Community: Khalilabad
Country: Islamic Republic of Iran Population: 48686 Starting the safe community movement: 1996 Institution: Primary Health Care Network of Khalilabad Address: Primary Health Care Network, Imam Khomeini Street, Khalilabad, Khorasan Razavi Province, Islamic Republic of Iran. Zip Code: 9677115565 Tel: (+98) 5327727310-2 Fax :( +98) 5327727315 E-mail: [email protected]
Mohammad Ali Mahdinejad: Governor& Head of Safe Community committee in Khalilabad Dr. Seyed Mehdi Hashemi: Head of Primary Health Care Network and Secretary of the Safe Community committee of Khalilabad Dr. Hassan Makarem: Senior Injury Expert & Technical Consultant of Safe Community movement in Khalilabad Engineer Javad Torkaman Nejad Sabzevari: Head of Secretariat of Safe Community committee of Khalilabad
Introduction:
Despite the fact that injuries consume a large number of health care resources, at least 5 million people worldwide die from injuries each year. (A mortality rate of 83 per 100,000 populations) Injuries account for 9% of world’s death and 12% of world’s burden. More than 90% of deaths occurred in low and middle income countries. In Islamic Republic of Iran as a middle income country (Gross National; income per capita =$ 3470), injuries are the first cause of burden (DALY=1962.9) and second cause of death (YLL=1259.4). On the other hand, the safe community is known as a community based solution oriented model in which community creates the capacity to address its disaster and injury challenges in a thoughtful and practical way. In this model there is a shift from individual to community based, to ensure everyone in the society is involved. This movement has been started in Khalilabad from 1996. We believe that Khalilabad can achieve the standards of an international safe community model regarding putting people and processes in place to ensure that a blend of strategic activities and community involvement will have a significant impact on the rate of its injuries wherever and however they occur. So that, the whole community, government and non government organizations that have a vested interest in community safety have become the main stakeholders.
A summary of the Community: Khalilabad has been separated from Kashmar in 29th June 2002. This city is located on the southern part of Khorasan Razavi province and its antiquity as an urban spot traces back to 40 years ago. On the average, its about 1767.5 square kilometers, 975 meters above the sea level. The population of Khalilabad has been reported 48686 by the Statistical Center of Iran in 2009. Khalilabad is about 1000 kilometers far from Tehran and 240 kilometer far from Mashad. This city leads to Kashmar(115th international safe community) from the east and the north, to Bardaskan(136th international safe community ) from the west and to Gonabad and Mahvelat from the south and it contains two districts. 1. Khalilabad is the center of the main district that consists of two rural regions (Rastagh County with Ebrahimabad as its center and Dehestan County with Nasrabad as its center). 2. Sheshtaraz district with Kondor as its center consists of two districts (Sheshtaraz County with Kondor as its center and Kavir county Sa'dodin village as its center). This city benefits from the proximity of the mountains, valley, and desert having very cold winters, pleasant springs, mild summers, and beautiful autumns. Economically, it relies on agriculture, animal husbandry, and handicrafts.
Population: Based on the latest census (2009), the population is about 48686 out of which 33130 (68.5%) in rural areas and 15556 (31.95%) in urban area. 23.37% are under 14 years old, 25.5% between 15 and 24 years old, 41.28% between 25 and 59 years old and 9.85% are above 60 years old. Male to female ratio is about 104.5, the average number of people per family is 2.4, 16.15 percent of the whole population are students, and the percentage of literacy is 93.53.
The reasons for running a committee to promote safety& prevent injuries are:
• Injuries are the second cause of death after cardiovascular disease in khalilabad. • Injuries (especially road traffic injuries) are the leading cause of burden. • Road traffic injuries cause high amount of years life lost and financial damages because high occurrence in the young age groups and breadwinners. • Most of Injuries are predictable and preventable with a simple intervention. • Islamic Republic of Iran is a disaster prone country, though it is almost impossible to fully recoup the damage caused by the disasters, we need to be prepared in order to minimize the potential risks.
A summary about beginning of the movement: A Safe Community is one which reflects the passion and commitment of people who dream of a community that is free of injury and prepared for disasters, and who dare to commit to do something tangible to realize that dream. The safe community movement was started in Islamic Republic of Iran in the level of province in 1996. This pattern was piloted from 1997-1999 in Kashmar(khorasane Razavi), lahijan (Gilan), Booshehr (Booshehr), Shazand (Markazi) and Eslamshahr (Tehran). At that time khalilabad was a part of kashmar. This movement was followed till now and will be continued.
