Road deaths are predictable and preventable

May 16, 2004 Life & Society, Sunday Nation

Of all the systems you and I have to deal with every day of our lives, one stands out as the most dangerous. Systems are, of course, all around us. Most things we deal with can be defined as a set of connected parts: your home, your office, the government. All of these systems present, to some extent, a source of danger to you. But there is one system that is now recognised to be the most complex and most dangerous one in your everyday life.

That system, of course, is the road traffic system. We know that we lose more than 3,000 people to this system every year in Kenya. We know also that worldwide, over 1.2 million people lose their lives in road crashes every year, and as many as 50 million are injured. A new report (World report on road traffic injury prevention) is the result of the first major study to be conducted jointly by the World Bank and the World Health Organisation. It reflects the growing concern that unsafe road traffic systems are not only seriously harming global health, but are also impeding economic development.

Consider some more facts highlighted by the report. Firstly, as is the case with so many things, this is a problem that has a disproportionate impact on the poor of the world. Low- and middle-income countries account for 85% of road deaths. The economic cost to these countries of road deaths and injuries is estimated to be US$ 65 billion – more than they receive in foreign development assistance.

President Kibaki, who contributed to the preface to the report, estimates the annual cost to our economy (exclusive of the loss of life) to be US$ 50 million. That, if you’re interested, is approximately the amount we receive from the UK government every year. It gets worse. Those killed tend mostly to be in the economically productive age group of 15 to 44 years. We could easily be losing as much as 2 per cent of annual gross domestic product.

Do we need numbers to understand the tragedy? Every road death or injury has an impact on a large number of other people. The suffering caused by unnecessary death or long-term injury can last generations. Many families are pushed over the edge into poverty by the loss of breadwinners or by the cost of caring for family members with long-term injuries. The psychological scars can change the course of many lives. But here’s the nub: most of these deaths and injuries are entirely unnecessary! Road injury is not the price we pay for achieving greater mobility and economic development; it is quite simply something we do to ourselves. As such, it can be analysed and prevented.

The report challenges us to take a ‘systems approach’ to the problem. Any road traffic system contains various interactive elements: vehicles, roads, and road users; as well as their physical, social and economic environments. To make this system less hazardous, we must understand it as a whole and identify the potential for making interventions.

If we in Kenya are serious about addressing this problem, we must be serious about making some emphatic, system-wide interventions. Road crashes are about more than just the (undoubted) idiocy of most of our drivers. A wider range of culprits exists; a wider range of measures will be necessary. Do we have the capability and appetite for these? Let me take you through what might be needed.

Are we ready, for example, to alter traffic flows? Reducing the number of motor vehicles allowed into areas with vulnerable populations, such as city centres, school and university areas is known to have a positive effect. But it requires charging for entry, punitive parking fees, or just plain barring. Preventing cyclists and pedestrians, or slow-moving vehicles, from accessing high-speed motorways is another measure to think about.

We have taken the first step in taming our matatus; are we willing to go all the way and invest in a safe public transport system? In advanced countries, you are ten times more likely to be killed in a car than as a passenger in a bus or a coach. In Kenya, given that we seem to allow the pathologically disturbed to drive public-service vehicles, the reverse may be true. Generally speaking, however, buses and trains are inherently safer than passenger cars. Do we have the expertise and the will to make public transport work here?

Speed kills. We all know that, but are we willing to slow down? The report recommends the use of realistic speed limits (not the 30kph one we all ignore every day) and self-enforcing mechanisms, such as speed cameras. Unaffordable, you say? Simpler methods are available. A study in Tasmania showed that the long-term placement of stationary police vehicles on high-risk stretches of rural road achieved a 58 per cent reduction in crashes resulting in death or serious injury. Simplicity itself, so what prevents us doing it?

Alcohol kills on the roads. We know that too, and discuss it avidly as we have our seventh beer of the evening. A study in South Africa found that alcohol was a factor in 47 per cent of driver deaths. We don’t need to do a similar study in Kenya. A casual drive on the roads around popular bars in Nairobi (such as the Langata Road) on a Saturday night will confirm the matter for you – if you live to tell the tale. The roads are usually strewn with crashed vehicles and sloshed drivers.

By now, you should have gathered two things: that preventing road injuries involves actions from a large variety of players; and that some rather unpalatable impositions will have to be made.

Everyone has a role to play: government to set laws and enforce the right behaviour; road planners, who must take account of road user patterns; firms that haul people and goods over long distances, who must be forced to recognise their responsibility in controlling their drivers and maintaining their vehicles; drivers, who must be prevented from making mobile-phone calls while driving drunk at high speed; hospitals, who must provide more focused post-crash facilities; and many, many others. Road safety is a shared responsibility. Intelligent coordination is a prerequisite.

It can be done, and the report highlights countries that have taken a system-wide approach and achieved significant gains. In Kenya, however, we face a cultural problem. We think we have the inalienable right to drive cars, drive them everywhere, drive them fast and drive them drunk. Kenyans of all colours and all economic classes think this way. It’s a national character trait, we say to each other in bars before stepping into the death machine.

It’s time we grew up, and stopped killing ourselves and those we meet on the roads. That is a challenge we must all individually address. Alternatively, we can keep playing Russian Roulette every time we go near a road, and count the cost with the next generation.