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The World Health Organization says the most dangerous place a child can be is in a car or on the road. That's true no matter where you go in the world. Car crashes account for the largest share of accidents that kill nearly one million children every year. NPR's Brenda Wilson reports.

BRENDA WILSON: When we think of the health and survival of children around the world, there's been a preoccupation with infectious disease and malnutrition. But a child who survives infancy faces a series of other dangers, says WHO's Dr. Etienne Krug.

Dr. ETIENNE KRUG (Director, Injuries and Violence Prevention, World Health Organization): Once a child reaches age nine, injuries become the leading cause of death. We have a huge public health problem out there. We have 830,000 children dying every year. It's like wiping out the entire child and adolescent population of Chicago every year.

WILSON: Millions more are maimed and left permanently disabled. The list of unintentional injuries includes drowning, burns, falls, and poisoning. But the main problem is road traffic accidents. The highest rate of fatalities is in Africa. There most children die just walking along the road.

Dr. KRUG: We keep building new roads, bringing in new cars, new drivers - going through villages where people are just not prepared and kids are not prepared to deal with the dangers of the roads.

WILSON: Low- and middle-income countries have yet to develop a safety culture that he says is prevalent in the Western world. Countries in Asia promote helmet use, but safe practices haven't quite taken hold.

Dr. KRUG: Entire families are being transported on a motorcycle. You see in countries like Vietnam, Laos, Cambodia, three, four, five people on one motorcycle being transported. When those get knocked over, we have severe injuries and often death.

WILSON: In the U.S., most fatal injuries to children involve teenagers in cars with drivers who are inexperienced and/or under the influence. But younger kids are also at risk, even though helmets and child restraints have dramatically reduced injuries. Dr. Ileana Arias of the Centers for Disease Control and Prevention says more should be done to make the world safer for children.

Dr. ILEANA ARIAS (Director of the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention): In a lot of communities in the U.S., sidewalks don't exist. If they do exist, they're not well kept. Crosswalks are not very clear. So, in addition to the motor vehicle crash issue, being hit as a pedestrian, there's the possibility of falling down and being hit, whether that child is walking or riding a bicycle to school.

WILSON: Dr. Mark Rosenberg of the Task Force on Child Survival says it's the same problem faced by developing countries.

Dr. MARK ROSENBERG (Executive Director, Task Force for Child Survival): There's no separation between the pedestrians and the motorized traffic in many places. Women walk down the middle of the road carrying their babies, and they and their babies are hit by trucks and buses that didn't see them or couldn't stop in time.

WILSON: Rosenberg says the safest roads are in Sweden. And road traffic experts there are astonished by what most countries consider safe.

Dr. ROSENBERG: They said, look at the intersection. Thin white lines don't slow cars down. You need to have a speed bump at every intersection in a residential neighborhood. They said you need to narrow the streets. They said you need to put a traffic circle there. They said we know if a car is going more than 35 kilometers an hour, the chances are that any pedestrian it hits will be killed.

WILSON: WHO recommends that in addition to promoting awareness of road safety, funding for preventing childhood injuries should be included in international projects for highway construction and health development. Brenda Wilson, NPR News.

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