Traditionally, we have a strong relation with child accident prevention, and we work closely together with Childsafe South Africa (formerly known as the Child Accident Prevention Foundation of Southern Africa (CAPFSA). Childsafe South Africa has a broad range of programs, including surveillance, research, education, advocacy, policy and legislation. Accident prevention has been the stalwart of our programs and includes projects in the field of poisoning, traffic injuries, home safety, school educational programs and other community based interventional programs. Since 1991 data from all patients attending the trauma unit have been captured in the Childsafe database, a database which at the moment includes over 130.000 entries. Datamining this database has led to some interesting findings. Research activities are a priority in our unit and the Childsafe South Africa database provides an excellent vehicle to initiate this. View more information on Childsafe South Africa.

1              Childsafe South Africa’s history

The global burden of childhood injuries is unequally distributed with Sub-Saharan Africa being the worst affected. The large and growing toll of child injury death, the progressive nature of childhood injuries and the frequently long-lasting effects of injury on children gave rise to the creation of the NGO “Child Accident Prevention Foundation of Southern Africa” at the Red Cross Children’s Hospital in 1978 by Prof Cywes, and is one of the oldest organizations of its kind in the world. Since July 2008, we are active under the new name and logo of “Childsafe - Keeping kids free from harm”.

Childsafe South Africa has been working tirelessly over the last 4 decades to transform South Africa to a safer place for all its children, irrespective of social class, income group or race.

Of the 53 million inhabitants of South Africa, an approximate 20 million inhabitants are children.  South Africa is a young democracy, and has one of the most advanced and progressive constitutions worldwide.  According to this constitution, children have preferential rights above adults.

However, this constitutional right is poorly reflected in reality.  From studies conducted by Childsafe South Africa children growing up in Cape Town, for example,  have a 25 times greater chance of being admitted with any type of injury compared to children growing up in Birmingham in the United Kingdom.

The local, regional and national government has been slow to develop an interactive plan for the prevention of injuries in South Africa.  Nearly all financial resources go to curative care (hospitals).  Almost no financial resources are allocated to prevention and rehabilitation. It can be convincingly argued that children’s rights have been, and continue to be, significantly violated because South Africa's most vulnerable little citizens are daily exposed to extremely dangerous environments

Childsafe South Africa aims to reduce and prevent intentional and unintentional injuries of all severity through research, education, environmental change and recommendations for legislation.

The three main programmes of Childsafe South Africa are:

(1)     Research  Since 1991, Childsafe South Africa has systematically kept a computerised Childhood Trauma Surveillance System of all injured children presenting to the Red Cross Children’s Hospital Trauma Unit. Approximately 10 000 children are seen annually. Childsafe South Africa has currently details of over 150 000 childhood injuries recorded in its database. The Childhood Surveillance System serves as a national and international information system for childhood injuries in South Africa.  The database has been systematically analysed for a large number of clinical and epidemiological studies about childhood injuries.  A specially adapted data mining computer programming has been utilised to analyse data.

(2)      Educational programmes  The two focus areas are child safety education and skills training, and creating a child-safe environment. Childsafe South Africa has specially designed educational and skills training programmes for child safety. Since 1990, over 100 general child safety courses have been delivered and these were specifically directed at community workers, child-minders, health professionals, social workers, parents, and educators from various institutions. Childsafe South Africa also conducted numerous safety courses for day-care centres aimed at child-minders, crèche teachers and supervisors, principals and day-mothers. Childsafe South Africa has designed courses on Safety when managing small children tailored specifically for child-minders. In 2008, based on our Childhood Injury Surveillance System, we started to develop Childsafe Educational Posters, available in various languages, but mainly with a pictorial safety message. These messages are categorized per age and mechanism of injury.

(3)     Advocacy  Childsafe South Africa plays an important role in advocacy, especially at policy level in the National Government of South Africa, and has been instrumental in legislation in the following areas: (a)The manufacturing of South African Bureau of Standards approved child-restraints for use in motor vehicles, (b) Motivated for a regulations on children’s furniture (c) Made numerous written and oral presentations in the South African Parliament regarding: Child friendly legislation; the New Firearms Bill and Gun Safety; the Prevention of Child Physical and Sexual Abuse; Made presentations to the Human Rights Commission of South Africa regarding; Child Safety at Schools; the National Development Plan and Corporal Punishment.

All of Childsafe activities are community-based and all of its main programs directed at previous disadvantaged people. Over 90% of all childhood injuries occur in low- and middle-income areas and the strength of its focus has been on empowering children and their parents to prevent the most common cause of childhood deaths and disability. All permanent staff of Childsafe South Africa meet the definition of “Black” as per BEE codes of Good Practice No. 29617, 9th February 2007.

Over the last decades we have developed a number of completely novel programs:

1)            Surveillance System of Child Injuries since 1991. The Childsafe Database has been maintained for over 20 years by volunteers and is the first and presently only Childhood Surveillance System in Africa. Data from this system have been the basis for a large number of scientific reports and have been widely distributed and assisted the rest of Africa and organizations such as the WHO and UNICEF. We currently have detained information on over 150 000 injury accidents in children.

