An injury narrative – a personal story sheds light on the silent epidemic of injury in Tanzania

My name is RM, I was raised in Dar es Salaam and where my parents were employed in the public sectors. Currently I am working as social welfare officer at the Muhimbili National Hospital. I am responsible for observing and implementing health policy particularly ensuring that the impoverished and the elderly who cannot afford to contribute are served accordingly. I also solicit funds from the clients, carry out voluntary counseling for HIV/AIDS, ordinary counseling for clients, family, relatives, marital and resolve patient, family and staff conflicts as well as teaching, counseling and supervision of students. As an organization it is one of the biggest teaching hospitals in the country.

Injuries affect almost all Tanzanians in some way shape or form. I can recount of my own personal experience of one of my own children who was eight months old at the time and had just begun crawling. The child pushed an improperly screwed thermos which had hot water kept for tea and coffee, the water spread onto the floor and soaked the baby’s clothes were she sustained burns to her lower limbs, buttocks and her forearm. Fortunately the burn was not very severe due to the fact that the thermos was pushed rather than being pulled thus when the water spread on the floor, the temperature was reduced as it came into contact with her body, furthermore I was around thus I immersed the little one into a basin of refrigerated water for an hour. One week later the skin peeled off at the sites.

Another burn occurred just the second day after the delivery of my first born were my mom was preparing porridge which is the major drink for nursing mothers. When she removed the pot from the stove she knocked the edge of table where she had to place the hot pot full of porridge, thus all the porridge soaked her both feet. Fortunately I was there and instructed her to do the same as in the first scenario and the burn was at least cooled down even though in some areas there were blisters. We came to realize that the burn was so large and severe one week later the skin became dark, peeled off leaving a very large open area with smooth, delicate and red skin liable to further harm for months.

We lost the only male child of my relative aged 14 months following ingestion of kerosene which was kept in a bottle which he thought was a soft drink. He was living at Kibaha an hour car driving from the city thus they transferred the child to Muhimbili National hospital where he died the same day due to severe induced pneumonia.

Just within the last month we were chatting in the living room and the baby of my brother aged 7 months was crawling. He picked up the cap of a bottled water and started playing with it then took it into his mouth without us taking any precaution to stop him from doing so as we all thought that the cap was too big to get into his small mouth. All of a sudden the cap went deep into his mouth and the baby started to choke and suffocate.

We really had to struggle to grab him to get it out as he was resisting, crying, kicking and sweating, struggling for air while the cap stacked upside down in his small mouth with four small yet sharp teeth couldn’t allow a space to insert my fingers for removal of the cap. About ten minutes later with the aid of saliva and non-stop struggle and prayers the cap came out leaving the baby’s hard palate bruised and blood was oozing out. He then went into a very deep sleep while leaving us blaming ourselves for taking the play just for granted. Indeed this incident was a shocking one even as I am narrating it as we thought that we were about to loose the baby right in our hands. It was a great dilemma even to take him to the hospital at the time was too short a time for him to be without air thus might not be able to arrive alive to the hospital which was just fifteen minutes walking distance due to air hunger.

Many causalities are brought to the Muhimbili Hospital and admitted in the various wards. Some of them were involved in motor accidents, open flames and three of them whom I remember were involved with an electrical cable buried in the ground were they were working to level the ground so that to allow construction to take place. These guys were terribly burned and such incidents are regarded as police cases thus the police were to come to my department for permission to interview the causalities. What makes matters worse is that there are few safety campaigns being conducted in the country. I am personally not aware of any such campaigns.

Whatever interventions take place must really engage the community at the local level. As there is at present very little awareness of injuries as an important public health issue among the average person, they might feel that campaigns if conducted might only represent a lessening of personal freedoms and jobs to make policy makers richer with few benefits for them.

– Contributed by RM

Child playing near cooking elements in Dar es Salaam By: Pieter de Vos
Child playing near cooking elements in Dar es Salaam By: Pieter de Vos

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