Based on the Statistics: • Based on the injury registry and Statistics in 1998: Population based: 46473 (urban areas: 8277, rural areas: 38196) Number of injuries: 2109 A) The most common cause of injury was fall from same and different level(28.12%), followed by penetrating trauma (16.36%) and Road traffic injuries (12.85%).
B) the most common type of injury was Cut, tear and scratch (43.48%), followed by Burning (15.12%).
C) The most common field of injury was home (60.56%), followed by Street and road (10.38%).
D) 61.02% injuries occurred in rural areas.
E) Males were the most vulnerable group. (70.14%)
F) 81.60% of the victims were recovered.
G) the most vulnerable age groups were 0-9 years old (26.69%), followed by 10-19(25.98%) and 20-29 years old (15.98%).
According to this data, the priorities were set as followings:
1. Home safety. 2. Road safety. 3. Child & young hood safety. 4. Prevent intentional injuries (emphasizing on violence & suicide).
Goals of the program: A) Main purpose: Prevent injuries and promote safety and well being of all the citizens.
B) Objective goals: 1. Reduce number of the injuries about 25% during the first three years after the beginning of the movement. 2. Reducing the mortality rate of injuries. (YLL: Year’s life lost) 3. Reducing the disabilities due to injury. (YLD: year’s life disability)
Strategies: 1. Advocacy: sensitizing the policymakers around the communities for injury
prevention & safety promotion.
2. Community engagement: a comprehensive and thoughtful plan to inform the community as
the key stakeholders.
3. Capacity building: increasing public awareness.
4. Injury surveillance: ongoing, systematic data collection, interpretation and
dissemination of data for public health actions to reduce the occurrence and
severity (morbidity and mortality) of injuries
5. Epidemiologic investigation in order to determine the risk and protective factors.
6. Highlighting the vulnerable groups & risky behaviors in order to implement
evidence based and solution oriented interventions.
7. Priority setting in the field of injury prevention & safety promotion.
8. Determining the responsibilities of each stakeholder.
9. Prepare disaster and injury prevention guidelines.
10. Providing appropriate and on time emergency service and medical care.
11. Ongoing participation the Safe Communities networks.
The international indicators of the safe community:
1. An infrastructure based on partnership and collaborations, governed by a cross- sectional
group that is responsible for safety promotion in their community;
2. Long-term, sustainable programs covering both genders and all ages, environments, and
situations;
3. Programs that target high-risk groups and environments, and programs that promote safety
for vulnerable groups;
4. Programs that document the frequency and causes of injuries;
5. Evaluation measures to assess their programs, processes and the effects of change; 6. Ongoing participation in national and international Safe Communities networks.
The six Indicator s of safe community:
1. An infrastructure based on partnership and collaborations, governed by a cross- sectional group that is responsible for safety promotion in their community
Regarding the national action plan, a safe community committee was formed. The governor (Mohammad Ali Mahdinejad) as the head of the committee, the manager of primary health care network (Dr. Seyed Mehdi Hashemi) as the secretary of the committee, and other stakeholders as the members of the committee are running their responsibilities. The secretariat is located in Center of disease control (CDC) of the Medical University. The junior injury expert of the medical university in the province level is responsible as the coordinator of the meetings.
Health and medical and social welfare commission of city
Safe community ... … committee of the city
Training & Research subcommittee
School Safety Subcommittee
Work safety Subcommittee
Home Safety Subcommittee
Social Safety Subcommittee
Road Traffic Subcommittee
Information & Statistical Data Analysis Subcommittee
Monitoring & Evaluation Subcommittee
Members of Safe community steering committee of khalilabad are: The governor, head of primary care network, head of education department, religious leader (Imam Jome), Injury experts of medical university, The delegate of the city in parliament, head of EMS, Red Crescent society, firefighting, Islamic council of the city, water and sewage, road and transportation, police, jurisdiction, culture& Islamic guidance, gas company, agriculture of jihad, welfare, electrical power, Basij organization, department of environment, PTT, national and regional journals who all participate in ongoing meetings.
The responsibilities of sub-committees are: 1. Sensitizing policy makers 2. Priority setting 3. Holding meetings with the relevant stakeholders to design & implement appropriate and evidence based interventions to prevent injuries from occurring. 4. Holding training workshops and face to face training for different target groups such as children, women, family, students, and kindergarten children. 5. Determining the black spots and risky environments all around the city and attempt to remove or modify them. (E.g. in roads, schools, play grounds and…) 6. Holding different maneuvers such as earthquake drills in schools with the cooperation of education department, Basij organization, Red Crescent society and other stakeholders for capacity building. 7. Running painting and photo exhibitions regarding the different issues such as the week of road safety, world health day, road traffic remembrance day. 8. Holding different festivals including whole family walking, hiking, Symbolic use of helmet for bicyclists and safe cycling. 9. Encourage the involvement & partnership of the health care volunteers (Rabetine Salamat) in the urban areas the same as behvarz in rural areas in the form of NGO's for injury prevention and safety promotion programs. 10. Teaching the traffic and safety rules to the children and encourage them to become the police assistants (hamyare police). 11. Internal evaluation & monitoring, interpretation and dissemination the results of each subcommittee. 12. Providing and distributing the brochures, instructional banners, and the news of the safe community by local journals to increase public awareness.
