community: khalilabad - .global is about 1000 kilometers far from tehran and 240 kilometer far from...

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.

: cupationsOc

- 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.

Site visit 2009

Site visit 2003

- 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).

Tab

le 1

. The

num

ber

of a

ccid

ents

in K

halil

abad

in 1

997

٭

Type

of a

ccid

ent

sharp tool

falling

Fall down on the ground

hot object

fire

hot liquids

chemicals

Road traffic injury

suicide

Taking drugs and chemicals

cruelty

Animal's biting

electrifying

drowning

Falling ruin

Poisoning with gas

External things in the body

Contact with hard objects

Other cases

345

25

9

334

88

64 22

5

29 27

1

13 35

30 11

8 3

8 20

57 27

5

24

Type

of i

njur

y

Cutting, tearing, scratching

Wound, crushing

burning

fracture

Dislocation of a limb, twisting

Bruise, getting dark blue, swelling, inflation, redness of a limb

poisoning

drowning

Limb cutting

Eye wound

Brain stroke

pain

blooding

Injury to some parts

shock

others

917

18

5

319

18

1

144

10

1

32 2

3 17

20 90

48 30

5 15

Inju

red

part

head

fa

ce

neck

br

ain

ey

e

ear

no

se

mou

th

hand

fin

ger

fo

ot

toe

bo

dy

Gen

ital

orga

ns

Som

e lim

bsIn

tern

al

orga

ns

247

19

7

138

17

47 12

3

122

21

5

293

15

8

209

10

8

92 13

55 75

Plac

e of

acc

iden

t

Reg

ion

of a

ccid

ent

house

streetو road

Work place

school

The way to school

Public places

Recreational centers

Other cases

village

city

1277

21

9

131

40

30 25

9

153

0

1287

82

2

Gen

der o

f inj

ured

R

esul

t of a

ccid

ent

A

ge o

f inj

ured

mal

e

fem

ale

re

cove

red

U

nder

tre

atm

ent

di

sabi

litie

sde

ath

0-

9

10-1

9

20-2

9

30-3

9

40-4

9

50-5

9

Abo

ve 6

0

1485

62

4

1721

37

8

0 10

563

54

8

337

27

4

143

12

4

120

Mon

th o

f the

yea

r

Farv

ardi

n

Ord

ibeh

esht

Kho

rdad

Ti

r

Mor

dad

Sh

ahriv

ar

Meh

r

Aba

n

Aza

r

Dey

B

ahm

an

Es

fand

175

17

7

198

21

4

268

23

1

153

17

0

90 13

4

139

16

0

Th

e w

hole

num

ber o

f acc

iden

ts in

199

7 w

as 2

109

Tab

le 2

. T

he n

umbe

r of

acc

iden

ts in

Kha

lilab

ad in

1998

Type

of a

ccid

ent

sharp tool

falling


hot thing

fire

hot liquids

chemicals

Road traffic injury

suicide


cruelty

Animal's biting

electrifying

drowning

Falling ruin

Poisoning with gas


objects

Other cases

277

14

4

205

29

27 25

6

2 23

5

2 31

35 7

2 0

1 1

11 28

6

16

Type

of i

njur

y


Wound, crushing

burning

fracture



poisoning

drowning

Limb cutting

Eye wound

Brain stroke

pain

blooding


shock

others

900

12

3

318

89

55 8

32 1

1 2

28 2

2 2

1 3

Inju

red

part

head

fa

ce

neck

br

ain

ey

e

ear

no

se

mou

th

hand

fin

ger

fo

ot

toe

bo

dy

Gen

ital

orga

ns

Som

e lim

bsIn

tern

al

orga

ns

240

15

6

4 3

11 6

5 10

449

10

2

431

13

35 6

62 34

Plac

e of

acc

iden

t

Reg

ion

of a

ccid

ent

hous

e

stre

etو

road

W

ork

plac

e

scho

ol

The

way

to

scho

ol

l Pub

lic p

lace

sR

ecre

atio

nal

cent

ers

O

ther

cas

es

villa

ge

city

793

48

5

95 37

1 52

86 18

1120

44

7

Gen

der o

f inj

ured

R

esul

t of a

ccid

ent

A

ge o

f inj

ured

mal

e

fem

ale

re

cove

red

U

nder

tre

atm

ent

di

sabi

litie

sde

ath

0-

9

10-1

9

20-2

9

30-3

9

40-4

9

50-5

9

Abo

ve 6

0

1113

45

4

1119

44

2

0 6

455

43

7

268

13

8

86 62

121

Mon

th o

f the

yea

r

Farv

ardi

n

Ord

ibeh

esht

Kho

rdad

Ti

r

Mor

dad

Sh

ahriv

ar

Meh

r

Aba

n

Aza

r

Dey

B

ahm

an

Es

fand

51 89

156

22

5

242

23

9

162

14

3

81 73

50 56

Th

e w

hole

num

ber o

f acc

iden

ts in

199

8 w

as 1

567.

