Long-term cost of road carnage

By Paul Stenhouse

Last year 13 people died during the Christmas and New Year period and more than 70 people were seriously injured, six critically. The holiday carnage leaves not only a $40 million cost to the taxpayer but a huge social burden.

From left: Chelsea Walker 21, Dontae Walker-MacDonald 4 and Freedom Walker 24. Photo / Magnum Images.
From left: Chelsea Walker 21, Dontae Walker-MacDonald 4 and Freedom Walker 24. Photo / Magnum Images.

Huddling on the grass on the side of the road, Chelsea Walker hugged her 4-year-old son, Dontae Walker-MacDonald, crying and praying he was going to be all right.

"I thought, 'Oh my god, this is it'," says Chelsea.

The pair, along with Chelsea's partner, Freedom Walker, and Freedom's sister and nephew, were in the Honda Domani that was part of a horror crash involving three cars and a truck on State Highway 2 on Monday.

They, along with seven other people, were admitted to Hawke's Bay Hospital. Two patients a 30-year-old male and 33-year-old female remain in a serious but stable condition in intensive care with another five patients recovering in general wards.

At the time of the accident the Walkers were in shock, crying and comforting each other on the roadside while they waited for emergency services to arrive.

The family had enjoyed a day out at Splash Planet waterpark in Hastings and were on their way home to Shannon.

"I remember driving around the corner and seeing a white car crossing the centre line. For a split second I thought, 'this is going to be a near miss', then all of a sudden there was a thud," says Chelsea. "I just started screaming. I was screaming for my life, screaming for all our lives. I turned around to check on my son and I was scared there was something wrong with him."

The car was badly damaged on the driver's side, where both Chelsea and Dontae were sitting. Freedom's passenger door wouldn't open so he climbed out the window to get his son out of the car.

Lowe Corporation rescue helicopter pilot Dean Herrick was at home when he got the call for assistance. He jumped in his car and was at the hangar in a couple of minutes. "There are many times I have had to give up Christmas and New Year - accidents can happen at anytime," says Herrick.

Summer sees an increase in the number of call-outs for the rescue helicopter service, with more holiday-makers out and about.

While the focus is usually on the number of people who die each holiday period, which was 13 in the 2009-10 Christmas and New Year road toll, the number of people who suffer serious and life-altering injuries often go unreported.

"Some of these major traumas pulverise the family," says Waikato Hospital's trauma nurse co-ordinator Jenny Dorrian. "They are going to hate Christmas time forever."

Seventy people were seriously injured during the holiday period last year.

Those 70 lives are changed permanently by fractures, concussion, internal injuries or severe cuts and lacerations.

ACC's records show six serious injuries during the period, which are forecast to cost taxpayers $33 million over their lifetime, an average of $5.5m spent on each patient. Add to that the 121 moderate to serious injuries lodged with ACC from that time and another $9m in costs.

It all adds up to $42m of government money in 278 hours - or $2518 a minute. There were also another 868 claims lodged for more minor injuries.

However, that is just the monetary cost. There is also the social cost to consider. "Some of these people may never function again the way they did before," says Dorrian.

"If they are employed it is a loss to the workforce. They suffer pain and being uncomfortable. It also destroys relationships."

Chelsea can relate to this. While everyone in her car had a lucky escape with only minor injuries, she says the emotional affect will stay with them.

"The bruises will go away but what has happened will stay in our minds forever. We'll never forget it."

It's the job of the trauma team to co-ordinate the care of trauma patients at Waikato Hospital, so Dorrian sees the affect the accidents have on families.

Last year the team saw 261 seriously injured multi-trauma patients - a majority of injuries were vehicle-related.

"Around Christmas and New Year you get family crashes. So you have children and parents involved, or grandparents," she says.

Dorrian says the affect can be devastating. She remembers one situation where a husband was in intensive care while his wife suffered from traumatic amnesia.

