Tanzania: Economic, Social Burden of Shunning Child Restraints

INITIALLY, a patient whose bone has broken, they need to buy a skin traction kit which costs at between 20,000/-to 25,000/-for each kit.

At times the procedure might be performed on both legs demanding two kits, the doctor said. By the looks of it, the cost may seem cheap but the long stay in hospital is a very huge expense to both the patient's family and hospital as whole.

Although not all the parties afford to pay the 20,000/-to 25,000/-some families apply for the destitute group, thus the cost is incurred by the hospital. Currently, the hospital has introduced other modalities of treatment for children ranging from 0-6 years, instead of putting the child on traction for a longtime, a procedure identified as hip spiker (a type of POP) is performed on the injured patient.

Usually, the spiker also identified as fiber casts, each POP costs 40,000/-but the whole cast comprises five POPs. Thus, it may cost up to 200,000/-to buy the whole cast. The theatre charge is 200,000/-along with other implants depending on the nature among others.

Treatment for public patients have been subsidized by government and hospital, thus the implants are charged a flat rate of 50,000/-. Undertaking the procedure for private patients for stance the femoral fracture (bone fracture), it may take about two hours.

Thus, the patient will be charged both theatre charges, implants inconsideration to the market price. Some of the nails are usually very expensive; the cost for a single nail may range around 250 US dollars. According to him, a single procedure may needs up to two nails.

The case of spine injuries, in most cases, the treatment involves stabilization, but if it occurs that a person needs surgery, it's even more expensive. Such procedure needs things like pedicle screws (fixation for correction of spinal deformities), the value for a single screw is about 500 US dollars.

A fracture may take up to six pedicle screws that makes up 3m/-for the gadgets leave along the implants. There are also circumstances whereby a patient is subjected to multiple traumatic injuries (polytrauma) which are life threatening at the same time like the femur fracture, head and spine injuries.

The kind of patient needs specialized care including ICU treatment and so many surgeries. A patient may arrive with traumatic brain injury that needs immediate surgery to save the life of the person. Damage control is also among important procedures in poly trauma the aim is to stabilize the bones, all these are emergency procedures.

On average the hospital may receive two to five patients in a day but there seasons whereby the cases are rampant especially when school opens most of kids use the roads to go to school and during the holidays.

Prevention is better than cure Dr Mcharo recommends that people should understand that safety protection gears are of great importance and very helpful in case of accidents for children.

"Although, it is also clear that these gears are quite expensive for an ordinary person to afford, but what is expense compared to life". "Like the way people opt to borrow money to buy vehicles and pay for the insurance covers, so should they find the strength to spend on protective gears for the safety and wellbeing of their children," he observed.

He went on to encourage the country's experts and investors to look into the area and devise a plan that will help the important safety gear to be available at affordable rates to all individuals possessing vehicles.

Dr Mcharo further called upon parents to enroll their children into health insurance coverage currently offered at much cheaper rates to ease the burden of treatment of their children in times of need.

The World Bank 2018 study "The High Toll of Traffic Injuries: Unacceptable and Preventable," found out that countries that do not invest in road safety could miss out on anywhere between 7 and 22 percent in potential per capita GDP growth over a 24-year period.

According to the report, deaths and injuries from road traffic crashes affect mediumand long-term growth prospects by removing prime age adults from the work force, and reducing productivity due to the burden of injuries.

Using detailed data on deaths and economic indicators from 135 countries, the study estimates that, on average, a 10 percent reduction in road traffic deaths raises per capita real GDP by 3.6 percent over a 24- year horizon.

The report suggests further that over the period 2014-38, halving deaths and injuries due to road traffic could potentially add 22 percent to GDP per capita in Thailand, 15 percent in China, 14 percent in India, 7 percent in the Philippines and 7 percent in Tanzania.

In addition to the GDP gains from preventing death and injury, road safety interventions improve welfare benefits to the society (WB, 2018). The eighth Global Road Safety Performance Targets indicate that by 2030 member states should increase the proportion of motor vehicle occupants using safety belts or standard child restraint systems close to 100 percent.

By enacting a comprehensive law on effective implementation on child restraint systems will help reduces the impact of road crashes on children in the country. Elaborating on the law, SP Sokoni noted that the country's law is silent on child car seats therefore people are not obliged to compliance.

Among the components which were observed in the Road Traffic Act of 1973 reforms was on the area of child restraints. The main objective is to protect the life of a child.

In recognizing the importance of the provision in the protection of a child occupant, he insisted that the move was supplemented by the UN Resolutions on Road Safety recommended for the amendment of the law and the important provision to be included.

He pointed out that the movement first came up in 2011 but the aspect on child restraints remerged in 2015. Several studies were conducted including going through similar laws in other countries and decided that it should be included in the law reform proposal.

In the process of looking at the rights of a child on the road, it was also realized that the law is depriving the rights of a child whereas Section 39 (4) (a, b) of the Road Traffic Act of 1973 provides that a child who is under the apparent age of three years and who does not occupy a seat shall not be deemed to be a passenger and any two children, each of whom is over the apparent age of three years and under the apparent age of twelve years, shall be deemed to be one passenger.

"Why then two children should be counted as one child, and this pushed us further to recognize a child who is involved in a crash a single souls unlike what is currently stated in the law. And, thus include a provision on child restraint in the proposal," added SP Sokoni.

But, again the proposal has taken account of the categories of vehicles which will only involve private cars to avoid causing chaos. Because, if it happens that such provision includes passenger vehicles it will bring about a lot of problems to the drivers for they will not be in a position to predict how many children will board the vehicles and thus creates a disaster.

Alternatively, it has also been recommended that if a child is not riding in the private vehicle on a particular day there is no need for the driver to go around with the restraint in the car.

Whereas, a person is carrying a child in the vehicle it is a must for the driver to possess a child restraint in the car. He pointed out that the proposal has already appeared for the first time to the Inter-ministerial meeting.

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