Tab

le 3

. T

he n

umbe

r of

acc

iden

ts in

Kha

lilab

ad in

199

9

Type

of a

ccid

ent

sharp tool

falling


hot thing

fire

hot liquids

chemicals

Road traffic injury

suicide


cruelty

Animal's biting

electrifying

drowning

Falling ruin

Poisoning with gas


hard objects

Other cases

318

14

0

173

20

0

32 29

1

11 20

3

3 34

31 43

2 0

0 1

13 50

0

Type

of i

njur

y


Wound, crushing

burning

fracture



poisoning

drowning

Limb cutting

Eye wound

Brain stroke

pain

blooding


shock

others

655

26

3

374

92

30 31

41 1

3 1

11 17

13 8

3 2

Inju

red

part

head

fa

ce

neck

br

ain

ey

e

ear

no

se

mou

th

hand

fin

ger

fo

ot

toe

bo

dy

Gen

ital

orga

ns

Som

e lim

bsIn

tern

al

orga

ns

147

13

5

2 5

7 7

7 4

473

10

6

465

15

36 4

91 41

Plac

e of

acc

iden

t

Reg

ion

of a

ccid

ent

hous

e

stre

etو

road

W

ork

plac

e

scho

ol

The

way

to

scho

ol

l Pub

lic p

lace

sR

ecre

atio

nal

cent

ers

O

ther

cas

es

villa

ge

city

777

37

2

53 22

1 16

8

147

5

1063

48

2

Gen

der o

f inj

ured

R

esul

t of a

ccid

ent

A

ge o

f inj

ured

mal

e

fem

ale

re

cove

red

U

nder

tre

atm

ent

di

sabi

litie

sde

ath

0-

9

10-1

9

20-2

9

30-3

9

40-4

9

50-5

9

Abo

ve 6

0

1030

51

5

856

68

3

2 4

403

45

6

259

14

6

91 70

120

Mon

th o

f the

yea

r

Farv

ardi

n

Ord

ibeh

esht

Kho

rdad

Ti

r

Mor

dad

Sh

ahriv

ar

Meh

r

Aba

n

Aza

r

Dey

B

ahm

an

Es

fand

116

12

8

68 20

4

154

13

4

133

11

7

109

11

5

127

14

0

Th

e w

hole

num

ber o

f acc

iden

ts in

199

9 w

as 1

545

Tab

le 4

. The

num

ber

of a

ccid

ents

in K

halil

abad

from

199

7 to

199

9

Type

of a

ccid

ent

sharp tool

falling


hot thing

fire

hot liquids

chemicals

Road traffic injury

suicide


cruelty

Animal's biting

electrifying

drowning

Falling ruin

Poisoning with gas


hard objects

Other cases

940

54

3

712

31

7

123

77

2

42 70

9

18 10

0

96 61

12 3

9 22

81 61

1

50

Type

of i

njur

y


Wound, crushing

burning

fracture



poisoning

drowning

Limb cut

Eye wound

Brain stroke

pain

blooding


shock

others

2472

57

1

1011

36

2

229

14

0

105

4

7 20

59 10

9

63 40

9 20

Inju

red

part

head

fa

ce

neck

br

ain

ey

e

ear

no

se

mou

th

hand

fin

ger

fo

ot

toe

bo

dy

Gen

ital

orga

ns

Som

e lim

bsIn

tern

al

orga

ns

634

48

8

144

25

65 13

6

134

22

9

1215

36

6

1105

13

6

163

23

208

15

0

Plac

e of

acc

iden

t

Reg

ion

of a

ccid

ent

hom

e

stre

etو

road

W

ork

plac

e

scho

ol

The

way

to

scho

ol

Pub

lic p

lace

sR

ecre

atio

nal

cent

ers

O

ther

cas

es

villa

ge

city

2847

10

76

279

99

32 47

9

386

23

3470

17

51

Gen

der o

f inj

ured

R

esul

t of a

ccid

ent

A

ge o

f inj

ured

mal

e

fem

ale

re

cove

red

U

nder

tre

atm

ent

di

sabi

litie

sde

ath

0-

9

10-1

9

20-2

9

30-3

9

40-4

9

50-5

9

Abo

ve 6

0

3628

15

93

3696

15

03

2 20

1421

14

41

864

55

8

320

25

6

361

Mon

th o

f the

yea

r

Farv

ardi

n

Ord

ibeh

esht

Kho

rdad

Ti

r

Mor

dad

Sh

ahriv

ar

Meh

r

Aba

n

Aza

r

Dey

B

ahm

an

Es

fand

342

39

4

422

64

3

664

60

4

448

43

0

280

32

2

316

35

6

Th

e w

hole

num

ber o

f acc

iden

ts d

urin

g th

ese

thre

e ye

ars w

as 5

221.

