Household safety: Prevention for children

It’s not easy to protect children from injuries due to falls or other domestic mishaps, especially toddlers. This is because children are playful and the risk of getting hurt is high. As much as there is little that can be done, health experts believe that there are small measures that parents can take on to help prevent injuries; like watching over the children and keeping harmful items out of their reach. COMMON DOMESTIC INJURIES Dr Gabin Mbanjumucyo, in the emergency care department at University Teaching Hospital of Kigali (CHUK), says common injuries among children can be divided into two categories; intentional and non-intentional, also further categorised into urban and rural settings. Children who are vulnerable to these kinds of injuries are usually aged one to five. He says falls, burns, poisoning and drowning are among the cases they attend to often. Falls, he says, depend on the age of the child and that the major cases they’ve received are in the non-intentional bracket. He says that children are always running around, and so they tend to fall most of the time while playing. “The major injuries that can occur from falls are head injuries, hands, and lower limbs,” he says. Janvier Rusizina, a general practitioner at La Nouvelle Clinic in Remera, says that when you go to the different settings, for instance in the urban settings, children can fall from the stairs, on the floor (like on slippery tiles) and play areas. He says some of them may be fatal, especially head injuries. “When it comes to rural settings, children tend to fall in areas such as slopes, especially during the rainy season,” he says. For instance, Mbanjumucyo says during the past season of rain, they had many cases where children were reported to have sustained injuries due to falls. Rusizina says that some fall in ditches when walking, especially in rural areas, and this tends to be severe. Statistics from University Teaching Hospital of Kigali (CHUK) indicate that in domestic injuries, the leading cause of injuries in children is burns, with 28 per cent of trauma in children connected to burns. Drowning is at 2 per cent, falls in general are more common than burns; however those reported at CHUK are around 20 per cent. However, the statistics also indicate that the mortality connected to burns is around 8 per cent, which is noteworthy. Also, Mbanjumucyo says that they normally receive severe cases and in the paediatric department, the leading admissions are connected to traffic accidents (accidents in the streets). HOW CAN THIS BE PREVENTED? Rusizina says that prevention is in educating the entire family and caretakers on how to take care of children and safety measures adopted to prevent such cases. For instance, he says, they are trying to sensitise mothers, especially when they go for consultation after giving birth, and also when they take children with injuries. However, Mbanjumucyo says this is not enough because the entire population needs to be aware of how to prevent domestic injuries. He says they are planning to create awareness through different platforms and work with health personnel who can sensitise families in rural areas. Carine Mutangana, a nurse at Galien Clinic in Remera, says parents should put away anything that can be dangerous to children, for instance, electric cables, and that they should arrange furniture in a way that will not be hazardous to the movement of children. “Burns are due to children playing around the cooking area. They can be severe and so parents should ensure that they keep children away from these areas,” she advises. She warns that babies who crawl or are learning to walk tend to hold onto things and pull them. Being careful, especially when cooking, serving hot foods or even where you place something hot can help prevent burns in children. Mutangana says that electrical burns in homes without child-proof cables also happen. In this case, she says, parents should keep such cables away from children. “Leaving children sleeping around burning candles, especially in houses that don’t have electricity should be avoided. There should be a policy on how to sensitise the entire population on this. Having fire extinguishers at homes is also important,” she adds. There is more that can be done to create awareness, Mutangana says. She points out that architects should put into consideration child-safety when designing. This, however, should come from government enforcement. Injuries due to poisoning, Mutangana says, can be preventable. Many people are on medication due to different health issues. And keeping those prescriptions away from children is important. When it comes to poison, she says this can as well happen to older children and even adults. She adds that some also commit suicide using these drugs, thus safety storage is important. In the intentional category, Mbanjumucyo says, is child abuse, like when parents leave children with caregivers who mistreat the child, leading to injuries. CALL FOR HELP Regarding non-intentional injuries, Mbanjumucyo says they are trying to teach parents and caregivers how to carry out cardiopulmonary resuscitation (CPR) or first aid, before seeking medical help. He explains that this is so because sometimes when an ambulance is called to respond to such cases, depending on the location where the incident occurred, it may take some time to reach the destination. Dr Claude Byiringiro, an orthopaedic surgeon at CHUK, says that without first aid, a victim’s situation can worsen in a few minutes, or depending on the intervention done within that critical time, the life of the victim can be saved. In Rwanda, he says, the emergency system is efficient and one can get response within a few minutes (less than 10 minutes of the call). Byiringiro emphasises that everyone needs to know that there is a public ambulance which can reach out to anyone who needs emergency care. It can be accessed by calling (toll free) 912 or 112. He adds that it also serves areas outside Kigali as it is interconnected to other hospitals from different parts of the country. For burns, Mbanjumucyo advises that the one taking care of the child should immediately put the burned area in cool water and keep the injury in water for five to 15 minutes as they wait for help. However, he warns that clothing should not be removed, especially if it is stuck to the skin, it should be left in place as you wait for the healthcare professional to handle it. Experts share their views Parents should be more careful with children who have conditions like epilepsy. They should never leave them alone because they could get hurt as their condition can put them in harm’s way. Francis Kazungu, General practitioner ----- As a caregiver, before the arrival of experts, taking caution while attending to a child who has been injured is important because any slight mistake could worsen the condition. Additionally, calling for help from other people before the ambulance arrives is important. Yvan Ntwari, Medic at Galien Clinic Remera ----- The public needs to be sensitised on the existing emergency hotlines, so that they get the help that is needed in time. Having First Aid kits at home is also vital in cases of minor injuries. Aline Gihoza, Nurse ----- Children aged six and below are more prone to accidents; therefore parents should keep an eye on them. Parents should know that interventions done before emergency help arrives can help save life, so having an idea on what to do is important. Bandora Iraguha, Paediatrician editorial@newtimes.co.rw

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Household safety: Prevention for children