Paediatric traumatic brain injury in South Africa: some thoughts and considerations.

PURPOSE: This paper endeavours to describe the socio-political and economic backdrop to the assessment and management of traumatic brain injury (TBI) in children in South Africa.

OUTCOMES: The argument put forward is that huge disparities in socio-economic status, diverse socio-cultural influences, and widely differing educational systems and educational attainment which characterize the country's population, render the management of TBI different from approaches adopted in developed countries. The main causes of TBI can be attributed to the high rates of violence in the country, as well as an inordinately high incidence of motor vehicle accidents. Compensation through existing national legislative and insurance agencies is unavailable to most of the population, and markedly insufficient in many cases. The access to medical care and rehabilitation is inadequate for the majority of South African children, although there are valiant efforts on the part of professionals working within the primary health care model to provide the support to the children and their families not offered by existing educational and school structures.

CONCLUSION

The impact of the HIV/AIDS pandemic on the clinical picture of children and their families is profound and guides many of the decisions that are made by health care professionals. Given this bleak scenario, a re-focus on the strengths of existing structures and the creation of new possibilities is suggested, as a positive and constructive approach to prevention, rehabilitation, and education.