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Morbidity and mortality due to injuries have been officially recognised as significant public health problems in the high income countries (HICs). However, this is not true for the low income countries (LICs). This lack of recognition is assumed by many to be because of an absence of data regarding injuries and because of the prevalence of a “fatalistic attitude” in the population of these countries. Both these assumptions are probably wrong. If you examine the contents of newspapers in LICs, deaths due to injuries are clearly given a great deal of importance by the public and officials and these newspapers carry frequent editorials regarding the lack of safety in their respective societies. These newspapers also report the concern that citizens show by demanding safer roads, schools, and homes. This concern is expressed in the form of letters to the editor, formation of community groups to tackle the problem, and protests in response to tragic events. Some studies also report that poor people spend enormous amounts of money (as a proportion of their incomes) on the treatment of their injuries and other ailments.
This evidence clearly shows that injuries are recognised as a serious problem by society and that the citizens at large do not have a fatalistic attitude toward life. If they did, they would not end up spending so much to have their injuries treated. However, what is true is that LICs have not been able to institute effective programmes for injury control. This is largely because problems in LICs are very complex and there is very little precedence for effective safety policies and interventions that suit low income societies. In addition, LICs also suffer from a lack of expertise and specialised institutions in the area of injury control. Unless local expertise is developed, promoting sustainable and effective injury programmes will be difficult. It appears that attempts are being made in some countries of Africa and Asia to move toward this goal of strengthening local expertise.
Mr Hua Yong Hong of the Traffic Management Research Institute of the People's Republic of China organised a week long seminar on road traffic safety and congestion last October. The seminar was held in Hangzhou and attended by senior police officials representing the different provinces of China. The lecturers at the seminar included experts from China, Japan, and India. The police officers from different provinces made presentations on specific issues concerning safety and traffic congestion in their specific locations. With increases in motorisation, there are serious problems concerning pedestrians and bicyclists of which a large number constitute children. The conflict between the need for providing facilities for faster motorised traffic and ensuring the safety of vulnerable road users became evident in the discussions. At present there are clearly no clear guidelines for the resolution of these problems except the control of vehicular speeds through traffic calming and police enforcement. However, much more work needs to be done to evolve location specific designs and policy measures.
An International Course on Injury Control and Safety Promotion was held in the first week of December in Delhi, India. The week long course was organised by the Transportation Research and Injury Prevention Programme of the Indian Institute of Technology, Delhi, in collaboration with Department of Public Health Sciences, Karolinska Institute, Sweden. The course was sponsored by SIDA, Sweden, and WHO and attended by 26 participants from 11 countries. The faculty included Leif Svanström, Ragnar Andersson, and Karen Leander from the Karolinska Institute, Dinesh Mohan, Geetam Tiwari, Mathew Varghese, Imrana Qadeer, and Rajesh Patel from IIT Delhi, and Larry Berger and Rick Smith from the USA.
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