Why isn’t road safety high on the Uganda development agenda?

Road traffic deaths and the subsequent injuries have increased world over and according to the Global burden of disease 2010 update, there were 5.1 million deaths from injuries (almost 1 out of every 10 deaths in the world), more than malaria, HIV and TB combined that killed 3.8 million people in 2010. The WHO 2013 fact sheet adds that road traffic crashes contributed 1.2 million deaths and 20-50 million injuries.

In Africa, Uganda has the 5th highest burden of road traffic injuries after Nigeria, Chad, Guinea-Bissau and South Africa. Compared to the global average of 18 deaths per 100,000, Uganda registered 28.9 road traffic deaths per 100,000 population, ranking 12th worldwide in road traffic fatalities per capita.

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The Uganda Police Force Traffic Report for 2012 adds that for every 100 road accidents, 16 deaths are registered. A 2010 research report shows research report has shows the burden of injuries in Uganda is 11-15%, with road traffic injuries alone contributing up to 50% of all the injuries.

This is arising due to the tremendous performance of the road traffic sector and car imports; according to the Uganda Revenue Authority estimates, there were 635,656 vehicles in Uganda as compared to 50,102 in 1991. The Uganda Bureau of Statistics 2012 report  shows that 125,518 new cars were registered in the country in 2011, compared to 79,312 in 2007. This is unfortunately not being marched by an upgrade of the roads, manifested by the increasing traffic jams. The implication is we are increasing the car population in a dangerous environment; Mulago National Referral hospital-the top most health facility in the country,receives from 5 to 20 boda-boda crash cases every day.

As a consequence of all this, road traffic deaths and injuries have emerged as a new phenomenon that requires immediate attention to try and mitigate in our society. The road traffic injuries affect people aged 15-44 years, mostly males than females, with pedestrians, cyclists and passengers as the most vulnerable yet this age group happens to be at the prime of their productivity shows that the injuries have a negative impact on the labor market due to work hours lost through treatment and rehabilitation, in addition to the financial cost of accessing the services. Other effects include premature deaths, disabilities from severe injuries, increasing cost of treatment and rehabilitation, as well as emergency response, law enforcement and judicial costs.

Research conducted at Mulago hospital shows that treating boda-boda injuries consumed 62.5% of the budget allocation for the directorate of surgery, amounting to shs 15bn. And this is just motorcycle injuries, without the cost of injuries from road traffic crashes, falls, burns, poisoning, domestic violence and drowning.

The United Nations has proclaimed 2011–2020 the Decade of Action for Road Safety, with the goal to reduce the increasing trend in road traffic deaths. It is therefore about time that we recognize injuries as a public health problem that requires immediate redress. As we all know, getting the road toll down is relatively straight forward; through public transport, enforcement of legislation to support speed limits, helmet use, safety belts, enforcing drink-driving laws, and separating pedestrians from high speed traffic. However the government needs to spearhead this by setting up injury prevention and control framework. This is vital for guiding a national public health approach, vital registration systems, coordinating all stakeholders to act within a unified front of multidisciplinary and collective public health action, rather than sporadic actions that bear short term gains yet fail in the long run.

Reducing the road carnage on our roads is achievable, but first, we as a country need to look at it as a development issue.

The writer is a MakSPH/JHU Chronic TRIAD fellow at Makerere University School of Public Health, Kampala, Uganda

josephmag24@gmail.com

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