Preventing Accidents Guidelines For The Aid Sector Revised Edition

Dr. Ted Lankester Director of Health Care and Senior Physician InterHealth

People In Aid 2003

People In Aid Development House 56-64 Leonard Street London EC2A 4JX UK Tel: +44 (0)20 7065 0900 Email: [email protected] www.peopleinaid.org

©People In Aid/InterHealth 2003

InterHealth 157 Waterloo Road London SE1 8US Tel: + 44 (0)20 7902 9000 Fax: +44 (0)20 7928 0927 Email: [email protected] www.interhealth.org.uk

Contents Foreword ..................................................................... 1 1.

Accidents As The Leading Cause Of Preventable Death .............................................. 2

2.

Safe Road Travel ................................................ 3

3.

Household Safety................................................ 6

4.

Safe Swimming ................................................... 9

5.

Other Areas Of Risk .......................................... 10

6.

Setting Up An Agency Policy ............................ 12

Reading and References .......................................... 14

Appendices Appendix 1: Transaid Vehicle Daily Defect Report ................................ 15 Appendix 2: Tearfund Accident Record ................................................. 16

Acknowledgements We are grateful to many individuals and agencies for their contributions to this report and would like to thank all those involved. This is a revision of the Preventing Accidents Health and Safety Guidelines for Aid Workers report produced by People In Aid and InterHealth in 2000.

Disclaimer People In Aid has taken considerable care in the production of the Handbook and its contents. However, People In Aid is unable to provide any warranty concerning the accuracy, completeness or relevance to your organisation relating to any information contained herein. People In Aid / March 2003

©People In Aid/InterHealth 2003

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Foreword “An aid worker had been killed in a motorbike accident the week before I hopped on a moped after work without a helmet. I was tired and didn’t want to wait for a lift home by car. I hit the only cement-line drainage ditch in Burundi headfirst. It needn’t have happened - I just didn’t think.” An aid worker

WHAT IS THE PURPOSE OF THIS PAPER? 1. To raise awareness of just how common accidents are and ways in which they can be prevented 2. To give information and guidance to agencies to help them set up accident prevention policies 3. To encourage aid workers to take all possible precautions 4. To show that the word accident is an inaccurate term. It should better be termed unintentional injury or defined as “an event that has an external cause and is potentially preventable”

WHO IS THIS PAPER WRITTEN FOR? People In Aid’s revised Code of Good Practice (2003) states: “We recognise that the work of relief and development agencies often places great demands on staff in conditions of complexity and risk. We have a duty of care to ensure the physical and emotional well-being of our staff before, during and after their period of work with us.” Principle 7 lists specific indicators which agencies can use to implement this. This paper is written mainly for aid agencies and in particular for those responsible for creating, implementing and monitoring accident prevention policies. It will be of special value to HR managers, health advisors, country directors and field and project managers. Aid workers should also find this useful, as it contains many practical tips and reminders on how to reduce dangers and hazards. It concentrates on major areas of risk, identified as road travel, household safety and swimming. “Youth With a Mission England would recommend People In Aid’s Preventing Accident guidelines to any organisation working in this sector. We imported the guidelines almost wholesale into our standard manual guiding staff on international operations. This saved us work and gave our team leaders and staff all they needed.” Clair Gorman, National Administrator, Youth With A Mission

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1. Accidents As The Leading Cause Of Preventable Death •

In the year 2000, 1.2 million people were killed in road traffic accidents. By the year 2020 this figure is expected to double. In some countries one in 10 hospital beds is occupied by victims of a road accident. The majority of these are pedestrians, cyclists and users of public transport1

•

More than one million deaths, at least, occur each year from work-related injuries and diseases, approximately equal to the number of people who die from malaria. This figure includes 300,000 fatalities from 250 million accidents in the workplace. In addition many million people are seriously injured, and some are maimed for life

•

Global economic losses from these incidents were estimated to be 4% of the world GNP in 19972

•

Between 1985 and 1998, 375 deaths were recorded in humanitarian organisations. Many more went undocumented, as did countless non-fatal injuries and accidents. Of the 375 deaths, 68% were caused by intentional violence, 17% were caused by motor vehicles, 7% were caused by unintentional violence and 8% by diseases and other natural causes.3

•

A study in 1990 showed that 5 million people worldwide died as a result of injury or poisoning, 10% of deaths from all causes that year4

•

Amongst travellers accidents are the commonest cause of death, with road accidents top, followed by drowning4

