What place can be safer for a child more than his or her own home? However research has shown that children are often injured and some times die as a result of hazards in their home environment. A recent survey undertaken in 2007 by Aga Khan University – Human Development Programme, found that more than 60 percent child injuries in Pakistan happened inside homes. The various events that caused these were falls, cuts, burns and scalds, electric shocks, drowning, poisoning and choking. The accidents had happened around the kitchen, stairs, balcony, bedroom and courtyard, leading to the conclusion that any place inside the house can be a potential risk unless parents/caregivers keep the child supervised all the time and ensure that the child is in a risk free environment. Besides being risky, unhealthy environments are detrimental for children’s development and growth.

In Pakistan unintentional injury continues to be the greatest cause of mortality, morbidity and disability for children. Razzak J.A (2004) in a hospital based research study in Karachi found that the common cause of injuries for younger children were falls while other causes were burns, drowning, falling objects, explosions, poisoning, contact with electric current and bite/ sting. It is estimated that 15% of the children died as a result of serious injuries, many of which could have been prevented if parents and caregivers had awareness on how to make their environment safer for children.

Injuries usually happen when:

• Parents/ caregivers are not paying attention. Small children, especially under 3 years, need to be watched all the time.
  
• Children are learning to do something new. Children are always learning and growing (for example: rolling over, climbing, and crawling). If parents are not ready, these new exploration skills can lead to injuries.
  
• They are somewhere new. Injuries are more likely to happen when children are in a place they are not familiar with.
  
• They are hungry or tired. Before they eat and before bedtime, children may be less likely to pay attention to what they're doing.

The good health and well-being of young children depends on a safe and healthy environment. Inadequate sanitation and drainage, lack of clean water and uncollected waste and pollution, all contribute to unacceptable levels of child mortality and morbidity. The main cause of serious illnesses in young children is poor and unhygienic environmental conditions.  Children are more seriously affected from these living conditions because they have a more vulnerable immune system as compared to an adult.

Young children tend to be more heavily exposed to viruses; babies, especially those learning to crawl and walk, spend time close to the ground and they have a tendency to put everything into their mouths. Children in unsanitary environments often have repeated diarrhea, worm infestations, scabies, rashes, open sores and eye infections. Malnutrition in children is not just a matter of getting too little to eat. Unsanitary living conditions pose a constant challenge to children’s immune systems. Clean drinking water or boiled water, adequate provision for sanitation, as well as drainage and waste removal, are essential to the prevention of these ailments.

Another challenge for children’s health is environmental toxins and air pollution. The single most serious source of pollution is open fires or poorly vented stoves in the homes. Exposure to biological pathogens can result in respiratory illness, skin and eye problems, birth defects, various cancers and damage to the immune system, the central nervous system, the internal organs and the cardiovascular system. This is a common practice that while caregiver, usually a mother, is cooking she keeps the child inside and closed; this is detrimental for toddlers’ health and can create serious respiratory problems. Children residing in smoked filled homes or kitchens develop serious respiratory infections.

Children need a safe and secure home environment that does not put them at risk of unintentional injuries such as burns, fall, poisoning, cuts and electric shock. In early childhood children are at their most vulnerable age for such injuries due to several reasons; this is the age which makes them curious about everything, they love to explore objects by using all their senses especially the sense of taste and they just cannot resist from any type of adventure.

Young children especially from birth to three years olds are curious by nature and have a drive to explore and investigate their world. However they lack the capacity to understand or respond appropriately to danger. Children’s drive to play and explore new things is fundamental and has significant implications for their development. We cannot restrict the child’s instinct of exploration because unnecessary restrictions will hamper his/ her development. By making slight modifications in the physical environment we can create an environment that is risk-free and conducive to the developmental needs of the child. It is common, overburdened caregivers are more likely to cut corners in the many procedures necessary to ensure their children’s health but they need to think alternatives of provisions.