Death on our roads: The Emerging Epidemic

Dr Edward Kanyesigye

A week ago, a young man about to enter his final year BSc Eng. at Makerere lost his life in a road traffic accident while on his way to Mbarara to celebrate his former schools centenary. His three colleagues survived with severe injuries.

Hardly a week later, a renowned journalist, businesswoman and wife to a government minister also died in another accident on Entebbe road. Within the same period, there were several bloody accidents: one on the Eastern route and another one in Lwera on Mbarara-Masaka road. The latter claimed three members from the same family in Busoga.

In this short period, the road carnage on our roads was certainly in tens which is the same as (if not more than) the numbers dying of the dreaded Ebola disease in Kibaale during the same period. In spite of the fact that a lot of people mourned these road traffic accident victims, there was no equivalent health campaign in the papers or other media about the incident.

As a student of public health, I was taught that it is better to prevent diseases rather than wait for it to occur and then you try to intervene. In the case of road accidents, you may never have the chance to intervene after they have occurred as most of them tend to be fatal.

The causes of road- traffic accidents broadly fall into two categories: Those caused by human errors of either commission or sometimes omission and those due to the environment.

There is a lot that campaigns can do to reduce those due to human errors which include (1) over speeding (2) drink driving (3) overtaking in bends and against continuous lines (4) betting and (5) lack of concentration ranging from excessive thoughts of the mind to sleep while driving, (6) laxity among enforcement agencies especially traffic police. 

The environmental factors include: (1) slippery road surface(s), (2) difficult terrain such us too many sharp bends or even very long stretches of smooth straight roads, (3) narrow roads, (4) absence of multiple lanes on motorways, (5) poor road design, (6) causes due to the vehicle such as burst tires, failed breaks or broken suspensions and (6) natural calamities such as floods, landslides and broken bridges.

It is generally believed that however much campaigns you conduct, there will always be a few residual accidents since human behaviour is usually impossible to completely control. However, these would be negligible. Many injury prevention experts, therefore, usually concentrate on policies and interventions to modify the environment as this have a great impact.

For example, if the 40km of Kampala Entebbe road was either dual carriage or had a different incoming route from the return road, the incidence of lethal accidents on the road would be greatly reduced as most of the serious accidents are head-on collisions between vehicles travelling in opposite directions.

It is little wonder, therefore, that countries which have invested more in making their roads more user-friendly (even when experiencing a higher traffic density) may experience a lower death toll on their roads than those whose roads are just basic. It is ironical that as the roads improve in surface from gravel to tarmac surface and as the pot holes get filled, the users tend to rush on them and accidents increase.

As we wait for our economy to recover and push more funds making our roads safer, we need to urgently re-examine ourselves as road users and contribute in our humble way towards safety for all. The following tips could help my reader make this contribution.

• When on the road, assume that everybody else is likely to make mistakes except you and so ensure you exercise maximum care when driving, cycling or even walking while looking out for errant users and avoiding them.

• Do not exceed the set speed limit for any stretch of road however inviting the road surface may seem.

• Do not drink before or while driving and should you find that you have already drank, get someone else to drive or park the car and use public transport.

• Report any taxi or bus driver who is driving dangerously. Take time and read off their number place and give it to the next police officer you see.

• If you are in any vehicle and the driver is either over speeding and or drink-driving, ask him to stop and you get out and if possible advise the other passengers to follow suit. Find alternative means of transport even if this may delay your journey.  

• Discourage and condemn passengers and even road users who try to portray fast driving as a virtue and slow drivers as incompetents. Sadly, many people fall prey to this fallacy.

• Ensure your vehicle is in good condition by having it regularly checked, services and driven only by competent drivers. People with poor sight should have their vision corrected before they drive.

• Drivers should have plenty of sleep before embarking on the journey and busy and stressed persons should avoid “jumping from their work onto the roads”. Driving is so sensitive that the driver should be very well prepared for it.

What can the government do?

• Sponsor the civic works needed to make safer roads

• Strictly inspect vehicles to ensure they are road worthy

• Traffic police should be counselors rather that disciplinarians who are just satisfied at imposing the on-the-spot fine or even taking a bribe from errant drivers.

• Revive the road safety council, which should comprise of prominent citizens, representative of drivers and cyclists, police, public health specialists and engineers. The council should be allowed to do research and advocacy and contribution to road usage policy. It should be adequately funded and some of the road safety campaigns should also be done alongside targeted fundraising for given specific activities.

• Widely circulate photographs, bill boards, and posters involving known accidents, which claimed lives and insert road signs at blind spots to warn users.

• In some countries, monuments have been built at sites where a lot of lives were lost in past accidents.

• Protect the vulnerable especially children, old and frail people and the disabled on the road.

What can professionals do?
No public health problem lends itself better to interventions by professionals than traffic accident prevention. There is a role for about each specialty in this project.

• The Public health persons can do campaigns and advocacy;

• The Police and other security agents can guide the users and enforce the code;

• The Engineers can contribute to policy on making safer roads;

• The teachers can disseminate the high way code and ensure pupils to observe it;

• The politicians can do campaigns and fundraise for some injury prevention events;

• The religious leaders can sensitise their flocks; 

• The public can ensure they know their rights and resist any errant road user who intends to hurt them;

• The journalists should continue sounding the gong of road safety loud and clear.

The writer is Senior Lecturer (public health) at UCU