2. Long-term, sustainable programs covering both genders and all ages, environments, and
situations;
Children 0-14 years old:
For injury prevention & safety promotion of this age group it is important to focus on Parents, Schools staff and the children themselves.
- So we focused on parental supervision, safe travel to and from school and safe schools. - Making some environmental modifications such as fencing the windows. - Free distribution of training CD regarding traffic rule and signs in all the schools. - Capacity building for children regarding appropriate use of emergency phone numbers(115,110 and 125) - Integrated programs in health care system e.g. IMCI(Integrated Management Of Child Health) in this programs all the children are vaccinated & screened for hearing loss, low vision, ADHD.
Youth 15-24 years: - Empowering this age group by Capacity building. - Providing free consultations for youth regarding violence and suicide prevention. - Compulsory training courses before catching a driving license. - Holding first aids and CPR Training courses by the Red Crescent organization for the youth.
- Encourage the youth to participate in the injury prevention workshops. - Distribution of brochures to the young drivers for safety awareness about protective factors such as helmet use, seat belt and the risk factors such as long time driving, fast driving, fatigue and substance abuse.
Adults 25-59 years:
- Focusing on occupational safety in work places. - Distribution of brochures and pamphlets to the house holders to raise their awareness regarding injury prevention and safety promotion. - Regarding the home safety program, filling the home safety checklists by Behvarz and increase the family awareness by face to face training. - Encourage to install fire extinguishers in different indoor places. - Tips for reducing the risk of carbon monoxide intoxication in different indoor places.
- Holding training workshop and drills regarding how to extinguish the fire and prevent burn. - Holding training workshop regarding stress management and the ability to cope with life challenges.
Elderly above 60:
- Holding monthly meeting regarding injury prevention and safety promotion among seniors. - Distribution of brochures and pamphlets for seniors to raise their awareness regarding injury prevention and safety promotion.
- Empowering seniors regarding life style modification, self care and risk factors which threat them. - Encourage elderly to wear glasses or hearing aid in case of need.
- Holding a ceremony for the grandfathers and grandmothers and encourage them to put their
experiences into practice for younger parents.
At the following environments: Home: - Encouraging structural and non-structural home resilience under the supervision of relevant stakeholders. - Face-to-face training for preventing home injuries by trained health care workers (Behvarz).
Traffic: - Law enforcement regarding use of seat belt for car driver and occupants. - Law enforcement regarding use of helmet for motorcyclists. - Encourage people for using public instead of private transport. - Encourage pedestrians for using pavements instead of the main roads. - The joint program of police & education department in which the pupils are trained and an identification cards is issued for them as volunteer police assistants (hamyare police). - Training the elementary school and day care teachers regarding road traffic for teaching the preventive tips to their students.
- Solution oriented environmental modification regarding evidence base documents.
Occupations: - Focusing on occupational safety promotion and injury prevention.
- Training different job owners about different occupational disease.
- Distribution of brochures and pamphlets for seniors to raise their awareness regarding injury prevention and safety promotion. - Forming the technical-steering committees in the factories in order to reduce the occupational injuries, and promoting safety and safety standards in work places.
School: - Distribution of brochures and pamphlets for increasing awareness regarding injury prevention and safety promotion. - Holding contests of poem, painting, and article writing on the topic of safety and health, and giving prizes to the winners. - Free distribution of CD’s regarding traffic rule and signs in all the schools.
- Training the pre-school children about the traffic matters. 3. Programs that target high-risk groups and environments, and programs that promotes safety for vulnerable groups;
We scheduled programs to create and promote safety in vulnerable groups, emphasizing on children, youth, housewives, and the elderly in all environments. The instructional handouts were distributed regarding intoxication (drug abuse), road traffic injuries, and Wednesday eve festival injuries and so on. We have also encouraged local journals to do so. First aid training courses for different sectors including traffic Police and teachers of day care centers was hold at different levels.
