence society can indeed be mobilised,” Professor Anthony Figaji, who heads the Paediatric Neurosurgery Unit at the Red Cross War Memorial Children’s Hospital and the African Brain Child Initiative at the University of Cape Town, said.
There is an African saying that it takes a village to raise a child. It also takes one to protect it. “We need to rally personal responsibility around seat belt usage,” he added.
Traumatic brain injury is referred to as a silent killer, because despite the staggering burden of injury on the healthcare systems in terms of premature death and disability, it remains overlooked and under-funded in the healthcare system.
“We need to enforce fear of the consequences for not wearing a seatbelt, in the same way we approach drunk driving,” Figaji added, saying South African regulations stated that all adults had to use seatbelts if available; the driver must ensure a child aged between three and 14 uses a child restraint or seatbelt; and, infants under three must be strapped into a car seat where possible.