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PUBLIC HEALTH ISSUE
Despite the carnage and the toll taken on national resources, preventing
traffic-related injury is rarely regarded as a public health issue.
Rather than being seen as an inevitable price of "modernisation",
there is an "urgent need to recognise the worsening situation in
road deaths and injuries, and to take appropriate action. Road traffic
injury prevention and mitigation should be given the same attention and
scale of resources that is currently paid to other prominent health
issues," noted the 'World Report on Road Traffic Injury
prevention', released by WHO earlier this year.
The sight of crumpled cars and overturned buses on major highways seems
to have become part of the driving experience in the developing world.
But the wreckage represents more than just a personal tragedy for the
individuals involved in each accident.
"Studies show that motor vehicle crashes have a disproportionate
impact on the poor and vulnerable in society," said the WHO report.
"The costs of prolonged medical care, the loss of the family
breadwinner, the cost of a funeral, and the loss of income due to
disability can push families into poverty."
Road crash vicitims are disproportionately young, male and poor. The
majority are pedestrians, cyclists, or users of public transport, with
limited access to post-crash emergency medical care. "They benefit
least from policies designed for motorised travel, but bear a
disproportionate share of the disadvantages of motorisation in terms of
injury, pollution and the separation of communities," WHO noted.
This week was the funeral of Irene Banda, a 21-year-old single mother,
who was hit by a car on 5 June while trying to cross the busy Seke Road
that connects the Zimbabwean capital, Harare, with the satellite town of
Chitungwiza. According to the police, the motorist was speeding in a 70
km/h zone, a common occurrence on this road.
Doctors struggled to determine the extent of her injuries, but the
medical equipment needed to do the necessary tests was out of service at
the two government hospitals in the capital - Parirenyatwa and Harare
general. Irene never regained consciousness. Her employers managed to
find the more than US $565 demanded by a private hospital, but on the
day she had been booked in for a set of scans, she died, leaving behind
a two-year-old child.
Pedestrian deaths account for half of Swaziland's road fatalities,
according to 2004 data released by the National Road Safety Board. In
rural and peri-urban areas, where no pavements exist, pedestrians walk
on the narrow single-lane roads, increasing the risk of being run over.
If a pedestrian is hit by a car travelling at 50 km/h they stand an 80
percent chance of being killed, compared with a 10 percent risk at a
speed of 30 km/h, according to WHO.
The most dangerous road in Swaziland is the busy national highway
connecting the capital, Mbabane, with the central commercial town of
Manzini and the Matsapha Industrial Site. Opened in 1998, it has come to
be known as the "death road". The risk factor is increased by
the number of livestock grazing beside it - a perennial hazard across
much of southern Africa.
Malawi has an annual road traffic fatality rate of 240 deaths per 10,000
vehicles, one of the highest in Africa, according to a recent study by
the country's Road Traffic Commission (RTC).
"There are three main causes of accidents in Malawi: the driver's
behaviour, the condition of the vehicle, and [road]
infrastructure," police officer Henry Banda told IRIN last week,
while out on patrol checking on the roadworthiness of cars in the
capital, Lilongwe.
TAKING ACTION
In Zambia the government is currently focusing on the behaviour of
drivers and the police have finally banned motorists from eating,
drinking or using cell phones while driving.
"As police we have noticed this lack of attention by drivers and
have linked it to the increasing number of road accidents," said
police spokesperson Brenda Mutemba. Motorists will be charged about $50
if they are caught violating the road safety rules and will have 20
points deducted from their driver's license. If they rack up more than
50 points, they lose their license.
Last year there were 21,692 road traffic accidents in Zambia, in which
1,046 people were killed and 2,696 seriously injured; an increase on the
2002 figure of 8,855 accidents and 1,000 fatalities.
Zambians generally blame the drivers of public transport vehicles for
their lack of road sense. But they also hold the local authorities
accountable for not maintaining the dilapidated road infrastructure,
which was originally built in the 1970s. Most roads in Zambia have huge
pot holes that often cause accidents when motorists try to avoid them,
while many of the street lights do not work, making it difficult to see
pedestrians in the dark.
Joseph Nkoloa, who last year formed the NGO, The Children's Road Safety
Trust Fund, said there was a lack of road safety awareness among
pedestrians. Children and the elderly were particularly vulnerable
because they did not understand road signs, and the fund was trying to
introduce road safety awareness into the school curriculum.
"Most of our drivers have not gone to driving school,"
commented Dr Francis Kasolo at the University Teaching Hospital in the
capital, Lusaka. The police lacked breathalyser test kits, and
corruption, which allowed unroadworthy vehicles to pass through road
blocks after a bribe had been paid, were contributing to the carnage on
the roads.
Speeding and alcohol were two significant factors in increasing the
likelihood of traffic accidents. One study in South Africa found that
alcohol was a factor in over 47 percent of fatally injured drivers and
61 percent of fatally injured pedestrians. Driver fatigue, poor
visibility of other road users, inattention to safety in road
construction, the non-use of seatbelts or motorbike helmets, and poor
medical care at the crash site and in hospital, also contributed to
fatality levels.
SAFETY IN MIND
Rather than simply chalking accidents down to human error, "the
design and layout of the road, the nature of the vehicle, and traffic
laws and their enforcement - or lack of enforcement - affect behaviour
in important ways," WHO pointed out. The traditional response has
been to get people to adopt "error-free" behaviour through
public information campaigns. The more effective approach is to focus on
the better design of the entire "transport system", which
should be aimed at minimising risk and protecting vulnerable road users.
Swaziland has been on a highway-building boom for a decade, extending
the road system by 25 percent, but it found the number of traffic
accidents was increasing. Motorists drove too fast on roads which had
not been built with safety in mind. In response, new better-planned
highways are being built with, for example, improved guard rails to
lessen car impact and save motorists' lives, and which offer greater
protection to pedestrians.
A decade ago, it was virtually unknown for a drunk driver to be stopped
or arrested. Now, highway checkpoints are common. "Police are
succeeding in arresting drunk drivers. They can be jailed overnight, and
face fines," Assistant Superintendent Vusie Masuku, spokesman for
the Royal Swaziland Police Force, told IRIN.
"Road traffic deaths and serious injuries are to a great extent
preventable, since the risk of incurring injury in a crash is largely
predictable and many countermeasures, proven to be effective, exist.
Road traffic injury needs to be considered alongside heart disease,
cancer and stroke as preventable public health problems that respond
well to targeted interventions," said the WHO report.
It pointed out that there were many examples of low-cost technology
transfers suitable for the developing world, from speed humps in urban
areas, rumble strips to slow down traffic at dangerous intersections, to
clearing roadsides of hazardous objects and providing cyclists and
pedestrians with safe paths to keep them off the roads.
But, "While there are many interventions that can save lives and
limbs, political will and commitment are essential, and without them
little can be achieved. The time to act is now. Road users everywhere
deserve better and safer roads," WHO concluded.
Source:
IRIN News
-- UN Office for the Co-ordination of Humanitarian Affairs
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