Road safety became the focus of attention on World Health Day 2004 (7th April). Organisations across the world hosted events to help raise awareness about road traffic injuries, their grave consequences and costs to society. In conjunction with the World Bank, WHO released the world report on road traffic injury prevention, and for the first time in its history, the UN General Assembly devoted a plenary session (14th April 2004) to road safety.
Countries which do not already have meaningful road safety strategy are now eagerly setting up high-profile committees to review the report and incorporate its recommendations to help prevent road traffic injuries and mortality. What is Ghana doing, now that renowned researchers into road crashes, trends, injuries and deaths have unanimously concluded that they are predictable as well as preventable?
According to the WHO report, road traffic crashes kill 1.2 million people a year or an average of 3242 people a day, and between 20 and 50 million people sustain injuries or become disabled. The irony is that a significant number of people who travel on Ghana?s roads never return home, and the plain but sad truth is that, they perish on their journeys. A considerable and often forgotten number too, return physically maimed and consequently become dependent on the benevolence of others for survival and the basic things able persons take for granted. Possibly as you read this piece, someone somewhere has been involved in a fatal road crash; and another victim added to the gruesome road traffic accident statistics.
According to the report, majority of road traffic injury-related deaths affect people in low-income and middle-income countries, especially young males and vulnerable road users (pedestrians, cyclists, users of motorised two-wheelers and passengers on public transport). Without proper recognition and appropriate action, the problem of road crashes could only worsen. It is not apt to simply sit unconcerned until one by one road crashes fade us into oblivion.
Dr Wilberforce Anane, the Minister of Roads and Transport stated recently that:
▫ Ghana spends over one trillion cedis on road accident victims annually, which amounts to two percent of the total annual national expenditure;
▫ For a 10-year period between 1993 and 2003, 15 000 road crash victims died; while
▫ 50 000 and 70 000 people were maimed and injured respectively (GNA, Kumasi, 19th April 2004).
Taking the 2000 population of 18.8 million, rising at a rate of 2.7 percent and calculating the average population for the ten year period, it can be estimated that the annual road traffic injury mortality rate (or injury-related deaths) is around 8.5 per 100 000 persons. If the Minister?s figures were reported correctly, Ghana?s road safety strategy would be a masterpiece for benchmarking and emulation by other countries. The figure is incredibly low as compared to the 2002 global average rate of 20.2 per 100 000 population reported by WHO for countries with similar traffic characteristics and income levels (refer to table below). With due respect, the Honourable Minister?s figures probably represent a minuscule fraction of actual fatal crashes on Ghana?s roads. Based on the global average, it is more likely that there are some victims whose fatal crashes are not even officially recorded.
Established models for estimating road traffic fatality trends predict that if present policies and actions on road safety continue and no additional road safety countermeasures are put into place, deaths will increase on average by over 80% in low-income and middle-income countries and decline by almost 30% in high-income countries by 2020. Considering the amount spent on road crash victims in Ghana, such a scenario will have the potential to impact on economic development and erode improvements already attained in standard of living.
Road traffic injury mortality rates (per 100 000 population) in WHO regions, 2002 | |||
WHO region | Low-income and middle-income countries | High-income countries | |
African Region | 28.3 | ? | |
Region of the Americas | 16.2 | 14.8 | |
South-East Asia Region | 18.6 | ? | |
European Region | 17.4 | 11.0 | |
Eastern Mediterranean Region | 26.4 | 19.0 | |
Western Pacific Region | 18.5 | 12.0 | |
| |||
Selected Countries (Males) | |||
Country | Rate (Per 100 000 Population) | ||
UK | 5.3 | ||
Norway | 7.6 | ||
Spain | 9.1 | ||
Canada | 9.3 | ||
Italy | 12.5 | ||
China | 15.6 | ||
Columbia | 18.1 | ||
Nicaragua | 21.5 | ||
Dominican Republic | 38.4 | ||
| |||
Source: WHO Global Burden of Disease project, 2002, Version 1 - Statistical Annex). |
Generally, reducing the number of road traffic victims is not considered a high priority by policy-makers and decision-makers. Politicians would state in their manifestoes the number of roads they would build if elected, but not the number of lives that could be saved, and believe that road accidents are unavoidably associated with road transport system. Perhaps they hold the traditional belief that road safety measures are rarely popular among road-users (voters) because they frequently restrict individual freedom and are capital intensive, while the anticipated positive results are not physically seen. If such beliefs are rife, it is no surprise that party manifestoes on road safety are never considered as part of the political agenda, particularly in developing countries such as Ghana.
