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Joseph Stalin is reputed to have said or written: a million deaths is a statistic; a single death is a tragedy. Some survey results show that even parents who accept that injuries are preventable, none the less believe injuries will not happen to their children. If this is generally true, we may need to put more emphasis on publicising individual events—what in medical terms is referred to as “case reports”, or, in Chapman's terms, “personalizing”. So, to bring the statistics close to home, and at the risk of being pronounced guilty of a sin against which I have preached, that of “parochialism”, I include in this issue three such examples, all Canadian.
The first is the account by Claire Adamson describing how her daughter lost her hand on an escalator. It is a tragic story and one that illustrates all too well how poorly designed and badly maintained equipment can maim for life. To the credit of parents and child, the case was taken to court and after a long ordeal the child received a substantial sum “in compensation”. Of course, no sum of money can compensate such an injury; but perhaps it helps to know that by taking legal action others may be spared similar calamities.
The second is a description by a distinguished Canadian colleague, Roger Tonkin, an international leader in adolescent medicine. Tonkin frequently contributes to the Medical Post a well written column about youth he has treated. I asked if he would share one pertaining to injuries. I trust readers will agree that his account of the aftermath of an all too common car crash rings true for all of us. Whether it is truly a story with a happy ending, I leave for you to decide.
Finally, there is the poignant letter from another colleague, Marielle Olivier. When I learned that her sister had been killed in a “car accident” I wrote to express my sympathies and asked what actually happened. Although the victim was not a child or adolescent, I make no apologies for publishing her reply. The drunken driver problem affects all age groups. Every injury prevention expert knows that alcohol is a major risk factor, not just for drivers, but in almost every injury producing situation. The seriousness cannot be underestimated, yet those who drink to excess and those who permit them to do so—friends, relatives, or bartenders—are rarely punished sufficiently to deter others. This must change and we must help it change. For starters, I have asked colleagues in Canada to join forces with Mothers Against Drunk Driving (MADD) to help have more stringent federal legislation passed.
Apart from recounting this personal tragedy, MADD sent some statistics so mind boggling that I wanted to share them in the hope that someone can explain them. In Canada, in 1997, 1680 people were killed and 74 000 injured in alcohol related crashes and I estimate that perhaps half were drivers. Nevertheless, the previous year there were only 133 charges for impaired driving causing death and 1028 charges for bodily harm! Even more perplexing is that in Ontario, the largest province, conviction rates were 43% and 48%, respectively and I assume this reflects the national average. Help me understand how this can be? Is it the same everywhere?