•

A major study on non-fatal accidents leading to medical evacuation placed road accidents top (45%), followed by falls, often from balconies (8%), sports injuries including diving into shallow water (4.5%), boating accidents (2%), aircraft crashes (1.5%), burns and electrical shocks (1%)4

“More than a million people, the vast majority in the poorest countries of the world, are being killed each year often because unsuitable vehicles are being driven on unsuitable roads by poorly trained drivers” WHO press release 11th Feb 2003

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WHO and Federation Internationale de l’Automobile join efforts for road safety. WHO press release 11th Feb 2003 2 Occupational Health WHO Fact Sheet No 84 June 1999, which quotes statistics from the International Labour Organisation 3 M Sheik et al Deaths among humanitarian workers British Medical Journal 2000 321 166-168 4 R Mcinnes, L Wiliamson, A Morrison Unintentional injury during foreign travel: A Review. Journal of Travel Medicine 2002 9 297-307. This is the most extensive review available, analysing 25 different studies

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2. Safe Road Travel “We were driving to Ruhengiri, Rwanda, four of us, two in the front and two in the back. Those of us in front had fitted our seat belts, but I noticed the back seat passengers were not wearing theirs. “Shouldn’t you put those seat belts on?” I enquired. “Of course we should” they said. Later I looked again and they were still unstrapped. The two passengers in the back seat were doctors.” An aid worker Getting the message across can be difficult! As one staff health officer said: “First timers are interested, but the old timers think they know it all.” Research indicates that both groups have similar risks. Road accidents don’t only kill. They maim, destroy families and lead to long-term disability. They increase the risk of becoming infected with hepatitis B, C and HIV, because of the risk of transfusion or major surgery in uncontrolled settings. In many relief or emergency situations, agencies will provide drivers. If they don’t, see if this is possible. In development situations aid workers more commonly do the driving themselves. These guidelines apply to all drivers. The following simple precautions should be known by all aid workers and be built into all accident prevention policies. Top Priorities

“In fact we have very little control over our circumstances: there is little thinking on safety issues amongst the local population: most people walk and drive all over the road.” A development worker with Christoffel-Blindenmission

Because there are so many situations we have no control over it makes it all the more important that we do everything possible to influence the situations we can control. Advise staff to do the following: •

Keep vehicles in the best possible repair This means regular, competent servicing, regular inspection of brakes, tyres, lights and steering. Train staff that use or drive vehicles in the essentials of maintenance. Keep records of maintenance and staff training (see Appendix 1: TransAid Vehicle Daily Defect Report)

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•

Ensure each vehicle contains the following: A repair kit, working car jack, at least one fully inflated spare tyre, stout gloves, a torch with spare batteries and warning triangle. A first aid kit should also be included and according to local circumstances might include needles, syringes, intravenous giving sets and intravenous fluids

•

Ensure good visibility at all times This includes working windscreen wipers in areas of heavy rainfall or where there is mud and spray on roads. It also means ensuring good visibility of traffic at your rear through internal or external mirrors

•

Choose public transport with care If possible avoid any form of transport known by reputation, or common sense, to be unsafe. This includes poorly maintained buses and lorries, any overcrowded vehicle, especially those with standing passengers and no firm handhold. Ensure the driver appears to be in a good state of health and not obviously under the influence of drugs or alcohol

•

Fit and wear seat belts These should be fitted to both front and rear seats and be installed both in passenger and goods vehicles. Using seat belts is the single most important way of saving lives. Un-strapped back seat passengers can die themselves and kill passengers in the front seats. If possible, use vehicles fitted with air bags, but never as a substitute for wearing seat belts Ensure children are well strapped in, e.g. using child belt adjusters

•

Issue and insist motorcyclists wear helmets These should be used even on the shortest journeys. Motorcyclists also need to wear heavy-duty footwear, jackets and gloves. Sandals and T-shirts give no protection

•

Never allow drivers or riders to use vehicles when under the influence of alcohol or drugs

•

Ensure that all drivers are well trained They must be competent to drive and be properly licensed. Make sure they have the skills for the type of driving they will be expected to do e.g. using 4 wheel drive vehicles, driving off-road or in flooded conditions, knowing how to handle road blocks and intimidation in high risk situations. Arrange any additional training that drivers may need

