Is drinking and walking much safer or it is just as lethal?

By Claire Biribawa

It is not quite unusual to find a drunken man on the streets of Kampala staggering and wobbling his way back home in the wee hours of the morning. Get ready to hit the brakes of your car when he totters across the road unexpectedly without thinking twice about the fast moving vehicles on the highway. Do not be too quick to judge this careless pedestrian, unknowing to you, his mind may be far from his but rather, the one that has been impaired by "spirits" he had at the bar for one too many of vodka, beer or a  local gin. 

Walking is an easy and straightforward task and once it is learned, it becomes essentially automatic and you really do not need to think about it. However, under the influence of alcohol, the mind and body may not be able to sync up to the task at hand. Modest amounts of alcohol like one sachet of liquor with 40% alcohol concentration or a bottle of beer may just be enough to impair the functioning of several processes which include vision, muscle control and motor skills although needless to say is that everyone absorbs and breaks down alcohol differently. Road use skills require a person's attentiveness, ability to make quick decisions on the road, react to changes in the environment and execute specific often difficult actions. Alcohol inhibits these skills, increasing the risk of traffic injuries among pedestrians since it will have adverse effects on judgment, reaction time and motor skills. Alcohol impairment will therefore make it difficult for pedestrians to judge how fast a car is moving or how close it is and it might just be too late by the time they've made their decision.

Road traffic injuries are taking an enormous toll on individuals and communities and are a major public health threat. A report from Uganda police indicated that pedestrian injuries made up 40% of all road traffic deaths in 2016. Alcohol impaired walking is one of the factors contributing to injury risk among these vulnerable road users. The 2011 WHO Global Health observatory data repository placed Uganda among the world's leading per capita consumers of alcohol. Though among the least motorized countries, Uganda shares disproportionate burden of road traffic injuries, which is an indication that many of those injured are actually outside cars, a large proportion of this burden is attributed to alcohol. Evidence from a study at Mulago National Referral hospital among road traffic injured patients found that almost half of the pedestrians injured were impaired by alcohol. 

Colossal emphasis has been put on drunk driving as a grave public safety concern and anti-drunk driving campaigns have coerced more people to walk home after drinking. Folks recognize the perils of drinking and driving and  in an effort to be "responsible road users" they will decide to take a bodaboda back home or just walk the distance after a night of drinking. But is drinking and walking much safer or it is just as lethal? The dangers of drunken driving have been well documented and yet although walking drunk is just as dangerous, there remains a dearth of information on interventions that can be put in place to address it. This oversight is a stark gap of the various interventions put in place that have seen the burden of drunk driving decreasing giving people the erroneous impression that drunk walking might be a safer alternative which is not. In addition, the absence of pedestrian walkways on most of the roads increases the vulnerability of the pedestrians who are already impaired with alcohol.

It is high time that interventions targeting drunk walking are put in place. Some of the interventions include enforcing bans against serving alcohol to obviously impaired customers, rationing of alcohol sales per adult and time restrictions on alcohol use/sale. None of these is in place in Uganda since alcohol can be bought around the clock without any restrictions including age limits. The public needs to be better informed about drunk walking and there is a need for a review of the policies that have led to the current situation.

Writer is an Epidemiology Fellow with the Uganda Public Health Fellowship programme, Ministry of Health attached to division of health information/injury control