The injured need care. Now.
Every year, over five million people die from road traffic crashes, violence, and other causes of injury. Millions more suffer lifelong disability and lost economic productivity. Injury accounts for 11% of the total global burden of disease. By far the greatest part of the burden of death and disability from injury, approximately 90%, occurs in low- and middle-income countries.
Preventing injuries is very important, but improving access and quality of trauma care can also reduce this burden significantly. Gross disparities in outcome of injury exist between low- and middle-income countries and high-income countries. For example, people with life-threatening but survivable injuries are six times more likely to die in a low-income setting (36% mortality) than in a high-income setting (6% mortality).
In an effort to diminish such inequalities and to improve care of the injured globally, WHO has taken several steps. WHO has published guidance documents on technical aspects of planning prehospital and hospital-based trauma care services. WHO has also provided on-the-ground assistance to many ministries of health on implementation of these guidance documents. However, much more remains to be done.
We can save 2 million lives each year.
What is needed is strengthening of trauma care systems, including prehospital care and transport, initial care in emergency departments, definitive hospital-based care, and long-term rehabilitation back to active life. Across all of these points of the spectrum, there is a need for greater attention to detail in planning human resources (staffing and training), physical resources (equipment and supplies), and administration (such as quality improvement programmes). Such improvements could save the lives of 2 million injured people each year.
In order to promote these improvements, government leaders adopted World Health Assembly resolution 60.22 in 2007 to strengthen the provision of trauma and emergency care services globally. The momentum was carried forward and in October 2009, over 100 leaders in trauma care from 39 countries converged in Rio de Janeiro, Brazil to develop recommendations to promote improved services for the care of the injured.