"You go and tell her something and she forgets straight away, and every time you go and give her a report on her husband she is finding out he is seriously injured and in ICU for the first time, over and over again.

"The kids see their father hooked up to a machine and IV and drains and one of the kids reciting that, 'the truck hit daddy right in his door, I saw the truck coming'."

Waikato Hospital's director of trauma Grant Christey says dedicated psychological services for patients and families affected by vehicle crashes are on the agenda. Currently it is up to the trauma team to provide these services.

"Our ability to provide post-traumatic stress counselling is sub-optimal to patients' families but we do the best we can with the resources available," says Christey.

He hopes dedicated services will be in place within a year.

"Because not only is the patient injured, but the families take a big hit as well," he says.

"They have all of the loss and grief issues that the patient has to deal with, to varying degrees, so they need to learn to deal with that emotionally, psychologically and they also need help on the social and financial aspects as well."

Also, those who are first on the scene at serious crashes often need counselling for their involvement.

Doug Third, St John paramedic and the southern region operations' manager, has been attending road crashes for 35 years.

He says ambulance officers are emotionally affected, even when people aren't killed.

"I can think of an accident a few years ago where a solo mum and her two children ploughed into a bridge. The two children survived with nasty injuries, but mum survived with a major head injury. We all thought she was going to die and were thinking this leaves two children by themselves.

"She survived, but what had more of an effect on us was that it took more than two years for her to be rehabilitated and during that time she couldn't care for her children."

Despite attending hundreds of crashes, Third says he was "blown away" when he discovered just how many people were affected by a single road accident.

At a workshop in Dunedin, organised by Students Against Driving Drunk, Third was an ambulance officer involved in a mock car-crash demonstration.

"We were in a room of about 30 kids and they started to read a list of the people affected by that 'crash', and as they read a person, one of the kids would stand up. They read out the immediate family, the two crew in the ambulance, the four fire-fighters, three policemen, the undertaker, and the list goes on and on.

"Within minutes they had all 30 students standing up and they said: 'Well, we haven't finished our list yet'."

That list continues in hospital. Dorrian says more people are involved in a patient's care than just doctors and nurses.

"There's occupational therapy, physiotherapy, speech and language, dietary, social worker involvement," she says. "It's a big team of people that look after these multi-traumas. It's the allied workforce we rely on."

They, too, are affected by the traumatic injuries they see.

"Yeah, sometimes it's difficult," says Dorrian. "But in saying the bad bits, there are also some good bits," she says, pointing to the photos of survivors on the wall of the trauma office.

"People are amazing. People that get majorly injured, I have to take my hat off to them ... They have been so damned injured and they come out the other side with such a good attitude."

Back in Shannon, little Dontae Walker-MacDonald and his family are grateful to be alive and spending the rest of the holidays at home together.

Dontae spent two nights in hospital under observation for a chest injury. After the crash he had headaches and was vomiting.

Chelsea is keeping a close eye on him and if the headaches return he will be going straight back to hospital.

Chelsea is wary about getting back behind the wheel of a car. "Going 100km/h on the open road will be the hard part."

Dream of unity

There are just two dedicated trauma services in New Zealand: one at Auckland City Hospital and the other at Waikato.

The Waikato unit, in Hamilton, takes the most serious patients from across the central North Island. In both hospitals, trauma patients are scattered throughout specialist and general wards.

Having dedicated trauma beds is the dream of Waikato Hospital's trauma nurse co-ordinator Jenny Dorrian and director of trauma Grant Christey.

He says such a facility would allow patients with specific and complex injuries to have dedicated care.

"There are no new beds required obviously because the patients would be in hospital anyway, but it's a concentration of the nursing and medical skill into one geographic area."

Christey says a dedicated unit would reduce cost. "What happens in a trauma centre is that the systems of care are improved so that risks are assessed early and mitigated. The mortality is lower."

- Herald on Sunday

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