The proposed 4 years action plan is as follows :( 2009-2013) Surveillance: 1. Improvement in data gathering (100% coverage for reporting injured regarding different sources e.g. hospital admission, forensic medicine, cemetery) 2. Ten percent reduction in the number of different kinds of hospital admitted injured. 3. Twenty percent reduction in the number death related road traffic injuries. Law enforcement: 1. Twenty five percent increase in the number of motorcyclists who use helmet. 2. Twenty percent increase in the number of cars who use child restraints. 3. Increase the rate of seat belt use in car divers and front seat occupants to 90%. 4. Remove 50% of the black spots, identified at the moment.
Also, the following activities have been done for the safety of vulnerable groups.
- School police (The joint program of police & Ministry of education in which the pupils are trained and identification cards is issued for them as volunteer school police) to help the police for the supervision smaller students on the way from school to home, and insisting their family to obey traffic rules). - Holding the poem, painting, and writing contests on the topic of “injury prevention” and giving prizes to the winners. - Earthquake maneuvers at schools. - Holding training of trainer(TOT) workshops regarding life skills (stress management, problem solving & decision-making) - Holding symbolic maneuvers regarding helmet use. - Completing the traffic signs in and out of the city. extending the main roads (making the Khalilabad - Kashmar road one-way) - Widening the roads in the entrance of villages and installing traffic signs and traffic lights on the way.
- Identify black spots and roads or squares which need environmental modifications. - Preparation of spot-map regarding black spots in Khalilabad.
Based on the map guide:
* Green: black spots which have been removed. * Yellow: black spots are going to removed *Red: known black spots in which nothing has been done yet.
- Protecting the safety, health and welfare of people engaged in work or employment which imposes a duty on employees to take practical steps to ensure safety of employees and others in the workplaces. - Encourage job owners to put prevention into practice and reduce the level of noise and air pollution. - Detect the risk and protective factors in workplaces. - Checking the health status before hire an employee also periodic health examination in the workplace. - Renewing rural Carpet-weaving small factories by free of charge distribution of building materials “Bagha project” to prevent coming problems. - Raising awareness through conducting School field drills on earthquake.
Sports & Recreational centers: - Reduce the accident prone areas in sport & recreational places. - Repair or renew the playground equipments. - building sport sites for the ladies and gentlemen considering the safety issues (1260 square meters) - Holding public walking festivals for all members of the family in order to change the sedentary life style and encouraging families to exercise. - Temporary deployment of EMS or relief and rescue ambulances beside crowded recreational centers to provide easy access to medical care in case of need.
Intentional injuries: - Holding training stress management classes for school and day care teachers, students and health care workers in order to improve life skills and to cope with stress full situations.
- Conducting studies on violence and its causes in different age groups.
- Distribution of brochures and pamphlets. - Running a behavioral consultation center and allotting a hot line number for easy access. - Encourage families to pass mental examination is case of need. - Training the family members with a mental ill relative regarding how to cope with him and how to keep his drugs.
Intoxication & drug misuse: Capacity building by House-to-house training of the families regarding the following issues is scheduled:
Children: - The door of cabinets should not be easy for kids to open. - Chemicals (detergents and poisons) should be kept away from children. - Poisoning materials, detergents & bleaches should be kept in a close container and should have labels on it.
Elderly: - low vision is a common impairment among seniors, so they are at risk for taking wrong pills, or to take chemicals or poisons instead of syrups, therefore Training the families to: - Remove all out-of-date medications and those no longer in uses. - Separate different kinds of medicines and put the right amount accessible for the elderly. - Supervise on drug-taking of the elderly. - Make the poisons recognizable in labeled containers and keep them in certain places.
Fall: Training the parents about: - Avoid leaving the kid in a cradle or bed without fence or protection. - Secure rugs with nonskid tape as well as carpet edges. - Carry a baby-carrier from the bottom. - Install a protecting fence at the beginning and at the end of stairs. - Have adequate lighting in stairways, hallways and pathways. - Put locks and window protector at the suitable height to prevent from children fall. - Always supervise children when they are using playground equipment.
Elderly: - Fall Prevention in the elderly and for seniors is a problem that affects everyone as they get older. Visual impairment may be compounding or causing falls. Other causes are poor mobility and balance impairment, degenerative diseases such as arthritis in knees and other parts of legs, taking drugs, dizziness, lack of concentration and other environmental problems. So we train the family to:
- Encourage elderly to have regular checkups. - Encourage elderly to manage gait and balance impairment with assistive aids. - Add contrasting color edge of steps to identify change of level. - Keep walk areas clear of clutter, rocks and tools. - Install adequate lighting by doorways and along walkways leading to doors. - Secure rugs with nonskid tape as well as carpet edges. - Encourage elderly avoid getting out of bed suddenly. - Have adequate lighting in stairways, hallways and pathways. - Install a handle on the walls of the bathroom to keep the balance while sliding.