•

Take steps to avoid driving when tired This is extremely important, as fatigue and dropping off to sleep at the wheel are a contributing cause to many accidents. Plan journeys in advance, allow sufficient time, and try to obtain adequate sleep the night before a long drive. Avoid night driving if you can. Have a co-driver except on the shortest journeys. Do not drive if you have a high fever, malaria or after taking medicines that make you drowsy, or when jet-lagged. Nor if feeling unduly anxious or depressed

•

Except in emergencies drivers should not use 2 way radios or mobiles

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•

Land mines and other security risks Avoid driving on roads unless you have current and reliable evidence these are free from land mines. Re-read security guidelines when driving in war zones or other areas with high security risks

•

Finally - ensure your safety as a pedestrian Look both ways when crossing the road, learn all round alertness in major cities, remember the side of the road traffic drives on especially when first arriving, or returning to a city from an up-country location. Consider wearing reflectors when walking at night (e.g. when appropriate, 5cm square yellow reflectors tied on to arms or pinned on to the back of clothes). Take extra care when accompanying children

“If policy makers were fully aware of the gains to be achieved by implementing policies on issues such as drunk driving, speeding, motorcycle helmets and visibility, many lives could be saved.” WHO press release 11th Feb 2003

CASE STUDY A UK-based volunteer agency was brought to the UK courts over an accident in Africa suffered by one of their volunteers. The vehicle she was being driven in had had a Ministry of Transport Vehicle Test (MOT) 3 weeks previously. On an empty road a combination of a loose wheel-bearing, faulty synchromesh and a pothole brought an accident - and a back injury to the volunteer. The UK courts presume, in a road accident, that the roads are in good condition and that MOTs are of a certain standard. The agency will be paying compensation to the volunteer. The main lesson they learnt is that an MOT does not guarantee a standard of maintenance: any agency with vehicles should set its own standards and maintain those. The agency is also looking into a policy regarding public transport and subsequent liability in case of an accident: if the vehicles are unsafe and uninsured, as is the norm where they work, then should they allow their volunteers to travel on them?

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3. Household Safety In Britain we know that accidents in the home account for more injuries than on the road. Domestic accidents have been described as the hidden epidemic. Children and those over 65 are especially vulnerable. But human error, unfamiliar surroundings, tiredness and stress all contribute to making both the home and work place, environments where accidents are all too easy. Families with children need to take special care. “One day our cat got into a serious fight with another animal. I rescued it but got bitten and scratched in the process. I needed a course of rabies jabs and medical attention. There was appalling weather at the time, but I just managed to reach the local hospital. Fortunately the hospital had the necessary treatment. I now realize I should have been protected from rabies before going on assignment and should never have touched an angry animal.” An aid worker Top priorities Advise staff to do the following: •

Carry out a risk assessment Do this at the earliest opportunity when you arrive in a new house, hotel or temporary accommodation. Look at it from your viewpoint, and also from the perspective of any children or people who may work with you, including domestic staff A more formal risk assessment should comprise these stages: o o o o

Identifying the hazards Identifying who may be harmed Assessing what further action is needed to minimise the risk Recording the findings

o Monitoring and reviewing at agreed intervals •

In assessing risk consider the commonest household dangers: o Electric shocks: Unsafe wiring in bathroom, kitchen and shower; poorly earthed appliances, including immersion heaters; broken sockets o Burns and scalding: From household cooking fires, boiling water, milk or cooking oil, antiquated kitchen equipment, cooking pots with protruding handles that can be grabbed by children

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o Slips, trips and falls: Both inside and outside, on the stairs and from balconies. Leaning against hotel balconies after drinking alcohol is a special hazard during times of relaxation, travel and R and R o Cuts and injuries: From swinging doors, windows, and broken glass left lying around o Bites and stings: From animals including rats, bats, dogs, cats, scorpions, and snakes, particularly in the bathroom o Drowning: A small child can drown in 3 inches of water, meaning that young children should never be left alone when bathing or swimming o Poisoning by household chemicals: Including bleach, bottles incorrectly labelled, medicines, especially if sugar coated which are attractive to small children o Fire hazards: Making sure there is a way of escape especially if windows are barred. In hotels, security allowing, choose lower floors. Be aware of the nearest fire escape and extinguishers o Carbon monoxide poisoning A danger when using solid fuel e.g. coal and charcoal, with inadequate ventilation •

