At the time of this lecture, I was the Honorary Chair of SAFE KIDS, would not assume the position of actual Chair until after
I left my post as Surgeon General in October 1989. SAFE KIDS was well-established, not-for-profit, non-governmental agency
intent on reducing mortality and morbidity from unintentional injury in children and it still had a long way to go to reach
its present size (2003).
This occasion was a symposium where we brought in the members of the various state, local, and regional chapters of SAFE KIDS
to Washington for a round-up, a pep-talk, and a plan to send them home inspired for the next year.
The major reason why SAFE KIDS works is that each of the local chapters is a group of foot-soldiers, composed of parents who
either know what has happened to their children, or who don't want what has happened to other peoples' children to
happen to their children. They are the ones who picket the Governor's Mansion, they are the ones who get the First Lady
of their state on their side, they are the ones who go down and sit with the city council until they acquiesce to do what
our chapter demands in the way of childhood safety. It was to these people that I addressed my remarks.
I started off by saying that we must demand and must work for safer road and highways, safer school buildings and playgrounds,
a safer marketplace (especially safer toys and bicycles), and me must work with each other to achieve safer homes for our
The first thing we had to do was convince the public and law enforcement people that injuries, intentional, as well as unintentional,
were the leading causes of death and disability among children (under fourteen). I didn't think the American people understood
this and therefore, we had a challenge.
Then, I went into the folklore about accidents (see a discussion of this subject on the front sheet of my testimony before
a Subcommittee of the House, delivered on February 9th, 1989). I repeated the adage that "Childhood injuries are no accident".
I raised the question about how we treat children in general in our society and that meant that where we needed to do better
and where we ought to get on with that task. Children do not automatically get a fair shake in our society, and I reminded
the audience that no child has ever learned a lesson or changed behavior because he or she was given severe corporal punishment.
There never was a major social problem solved by the beating of a child.
This was the time that I launched into my favorite subjects, which were some statistics on the fact that the greatest dangers
to children was a flight of stairs. Their parents frequently say in the emergency room, "They fell down the stairs."
But the signs of physical abuse on these children doesn't come from falling down stairs; they were slapped, punched, thrown,
or beaten before they "fell" down stairs. This wasn't in line with "unintentional injuries", but it was
something that had to be said.
Tied right in with that is the mythology in which when a child gets hurt, we automatically perpetuate the mythology that it
must have been the child's fault or the result of another mysterious "accident". Adults unconsciously booby-trap
the world around children to the youngsters detriment and there are those who intentionally injury children.
I then turned to the connection between children and adults. And by that, I mean the connection between a young man in a wheelchair
and a little boy, many years before, who was knocked off his bicycle by a passing automobile. We don't see the connection
between the youngster and the adult, we don't see the facial skin grafts, the grief, the injury that changed the life
not just of one youngster, but of a family and sometimes a community.
This was a time to mention statistics; 19 million children under the age of 15 were injured each year . . . enough to require
medical attention; two million youngsters were incapacitated for at least two weeks . . . most of them for a lot longer. The
terrible statistic from all of this was that at least 100,000 boys and girls under the age of 15, who were at one time healthy
and not incapacitated, became permanently disabled in some way, every year.
As I frequently did in my lectures, I tried to outline some of the difficulties disabled children face as they go from one
stage of life to the other, because of an unintentional injury in childhood. It starts with the injury and goes right through
life, including all of its vicissitudes that naturally occur until death. Therefore, we have to face the fact that the childhood
injuries are the leading cause of physical and mental disability, of the arrested development, and of restricted life experiences
for millions and millions of adults. These were adults who were injured when they were children, but who survived.