Kitchen: The kitchen is often one of the busiest and most dangerous places in the home. - The floor should not be slippery. - The things which are regularly needed should be placed in cabinets at the low height. - The wet floor must be immediately dried.
- Have adequate lighting in the kitchen.
- Keep knives and other sharp edges also fires and other hot things out of reach of children.
Other places:
- Fixing the carpets so that their edges do not make people fall. - Keep electrical and telephone cords out of the way. - Arrange furniture so children and elderly can easily move around it.
Electrical shock: - Training the families about keeping the electrical devices away from children. - Training the families to wipe their hands dry before handling electrical appliances. - Wearing of rubber slippers while using an electrical appliance is a must. - Putting a lid for the outlets inside the building. - implementing the extinguish system in buildings and store rooms of offices
Other affairs: - Animated training clips on road safety and prevention of traffic injuries, which was prepared and supported by Law Enforcement Organization broadcasts routinely in the national TV for raising awareness of both pedestrians and drivers. This action has encouraged youngsters and teenagers to work more actively and closely with traffic police in Police Assistant Initiative.(hamyare police) - Putting many warning sentences on the billboards and banners regarding injury prevention and safety promotion.
4. Programs that document the frequency and causes of injuries;
We have an EMS based injury registry which documents the frequency of injuries regarding
the cause of injury, the field in which injury occurred, and demographic characteristics
(Tables in appendix)
Also regarding the home safety program behvarz fills the home safety checklists once a
year; also participate in increasing public awareness by face to face training.
5. Evaluation measures to assess their programs, processes and the effects of change;
1. Input measures: For example number of block spots. 2. Process measures: For example number of environmental modifications.
3. Output measures: For example, number of road traffic crashes, road traffic injured, injury related dead and disability, before and after an environmental modification.
The results of evaluation measures guide for priority setting and design evidence based, solution oriented interventions.
6. Ongoing participation in national and international Safe Communities networks.
- participating in safe community conferences - Submitting 13 articles in the 16th international safe communities conference (Tehran, June 11th to 13th, 2007), out of which, 11 articles were accepted for the presentation and poster.
- The city has been field visited twice in 2003 and 2009 so far, (in 2003 it was visited by Mr. Lars Gunar Hort and Dr. Reza Mohamadi from WHO collaborating center along with national and provincial authorities and in 2009 it was visited again by Dr. Bo Henrickson and Mrs. Henrickson from WHO collaborating center, along with Dr. Haddadi , head of injury prevention & safety promotion department of the Ministry of health & Medical education and Dr. Reza Majdi, the public health deputy of Mashad medical university of sciences and other Provincial experts).
Site visit 2003
Site visit 2009
Table 1. The number of accidents in Khalilabad in 1997 ٭
Type of accident
Taking drugs and chemicals and drugs Taking
External things in the body the in things External Contact with hard objects hard with Contact Fall down on the ground the on down Fall
Poisoning with gas with Poisoning Road traffic injury
Animal's biting Animal's
sharp tool sharp
Falling ruin Other cases Other electrifying hot liquids hot chemicals hot object hot drowning
suicide cruelty falling
fire
2 4 24 275 57 20 8 3 8 11 30 35 13 271 29 225 64 88 334 259 345
Type of injury
Bruise, getting dark blue, swelling, swelling, blue, dark getting Bruise, Dislocation of a limb, twisting
Cutting, tearing,scratching inflation, redness of a limb
Injury to some parts
Wound, crushing Wound,
Limb cutting Limb
Brain stroke Brain
Eye wound
poisoning drowning blooding
fracture burning
others shock pain
1 5 15 5 30 48 90 20 17 3 2 32 101 144 181 319 185 917
Injured part
Internal Genital Some limbs body toe foot finger hand mouth nose ear eye brain neck face head organs organs
75 75 55 13 92 108 209 158 293 215 122 123 47 17 138 197 247
Region of accident Place of accident
Recreational centers Recreational The way to school to way The
Public places Public
Work place Work Other cases Other road
village school
house city ﻭ street
822 822 1287 0 153 259 30 40 131 219 1277
Age of injured Result of accident Gender of injured
Under Above 60 50-59 40-49 30-39 20-29 10-19 0-9 death disabilities recovered female male treatment
120 120 124 143 274 337 548 563 10 0 378 1721 624 1485
Month of the year
Esfandٍ Bahman Dey Azar Aban Mehr Shahrivar Mordad Tir Khordad Ordibehesht Farvardin
160 160 139 134 90 170 153 231 268 214 198 177 175
