SAHR 2007 - Health Systems Trust

Injuries
Data on injuries have largely come from the StatsSA cause of
death reports, based on reported ICD-10 codes. The Cause
of death 2005 report, published in 2007, notes that South
Africa has devised unique codes for causes of death related
to herbal poisoning (Y67), enemas by traditional doctors
(Y68), mine accidents (Y37), accidents in sports (Y38) and
circumcision (Y39). Data which have been adjusted for underreporting
are also available from the StatsSA Adult Mortality
report, published in 2006. Figure 21 shows the distribution of
selected causes of unnatural deaths for adults (age 15-64)
from 1997 to 2004. A notable feature is the high proportion
of deaths where the underlying cause is an “unspecified event
unknown intent” (ICD-10 code Y34). The StatsSA report notes
that “[o]ne reason for this large percentage of undetermined
cause is the Wet op Geregtelike Doodsondersoeke (Judicial
Death Inquest Act #58) of 1959. This law states that determination
of intent (assault by others, intentional self-harm,
or accident) is the prerogative of the court. Court proceedings
can take a long time, and the death notification form
is usually filled out long before any court proceedings have
been completed. Thus, intent is rarely recorded on the death
notification form. This means that a classification of unnatural
deaths into the traditional categories of homicide, suicide,
and accident is not possible from death notification data.
Very often the circumstances of death (transport, firearm,
knife, etc.) is also not recorded, although the Judicial Death
Inquest Act does not prohibit the recording of that kind of
information”.
The StatsSA Adult Mortality report also includes data on
transport-related deaths by age for 2001 and 2003, as
supplied by the Department of Transport. Figure 22 shows
death rates for both sexes, disaggregated as pedestrian
and non-pedestrian transport deaths per age band.
The Road Traffic Management Corporation issued an “Interim
Road Traffic and Fatal Crash Report for the Year 2006” in
January 2007 [Arrive Alive]. Of particular interest are data
showing the possible effect of long-distance travel over
public holidays. In 2006, 3 months showed high increases
in traffic fatalities. These were April (including both the Easter
and Freedom Day holidays), June and November.
Another potential source of data, not used for the StatsSA
report, is the National Injury Mortality Surveillance System
(NIMSS), established in 1999. This is, however, a voluntary
system. The report stated that mortuaries in provinces participated
in 2004, predominantly in urban areas, and that the
data submitted “covered about 40% of all unnatural deaths”.
As the NIMSS form is not a legal document, indicating the
apparent manner of death does not violate the Judicial
Death Inquest Act, reducing the number reported as “undetermined
intent”.
Figure 21: Percentage distribution of selected causes of unnatural deaths, age 15-64, 1997-2004
100
90
80
70
Percentage
60
50
40
30
20
10
0
1997 1998 1999 2000 2001
2002
2003
2004
Firearms
Knife
Other specified cause
Transport
Y34 Unspecified event unknown intent
Poisoning
Source:
StatsSA Adult mortality.
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