The dangers to children from coconut tree trauma, in KiraKira, Solomon Islands: a retrospective clinical audit

Background: Kirakira is small community of 3,000 people and is the capital of Makira-Ulawa province in Solomon Islands. Kirakira is an impoverished community with a small 30 bed hospital with limited resources. This audit was conducted by final year students from Bond University as part of a selective clinical placement. Methods: The audit included admissions to the hospital from 2011 to 2014. Trauma-related admissions were identified and classified according to the patient's age, sex, description of injury, mechanism of injury and whether they were transferred to the National Referral Hospital (NRH) in Honiara for further treatment. Injuries due to Coconut tree trauma were classified as being due to falls from the tree, or trauma from either falling branches or falling coconut fruit. Results: There were 3455 admissions and 23(0.7 %) non-neonatal deaths over the 3 year period. 126(3.6 %) admissions were referred on to the NRH for further treatment. 277 (8.02 %) admissions were trauma-related with 57(21 %) of these referred on to the NRH. 142 (55 %) of the trauma admissions involved children. Coconut Tree trauma was the commonest cause of a traumatic admission to hospital. There were 49 Coconut Tree trauma admissions including 35 from falls, 12 from falling branches and two from falling coconuts. 80 % of Coconut tree trauma involved Males and the median age of those injured was 13. Primary School age children aged 6-14 years were most at risk for Coconut Tree Trauma. 15(31 %) of the Coconut tree trauma admissions were referred to NRH for further treatment. Conclusions: Coconut Tree Trauma is common in Kirakira and is an important preventable cause of serious injury that particularly affects primary school aged boys in Kirakira, Solomon Islands. A public education campaign that focuses on this at risk age group warning of the dangers of climbing Coconut trees should be considered.