Bear in mind local factors such as; o Climate - ensure the house is safe in the hottest, coldest, wettest seasons o Your own culture shock and tiredness o The safety of the immediate environment including garden and paths o Dangers in the homes of friends and neighbours, especially if your children frequently play or visit there o Isolation, poor transport or security risks making treatment for any accident more difficult or dangerous o Access to safe water to reduce water borne illnesses o Precautions against insect born disease such as malaria (and dengue) by reducing immediate breeding sites. For example, remove nearby sources of standing water - flowerpot stands, areas where puddles form, unsealed water tanks, old tyres. Also ensure doors and windows are screened

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o Presence of rabies in the local mammal population, including dogs, cats, squirrels and monkeys. Household pets may become rabid, including yours or your neighbours. Ensure your dogs or cats have regular rabies injections. Ideally don’t keep domestic pets o The ease of children running onto a nearby road or hazardous location o Install essential safety equipment This includes a fire extinguisher, fire alarms (check regularly that these work as the majority quickly fall into disuse), a comprehensive First Aid Kit

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4. Safe Swimming “I had a day off and took a minibus out of Accra to the coast. I planned to spend a couple of hours on the beach. The waves didn’t look too high and I am a strong swimmer. I found myself being dragged down by the undertow and rolled like a ball inside the wave. I don’t know how I got out alive. I realize I should have found out about this stretch of coast first and shouldn’t have gone alone.” An aid worker TOP PRIORITIES Advise staff to do the following: •

Find out about local beaches, lakes, rivers or swimming pools known to be safe

•

Swim only in areas known to be free from dangerous currents, sharks, sea snakes, poisonous fish e.g. stonefish, stingrays, and box-jellyfish

•

Avoid any areas where crocodiles are known to live

•

Never swim out of your depth except possibly on beaches known to be safe and if you are a strong swimmer

•

Always swim with a companion

•

Never swim if you have been drinking alcohol, recently had a large meal, or have taken recreational drugs. Alcohol lessens awareness, and increases risktaking behaviour including staying too long in cold water.

•

Avoid sunburn by staying in the shade where possible, covering up, or using sunblock. Give special attention to any children you are responsible for

•

Avoid polluted areas

•

Keep a close watch on children especially if using inflatables: ensure they wear inflatable arm-bands

•

Always wear a life jacket for off-shore water sports or trips by canoe or small boats

•

Never dive into any water without first checking the depth

•

Never dive into cloudy water

•

Never run along the edge of a swimming pool

•

Finally try to avoid swimming in fresh water where bilharzia is known to be present – in particular avoid swimming near overgrown water margins where the disease- spreading snails are most likely to live, (mainly applies to Sub-Saharan Africa)

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5. Other Areas Of Risk Two further areas which need to be addressed with care include: Health and Safety at Work Although many of the risks described under domestic safety also apply to the office, as do the principles of risk assessment, a UK-based agency has a duty under The Management of Health and Safety at Work Regulations 1999 to ensure a safe working environment for staff members, both in the office and any other area where work is regularly carried out. Other countries have similar legislation. See further reading and specific websites below. Health and Safety legislation differs between countries. However the United Nations through the World Health Organisation and International Labour Organisation state: "Every citizen of the world has a right to healthy and safe work, and to a work environment that enables him or her to live a socially and economically productive life”5 UK based organisations need to be guided by two specific pieces of legislation as they consider their duty of care to those whom they employ: Firstly, the Health and Safety at Work Act 1974. This places risk assessment of the working environment at the heart of agency policy: As previously mentioned, risk assessment includes the following 5 steps: 1. Identifying the hazards. Common ones will include personal security, vehicles, other hazards associated with travel, electrical fittings, manual handling, accommodation, office premises, hazards from the work environment including building and construction sites, water supplies, sanitation, computers, fire, locally occurring disease, the additional hazards of politically unstable situations 2. Identifying who might be harmed. This needs to cover adequately those with little experience, including volunteers, and also locally recruited staff 3. Deciding if the identified risks are adequately controlled and what further steps need to be taken 4. Recording the findings of the risk assessment 5. Monitoring and reviewing the risk assessment Secondly, The Management of Health and Safety Regulations (1999) emphasises management of risk as being of prime importance. In addition to legislation in the country where the agency headquarters is based, there will also be the need to identify and follow legislation specific to the country in which staff are working. There is one important legal precedent, which indicates that an agency based in one country has a legal duty of care to staff recruited in another country. In 1998 South African former employees of a UK based-firm Cape Asbestos, won compensation on

5

Global Strategy on Occupational Health for All, WHO, 1995

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the grounds that the employer did not adequately protect them from the hazards of exposure to asbestos in South Africa. For further information see Health and Safety in Aid Agencies, People in Aid 2002 and websites listed under Reading and References. Adventure sports and high-risk leisure activities Encourage individuals to use common sense and to err on the side of caution when indulging in high-risk activities during holidays or during rest and relaxation. This will include adventure sports such as mountaineering and skiing and less obvious hazards such as playing squash or dancing in a temperature of 42°C!