The whole number of accidents in 1997 was 2109 Table 2. The number of accidents in Khalilabad in1998
Type of accident
Taking drugs and chemicals and drugs Taking
External things in the body the in things External Fall down on the ground the on down Fall
Road traffic injury Poisoning with gas with Poisoning
Animal's biting Animal's
sharp tool sharp
Falling ruin Other cases Other electrifying
hot liquids hot chemicals drowning
hot thing hot suicide objects cruelty falling
fire
1 6 16 286 11 1 1 0 2 7 35 31 2 235 2 256 27 29 205 144 277
Type of injury
Bruise, getting dark blue, swelling, swelling, blue, dark getting Bruise, Dislocation of a limb, twisting
Cutting, tearing,scratching inflation, redness of a limb
Injury to some parts
Wound, crushing Wound,
Limb cutting Limb
Brain stroke Brain
Eye wound
poisoning drowning blooding
fracture burning
others shock pain
3 3 1 2 2 2 28 2 1 1 32 8 55 89 318 123 900
Injured part
Internal Genital Some limbs body toe foot finger hand mouth nose ear eye brain neck face head organs organs 34 34 62 6 35 13 431 102 449 10 5 6 11 3 4 156 240
Region of accident Place of accident
Recreational The way to street houseﻭcity village Other cases l Public places school Work place road centers school
447 447 1120 18 86 52 1 37 95 485 793
Age of injured Result of accident Gender of injured
Under Above 60 50-59 40-49 30-39 20-29 10-19 0-9 death disabilities recovered female male treatment
121 121 62 86 138 268 437 455 6 0 442 1119 454 1113
Month of the year
Esfandٍ Bahman Dey Azar Aban Mehr Shahrivar Mordad Tir Khordad Ordibehesht Farvardin 56 56 50 73 81 143 162 239 242 225 156 89 51
The whole number of accidents in 1998 was 1567. Table 3. The number of accidents in Khalilabad in 1999
Type of accident
Taking drugs and chemicals and drugs Taking
External things in the body the in things External Fall down on the ground the on down Fall
Poisoning with gas with Poisoning Road traffic injury
Animal's biting Animal's
hard objects hard
sharp tool sharp
Falling ruin Other cases Other electrifying
hot liquids hot chemicals drowning
hot thing hot suicide cruelty falling
fire
0 0 50 13 1 0 0 2 43 31 34 3 203 11 291 32 200 173 140 318
Type of injury
Bruise, getting dark blue, swelling, swelling, blue, dark getting Bruise, Dislocation of a limb, twisting
Cutting, tearing,scratching inflation, redness of a limb
Injury to some parts
Wound, crushing Wound,
Limb cutting Limb
Brain stroke Brain
Eye wound
poisoning drowning blooding
fracture burning
others shock pain
2 2 3 8 13 17 11 1 3 1 41 31 30 92 374 263 655
Injured part
Internal Genital Some limbs body toe foot finger hand mouth nose ear eye brain neck face head organs organs
41 41 91 4 36 15 465 106 473 4 7 7 7 5 2 135 147
Region of accident Place of accident
Recreational The way to street houseﻭcity village Other cases l Public places school Work place road centers school
482 482 1063 5 147 168 1 22 53 372 777
Age of injured Result of accident Gender of injured
Under Above 60 50-59 40-49 30-39 20-29 10-19 0-9 death disabilities recovered female male treatment
120 120 70 91 146 259 456 403 4 2 683 856 515 1030
Month of the year
Esfandٍ Bahman Dey Azar Aban Mehr Shahrivar Mordad Tir Khordad Ordibehesht Farvardin
140 140 127 115 109 117 133 134 154 204 68 128 116
The whole number of accidents in 1999 was 1545
Table 4. The number of accidents in Khalilabad from 1997 to 1999
Type of accident
Taking drugs and chemicals and drugs Taking
External things in the body the in things External Fall down on the ground the on down Fall
Poisoning with gas with Poisoning Road traffic injury
Animal's biting Animal's
sharp tool sharp hard objects hard
Falling ruin Other cases Other electrifying
hot liquids hot chemicals drowning
hot thing hot suicide cruelty falling
fire
5 0 50 611 81 22 9 3 12 61 96 100 18 709 42 772 123 317 712 543 940
Type of injury
Bruise, getting dark blue, swelling, swelling, blue, dark getting Bruise, Dislocation of a limb, twisting
Cutting, tearing,scratching inflation, redness of a limb
Injury to some parts
Wound, crushing Wound,
Brain stroke Brain
Eye wound
poisoning drowning Limb cut Limb blooding
fracture burning
others shock pain
2 0 20 9 40 63 109 59 20 7 4 105 140 229 362 1011 571 2472
Injured part
Internal Genital Some limbs body toe foot finger hand mouth nose ear eye brain neck face head organs organs 150 150 208 23 163 136 1105 366 1215 229 134 136 65 25 144 488 634
Region of accident Place of accident
Recreational The way to street homeﻭcity village Other cases Public places school Work place road centers school
1751 1751 3470 23 386 479 32 99 279 1076 2847
Age of injured Result of accident Gender of injured Under Above 60 50-59 40-49 30-39 20-29 10-19 0-9 death disabilities recovered female male treatment 361 361 256 320 558 864 1441 1421 20 2 1503 3696 1593 3628
Month of the year
Esfandٍ Bahman Dey Azar Aban Mehr Shahrivar Mordad Tir Khordad Ordibehesht Farvardin
356 356 316 322 280 430 448 604 664 643 422 394 342
The whole number of accidents during these three years was 5221.