2)            Candle in the jar. This project has been running for years and provides a extremely cheap and practical solution for the second most common cause of shack (informal dwelling) fires in Africa, fallen candles. A fallen candle can burn a shack down within 2 minutes. By using glass jars and filling them with sand, these fires can be completely prevented. (See:

3)            Early Childhood Development (ECD) workshops. Over the last 4 decades Childsafe has run hundreds of Child Safety Courses; teaching child minders, parents, teachers and ECD teachers all aspects of child safety and  how to create a safe environment for children. Childsafe’s courses are the first to have been taught in South Africa and are substantially different from all other courses since the certification is not the end of the process, but there is ongoing evaluation after each course.

4).           Safe Schools Project. The Safe School project aims to reduce child pedestrian injuries and deaths in South Africa by introducing the International Road Assessment Programme (iRAP) star rating of schools concept to guide both interim small infrastructure improvements and encourage long term sustainable investment in safety by government. Infrastructure assessment and improvement are combined with high quality road safety education, designed by Sesame Workshop, and community and policy engagement.

5)            Safe Travel to School Project Project. This project arose from the fact that children are most likely to be involved in road traffic crashes to and from school. Schoolbus (taxi) drivers have generally a very bad reputation in South Africa. This project, launched a few months ago, includes and incorporates this very difficult group (of drivers) in establishing a safer travel modality for children to their schools. Through the installation of a “DQ tracker” in the school buses.  Childsafe is able to monitor the safety of the children while being transported. This project is completely novel in nature; no earlier programme included “buy-in” from the taxi industry.

6)            Child Advocacy. In the year 2000 Childsafe was faced with a massive increase in children being injured by firearms. As part of the “Anti-Gun Lobby” Childsafe made a strong submission to the South African Parliament to tighten the regulations on the possession of firearms. Childsafe made the (first ever!) Powerpoint presentation in the South African Parliament resulting in the “New Firearm Bill” being accepted and implemented. Since its inception, it has decreased the number of children presenting with gunshots to the hospital by 70% and also reduced the total number of people dying from gunshots by 60%.

7)            First Childsafe Research and Educational Centre (Demonstration Safehouse)  in Africa. Since 1990 Childsafe has had the desire to have a demonstration Safehouse as the centre of our research and educational activities. After literally decades of lobbying and securing funds, we finally received permission and secured sufficient funds to build this new centre. It has been opened in May 2014 and currently functions as the hub around all our child safety activities in South Africa and beyond.

2          Childsafe’s Impact on South Africa

Childsafe has increased community and population awareness of Childhood Accidents and Injuries as the number 1 Killer of children in South Africa:

The Childsafe Injury Surveillance System is the largest Single Centre database on childhood injuries for children under the age of 13 worldwide. Research from Childsafe South Africa has produced literally hundreds of peer-reviewed scientific articles and has been the basis for advocacy and lobbying for changes in legislation. It is not only a local resource but has Provincial, Regional and National importance. Important recent activities have included the changes in legislation regarding firearm ownership, seat belt use in motor vehicles and even the roll out of the “Candle in the Jar” project, preventing shack fires. The impact Childsafe has had has been documented in scientific publications such as those on the New Firearm Bill (Firearm injuries to children in Cape Town, South Africa: impact of the Firearms Control Act. Campbell NM, Colville JG, van der Heyde Y, van As AB. S Afr J Surg 2013;51(3):92-6) and Seat belt (Restraint use for child passengers in South Africa. Kling J, Nicholls T, Ntambeka P, van As AB. SAMJ 2011;101(3):146), but also on the international front on numerous topics such as ingestion of foreign bodies.(Inhaled Foreign Bodies in Children: A Global Perspective on Their Epidemiological, Clinical and Preventative Aspects. Fontran F, Ballali S, Rodriguez H, van As AB, Passali D, Gulati A, Gregori D. Pediatric Pulmonology 2013(48):344-51.)

Childsafe South Africa also has very important educational role in informing both children and adults at every available opportunity at schools, factories and work places, clinics, through posters and TV programmes, talk radio, newspapers and other media. Over the years hundreds of certified child injury prevention and safety promotion courses have been conducted nationally. It initiated and developed a range of Childhood Injury Prevention posters that won the global award for “Best Educational Poster” in its category on the World Safety Conference in 2008 in Mexico and is now been copied and used worldwide.

Childsafe South Africa also developed an interactive website ( with over 270.000 visitors from around the globe.

Childsafe South Africa also has also convened a number of large international conferences on childhood injuries Injuries and is closely associated with the WHO International Safe Communities Conference and the International Society for Violence and Injury Prevention, UNICEF, the international Susy Safe project and Johns Hopkins Bloomberg School of Public Health. Childsafe South Africa has led numerous large child safety promotion campaigns (Newspapers, Radio and TV) in South Africa, with a (completely self-generated and unpaid for) media coverage monetary value in excess of 25 millions of Rand over the last 3 years; all of these on child safety issues.