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6. Setting Up An Agency Policy An agency has a duty of care and needs to have a health and safety policy which also applies to field staff. A policy on accident prevention can either be part of that policy6 or be a separate accident prevention policy designed for specific assignments or locations. Draw up your accident prevention policy with the help of a health and safety expert or a medical advisor. Obtain input and advice from different staff members especially those who are currently working in the field or have had recent field experience. A well-created, well-managed policy, accompanied by training, will not only help to save lives, it will reduce the likelihood of the agency suffering legal challenge through inadequate preparation and care of staff. The policy should include:

6

•

Clear guidelines on accident prevention, such as are described above

•

Briefing on accident prevention both before departure and on arrival in the field

•

Ensuring staff minimise their own risks when responding to an emergency or an accident. An example would be to use gloves when touching or moving victims with a high risk of HIV/AIDS

•

Ensuring all staff know the procedure in case of accidents and have a copy of any agency guidelines and policy

•

A comprehensive insurance policy, which covers all staff in all locations and situations. Insurance taken out by an HQ in one country may need to be supplemented by local insurance schemes. Staff need to be fully informed about their insurance cover

•

Training in first aid as appropriate, ensuring that each field team has at least one person trained in first aid

•

Procedures to follow in case an accident occurs. Field leaders will need to draw this up so it can be relevant and realistic bearing in mind local risks, transport and hospital facilities

•

Setting up safe blood donor schemes, ideally through a trusted donor list or “walking blood bank”

•

Keeping an updated accident book in field offices in which all incidents are recorded. Apart from contributing valuable data this will help you to improve existing health and safety practices

•

Reporting all accidents to local and head office with clear written, dated and signed records. See Appendix 2: Tearfund Accident Record

•

Having the means of investigating any serious or fatal accident

K. Howell, Health and Safety in Aid Agencies – People In Aid 2002

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•

A clause on the limits of responsibility where staff are seconded to projects or institutions where they have no direct authority for health and safety. Examples are the use of vehicles over which they have little control or accident procedures within a hospital

•

Training - perhaps the most vital issue of all. The agency should ensure both adequate levels of training across the whole range of risks identified in any assessment, and to encourage all individuals to take a personal responsibility for managing their own risks and not always to assume this is someone else’s responsibility

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Reading and References Health and Safety in Aid Agencies K. Howell - People in Aid 2002 People in Aid Code of Good Practice in the Management and Support of Aid Personnel People In Aid Preventing Accidental Injury - Priorities for Action UK Chief Medical Officer’s report Oct 2002 Available from The Stationery Office PO Box 29, Norwich NR3 1GN or www.doh.gov.uk/accidents The Travellers Good Health Guide TE Lankester 2002 - Sheldon Press (revised every 2 years) Practical Transport Management Manual Transaid. Available free of charge to charities and developing country government departments - [email protected] Useful websites www.who.int/violence_injury_prevention - World Health Organisation, injuries and violence prevention www.lhc.org.uk - London Hazards Centre www.rospa.com - Royal Society for the Prevention of Accidents www.cdc/niosh/homepage/html - National Institute for Occupational Safety and Health (USA) www.doh.gov.uk/accidents - UK Government Dept of Health www.hse.gov.uk - Health and Safety Executive www.dti.gov.uk/er/directive.htm - Dept of Trade and Industry on “Posting Workers Directive” Information on legal health and safety rights for staff working abroad www.interhealth.org.uk - InterHealth www.peopleinaid.org - People In Aid

Page 15 Transaid Transport Management System SAMPLE ONLY Appendix 1: TransAid Vehicle Daily Defect Report

VEHICLE OPERATOR’S DAILY DEFECT REPORT Vehicle Type Vehicle Registration Vehicle Operator Date

………………………………………….. …………………………………………… …………………………………………… ……………………………………………

Roadworthiness defects must be cleared before the vehicle is used.
= no defects Item Checks Remarks Instruments, warning lights all working. General Seat secure. Mirrors, windscreen, wipers, washers, horn, doors, locks, tools, jack.