Tab

le 5

. T

he c

ause

s res

ultin

g de

ath

due

to a

ccid

ents

dur

ing

the

proj

ect i

n K

halil

abad

caus

es re

sulti

ng d

eath

due

to a

ccid

ents

in19

97

Type of accident

Car Accident

suicide

fall

electrifying

Contact with objects


Contact with sharp tools

drowning

hot liquid

fire

smoke and gas

cruelty

Falling on the ground

total

Num

ber o

f cas

es

4 2

1 0

0 0

0 0

0 1

0 2

0 10

caus

es re

sulti

ng d

eath

due

to a

ccid

ents

in 1

998

Type of accident

Car Accident

suicide

fall

electrifying



sharp tools

drowning

hot liquid

fire

smoke and gas

cruelty


total

Num

ber o

f cas

es

3 0

1 0

0 1

0 0

0 0

0 1

0 6

caus

es re

sulti

ng d

eath

due

to a

ccid

ents

in19

99

Type of accident

Car Accident

suicide

fall

electrifying



sharp tools

drowning

hot liquid

Contact with fire

smoke and gas

cruelty


total

Num

ber o

f cas

es

1 1

0 0

1 0

0 0

0 0

0 1

0 4

Cha

rt 1

. Per

cent

age

of a

ccid

ent w

ith th

e di

visi

ons o

f typ

e of

acc

iden

t dur

ing

the

thre

e ye

ars o

f con

duct

ing

the

oper

atio

n

0246810121416182018

10.4

13.6

4 6.07

2.35

14.7

913

.58

11.7

0.8

0.34

1.91

1.84

1.17

0.23

0.06

0.17

0.43

1.55

0.97

contact with sharp toolfallingFall down on the groundContact with hot thingContact with fireContact with hot liquidsContact with chemicalsaccidentsuicideTaking drugs and chemicalscrueltyAnimal's bitingelectrifyingdrowningFalling ruinPoisoning with gasExternal things in the bodyContact with hard objectsOther cases

