Though other causes of mortality, such as respiratory infections, perinatal complications, malaria and diarrhoeal diseases, still account for over two-thirds of deaths, health workers are concerned about the growing risk of road accidents. In Africa, nearly 20 children for every 100,000 of the population die because of a road traffic accident (compared to nearly 11 per 100,000 population globally).
Though there are fewer cars on the continent’s roads, urbanisation and the rising number of vehicles are adding to the dangers. Poorly maintained roads and low standards of driving exacerbate the problem. And because many countries have limited emergency services, accidents often prove fatal or lead to lifelong disability.
In Zambia, for example, the country has just 0.02% of the world’s registered vehicles, but almost 14 times the proportion of fatalities; annually, there are an estimated 3,000 deaths from the country’s more than 20,000 road traffic accidents. The heavy death toll is partly due to the fact that 60% of Zambians live in rural areas, where emergency services are extremely limited. Accident victims commonly have to make their own way to health centres, which can be many miles away. Even then, there is no guarantee that rural facilities will have a surgeon or the necessary equipment to treat an injury. And patients also have to worry about the cost of treatment.
All too often, accident sufferers do not receive the care they need. The Guardian’s reporter spoke to one 16 year-old boy who’d been hit by a car when riding his bicycle. Initially taken to a rural health post, he was then referred to a district health centre 60km away. By the time his family had raised the money to send him and pay for an X-ray, the teenager’s fractured femur had been without treatment for three weeks and the bone had partially ‘malunited’. The boy finally had to travel 130km to the general hospital at Livingstone. Such delays in addressing injuries are common and the deputy director of emergency health services in the country admits “people end up being handicapped”, which can then lead them “deeper into poverty”.
To reduce the number of traffic accidents, government officials are working to encourage the enforcement of laws on drink driving, seatbelts and the use of mobile phones when driving. The Zambian government is also trying to improve ‘post-crash care’ by increasing the number of emergency vehicles and providing police officers with first aid training. Some of Zambia’s surgeons (there are just 44 in the country) also travel round local health centres to give advice and training about emergency and trauma procedures. As one of these surgeons says, treatable injuries from road traffic accidents “shouldn’t make someone incapacitated”.