Mitigating carnage on our roads

When I set my foot into Rwanda a couple of months ago, what caught my attention was not the obviously huge number of motorcycles on the road as a means of public transport in the City of Kigali. This means of transport is now popular in most cities across sub-Saharan Africa. However, my attention was caught by the orderly manner in which they conducted their transport business. More particularly, the strict use of the helmet as a safety measure. I have no military training or background, but I have an imagination that the helmet used by riders and passengers is similar to how a solder would embrace a gun in a neighbourhood infested with hostile enemies. Riding on one of the public transport motorcycles to my university office, it began to dawn on me that this could be possibly one of the reasons why WHO’s 2006 African Regional Health Report singled out Rwanda as a shining example of how African countries can improve road safety. A distinguished scholar and road transport injury expert, who is also Regional Advisor on Violence, Injuries and Disabilities at WHO’s Regional Office for Africa, described Rwanda as a country with focused leadership in road safety, and one which is supported by enabling political will. While I want to avoid the danger of complacency, I agree that the compliance in the use of the helmet by motorcycle riders and passengers alike in the City of Kigali, for example, is a success story. I am of the opinion that the same effort should now be extended to the fast-growing number of bicycle users in the City of Kigali and the whole country. This category of road users needs attention of safety enforcers as well. There is growing global concern about road safety. The United Nations resolution 70/1 of September 25, 2015 entitled “Transforming our world: the 2030 Agenda for Sustainable Development” calls for action to reduce road traffic deaths and injuries as a pressing development priority. Consequently, road safety was included the United Nations 2030 Agenda for Sustainable Development. In these comprehensive set of universal and transformative Sustainable Development Goals and targets to be achieved by 2030, two targets address road safety. SDG target 3.6 aims to reduce global road traffic deaths and injuries by 50 per cent by 2020, while SDG 11.2 aims at providing access to safe and sustainable transport systems for all by 2030. A recent move to legislate and implement the speed limit of public transport vehicles to not exceeding 60 kilometres per hour should be hailed as a bold step and one in the right direction to reduce road traffic crashes, serious injuries and deaths. Speed management is a proven strategy to improve on safety. Unfortunately, speed seems to have an intuitive appeal to many of us. There is a general belief that speed saves time and enables us to accomplish several tasks within a small-time span. The intuitive appeal notwithstanding, speed is a killer. The WHO recommends that the countries in WHO Regions should set and enforce speed limits appropriate to the function of specific roads. Scientific evidence also informs us about speed and its relationship with crash and serious road traffic injuries and death. Vast knowledge exists of a significant relationship between mean speed and crash risk. For example, Finch DJ et al., in their work Speed, speed limits and accidents, published by Transport Research Laboratory, reveals that a decrease of 1 km/h in mean traffic speed will result in a 3% decrease in the incidence of injury crashes (or a decrease of 4-5% for fatal crashes). It has also been shown that at levels above 50km/h, there is a decrease of 2% in the number of crashes for every 1km/h reduction in the average speed. That is why any effort to protect the safety road cannot exclude control of speed. A research work that my team indicated that road traffic injury is the second leading cause of injury visit to Emergency Department in one major Teaching and Referral Hospital in western Kenya. Speed contributes in no small measure to the crashes that lead to these injuries. This is not to say that there are no other causes of the road traffic crashes that could be identified. But speed, certainly, is an important factor. The benefits of use of the helmet, as a safety measure against serious injuries and deaths, are well documented. Let me share with dear readers some research findings on the public health benefits that result from proper use of helmets by motor cycle users. Substantial growths in motorcycle use in low-income and middle-income countries are being accompanied by an increase in head injuries. Use of helmets has been shown to reduce fatal and serious head injuries by between 20% and 45%. According to World Health Organization report on traffic injuries, proper use of head helmets by motor cycle users is the most successful approach for preventing serious injury among motorised two-wheeler riders. I highlight these two major safety steps, not because they are safety panacea for the country but if these safety efforts are implemented as stated, they can, in no small measure, contribute to significant reduction in road traffic deaths. Every effort should be made to ensure that compliance on helmet use is sustained and that speed limit is implemented as set by road users. The writer is a Lecturer at the School of Health Sciences, Mount Kenya University, Kigali.

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Mitigating carnage on our roads