Posted on: Tue 18-10-2022

TRAUMA is the act of injury which can lead to physical or emotional damage. The common cause of trauma in our environment is Road Trafic Accident (RTA). Other causes include gunshot injuries, falls from height, assaults, etc. In Nigeria, incidence of gunshot injuries and psychological trauma are on the increase due to banditry, kidnapping and other forms of terorism, which make up the headlines on a regular basis. 

Road Traffic Accident (RTA), which is a common cause of trauma in our environment, is caused by the following: 

a. Poor mad network 

b. Use of old/poorly maintained vehicles 

c. Poor driving skills 

It is recorded that over 2 million Nigerians are currently hospitalised, upon incurring various injuries, following road traffic accidents and gunshot injuries. More than 3o percent of these persons present serious injuries requiring surgical interventions. It is also noteworthy that majority of these victims are recieving treatment within the country with only a small fraction jetting out of the country. Unfortunately, more than 5o percent of those injured still present to the Traditional Bone Setters (TBS) practice, which presents grave consequences such as increase in mobidity and mortality. TBS are community-based individuals lacking formal medical training but engaged in administering healthcare to injured victims, using age-long methods supposedly inherited from their ancestors. This form of care is readily available, with high patronage in urban and rural settings across Nigeria. They are also available at accident sites nationwide.

It is imperative to note that the frequently injured parts of the body are the lower limb bones (tibia and femur). However the most deadly injuries are the head, spinal and abdominal injuries. About 4,000 Nigerians incur spinal injuries yearly; and spinal injuries require prompt and efficient treatment to prevent early death and debilitation. More than 5o percent of spinal injury patients die from complications resulting from injury or treatment. Deliberate and coordinated treatment for spinal cord injuries is lacking in our sub-region. Currently, the only known dedicated spinal injury centre is the 50-bed Sultan Sa'ad Abubakar Spine Centre at the National Orthopaedic Hospital, Dala, Kano. More of such centres are needed in each of the geopolitical zones in Nigeria, for ease of access to standard orthodox spinal trauma care. 

Trauma is a neglected disease worldwide, but the degree of neglect in Nigeria is acute, with a near complete absence of organised trauma services. The capacity of our various hospitals to manage trauma victims requires a lot of improvement. The recent efforts by Federal Government to establish more Orthopaedic Hospitals to ensure every geopolitical zone has access to a nearby trauma care center is a step in the right direction. We encourage every state Government in the federation to establish Trauma Centers and incorporate organised Trauma Services for their residents. 

In conclusion, below is a message to Nigerians - Government and citizens alike.

To Nigerian Citizens,

1. Prevention is better than cure. Avoid all known causes of trauma 
2. When accidents occur, a hospital remains the best place to receive appropriate treatment 
3. Do not send acutely injured patients to Traditional Bone Setters (TBS) centers. Take them to the emergency department of our hospitals for adequate trauma care and referral services

To the Government,

1. Ensure full implementation of Emergency Care Services including Trauma Services in Nigeria
2. Establish legislations and regulations to reduce patronage of unorthodox trauma care in Nigeria 
3. Create more trauma and spine centres to cover each geopolitical zone for ease of access to standard orthodox trauma care in Nigeria.

Signed:

Dr. Muhammad Nuhu Salihu

President, Nigerian Orthopaedic Association 

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