One of the most dramatic developments in international public health this decade in the emergence of trauma as a growing cause of life years lost. Some of this trend is due to better control of HIV, one of trauma’s chief competitors, and the growing availability of motor vehicles throughout developing economies.
Of all the grotesque causes of trauma, it’s road injuries that lead to the greatest mortality. I witness this firsthand each summer at CEML Hospital, where individuals with motorcycle and vehicular femur, hip and tib-fib fractures present every day, accompanied by a disturbing number of head injuries.
What can be done? Clearly, improved emergency medical care is one priority. Risky behaviors must also be addressed, like curbing alcohol consumption and wearing protective helmets. Upgraded highways and bridges not only decrease trauma, but also increase economic output.
Naturally, multiple strategies to target a particular injury problem may be more effective than any one strategy alone. Government agencies usually have the greatest power to curb injuries through public education, engineering policy and police enforcement. With the reduction in infectious disease deaths in many developing nations, attention to the task of injury prevention must become a higher priority. All of us involved in international health can champion these redeployments.