Perc

enta

ge

Typ

e of

acc

iden

t

Cha

rt 2

. Pe

rcen

tage

of a

ccid

ents

with

the

divi

sion

of t

he in

jure

d ag

e du

ring

the

thre

e ye

ars o

f con

duct

ing

the

oper

atio

n

27.2

227

.6

16.5

5

10.6

9

6.13

4.9

6.91

051015202530

0-9

10-1

920

-29

30-3

940

-49

50-5

9ab

ove

60

Inju

red

age

Perc

enta

ge

Cha

rt 3

. Pe

rcen

tage

of a

ccid

ents

with

the

divi

sion

of t

he p

lace

of a

ccid

ent d

urin

g th

e th

ree

year

s of c

ondu

ctin

g th

e op

erat

ion

010203040506054

.53

20.6

1

9.18

7.39

5.34

1.9

0.61

0.44

house

streetو road

Work place

school

The way to school

Public places

Recreational centers

Other cases

Plac

e of

acc

iden

t

Perc

enta

ge

C

hart

4. P

erce

ntag

e of

acc

iden

ts w

ith th

e di

visi

on o

f the

reg

ion

of a

ccid

ent d

urin

g th

e th

ree

year

s of c

ondu

ctin

g th

e op

erat

ion

33.5

4

66.4

6

city

villa

ge

Cha

rt 5

. Per

cent

age

of a

ccid

ents

with

the

divi

sion

of t

he in

jure

d ge

nder

dur

ing

the

thre

e ye

ars o

f con

duct

ing

the

oper

atio

n

30.5

1

69.4

9

mal

efe

mal

e

C

hart

6. P

erce

ntag

e of

acc

iden

ts w

ith th

e di

visi

on o

f the

con

sequ

ence

of a

ccid

ent d

urin

g th

e th

ree

year

s of c

ondu

ctin

g th

e op

erat

ion

01020304050607080

70.7

9

28.7

9

0.38

0.04

reco

vere

dun

der t

reat

men

tdi

sabi

lities

deat

h

Perc

enta

ge

Res

ult o

f acc

iden

t

Cha

rt 7

.Per

cent

age

pf c

ases

of f

all w

ith th

e di

visi

ons o

f the

thre

e te

ars o

f ope

ratio

n

02468101214

12.2

8

9.07

9.18

1997

1998

1999

Perc

enta

ge

Yea

r

Cha

rt 8

. Per

cent

age

of c

ases

of a

ccid

ent b

ased

on

the

plac

e of

acc

iden

ts (h

ome,

wor

k pl

ace,

scho

ol, t

he w

ay to

scho

ol) w

ith th

e di

visi

ons

of th

e th

ree

year

s of o

pera

tion

60.5550.650.29

6.226.073.43

1.892.371.43

1.430.060.07

01020304050607080

home

work place

school

the way to school

1997

1998

1999

Plac

e of

acc

iden

ts

Perc

enta

ge

C

hart

9. P

erce

ntag

e of

mor

talit

y du

e to

acc

iden

t with

the

divi

sion

s of t

he th

ree

year

s of c

ondu

ctin

g th

e op

erat

ion

0.48

0.38

0.26

0

0.050.

1

0.150.

2

0.250.

3

0.350.

4

0.450.

5

1997

1998

1999

Perc

enta

ge

Yea

r

Cha

rt 1

0: th

e nu

mbe

r of

mor

talit

y du

e to

acc

iden

ts in

Kha

lilab

ad d

urin

g th

e 3

year

s of o

pera

tion

64

10

024681012

1997

1998

1999

Tren

d lin

e

Yea

r

Num

ber

40.2

8

30.0

729

.65

051015202530354045

1997

1998

1999

Perc

enta

ge

Yea

r

Cha

rt 1

1. P

erce

ntag

e of

the

case

s of a

ccid

ents

in K

halil

abad

from

199

7 to

199

9

- 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.

Tab

le 6

.

Oth

er

case

s

two

whe

eler

ac

cide

nt

driv

ing

acci

dent

Pe

dest

rian

acci

dent

su

bsid

e cr

uelty

po

ison

hi

t fu

ll el

ectri

city

burn

ing

Stin

g by

sn

ake

and

scor

pion

Ani

mal

s at

tack

s Ty

pe o

f ac

cide

nt

152

369

48

48

25

96

39

499

194

2 71

77

19

nu

mbe

r 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

perc

enta

ge

Un

know

n O

ther

cas

es

Plac

e of

wor

k R

oad

and

high

way

s St

reet

s and

w

ays

Spor

t and

re

crea

tiona

l ce

nter

s Pu

blic

pla

ces

Scho

ol a

nd

educ

atio

nal

cent

ers

hom

e Pl

ace

of

acci

dent

22

104

210

131

543

25

30

21

553

num

ber

1.3

6.3

12.8

8

33.1

1.

5 1.

8 1.

3 33

.7

perc

enta

ge

Un

know

n O

utsi

de u

rban

and

rura

l are

a ru

ral

ur

ban

R

egio

n of

acc

iden

t

9 11

0 84

2 67

8 nu

mbe

r 1

7 51

41

pe

rcen

tage

Mal

e Fe

mal

e G

ende

r of i

njur

ed

1223

41

6 nu

mbe

r 75

25

pe

rcen

tage

Un

know

n 85

+ 80

-84

75-7

9 70

-74

65-6

9 60

-64

55-5

9 50

-54

45-4

9 40

-44

35-3

9 30

-34

25-2

9 20

-24

15-1

9 10

-14

5-9

0-4

Age

of

inju

red

10

2 8

13

17

16

16

24

31

58

48

79

86

119

189

258

253

106

119

97

num

ber

7 0

0 1

0 1

2 2

4 3

4 6

7 12

16

15

6

7 5

perc

enta

ge

disa

bilit

ies

deat

h U

nder

trea

tmen

t

Res

ult o

f acc

iden

t

0 6

1633

nu

mbe

r 0

0.37

99

.63

perc

enta

ge

Esfa

nd

Bah

man

D

ey

Aza

r

Aba

n

Meh

r

Shah

rivar

M

orda

d

Tir

K

hord

ad

Ord

ibeh

esht

Farv

ardi

n

mon

th

147

103

79

99

117

150

167

221

109

155

156

136

num

ber

8.97

6.

28

4.82

6.

04

7.14

9.

15

10.1

9 13

.48

6.65

9.

46

9.52

8.

30

perc

enta

ge

Th

e w

hole

num

ber o

f acc

iden

ts in

200

8 w

as 1

639

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