The most ambitious injury prevention intervention to date is the Swedish ‘VisionZero’, a road accident prevention initiative. While road accident mortalities might never be reduced to zero in Sweden, this intervention was successful because its ambitious name and laudable goal engendered buy-in from both government and the general public.
The BokSmart National Rugby Safety Program, sponsored by SuperSport, has embraced VisionZero, but has applied this concept to rugby.
The BokSmart #VisionZero initiative would like to take this very ambitious and exceptionally audacious goal on board, and build it into all of its relevant platforms, including but not limited to the following:
• The BokSmart 6 educational DVDs, Concussion Guides, BokSmart Toolkit Manual and accompanying educational materials
• The BokSmart Website and all social media initiatives and platforms
• All relevant articles, press releases, promotional content and marketing opportunities
#VisionZero is not a target to be achieved by a certain date or time! More aptly described, it is a process whereby all of rugby stakeholders work actively together towards the ultimate goal of achieving sustainable interventions and ZERO catastrophic injuries or events in South African Rugby Union!
#VisionZero is focused primarily on preventing rugby-related fatalities and those catastrophic concussion, head, neck and spinal injuries where the victim does not physically recover.
So, what does #VisionZero essentially mean for BokSmart?
• Strive towards (major focus, and overriding ultimate goal/objective):
o ZERO catastrophic spinal injuries
o ZERO catastrophic traumatic brain injuries
o ZERO rugby related cardiac fatalities
o ZERO severe concussion injuries
• Strive towards (secondary focus, but still important, as these contribute towards the primary objective):
o ZERO anti-doping violations
o ZERO schools and clubs without a Concussion register, and ZERO without someone monitoring the graduated return to sport (GRTS) processes in their concussed players
o ZERO concussed players remaining on the rugby fields
o ZERO concussed players returning to play without following the correct GRTS clearance processes
o ZERO breaches of rugby safety regulations
o ZERO unsafe playing fields
o ZERO matches starting without the referees performing Field Safety Inspections
o ZERO coaches and referees not being BokSmart Certified at matches
o ZERO matches starting without Referees reviewing Team Sheets and controlling for age-appropriate players
o ZERO matches starting without the minimum medical staffing and equipment being in place
o ZERO schools and clubs starting matches without a functional Emergency Action Plan (EAP) for dealing with catastrophic concussion, head, neck and spine injuries
o ZERO schools and clubs without a Technical Table controlling for Team Sheets, match related rugby safety regulations and minimum medical requirements
o ZERO under-age players playing in incorrect age-groups
o ZERO over-age players playing in incorrect age-groups
o ZERO uncivilized, malicious, intimidating and violent behaviour at rugby matches around South Africa
o ZERO unsafe contact techniques
o ZERO illegal dangerous play actions on the field
#VisionZero is not something that will happen overnight, but if everyone, i.e. SARU, marketing, communications, Top management, provincial rugby unions, schools, clubs, parents, players, coaches, referees, medical staff, teachers, corporate sponsors, corporate partners such as the Players’ Fund, and spectators, can collectively get behind this initiative, there is an opportunity to make significant inroads in moving towards ZERO.
A core principle of #VisionZero is that when someone’s life and health is at risk, one cannot argue about the benefits within the society that are available as a result of participation in rugby. No loss of life can ever be seen as acceptable, and by loss of life, this can also be loss of functional living too, e.g. quadriplegia. Hence, the focus should always be aimed towards achieving ZERO.
In line with original work on Road Safety Vision Zero, a slogan such as “Rugby Safety is no accident” would hold true. Let’s all work towards a ‘Vision Zero and a rugby-safe society’.
#VisionZero must be jointly shared by those controlling the game (the system designers), and those participating in it (the end-users).
#VisionZero by its very name implies that safety is a more important area than any other issue, and that all decisions must be made with safety as the primary consideration. Everything else must be secondary to that. Changes to the system cannot be at the expense of safety!
Albeit that we have come a long way from the 20 ASCI and 1 Catastrophic-TBI recorded in 2007, we are still far off from achieving our ambitious #VisionZero target when it comes to catastrophic head, neck and spine rugby injuries!
While it might be seen as setting the bar very high with this target, the sheer fact that it is an overly ambitious goal should not prevent us from continually trying to reach it, as no loss of life can ever be seen as acceptable, and this also refers to a loss of functional living such as with quadriplegia.
Associated references of interest:
Belin M-Å, Tillgren P, Vedung E. Vision Zero – a road safety policy innovation. International Journal of Injury Control and Safety Promotion 2012;19:171–9.
Brown J, Viljoen W, Readhead C, et al ‘VisionZero’: Is it achievable for rugby-related catastrophic injuries in South Africa? Br J Sports Med Published Online First: 16 February 2017. doi: 10.1136/bjsports-2016-096861