Table 5. The causes resulting death due to accidents during the project in Khalilabad causes resulting death due to accidents in1997
Taking drugs and chemicals and drugs Taking
Contact with sharp tools sharp with Contact
Falling on the ground Contact with objects with Contact Type ofaccident
smoke and gas and smoke
Car Accident Car
electrifying hot liquid hot drowning
suicide cruelty
total fire fall
1 0 10 0 2 0 1 0 0 0 0 0 0 1 2 4 Number of cases
causes resulting death due to accidents in 1998
Taking drugs and chemicals and drugs Taking
Falling on the ground Contact with objects with Contact Type ofaccident
smoke and gas and smoke
Car Accident Car
electrifying sharp tools sharp hot liquid hot
drowning
suicide cruelty
total fire fall
6 6 0 1 0 0 0 0 0 1 0 0 1 0 3 Number of cases causes resulting death due to accidents in1999
Taking drugs and chemicals and drugs Taking
Falling on the ground Contact with objects with Contact
Type ofaccident
Contact with fire with Contact
smoke and gas and smoke
Car Accident Car
electrifying sharp tools sharp hot liquid hot drowning
suicide cruelty total fall
4 4 0 1 0 0 0 0 0 0 1 0 0 1 1 Number of cases
Chart 1. Percentage of accident with the divisions of type of accident during the three years of conducting the operation
Percentage 20 18 18
16 14.79 14 13.64 13.58
12 11.7 10.4 10
8 6.07 6
4 2.35 1.91 2 1.84 0.8 1.17 1.55 0.97 0.43 0.34 0.23 0.060.17 0 Type of accident c f F C C C C a s T c A e d F Po Ex C O a u o a c a r l r a o o o o n e o t l l u l n l c i k o i t h l n n n n c i c l n i s e t i i e m w i n d d i t o t e a t t t t n n r a a a a d l r a t n n r c g o e a i n g c c c c e g y c n f c t w l i i a t t t t y ng t d ' n r a w t s l n w w w w i ui w r g s b n t i u h e t o i i i i i g n w i t s h t t t t g t i n h h h h i n h i s n s t g t h f h c h a g h h h i he s o r o n a a e g t e t i r r d n a d g l m p t hi i s r c t q o t i he h o c o ng ui b e u a o j nd d l m b e l s s o c i t c d s a y l s
Chart 2. Percentage of accidents with the division of the injured age during the three years of conducting the operation
30 27.6 Percentage 27.22
25
20
16.55
15
10.69
10
6.91 6.13
4.9 5
Injured age 0 0-9 10-19 20-29 30-39 40-49 50-59 above 60
Chart 3. Percentage of accidents with the division of the place of accident during the three years of conducting the operation
Percentage 60 54.53
50
40
30
20.61 20
9.18 10 7.39 5.34 1.9 Place of accident 0.61 0.44 0 s t h W s T R O r P c o e h e h u t u e o e c h o b t r r e ﻭ s k o w l e e i r r a l c p a o t c y p a l i a a o d l s to a c n e c e a s s e l c s c h e o n o te l r s
Chart 4. Percentage of accidents with the division of the region of accident during the three years of conducting the operation
33.54
66.46
city village
Chart 5. Percentage of accidents with the division of the injured gender during the three years of conducting the operation
30.51
69.49
male female
Chart 6. Percentage of accidents with the division of the consequence of accident during the three years of conducting the operation
Percentage 80
70.79 70
60
50
40
28.79 30
20
10 Result of accident 0.04 0.38 0 recovered under treatment disabilities death
Chart 7.Percentage pf cases of fall with the divisions of the three tears of operation
14 Percentage 12.28 12
10 9.18 9.07
8
6
4
2
0 Year 1997 1998 1999
Chart 8. Percentage of cases of accident based on the place of accidents (home, work place, school, the way to school) with the divisions of the three years of operation
80 Percentage
6 70 0 . 5
5
60 5 5 0 0
. . 6 2 9 50
40
30
20
6 6 3 . 2 . 0 . 4 2 2 1 7 1 0 10 1 0 3 . . 3 . . 8 4 . 0 . 4 7 0 9 3 6 3 7 0 Place of accidents h wo s t h o c e m h rk o w e o p a l l y a
c t o e
s
c
h
o
o
l
1997 1998 1999
Chart 9. Percentage of mortality due to accident with the divisions of the three years of conducting the operation
0.5 Percentage 0.48
0.45
0.4 0.38
0.35
0.3 0.26 0.25
0.2
0.15
0.1
0.05
0 Year 1997 1998 1999
