Today's News

Thursday, March 1, 2001

Orthopaedists focus on global traffic crashes

By Laura Lane

Marcos Musafir, MD, had seen enough when his sister was killed in a traffic crash in 1989. Without a seatbelt, her head smashed into the windshield giving her fatal head injuries. On that day, the Brazilian orthopaedic surgeon vowed to prevent such unnecessary deaths.

Today, the Rio de Janeiro chapter of the Brazilian Orthopaedic Society has saved thousands of lives by spreading the word on buckling up. Not only that, Musafir and his colleagues rallied the government to make seatbelts a law. It happened in 1995. And, ever since, the number of deaths from high-energy car crashes decreased by 48 percent. Injuries decreased by 28 percent.

"We told the government, you are killing people with road traffic injuries," Dr. Musafir said, explaining the pressure they put on legislators to react to the thousands that were dying on the road every year.

Physicians lauded the efforts of the Brazilian orthopaedists at the International Presidents Forum and Breakfast on Wednesday. By using the Brazilian program as a model, attendees discussed how orthopaedic surgeons could help reduce the nearly 900,000 traffic crash deaths and 34 million injuries that occurred in 1999. The numbers make road traffic crashes the third leading cause of death in the world.

Similar statistics impressed Barry Gainor, MD, chairman of Health Volunteers Overseas, an organization that sends volunteer physicians all over the world. Three years ago, he and his colleagues studied the number of war injuries in preparation for sending physicians to help land mine victims. Instead of confirming their conviction, they discovered that road traffic crash deaths and injuries were the real problem.

"This was an eye opener for me," Dr. Gainor said. "We figured out this is what we need to be focusing on."

The problem is growing in developing countries, which have an increasing number of cars on inadequate roads. Not surprising considering that 85 percent of the world's traffic crash deaths occur in developing countries, Bruce Browner, MD, chairman of the Academy's international committee, pointed out during his presentation on the issue. Only 6 percent of the deaths occurred in "highly-motorized countries," or, industrialized nations.

The difference is that, in developing countries, pedestrians, buses, big trucks, bicycles, cars, and horse-drawn carts share the same roads, increasing the chance of mishap. Vehicles also hold many more passengers, some sitting on top of buses, if not jam packed into the car. "Rolling coffins," was how Dr. Browner, described some buses.

Adding to the problem is that vehicles in developing countries lack injury-preventing seatbelts and airbags. Effective traffic safety laws, enforcement and anti-drunk driving programs are also lacking.

The solution is "advocacy with education," Dr. Gainor said of the problem that costs $500 billion worldwide every year. "It could be the most powerful potential tool."

Gainor encourages orthopaedic societies around the world, such as those in Brazil, to take the lead in rallying their governments and to educate the public on prevention tactics. "Then you begin to accrue power to make a change," he said.

In Brazil, where Dr. Musafir and his colleagues have been laboring away on the issue for 11 years now, traffic crash deaths have decreased 24 percent and injuries decreased by 33 percent since 1999. In addition to the seatbelt law and other media blitzes, electronic guards stationed at intersections to catch red-light runners and speeders have also given Brazilian drivers incentive to be careful. Dr. Musafir said that his goal is to erect 8,000 more for a total of 10,000.

"Our goal in medicine is to prevent deaths," Dr. Musafir said. "Why not prevent traffic injuries?"

While Musafir said he realizes that his battle is not yet won, he can rest in the fact that his efforts have so far made a difference, helping him to fulfill his promise to his sister. "I'm giving her a present," he said.

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