While a lot of people don’t think of injury as a public health issue, that is exactly what it is.

In some cultures, injuries are blamed on spirits or are thought to have happened as a punishment for bad behavior. Similarly, in the West, we often attribute an injury to intangible “bad luck.”

But for every injury, there were a sequence of events and environmental conditions that led to the injury. And in most cases, those events and conditions could have been altered. What we often think of as accidents aren’t really accidents at all, but preventable incidents. On a wide scale, injury can be prevented through public health initiatives.

In the West, we do a pretty good job of preventing injuries before they happen: public safety concerns figure in everything from car designs to building codes. But this wasn’t always the case.

Consider road traffic safety in the United States. Just 25 years ago, driving drunk was socially acceptable, and a minor legal infraction; our cars had lots of sharp edges and were heavy on the steel.

But since then, a number of things have happened: drunk driving laws were toughened and enforced; car manufacturers increasingly took safety into account in their designs; the conditions of roads were improved; new types of reflective materials were introduced; and public education campaigns on the importance of road traffic safety were implemented.

The result? Between 1979 and 2000, the fatality rate on America’s roads was reduced by 45.6%. That’s about 20,000 fewer people killed on the roads every year. And for every death prevented, roughly a dozen debilitating injuries were also prevented.

Compare that to the developing world. Parts of the developing world are, to varying degrees, doing just that, developing. And one thing that economic development invariably brings is more vehicles to the roads. But, there is little attention to or conception of road traffic safety in the developing world, as anyone who has driven on African roads at night can attest.

Roads in the developing world rarely have dividers, barriers or other safety features, and are used for all kinds of traffic—motor vehicles, animals, bicycles, and pedestrians. Of these groups, pedestrians are the most vulnerable. And the most vulnerable pedestrians are children.

The statistics are shocking:

• 90% of road traffic deaths occur in the developing world.
• In Africa, 50% of deaths of 5–14 year olds are due to injury.
• Road traffic is the number one cause of childhood injury in Africa.

To illustrate the point: in Uganda, there are 160 deaths per 10,000 vehicles annually, one of the highest rates in the world. In the United States, there are two deaths per 10,000 vehicles annually.

In countries like Uganda, for those who survive road traffic incidents, but suffer serious injuries, there is usually little, if any, medical care available. Additionally, the financial impact of a serious injury to a family member often pushes entire families into poverty.

And the problem is only going to get worse in the developing world. The World Health Organization’s “Global Burden of Disease” study predicts that, by 2020, vehicle injury will account for more years of life lost than either malaria or HIV/AIDS. We must act now to lessen the coming blow.

Fortunately, there are inexpensive, cost-efficient interventions, like Amend.org’s See Me Walk program, that utilize methods that have been proven to result in significant and sustainable decreases in the rate of childhood injury on the roads.

Of course, injury is not limited to road traffic incidents. There are many other areas where simple interventions can have an enormous impact. For instance, the leading cause of childhood burns in Africa is unstable oil cookers, over which children often trip, drenching themselves in hot oil. The resulting burns devastate these children in ways worse than most of us can imagine. Yet, one of the most devastating aspects of these injuries is that inexpensive, easily manufactured cooking shields that go around the base of the oil cookers can virtually eliminate the risk of these incidents. The only reason these cooking shields are not being widely used is that no organization has taken the initiative to distribute them.

Another significant cause of childhood injury in many African countries is war. While the causes of conflicts are often multifaceted and obscure, and their resolutions difficult, it has been shown that advocacy can help raise awareness and put an end to conflicts, as in the south of Sudan. With that in mind, Amend.org will conduct targeted advocacy campaigns focused on raising awareness of and ultimately helping to end African conflicts that result in so much injury to children.