Chart 10: the number of mortality due to accidents in Khalilabad during the 3 years of operation
12 Number 10 10
8
Trend line 6 6 4
4
2
0 Year
1997 1998 1999
Chart 11. Percentage of the cases of accidents in Khalilabad from 1997 to 1999
Percentage 45 40.28 40
35 30.07 29.65 30
25
20
15
10
5
0 Year 1997 1998 1999
- 1. The whole number of the accidents during three years in Khalilabad was about 5221. If we consider on the average the population of the city during three years 46473, the percentage of occurring the accidents will be about 11.23 % and separately in each year the percentage of occurring the accidents and events in 1997 was about 3.40%, 1998 about 3.40% and in 1999 about 3.26%. - 2. According to the statistics, the number of events and accidents has decreased from 1997 to 1999. - 3. In studying the table 4, the most common kinds of accident from the first to the forth respectively were: - A) Contact with sharp tool - B) Contact with hot liquid - C) Falling down - D) Accident - 4. Based on the table 4 the most common injured limbs of the body respectively are: - A) Hands - B) Feet - C) Head - D) Face - 5. According to the table 4, the number of accidents based on the type of injury respectively is: - A) Cutting, tearing, scratching - B) Burning - C) Wound and crush - D) Fracture - 6. Based on the tables, the most common place of accident respectively are: - A) House - B) Street and road - C) Public places - D) Recreational centers - E) Work place - 7. According the table 4 the most common area for the accidents is the rural area. - 8. Based on the above tables the most common age for occurring the accidents and events is the age below 20. - 9. According to the above table, most of the accidents and events occurred in Tir (June), Mordad (July), and Shahrivar (August and September). - 10. According to the above table, the amount of occurring accidents and events in male is twice as many as female. - 11. After observing the percentage of occurring accidents and events from 1377 (1997) to 1379 (1999), it can be stated that at the end of the project we had 26% decrease in the occurrence of accidents in proportion to the beginning of the project. - Regarding to the success of the operation, this process has been continued and it is tried that in addition to the more careful conducting of the registration, a more careful program for the operation based on the safe community model be applied. - Table 6. The following table consists of the cases of accident and injuries related to accident which happened before conducting the safety program of the city. Table 6.
Sting by two Other driving Pedestrian snake Animals Type of wheeler subside cruelty poison hit full electricity burning cases accident accident and attacks accident accident scorpion 152 369 48 48 25 96 39 499 194 2 71 77 19 number 9.3 22.5 2.9 2.9 1.5 5.9 2.4 30.4 11.8 0.1 4.3 4.7 1.2 percentage
Sport and School and Road and Streets and Place of Un known Other cases Place of work recreational Public places educational home highways ways accident centers centers 22 104 210 131 543 25 30 21 553 number 1.3 6.3 12.8 8 33.1 1.5 1.8 1.3 33.7 percentage
Un known Outside urban and rural area rural urban Region of accident 9 110 842 678 number 1 7 51 41 percentage
Male Female Gender of injured 1223 416 number 75 25 percentage
Un Age of 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 known injured 102 8 13 17 16 16 24 31 58 48 79 86 119 189 258 253 106 119 97 number 7 0 0 1 0 1 2 2 4 3 4 6 7 12 16 15 6 7 5 percentage
disabilities death Under treatment Result of accident 0 6 1633 number 0 0.37 99.63 percentage
Esfand Bahman Dey Azar Aban Mehr Shahrivar Mordad Tir Khordad Ordibehesht Farvardin month 147 103 79 99 117 150 167 221 109 155 156 136 number 8.97 6.28 4.82 6.04 7.14 9.15 10.19 13.48 6.65 9.46 9.52 8.30 percentage
The whole number of accidents in 2008 was 1639
The preparation of Khalilabad safe Community charter