Motorcycle-related trauma in the Philippines resulting in hospital admission: The epidemiology of cases at the Philippine General Hospital

OBJECTIVE: To describe the epidemiology of motorcycle related trauma (MCRT) admitted to the Philippine General Hospital (PGH). METHOD: Restrospective analysis of records of motorcycle crash victims admitted to the Trauma Division, Department of Surgery, PGH from January 1, 2004 to December 31, 2006. RESULTS: MCRT victims comprised 6.7% of all trauma admissions to PGH. Most were males (83.8%) and young adults (median age 26 years), and 38.6% were road users other than motorcycle drivers or passengers (primarily pedestrians). Two-thirds of victims suffered multiple injuries (68.9%). Common injuries were maxillo-facial (78%), fractures of the lower and upper extremeities (46.9% and 36.1%, respectively) and traumatic brain injuries (40.7%). The median length of hospital stay was 13 days. The in-hospital mortality rate was 5.8%, 43% of fatalities were due to traumatic brain injuries. Based on self-reported information, 88% of the motorcyclist victims were riding under the influence of alcohol, and 13% were wearing helmets at the time of the crash. CONCLUSIONS: A significant proportion of MCRT victims are not motorcycle users. There is an urgent need to implement effective strategies to prevent MCRT in the Philippines, including the implementation of enforcement of national laws agains drink driving and use of standard helmets.

The epidemiology of child drowning injury in the Philippines

OBJECTIVE: This paper aims to quantify the magnitude of drowning injury related deaths among children in the Philippines, to form the evidence base for national policies for drowning prevention. METHOD: Retrospective review and analysis of published data on child drowning injury (1963-2003) in the Philippines. RESULTS: At least 3,000 Filipinos of all ages die annually from drowning injury (0.43% of deaths), more than a third of which (35.6%) are children under 14 years. Mortality is highest among children ages 1-4 years compared to other age groups [Mortality Rate (MR) 6.4 vs. 3.8 per 100,000]. Child drowning mortality rates have remained largely unchanged from 1963 to 2003, belying its under recognition as a public health priority. There is also a paucity of local data to adequately describe the epidemiology of child drowning in the Philippines. CONCLUSION: In the Philippines, drowning deaths disproportionately account for 5% of deaths for 1-4 year olds. Drowning prevention could be a 'low-hanging fruit' in the quest to meet the Millenium Development Goals (MDG's) set for 2015. There is a need for better surveillance of child drowning deaths to guide policy formulation for its prevention and treatment in the Philippines.

The sinking of the MV Doña Paz - A critique on maritime disaster preparedness in the Philippines: An analysis of the event

OBJECTIVE: To discuss the various factors contributory to the fatalities that resulted from the sinking of the MV Dona Paz. METHODS: Review of the pre-disaster, disaster and post-disaster events surrounding the sinking of the MV Dona Paz, as well as the subsequent response by the government and responsible agencies to the disaster. RESULTS: The Sinking of the MV Dona Paz, along with the loss of more than 4,000 precious lives, is but a footnote in the long litany of misfortunes plaguing the Philippine maritime industry. A closer look into the events and circumstances leading to this tragedy demonstrates a confluence of equipment and system inadequacy on one hand and human error and lack of preparedness on the other. CONCLUSION: Multiple factors account for the occurence of this tragedy, along with other maritime disaster incidents dotting the long maritime history of the Philippines. A cursory analysis of these factors may lead to recommendations that can prevent similar occurrences in the future and mitigate damage to property and loss of life. The policy implications of these findings are discussed in a subsequent paper.

The sinking of the MV Doña Paz - A critique on maritime disaster preparedness in the Philippines: Policy implications

OBJECTIVE: To discuss the various factors contributory to maritime disaster preparedness in the Philippines, in the context of the sinking of the MV Dona Paz and formulate recommendations to address these factors. METHOD: Review of the state of maritime preparedness in the pre-disaster setting and the post-disaster response following the sinking of the MV Dona Paz by the government and responsible agencies. A scrutiny of the state of preparedness of concerned agencies and subsequent response to the disaster was conducted with the objective of formulating recommendations which may lead to prevention and mitigate loss of lives. RESULTS: Multiple factors accounted for the occurrence of this tragedy. These factors include an inherent risk due to the geography of shipping industry and its labor force. Economic conditions prevent both the industry and government agencies from upgrading vessels and communications equipment. Lack of enforcement of existing regulations allows vessels to sail overloaded and at times manned by less-than-qualified crew. Delayed response and deficient post-disaster medical response may have led to a disproportionately high mortality. CONCLUSIONS: The systems inadequacies of the Philippine maritime disaster response mechanism are highlighted by the Dona Paz tragedy. Many of the factors contributing to the disproportionately high incidence of maritime disasters in the Philippines and the resulting loss of limb may be preventable. Recommendations on regulation and enforcement, disaster preparedness, search and rescue, and medical response are discussed.