Brakes

Check function, foot pedal, hand brake, handlebar lever, adjustment, noisy operation.

Steering

Check operation, play at wheel, wander, pull, position of handlebars.

Lights

Check operation of headlamps (dip/main), tail, brake, number plate, indicators, condition of reflectors.

Engine

Oil/Coolant/Brake/Clutch fluid levels. Screen wash reservoir. Leaks under vehicle. Battery connections. Exhaust smoke colour. Unusual noise.

Transmission

Clutch and gear change function. Noise, engagement. Handlebar lever. Chain adjustment and lubrication.

Wheels

Security of all wheel nuts/damage. Hubs. Lubrication of hubs.

Tyres

Condition, tread/damage/pressure/spare.

Body

Any visible damage, all nuts and bolts tight.

Fuel

Fuel level, filler cap, damage, leaks.

Suspension

Spring condition, vehicle attitude, shock absorber leaks.

Statutory

Legal signs (speed/weight), identification, vehicle documents, road/radio licence. Log book.

Safety

Seat belt/ safety helmet condition, other safety equipment. Transaid 137 Euston Toad London NW1 2AA 020 7387 6136 [email protected] www.transaid.org

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Appendix 2: Tearfund Accident Record

Accident Record PLEASE PRINT CLEARLY OR TYPE Name of person who had the accident

Name of person completing accident record:

Address of person who had the accident:

Contact address: Telephone, Fax or E-mail

If the person completing this form is different from person who had the accident, please state relationship to injured party: Line manager Medical link person Friend/colleague Other (please specify) Appropriate designation of person who had the accident (tick one of the following boxes): International Personnel Worker Regional Advisor Disaster Response Team Member Transform Team Member

Consultant Supporter/Volunteer Team Member UK Staff Member Other (please specify)

About the accident: when and where it happened: Date:

Time:

Location:

About the accident: what happened (Say how the accident happened. Give the cause if you can.)

Injuries sustained: (In the event of personal injury, say which part of the body affected and how.)

Page 17 SAMPLE FORM Immediate treatment administered: (Describe initial treatment, if any, given at site of accident, and by whom administered, e.g. self, colleagues, medically trained person, other.)

Was person referred to any other medical or other facility for assessment/treatment? (If so where, to whom and with what result?)

If injuries indicate a need for time away from work, estimated time: Days:

Weeks:

Months:

Signature of person who had the accident:

Date:

(As confirmation that they agree that the accident record is a true and accurate record of events.) (Please also print name.)

Signature of person completing the form (if different from above):

Date:

(Please also print name)

Would the injured person like Tearfund to contact next of kin/family? Yes

No

(In some cases the Team Leader/Supervisor may have to advise on the appropriate response)

A review of the details of the accident/injury data should happen no later than one week following an accident, unless more immediate medical referral is called for. Date of review:

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Details of any ongoing medical treatment being given, type and by whom:

Actual time off work, with anticipated time frame before return to work: Days:

Weeks:

Months:

Any action being taken as a result of accident: (this may include repair of machinery that may have caused accident, revision of working practice etc.)

Are the Police or local authorities involved (if appropriate)? Explain in what capacity.

Page 19 SAMPLE FORM

For completion by Tearfund’s International Personnel Team

Name of person sustaining accident: Date of receipt of accident record:

Action following on from notification of above: InterHealth Advised:

YES/NO (delete as appropriate)

Resultant action/advice:

Additional action taken:

Date action reviewed, with what outcome:

Signature of person reviewing accident record: ..................................................... Position:

.....................................................

Date:

.....................................................

Preventing Accidents – Guidelines for the Aid Sector Prepared for People In Aid by Dr. Ted Lankester - March 2003

Preventing Accidents Guidelines for the Aid Sector – March 2003 Your comments - please tell us what you think… 1. What did you find most useful about the information in this handbook?

2. How can we improve the handbook?

3. How do you use, or plan to use the handbook in your agency?

4. We would be interested to hear about policies or practices in your agency that have helped contribute to preventing accidents. Please tell us about them here, or send examples of written policy.

Thank you Name: Organisation: Address: Email: Tel/fax: Please send your answers via: email: [email protected] fax: +44 (0)7005 802 880 mail: People In Aid, Development House, 56-64 Leonard Street, London EC2A 4JX, UK