Road safety countermeasures could be designed, constructed and managed to generate revenue. In Britain, for example, speed cameras like many road safety countermeasures, have been found to be self-financing. What is required is the initial installation cost, which is quickly paid for by imposition of appropriate fines to offending drivers. Penalty points are also marked in an offender?s license. If an offender is caught four times he/she is automatically disqualified from driving! The fines pay for administrative and overhead costs with huge surpluses, which are re-invested in additional road safety measures. Thus, the higher the number of drivers caught overspeeding, the more stringent speed enforcement becomes. Drivers with penalty points not only suffer the indignity of a conviction, they are categorized as high-risk and made to pay higher insurance premiums. It must be emphasized that speed cameras are not installed to punish drivers but to stop speeding and make the roads safer. A recent independent monitoring of their effectiveness reported over 35 percent reduction in deaths and serious injuries at camera sites.
Road safety is a complex problem. It involves driver/road-user behaviour, vehicle characteristics, roadway features, and driving condition. Safety is approached both as a question of vehicle, highway design and as a question of use, driving habits, traffic regulation, law enforcement and risk management. Safety is not an individual concern and collective initiative is required to change endemic negative habits. For example, certain groups of mini-buses on long journeys are notoriously known to over-speed with impunity and some buses carry more passengers than they are legally allowed. Some of us are prepared to be the overloaded passenger. Some drivers stop in the middle of their journeys to top up their alcohol levels, claiming falsely to drive better and make the journey quicker when drunk. Even some road contractors fail to provide basic safety gear (helmets and high-visibility clothing) for use by workers on live carriageways and around lifting equipments. Some of the culprits include international contractors who would be prosecuted in their own countries for ignoring Health and Safety at Work regulations (refer to photo). Some travellers from towns/villages report at bus stations holding fowls with legs loosely tied together as hand luggage. This practice would probably continue until the day a hungry and frustrated fowl mistakes a driver?s eye for a grain of corn. We encourage these and several other derogatory practices and become victims of avoidable tragedies!
Evidence from advanced economies makes it abundantly clear that the risk of incurring injury in a crash is largely predictable and can be tackled successfully. Our national pride would not be dented if we adopt traffic policies acknowledged to have achieved reductions in road crashes in other countries, and adapt for local use. Transport organisations learn from one another. For instance, when the Transport Research Laboratory (UK) found through driving simulator experiments that drivers talking on mobile phones had 50 percent slower reaction times than those who had been drinking, the reaction was to ban the use of hand-held mobile phones whilst driving. Many countries followed suit and implemented various variants of the mobile phone ban when driving. What is needed is not further research into road crashes, related injuries and mortality but mobilisation of efforts at all levels and initiative to courageously change our culture relating to the following:
▫ seat-belt usage;
▫ Driver training, testing and qualification;
▫ Vehicle testing and their roadworthiness;
▫ Drinking and driving;
▫ Vehicle speeds on roads;
▫ Road safety awareness and education;
▫ Respect for all road users;
▫ Highway design, maintenance and safety auditing;
▫ Roadside assistance to crash victims; and
▫ Traffic law enforcement.
Finally, without reliable data and record of evidence, road traffic injury prevention strategy cannot be rationally determined.