24 November 2014By Lorraine KearneyFrom April 2015, South African motorists are going to have to take a more serious approach to road safety. The country has among the highest numbers of road deaths and trauma, particularly of children.Until now, wearing seatbelts has been compulsory for older children and adults, yet not for children under the age of three; appropriate safety seats and booster seats have also not been required, and there have been no rules against children older than three sitting in the front seat.But the Department of Transport has taken this fatal anomaly into account, and has published amendments to the National Road Traffic Regulations 2000 under the National Road Traffic Act, 1996.“There is also a requirement that will require that children that are being transported in a motor vehicle to be buckled up with appropriate child restraints,” says department spokesperson Tiyani Rikhotso.“This requirement applies to children [who] cannot fit on the current seat belts that are fitted in motor vehicles. The requirement is only going to be applicable after six months from the date of publication of this regulation.”Time to complyExpecting motorists to raise concerns about the costs of having to buy child seats, the “department has attempted to ensure that in relation to those requirements that have financial implications it gives the general public time to comply with the requirements”.These new regulations have been welcomed by trauma doctors and road safety campaigners. “It’s fantastic,” says Prof Sebastian van As, the president of Childsafe and the head of trauma at the Red Cross War Memorial Children’s Hospital in Cape Town.“It’s long overdue. For 20 years there has been no seatbelt law for children under the age of three. It was an indictment of our country, and was probably done for people who could not afford to buy child safety seats.“But now, with the cost of petrol being what it is, people who can afford to put petrol in the car can afford a child safety seat, even a second-hand one.”‘Proper safety’Van As points out that children under the age of six are unable to secure their own safety; it is up to adults to do this. The new law includes minibus taxis. “It is possible to do – we even have ambulances now that have special safety belts,” he adds, but points out that at present buses are exempt, although this is under negotiation: “There is no doubt that even luxury buses should have proper safety,” Van As says, referring to high- fatality bus accidents on intercity roads.PenaltiesTransport and public works spokesman Siphesihle Dube has been reported as saying penalties for offenders will be determined following the submission of recommendations to the chief magistrates of different districts for consideration and approval.But it is less about the penalty than the message, says Van As. “The fine itself is not going to be a deterrent, especially as enforcement can be a problem. But the main message for the public is that the government is very serious about this.”As head of trauma at the children’s hospital, Van As sees 200 to 300 children a year admitted with serious injuries, usually brain damage, from car crashes – and this figure does not take into account other parts of South Africa, or children admitted to other facilities.“If you are not strapped in and you are in an accident, you are likely to be brain- damaged. Besides any personal suffering, this is a huge cost to the state in terms of medical care and lifelong care.”Given this, seatbelts and child seats are a public issue, not a private concern.StatisticsSouth African accident statistics make sober reading. According to the Medical Research Council (MRC), road traffic accidents are the leading cause of injury deaths among under-fives in South Africa, and most of these are children who are not buckled up.Although exact, up-to-date statistics are difficult to come by, it has been reported that more than 17 000 people are killed on the roads each year. For each of these deaths, four people are seriously injured, with paralysis, brain damage, severe burns and dismemberment common.The MRC reports that 23% of all deaths in children aged five to 14 years are the result of injury – especially pedestrian injury and passenger injury, drowning, burns and firearm-related injury. In Gauteng, the country’s most populous but geographically smallest province, 1 513 children died in traffic accidents between 2008 and 2011. Of these, 348 were passengers; the remainder were pedestrians.Road traffic injuries accounted for the largest proportion of deaths in the preschool and school age groups.In the Gauteng school age group, traffic-related injuries were the most common type of injury, accounting for about half of school age deaths (50.9%). Road traffic injuries were the second leading cause of death in adolescence, closely following homicide.But the road safety message seems to be filtering down: at Red Cross, the number of severely injured children admitted dropped from 110 in 2010, to 102 in 2012, and 72 in 2013. “In all the serious cases, these were unrestrained passengers,” says the Childsafe Centre.Reducing the riskResearch by the Centers for Disease Control and Prevention (CDC) in the United States has found that strapping babies into appropriate car seats reduces the risk of death in car crashes by 71%; among properly strapped in toddlers between one and four years old, this risk drops by 54%.,p> Booster seats cut the risk of serious injury by 45% for children aged between four and eight years compared to seatbelt use alone, the CDC claims.For drivers and front seat passengers, wearing a seatbelt halves the risk of fatal injury and cuts the risk by up to 75% for back-seat passengers, according to the World Health Organization (WHO).In 2010, the MRC found that nine out of 10 back-seat passengers, including children, were not properly restrained. Across the country, just 59% of drivers wear seatbelts, according to the WHO.It has also been reported that in South Africa, the highest number of road accident fatalities is among passengers – who accounted for 37% of all road deaths in 2009/10, according to figures from the Road Traffic Management Corporation.The figures show that pedestrians accounted for 34% of deaths, while drivers themselves made up 29% of fatalities during the period.