Part 1: SAVE KIDS INITIATIVE

Save Kids Initiative emerged as a humanitarian response to my numerous heart-wrenching clinical encounters with child victims of accidents during the course of two decades of my career, initially as a General Practitioner and later as an Anesthesiologist cum Critical Care Practitioner.

For instance, one of the burn patients I received in surgical emergency, early in my career during junior residency, was a 9-month-old baby, who while crawling around his father busy frying snacks [he was a local snack-seller "monji-goer"] fell head-on into the pan of boiling oil. He sustained 90% scalds and died the next day!

The other one, a 6-year-old child, was under my care in the neurosurgical ICU during my post graduation. He had fallen from the second storey of his house through the open window and had sustained severe head and chest injuries.

He fought the tough and agonizing battle of life for two months during which his parents got physically, emotionally and financially drained even to the point of starvation. Ultimately, the little child lost the battle and succumbed to his injuries.

No sympathy and empathy from the treating staff could save him from the clutches of death but his protracted suffering in the ICU due to the disease as well as its treatment did trigger me to go back to the society with the bitter lesson of holding itself responsible for his disastrous fate and of his likes.

These are not rare and sporadic cases that could be comfortably ignored and accepted as normal life-events. Accidents are among the leading causes of childhood mortality and morbidity. Childhood accidents have been recognized as a major public health problem by international and national health-care regulatory bodies like UNICEF^[1] and Indian Pediatric Association^[2].

Childhood injuries are the second commonest cause of death in school-going children in India^[2]. With the graph of childhood accidents rising uncontrollably, these are expected to become the leading cause of death in this age-group in a few decades. Every 4 minutes, a child is killed in a road accident in the world^[3]. Many more are injured, often seriously.

186300 children die each year in road traffic accidents alone, that is more than 500 children a day^[3]. Globally, more than 1,600 children and adolescents below the age of 19-years die every day from preventable injuries.^[4] An attitude of passing over this gigantic problem, has no medical rationale and ethical justification. The cost of doing nothing is too heavy and should be unacceptable for all.

The bitter lessons that each child-accident teaches are those of common sense: Children, due to their small physique, mental immaturity and naive adventurism are predisposed to accidents. At the same time, they are unable to handle challenging and jeopardizing situations. They are unable to ensure their own safety.

The responsibility of protecting the children, therefore falls on the shoulders of their parents and other adult caregivers, by default. Children are dependent on their adult caregivers for their very survival, safety and wellbeing. Any lapse from the caregivers makes the children pay the price through death, lifelong disability and unrelatable suffering.

Ironically, thus it is usually the parents and other adult caregivers who push their children into accidents through their ignorance, neglect and carelessness. This grants a unique emotional angle to the issue of accidents in child age that is not seen with accidents in adulthood. While adults are responsible for their own safety, children are not.

Occurrence of child accidents puts the onus on adult caregivers, not on child victims. A question that every person with a sane mind and humane heart should ask: Why should tender little children pay the price of callousness and apathy of their adult protectors?

Children too have the right to live. Accidents in childhood have to be prevented. Causes and predispositions must be looked into just like any other medical or social problem. Role of parental ignorance, neglect and carelessness in causing this menace must be explained to common people . Ideas based on ignorance and misconceptions and dangerous attitudes and behaviours must be curbed to change the scenario. Awareness, caution and care make accidents rare.

With this goal, Save Kids Initiative was launched two years ago in the form of a Whatsapp group [Save Kids] comprised mainly of my friends, relatives and other acquaintances and a Facebook page of the same name, wherein I have been sharing brief outlines of the cases of child-accidents that I come across so frequently during my day to day clinical practice either for providing anesthesia for high-risk surgical procedures or for resuscitation and other life-saving management in the Intensive Care Unit.

The prime focus of these clinical outlines submitted to an audience comprising lay public as well as healthcare professionals, is to highlight ignorance, neglect and carelessness by parents and other adult caregivers as factors leading undeserving, weak and helpless children to devastating accidents.

Months later, I achieved success in motivating the Help Poor Voluntary Trust, a popular health-NGO of the valley, to lend support to the initiative. HPVT published the "Save the Kids" educational pamphlet with textual and graphic depiction of the common modes of accidents in children in our society and the call for action to prevent these.

The pamphlet features English, Urdu and Kashmiri sections, and has received warm appreciation from its recipients throughout. Some 3000 copies of the pamphlet were printed in the first phase which were distributed over a span of one year in one-to-one interactions and various public gatherings in schools, medical camps, and meetings of volunteers of a couple of local NGOs.

Simultaneously, a PowerPoint presentation entitled, "ACCIDENTS IN CHILDREN. . . . . . .A PASSIONATE APPEAL FOR PREVENTION!" was designed and delivered before a number of public gatherings of teachers, parents, and volunteers.

The presentation discusses the various important aspects of the topic including medical, social and emotional burden of accidents in children, their causes, predisposing factors and common modes and patterns in our society as well as the ways and mechanisms to prevent specific accident-types.

The presentation underscores the importance of prevention through community-action as the standard of care of children, achievable through education of children and their caregivers and adoption of proper safety measures in various domestic and outdoor settings.

Introducing and promoting concepts of self-safety among older children is an important activity of the initiative. We have initiated this with a couple of children who are trained to speak briefly about safety and accidents, in their morning school-assemblies.

In August 2023, the Save Kids Initiative received a shot in the arm when Hope & Health, a local NGO dedicated to the welfare and wellbeing of children, decided to adopt and patronize this initiative thereby bolstering our endeavours toward higher professional and operational standards.

[To be continued…]

Dr Raashid Javaid Fazili is a Senior Resident, Department of Anesthesiology, SKIMS. He is a child-safety campaigner associated with JK Hope & Health Foundation and Help Poor Voluntary Trust. He has launched the Save Kids Initiative to promote awareness and facilitate training about child safety and prevention of childhood accidents.