community: khalilabad - .global is about 1000 kilometers far from tehran and 240 kilometer far from...
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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
Fall down on the ground
hot thing
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
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
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
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
Fall down on the ground
hot thing
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
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
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
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
Fall down on the ground
hot thing
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
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
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 cut
Eye wound
Brain stroke
pain
blooding
Injury to some parts
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
Taking drugs and chemicals
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
Contact with objects
Taking drugs and chemicals
sharp tools
drowning
hot liquid
fire
smoke and gas
cruelty
Falling on the ground
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
Contact with objects
Taking drugs and chemicals
sharp tools
drowning
hot liquid
Contact with fire
smoke and gas
cruelty
Falling on the ground
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
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