Firearm injuries to children in Cape Town, South Africa: Impact of the 2004 Firearms Control Act

Abstract

Compared with the earlier study, this study showed a significant reduction in the number of children presenting with a firearm-related injury. Mortality and inpatient stay were also significantly reduced. The study shows the impact that the Firearms Control Act has had in terms of paediatric firearm-related injury and provides evidence that the medical profession can play an important role in reducing violence.

The wrong and wounding road: Paediatric polytrauma admitted to a level 1 trauma intensive care unit over a 5-year period

“…Of major concern was their finding that 94 patients with GSWs were admitted to hospital, but three times as many died before admission and were taken straight to mortuaries, showing the heavy burden of gunshot injuries to children. In the Western Cape Province at Red Cross War Memorial Children's Hospital, Campbell et al [11] found the same incidence as Mars and Hadley but with a ten-fold increase in prehospital compared with in-hospital deaths. Although the Firearms Control Act of 2004 appeared to have an impact, the effect appears to be waning with a steady increase in incidence in the latter part of their study.…”

“…Tragically, similar findings have been reported from other SA studies over the past two decades. [10,11] In KZN, Mars and Hadley [10] reported the peak incidence of GSWs in children to occur in the first quintile of life, multisystem injuries were the commonest presentation, and of those who survived, one in ten was left severely disabled. Of major concern was their finding that 94 patients with GSWs were admitted to hospital, but three times as many died before admission and were taken straight to mortuaries, showing the heavy burden of gunshot injuries to children.…”

“…[6][7][8][9] In addition to the burden of motor vehicle-related injuries, studies from Nigeria and SA have shown that gunshot wounds (GSWs) in infants and children are a tragic emerging mechanism of injury. [8,10,11] Although the number of hospital admissions following GSWs in Cape Town decreased between 2000 and 2007, the vast majority of deaths occurred before treatment could be instituted and a steady increase in admissions was seen in the subsequent 3 years. [11] Africa has the dubious label of being the most dangerous place in the world for a child, [12] and prevention and political will to back up the necessary policies are the most cost-effective methods of reducing trauma-related deaths.…”

“…[8,10,11] Although the number of hospital admissions following GSWs in Cape Town decreased between 2000 and 2007, the vast majority of deaths occurred before treatment could be instituted and a steady increase in admissions was seen in the subsequent 3 years. [11] Africa has the dubious label of being the most dangerous place in the world for a child, [12] and prevention and political will to back up the necessary policies are the most cost-effective methods of reducing trauma-related deaths. [4] To that end, information documenting causation, morbidity and mortality are essential for planning, implementation and evaluation of preventive measures.…”

Physical and sexual violence against children

“…Most children admitted with firearm-related injuries are victims of 'stray bullets' . [5] Causes of child abuse and predisposing factors…”